Measuring Ketones
An important aspect of the Ketogenic Diet is knowing how high your ketone levels are. There are three types of Ketones; beta-hydroxybutyrate (BOHB) which is measured in the blood, acetoacetate (AcAc) which is typically measured in the urine, and acetone which is typically measured in the breath. Measuring Acetone in the breath is becoming a good option, and I believe that this is probably the future of ketone measurement. It's an area of rapid development, and it was not available when I performed my Ketogenic Experiment, so I'm still gathering data. Measuring BOHB is the most accurate, and it's now practical at home using a similar technique to measuring blood glucose, but it's really expensive at several dollars per test. The easiest and cheapest technique is to measure AcAc in the urine using a test strip. However, this approach is too inaccurate to be useful. Acetone levels correlate well with body fat loss[1], but are also elevated by the Ketogenic Diet[2], MCT [3] intake, and exercise[4] even in the absence of weight loss. One study found that a one pound (0.5 Kg) per week fat loss correlated with 1.7 PPM of acetone (67 nmol/L). Each ~40% increase in breath acetone was an additional ∼0.5 Lb (250g) of weekly fat loss[5]. Breath acetone correlates well (though not linearly) with blood (BOHB) ketone levels[5]. This makes it useful for monitoring the progression of a ketogenic diet, as well as for measuring weight loss. The formula below was developed based on 12 adults consuming Ketogenic meals over a short period[6]: For Breath Acetone (BrAce) in mmol/L: BOHB = 0.11 * BrAce0.47 - 0.18 Note that the relationship is far from exact (r=0.5 or so.) Breath acetone levels can vary dramatically, with healthy individuals on a regular diet having less than 1 PPM (parts per Continue reading >>
Blood Versus Urine Ketone Monitoring In A Pediatric Cohort Of Patients With Type 1 Diabetes: A Crossover Study
Go to: Type 1 diabetes (T1D) incidence is consistently rising, especially in children below the age of 5 [Lipman et al. 2013]. Among the acute complications related to the disease, diabetic ketoacidosis (DKA) is the most important and is associated with a mortality rate of 0.15–0.30% [Rosenbloom, 2010], mostly (57–87%) due to cerebral edema [Wolfsdorf et al. 2006]. Other causes of death with DKA include hypokalemia (risk of cardiac arrhythmias), hypophosphatemia, hypoglycemia, peripheral venous thrombosis, acute renal failure, sepsis, or aspiration pneumonia [Rosenbloom, 2010; Wolfsdorf et al. 2009]. Estimation of the annual incidence of DKA in patients with T1D outside of partial remission phase varies between 1.5 to 8 episodes per 100 patients [Rewers et al. 2002]. Risk factors for DKA include poor diabetes control or compliance with insulin injections, sick days and errors in manipulation (e.g. insulin pump therapy) [Rosenbloom, 2010]. As DKA is physiologically always preceded by the production of ketone bodies (i.e. acetoacetate and 3β-hydroxybutyrate), strategies aiming at reducing the occurrence of ketosis events may have a direct impact on the global reduction of DKA incidence. Besides DKA, diagnosis of ketosis may influence diabetes outcome as suggested by investigations showing the activation by ketones of oxidative stress via mitogen-activated protein kinase pathways, with possible implications in vascular disease and atherosclerosis [Kanikarla-Marie and Jain, 2016]. Ketone testing traditionally depends on urine collection, which might prove difficult to implement in young children. An alternative has been developed for testing ketones in capillary blood, and recent meters now allow accurate monitoring, especially below values of 5 mmol/L of 3β-hydroxybu Continue reading >>
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Urine Ketones - Meanings And False Positives
Professional Reference articles are written by UK doctors and are based on research evidence, UK and European Guidelines. They are designed for health professionals to use. You may find the Urine Ketones article more useful, or one of our other health articles. Description Ketones are produced normally by the liver as part of fatty acid metabolism. In normal states these ketones will be completely metabolised so that very few, if any at all, will appear in the urine. If for any reason the body cannot get enough glucose for energy it will switch to using body fats, resulting in an increase in ketone production making them detectable in the blood and urine. How to test for ketones The urine test for ketones is performed using test strips available on prescription. Strips dedicated to ketone testing in the UK include[1]: GlucoRx KetoRx Sticks 2GK® Ketostix® Mission® Ketone Testing should be performed according to manufacturers' instructions. The sample should be fresh and uncontaminated. Usually the result will be expressed as negative or positive (graded 1 to 4)[2]. Ketonuria is different from ketonaemia (ie presence of ketones in the blood) and often ketonuria does not indicate clinically significant ketonaemia. Depending on the testing strips used, urine testing for ketones either has an excellent sensitivity with a low specificity, or a poor sensitivity with a good specificity. However, this should be viewed in the context of uncertainty of the biochemical level of significant ketosis[3]. Interpretation of results Normally only small amounts of ketones are excreted daily in the urine (3-15 mg). High or increased values may be found in: Poorly controlled diabetes. Starvation: Prolonged vomiting. Rapid weight loss. Frequent strenuous exercise. Poisoning (eg, with isop Continue reading >>
Ketones — Urine
Definition Ketones build up when the body needs to break down fats and fatty acids to use as fuel. This is most likely to occur when the body does not get enough sugar or carbohydrates. A urine test can be done to check the level of ketones in your body. Alternative Names Ketone bodies - urine; Urine ketones How the test is performed The test requires a clean catch urine sample. To obtain a clean catch sample, men or boys should clean the head of the penis. Women or girls need to wash the area between the lips of the vagina with soapy water and rinse well. As you start to urinate, allow a small amount to fall into the toilet bowl to clear the urethra of contaminants. Then, put a clean container under your urine stream and catch 1 to 2 ounces of urine. Remove the container from the urine stream. Cap and mark the container and give it to the health care provider or assistant. For infants, thoroughly wash the area around the urethra. Open a urine collection bag (a plastic bag with an adhesive paper on one end), and place it on the infant. For boys, the entire penis can be placed in the bag and the adhesive attached to the skin. For girls, the bag is placed over the labia. Diaper as usual over the secured bag. This procedure may take a couple of attempts -- lively infants can displace the bag. The infant should be checked frequently and the bag changed after the infant has urinated into the bag. The urine is drained into the container for transport to the laboratory. Urine ketones are usually measured as a "spot test" using a dipstick coated with chemicals that react with ketone bodies. The dipstick is dipped in the urine sample, and a color change indicates the presence of ketones. How to prepare for the test You may have to eat a special diet, and you should stop taking a Continue reading >>
How To Detect Ketosis
How can you tell if your low-carbing efforts have been effective enough to induce ketosis? Learn how to check your ketones! The state of ketosis The state of ketosis means that the body has switched from depending on carbohydrates for energy to burning fats for fuel. This means not only dietary fats (olive oil, guacamole, deep-fried pig ears), but also all the jiggly bits around your waist — clearly a desirable state for anyone looking to shed extra weight. When the body metabolizes fat, it generates molecules called ketones (also known as ketone bodies). As you restrict carbohydrate intake and amp up the dietary fat, more fat is metabolized and a greater quantity of ketones are created. Most of the cells in your body — including those in your brain — are able to use ketones for energy, although many people experience a few days’ adjustment period, often called the low carb flu. One of the varieties of ketones generated — acetone — cannot be used by the body and is excreted as waste, mostly in the urine and the breath. Conveniently, this makes it very simple to measure whether or not you are in ketosis. Upon entering ketosis, some people report a distinct change in the smell of their breath as a result of the extra released acetone. It could be “fruity” — it’s been likened to overripe apples — or even “metallic.” If you notice this happening during your first few days of changing your diet, it could be a good sign you’re in ketosis. The unusual smell isn’t anything dangerous, but it could be annoying. Drinking plenty of water should help, or get yourself some sugar-free gum. Most people report “keto-breath” diminishing after the first few weeks. Detecting ketones in urine The more accurate way — and the one we recommend — to check f Continue reading >>
Urine Tests For Diabetes: Glucose Levels And Ketones
The human body primarily runs on glucose. When your body is low on glucose, or if you have diabetes and don’t have enough insulin to help your cells absorb the glucose, your body starts breaking down fats for energy. Ketones (chemically known as ketone bodies) are byproducts of the breakdown of fatty acids. The breakdown of fat for fuel and the creation of ketones is a normal process for everyone. In a person without diabetes, insulin, glucagon, and other hormones prevent ketone levels in the blood from getting too high. However, people with diabetes are at risk for ketone buildup in their blood. If left untreated, people with type 1 diabetes are at risk for developing a condition called diabetic ketoacidosis (DKA). While rare, it’s possible for people with type 2 diabetes to experience DKA in certain circumstances as well. If you have diabetes, you need to be especially aware of the symptoms that having too many ketones in your body can cause. These include: If you don’t get treatment, the symptoms can progress to: a fruity breath odor stomach pain trouble breathing You should always seek immediate medical attention if your ketone levels are high. Testing your blood or urine to measure your ketone levels can all be done at home. At-home testing kits are available for both types of tests, although urine testing continues to be more common. Urine tests are available without a prescription at most drugstores, or you can buy them online. You should test your urine or blood for ketones when any of the following occurs: Your blood sugar is higher than 240 mg/dL. You feel sick or nauseated, regardless of your blood sugar reading. To perform a urine test, you urinate into a clean container and dip the test strip into the urine. For a child who isn’t potty-trained, a pa Continue reading >>
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Ketones Urine Test
Ketone bodies - urine; Urine ketones; Ketoacidosis - urine ketones test; Diabetic ketoacidosis - urine ketones test A ketone urine test measures the amount of ketones in the urine. How the Test is Performed Urine ketones are usually measured as a "spot test." This is available in a test kit that you can buy at a drug store. The kit contains dipsticks coated with chemicals that react with ketone bodies. A dipstick is dipped in the urine sample. A color change indicates the presence of ketones. This article describes the ketone urine test that involves sending collected urine to a lab. A clean-catch urine sample is needed. The clean-catch method is used to prevent germs from the penis or vagina from getting into a urine sample. To collect your urine, the health care provider may give you a special clean-catch kit that contains a cleansing solution and sterile wipes. Follow instructions exactly so that the results are accurate. How to Prepare for the Test You may have to follow a special diet. Your provider may tell you to temporarily stop taking certain medicines that may affect the test. Why the Test is Performed Ketone testing is most often done if you have type 1 diabetes and: Your blood sugar is higher than 240 mg/dL Nausea or vomiting occur Pain in the abdomen Ketone testing may also be done: You have an illness such as pneumonia, heart attack, or stroke Nausea or vomiting that does not go away You are pregnant Normal Results A negative test result is normal. Normal value ranges may vary slightly among different laboratories. Some labs use different measurements or test different samples. Talk to your provider about the meaning of your specific test results. What Abnormal Results Mean An abnormal result means you have ketones in your urine. The results are usually li Continue reading >>
Ketones Urine Test
Definition A ketone urine test measures the amount of ketones in the urine. Alternative Names Ketone bodies - urine; Urine ketones; Ketoacidosis - urine ketones test; Diabetic ketoacidosis - urine ketones test How the Test is Performed Urine ketones are usually measured as a "spot test." This is available in a test kit that you can buy at a drug store. The kit contains dipsticks coated with chemicals that react with ketone bodies. A dipstick is dipped in the urine sample. A color change indicates the presence of ketones. This article describes the ketone urine test that involves sending collected urine to a lab. A clean-catch urine sample is needed. The clean-catch method is used to prevent germs from the penis or vagina from getting into a urine sample. To collect your urine, the health care provider may give you a special clean-catch kit that contains a cleansing solution and sterile wipes. Follow instructions exactly so that the results are accurate. How to Prepare for the Test You may have to follow a special diet. Your provider may tell you to temporarily stop taking certain medicines that may affect the test. How the Test will Feel The test involves only normal urination. There is no discomfort. Why the Test is Performed Ketone testing is most often done if you have type 1 diabetes and: Your blood sugar is higher than 240 mg/dL Nausea or vomiting occur Pain in the abdomen Ketone testing may also be done: You have an illness such as pneumonia, heart attack, or stroke Nausea or vomiting that does not go away You are pregnant Normal Results A negative test result is normal. Normal value ranges may vary slightly among different laboratories. Some labs use different measurements or test different samples. Talk to your provider about the meaning of your specific test re Continue reading >>
Ketosis & Measuring Ketones
Generally, ketone concentrations are lower in the morning and higher in the evening. Whatever time you pick to measure ketone levels, make sure to keep it consistent. Also, do not measure your ketone levels right after exercise. Ketone levels tend to be lower while your glucose levels higher so you won't get representative numbers. Keep in mind there are daily fluctuations caused by changes in hormone levels. Don't get discouraged! Another aspect that affects the level of ketones is the amount of fat in your diet. Some of you may show higher concentration of ketones after a high-fat meal. Coconut oil contains MCTs that will help you boost ketones. To easily increase your fat intake on a ketogenic diet, try fat bombs - snacks with at least 80% fat content. Ketone levels tend to be higher after extensive aerobic exercise as your body depletes glycogen stores. Exercise may help you get into ketosis faster. ketogenic "fruity" breath is not pleasant for most people. To avoid this, drink a lot of water, mint tea and make sure you eat foods rich in electrolytes. Avoid too many chewing gums and mints, as it may put you out of ketosis; there may be hidden carbs affecting your blood sugar. Increase your electrolyte intake, especially potassium. You are likely going to lose some sodium and potassium when switching to the keto diet. Finally, if you find it hard to lose weight on a ketogenic diet, there may be plenty other reasons than the level of ketone bodies: Not Losing Weight on Low-Carb Ketogenic Diet? Don’t Give Up and Read Further. Continue reading >>
Ketones Urine Test
Ketone bodies - urine; Urine ketones; Ketoacidosis - urine ketones test; Diabetic ketoacidosis - urine ketones test Urine ketones are usually measured as a "spot test." This is available in a test kit that you can buy at a drug store. The kit contains dipsticks coated with chemicals that react with ketone bodies. A dipstick is dipped in the urine sample. A color change indicates the presence of ketones. This article describes the ketone urine test that involves sending collected urine to a lab. A clean-catch urine sample is needed. The clean-catch method is used to prevent germs from the penis or vagina from getting into a urine sample. To collect your urine, the health care provider may give you a special clean-catch kit that contains a cleansing solution and sterile wipes. Follow instructions exactly so that the results are accurate. You may have to follow a special diet. Your provider may tell you to temporarily stop taking certain medicines that may affect the test. The test involves only normal urination. There is no discomfort. Ketone testing is most often done if you have type 1 diabetes and: Your blood sugar is higher than 240 mg/dL Nausea or vomiting occur Pain in the abdomen Ketone testing may also be done: You have an illness such as pneumonia, heart attack, or stroke Nausea or vomiting that does not go away You are pregnant A negative test result is normal. Normal value ranges may vary slightly among different laboratories. Some labs use different measurements or test different samples. Talk to your provider about the meaning of your specific test results. An abnormal result means you have ketones in your urine. The results are usually listed as small, moderate, or large as follows: Small: <20 mg/dL Moderate: 30 to 40 mg/dL Large: >80 mg/dL Ketones build up Continue reading >>
Ketone Measurements— Which Method Is Best?
Early recognition and rapid induction of treatment are critical to reducing morbidity and mortality in diabetic cats that become ketoacidotic.Urine dipstick is the standard means for detecting ketone bodies in diabetic cats.The plasma ketone dip test (PKDT) using the urine dipstick colorimetric method was introduced in 2003. In this study, the results of the urine ketone dipstick test (UKDT) and PKDT in cats with possible ketosis or diabetic ketoacidosis (DKA) were compared, with plasma beta-hydroxybutyrate (beta-OHB) measurements used as the gold standard.On the basis of clinical examination findings, beta-OHB measurements, and blood gas analysis, 54 cats with diabetes mellitus were classified into 1 of 3 groups: nonketotic cats (n= 3), ketotic cats (n = 40), or ketoacidotic cats (n = 11). Paired urine and blood samples were collected, and urine and plasma were both tested on urine ketone reagent strips to determine acetoacetate concentrations. Although a good correlation was found between blood and urine ketone measurements, the results differed significantly—measurements of the PKDT were on average higher than results of the UKDT.The best cutoff values for detecting ketoacidosis was 1+ (≥ 1.5 mmol/L) for urine and 2+ (≥ 4 mmol/L) for plasma.Using these cutoff values yielded the following sensitivities and specificities: 82% and 95% for urine and 100% and 88% for plasma, suggesting that PKDT is a useful tool for ruling out DKA.Because of its higher sensitivity, the PKDT performs better than the UKDT in identifying cats with impending or established ketoacidosis. COMMENTARY: It is very interesting that so many cats were found to be positive for beta-OHB even though they did not have metabolic acidosis.As highlighted by the authors, hospitalization is typically re Continue reading >>
Reference Range
Acetoacetate, beta-hydroxybutyrate, and acetone are ketone bodies. In carbohydrate-deficient states, fatty-acid metabolism spurs acetoacetate accumulation. The reduction of acetoacetate in the mitochondria results in beta-hydroxybutyrate production. Beta-hydroxybutyrate and acetoacetate, the predominant ketone bodies, are rich in energy. Beta-hydroxybutyrate and acetoacetate transport energy from the liver to other tissues. Acetone forms from the spontaneous decarboxylation of acetoacetate. Acetone is the cause of the sweet odor on the breath in persons with ketoacidosis. [1, 2] Ketone bodies fuel the brain with an alternative source of energy (close to two thirds of its needs) during periods of prolonged fasting or starvation, when the brain cannot use fatty acids for energy. The reference range for ketone is a negative value, at less than 1 mg/dL (< 0.1 mmol/L). [3] Continue reading >>
Blood Ketones
On This Site Tests: Urine Ketones (see Urinalysis - The Chemical Exam); Blood Gases; Glucose Tests Elsewhere On The Web Ask a Laboratory Scientist Your questions will be answered by a laboratory scientist as part of a voluntary service provided by one of our partners, the American Society for Clinical Laboratory Science (ASCLS). Click on the Contact a Scientist button below to be re-directed to the ASCLS site to complete a request form. If your question relates to this web site and not to a specific lab test, please submit it via our Contact Us page instead. Thank you. Continue reading >>
3 Best Ways To Measure Ketones For Your Ketogenic Diet (review & Buyers Guide)
How do you get accurate readings of ketones? Which methods actually work? These are common questions I going to help you with in this article. Anyone interested in using the latest nutritional research to improve their health has likely heard of a ketogenic diet. Ketogenic diets are a simple way to get your metabolism to prioritize the consumption of fatty acids, also known as ketones, when at rest or exercising. While there is a wide body of research that confirms the benefits of this type of nutritional plan, for the average user at home – one big question remains. How can you measure ketone levels to ensure your body is reaching a perfect state of ketosis? Without an accurate method of ketosis measurement, you will never achieve an optimized LCHF or ketogenic diet. However, it has not always been easy to measure your level of ketosis at home. At least this concern is now a thing of the past, because there are many ways to measure ketone levels easily and accurately in the comfort of your own home. Find out the very best method to test your level of nutritional ketosis that strikes the perfect balance of ease, price and quality. Before getting too deep into the different methods for measuring ketosis, it is important to first look at exactly why measuring them is so important and to clarify some of the more complex scientific terms. Ketone Testing Terminology If you have decided to try a ketogenic diet to achieve nutritional ketosis, then finding an accurate way to measure your ketone levels is important. You need to be able to maintain yourself in the optimal zone where fat is used as energy rather than glucose. Too little ketone and you will not see any positive effects. But higher levels give no real benefit and could indicate a serious problem with your diet. Li Continue reading >>
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Why Test For Ketones: Is Blood Or Urine More Accurate?
There are certain situations when ketone testing is needed to reduce the risk of critical complications of diabetes. Options are using plasma blood with a meter to check for ketones or using urine testing kits. We will review which is more beneficial. Let’s first look at the basics of ketones and when they can cause a possible life threatening situation. What are ketones? Ketones are formed when fat is used as an energy source instead of carbohydrates. There are dietary ketones which are formed on a low- or no-carbohydrate diet with a high fat/protein intake; when blood sugars are controlled these ketones are not dangerous. When blood sugars are uncontrolled the carbohydrate source may be available, but with no (Type 1 Diabetes) or little (Type 2 Diabetes) insulin present, the body relies on fat breakdown for energy source; ketones are a toxic by product of the fat breakdown. Ketones circulate in the system as acids and change the PH of the blood, resulting in DKA or Diabetic Keto-acidosis. This is a serious medical situation and must be treated. What is DKA and what are the symptoms? Diabetic Ketoacidosis (DKA) is a condition that can occur when people have diabetes type 1 and are suffering from illness, excessive stress, or lack of insulin delivery. It can be because of a displaced insulin pump or using expired insulin. Although less common, it can occur in those who have diabetes type 2 when they are ill, have an infection, are severely stressed or prone to ketone production. The ketones accumulate in the blood, eventually go to the kidneys and are released from the body through urine. Ketone production can also occur in pregnant women with diabetes or women who develop gestational diabetes when pregnant. Ketones can form in patients who are switched from exogenous Continue reading >>
