Ketone test strips, which test the ketone levels in your urine, are the most cost-effective and straightforward (hassle-free) way to determine your level of ketosis. This is why many beginners keep these test strips handy as they’re transitioning into keto.

In addition, long-term keto followers find test strips beneficial for identifying hidden sources of carbs, when traveling, or for purposes like achieving therapeutic ketosis.

In this article, you’ll learn:

• How ketone urine test strips work
• A step-by-step guide to urine testing
• When and why to test ketones
• The pros and cons of using keto testing strips

How to Use Ketone Urine Test Strips

Ketone test strips work by detecting the amount of ketones in your urine — specifically, the ketone body acetoacetate. The strips have a small absorptive pad at one end of the strip, which you place in your urine stream. The pad contains a chemical that will detect ketones and will change color depending on the concentration of the ketones in your urine.

Every manufacturer is a little different, but typically the fewer ketones you have, the lighter the color will be on the test strip. Similarly, the more concentrated your urine is with ketones, the darker the test strip will be. Most color schemes range from light pink on one end to dark purple on the other (indicating progressively higher ketone levels).

Step-by-Step Instructions For Ketone Test Strips:

Using ketone test strips is very straightforward:

1. Remove one of the strips from the sealed container.
2. Hold the strip in your urine stream to saturate the small pad at the end.
3. Tap or shake off any excess urine.
4. Wait 15 to 45 seconds to determine the color of the test strip, then compare the color to the ketone strips color chart on the side of the container.
5. The color chart will approximately match the color of your test strip, with the lighter colors indicating low ketones and the darker colors indicating higher levels.

If you’re new to keto and are trying to determine how deep into ketosis you are, it’s best to test at the same time every day. Since your hydration level plays a role in your test results, it’s best to test at a time when your hydration will be relatively the same each day. For most people, in the morning before consuming liquids is the best time.

In general, you should aim for moderate to high ketones as you’re transitioning into ketosis. In the beginning, before you become fully keto-adapted, you may get mixed results as your body is still learning how to produce ketones in abundance and working through your glucose stores.

Using ketone test strips is an affordable and effective way to make sure you’re staying on track, especially in the beginning phases of keto. Furthermore, they’re incredibly easy to use and portable, so having a stash of test strips around is always a good idea no matter what phase of ketosis you’re in.

Reasons To Test Ketone Levels

Here are the most common reasons people use ketone test strips to monitor their ketone levels:

Confirming You’re Actually In Ketosis

Perhaps the most straightforward reason you would want to test your ketones is to confirm that you’re in ketosis. This is an extremely important stage for beginners as you’re transitioning out of glucose-burning mode into ketone-burning predominance.

However, even seasoned keto dieters may want to test their ketones from time to time to ensure that they’re still burning ketones for a number of reasons (cheating on keto, traveling, or looking for hidden carb sources). No one’s perfect and we all get complacent from time to time, so monitoring ketones from time to time is an excellent idea.

Gauging Therapeutic Ketosis

If your main reason for going keto is weight loss, light to moderate ketosis (1.5-3.0mmol/l) is likely sufficient for your goals.

But if you’re using the keto diet for another reason, especially a medical reason like treating epilepsy or some types of cancer, some scientific perspectives suggest that higher levels are better — typically in excess of 3.0mmol/l.

A related consideration for therapeutic ketosis is calculating your glucose ketone index (GKI), which involves dividing your ketone level into your glucose level to provide an overview of your glucose levels as well as ketone metabolism.

Everyone’s body and medical history is different, and therefore a therapeutic level of ketones may look different in your body compared to someone else’s. By therapeutic, we’re referring to the ketones level that produces a physiological effect in your body that relates to a specific medical goal. Typically, this level can range from from 1.5mmol/l to 3.0 mmol or more. If you’re not sure what that looks like, the best way to determine it is to work together with a physician who understands your medical condition and how to achieve success using keto.

Assessing Your Carb Tolerance

We recommend people begin with 30 grams of net carbs per day on the keto diet, but this starting point isn’t a hard and fast rule for everyone.

Due to your body’s unique makeup, you may have a higher or lower carbohydrate tolerance than someone else. As you learn what your body needs to get into and stay in a state of ketosis, you may want to play around with your daily carb load a bit.

Another, related consideration is the specific type of source of carbs that you’re consuming (in addition to the amount of net carbs per serving).

For instance, you may find that you wake up in ketosis, but after breakfast, your ketones plummet. By checking ketones after meals, you can get an idea if there is a food item that’s pushing you out of ketosis. Many mainstream “keto-friendly” packaged foods actually have more carbs than they suggest, so this is a common issue.

It’s also a good idea to check ketones after you eat out at a restaurant where the ingredients are iffy. A meal that may, on the surface, check out as keto-friendly might actually have hidden sources of carbs in the sauces.

You Had a Cheat Meal

It happens to everyone. At one point or another on your keto journey, you’ll end up having a little cheat here and there. This is no big deal, but you may want to get an idea of how far out of ketosis you are (if at all) so you can plan your way back into ketosis accordingly.

The Drawbacks Vs. Benefits Of Ketone Test Strips

There are pros and cons to every type of testing method — let’s explore some of the benefits and drawbacks of ketone urine strips.

Drawbacks

Potential for False Negatives

Ketone urine strips only test for the ketone body acetoacetate. As you get deeper into ketosis and become keto-adapted, your body will begin to efficiently convert acetoacetate and, as a result, produce more of the ketone beta-hydroxybutyrate (BHB), which cannot be detected using urine test strips. For this reason, experienced keto dieters who have been in ketosis for a while may present with very few ketones on their test strips. In reality, they are no longer producing a lot of acetoacetate[*][*].

In this case, it’s best to switch over to a more accurate method that measures BHB, such as a blood test. Using a blood monitor, you’ll be able to directly test blood ketone levels, which will be inversely correlated with blood glucose.

If you’re squeamish around blood, another option would be a breath ketone testing device, which will test your breath ketone levels, but the ketone readings on these devices aren’t as accurate as blood, and they tend to be quite expensive.

Moderate Accuracy

Of all the ways to test ketones, urine test strips tend to provide the least accurate results. This is due to a number of reasons, one of them being the switch to BHB, as previously mentioned. Again, if you really want peak accuracy, blood ketone testing is probably the way to go.

With that being said, urine strips are an inexpensive and convenient way to get a  general idea of which way you’re tending, which is very helpful in the beginning of keto as you’re getting to know your body.

Urine Can be Diluted or Discolored

Foods and beverages can create harmless color changes in your urine that have nothing to do with ketosis. For instance, some people find that when they consume a large amount of beets, it shows up in their urine as a light pink color. This would create a color change on your test strip that would ultimately make it look like you had more ketones in your urine than you actually do.

Furthermore, your state of hydration will impact the concentration of ketones on the urine stick. If you are dehydrated, it may make it appear that you have higher ketones, while being very hydrated may dilute your ketone count.

Benefits

Inexpensive

One of the biggest benefits of ketone urine strips is that they’re relatively quite inexpensive. Where a blood ketone meter will set you back anywhere from $30 to $50, with the test strips costing close to $1 each, urine test strips are typically in the $8 to $10 range for 100 strips.

This makes urine test strips an excellent choice if you’re watching your budget or just trying out keto and don’t want to commit to buying a blood monitor.

Portable

Urine test strips come in a small container and don’t require anything other than the strip itself (no fancy add-ons). This makes them perfect for when you’re traveling as you can just throw them in your bag, and you’re good to go.

They are also pretty hassle-free. Unlike blood monitors, which require you to prick your finger with a lancet, drop blood onto a strip, and then insert the strip into your device, all you need to do with a urine strip is pee on it.

This makes ketone test strips wonderful for travel when sticking to a low-carb diet may be more challenging.

Straightforward Results

Reading your results with a keto test strip is incredibly straightforward. There’s no user’s manual with these guys, just compare the color to the chart on the container, and you’ve got your ketone level.

The only way to go wrong here is if you wait too long to read the results. If you get distracted and wait longer than about a minute to compare to the color chart, you’ll get a reading that falsely shows higher ketone levels than it should. If this happens, don’t worry — just discard the first strip and perform another test.

Takeaway

The single most important aspect of the keto diet is to avoid high blood sugar and keep the levels of ketones in your body steadily elevated. For many people, it can be tricky to know if you’re in ketosis or not, which is why you may want to measure ketones (especially in the beginning).

Urine ketone testing is one of the most straightforward, inexpensive, and accessible ways to keep an eye on your ketones.

If you’re looking for accurate and reasonably priced urine test strips, check out Perfect Keto’s Urine Test Strips that are specifically designed to help you stay in ketosis.