Monitoring For Compliance With A Ketogenic Diet: What Is The Best Time Of Day To Test For Urinary Ketosis?
Go to: Methods The KetoPerformance study with its before-and-after comparison design was registered at germanctr.de as DRKS00009605 and took place from February to June 2016. Exclusion criteria included underweight, obesity, kidney stones, pregnancy, diabetes mellitus and any fatty acid-metabolism disorders. The study protocol was approved by the Ethics Commission of the Albert-Ludwig University Freiburg (494/14) and all subjects signed a written consent form. Twelve of the 42 subjects from the KetoPerformance study could be recruited for the present substudy. Experimental design and dietary intervention The experimental intervention consisted of a KD without caloric restriction lasting 6 weeks with a previous preparation period including detailed instructions during teaching classes and individual counselling by a dietitian. The subjects were free to follow a KD according to their personal preferences but were advised to reach a ratio by weight of approximately 1.8:1 fat to carbohydrate and protein combined, yielding a diet with 80, 15, and 5 % of total energy intake from fat, protein and carbohydrate, respectively. During the KD intervention's sixth week, our substudy subjects were instructed to measure urine and blood ketone concentrations at regular intervals in as close proximity as possible during a 24-h period from 07:00 to 07:00 in the morning. During the day (07:00 till 22:00) blood and urinary ketones were measured every full hour and every three hours, respectively. During the night, blood and urinary ketones were measured once at 03:00. In total blood and urine and ketones were measured 18 and 8 times, respectively, and were recorded in a table sheet. Subjects were asked to drink 400 ml of water every 3 h during the day to ensure sufficient urination and to Continue reading >>
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Urine Test Types: Ph, Ketones, Proteins, And Cells
Urine as a Diagnostic Tool A long time ago, disgusting as it may be, people used to actually taste and drink urine in order to try and diagnose a patient's disease! I'm not even kidding you. Thankfully, modern-day doctors do not have to resort to such disgusting and even dangerous methods. One of the reasons the doctor barbers of yesteryear used to drink their patient's urine was to see if it had a sweet taste, often indicative of diabetes mellitus. Finding the sweet-tasting glucose in the urine was covered in detail in another lesson, so we'll focus on other important measurements here instead. Interpreting Urine pH One value that can be measured in the urine is known as urine pH. pH is a measure of the acidity or alkalinity of a substance. If the pH is low, then it is acidic. If the pH is high, then it is basic, or alkaline. To remember which is which, I'll give you a little trick that has worked for me. If you grew up watching cartoons, you probably saw some comical ones where cartoonish robbers poured acid on the roof of a bank vault and waited while the acid ate its way downward into the vault, so the robbers could get down there to steal all the cash. If you can recall that acid likes to eat its way downward into things, then you'll remember that acidic substances go down the pH scale. That is to say, their pH numbers are lower than basic substances. Normal urine pH is roughly 4.6-8, with an average of 6. Urine pH can increase, meaning it will become more basic, or alkaline, due to: A urinary tract infection Kidney failure The administration of certain drugs such as sodium bicarbonate Vegetarian diets On the flip side, causes for a decreased, or acidic, urine pH, include: Metabolic or respiratory acidosis Diabetic ketoacidosis, a complication of diabetes mellitus Continue reading >>
Getting To Know Ketones
People with diabetes, particularly those with Type 1 diabetes, have been at least vaguely aware of the word ketones for a long time. With the recent resurgence of popular interest in low-carbohydrate diets, however, just about everyone seems to be talking about ketones these days. But does anyone really know what ketones are? Are they a danger to your health (as in diabetic ketoacidosis), or a sign that you have lowered your carbohydrate intake enough to cause weight loss (as some people who follow low-carbohydrate diets believe)? What are ketones? Ketones are end-products of fat metabolism in the body. That is, they are formed when fat is burned for energy by the muscles. Chemically, they are acids known as ketone bodies, and there are three types: beta-hydroxybutyric acid, aceto-acetic acid, and acetone. But you don’t have to be a chemist to understand what role they play in the body. To get to know ketones, it’s helpful to understand how your body burns fuel. A simple analogy is that of an automobile. For a car engine to run, the engine must burn fuel (gasoline), and when the fuel is burned, exhaust (carbon monoxide) is created. The carbon monoxide is the end-product of gasoline combustion. Your body also has an engine that must burn fuel to operate. The engine is muscle, and the fuel is fat, carbohydrate (glucose), and, in certain conditions, protein. When fat is burned, the “exhaust” is ketones, and when glucose is burned, the “exhaust” is lactic acid. Fat is more desirable as a fuel than glucose because there are more calories in a gram of fat (9 calories per gram) than there are in a gram of glucose (4 calories per gram), so you get more energy per gram of fat burned. In a sense, you could call fat a high-test fuel. But there is one catch to burning f Continue reading >>
5 Ways To Measure Your Ketones
5 Ways to Measure Your Ketones A ketogenic diet is a very low carbohydrate, moderate protein and high fat based nutrition plan. A ketogenic diet trains the individual’s metabolism to run off of fatty acids or ketone bodies. This is called fat adapted, when the body has adapted to run off of fatty acids/ketones at rest. Research has demonstrated that this nutrition plan improves insulin sensitivity and reduces inflammation throughout the body. This leads to greater fat metabolism and muscle development as well as a reduced risk of chronic disease. (1, 2). I get asked all the time how to measure the state of ketosis. There are several major ways and we will discuss those in this article. Measuring Your Ketones There are three types of ketone bodies: Acetone, Acetoacetate and Beta-Hydroxybutryate (BHB). Each of these three can be tested as acetone is a ketone released through the breath, acetoacetate is a ketone released through urine and BHB is (although not technically a ketone it acts like a ketone) in the blood stream and used by the cells for energy. 1. Blood Ketone Meter This measures BHB and is considered to be the most accurate way to measure ketone bodies. These have the ability to determine the ketone level in your blood precisely but they are also pricey and invasive. Personally, I freak out every time I have to prick my finger!! The Precision Xtra blood glucose and ketone meter is a good buy at $28-$30. The expensive part is the ketone test strips here which can cost $4 each. If you are looking at testing yourself every day it is going to cost you $120 a month and the $30 meter. Here is a starter kit you can get on Amazon Most people will enter into a light nutritional ketosis (between 0.5-1.0 mmol/L on the meter) within two or three days. It typically takes Continue reading >>
Ketones In Urine – How To Test And What Levels Are Optimal
There are likely two reasons you want to test the ketone levels in your urine: REASON 1 – you’ve got type one diabetes (or type two diabetes, in some cases) and you need to test the ketones levels in your urine to help you avoid ketoacidosis. If that’s the case, skip down to the sections on… Then, skip straight to the section on… REASON 2 – you’re on the Keto diet and you want to use urine strips to check if you’re in ketosis. If that’s the case, then don’t worry we’ll also cover: But skip the section on ketoacidosis – it doesn’t apply to you unless you’re diabetic! Note that information contained in this article (and website) is not intended to and shall not convey or recommend any medical or nutritional advice or course of action. Any diet, health, or nutritional program you undertake should be discussed with your doctor or other licensed medical professionals. All opinions expressed in this article are based solely on personal experiences and research. We are NOT licensed doctors, dietitians, or nutritionists. Testing Laboratory Microbiology - Air Quality - Mold Asbestos - Environmental - Lead emsl.com What are ketones? First things first – a quick 101 intro on what ketones actually are: Ketone bodies (or ketones) are produced by your liver during the break down of fatty acids when your body is low on glucose. Your body then uses these ketone bodies as fuel. You see, your cells can’t directly use the fatty acids in your fat stores to produce energy. And that’s because those fatty acids are unable to pass through the membrane which surrounds your cells. And if they can’t get inside? They can’t be used as fuel. So there’s an extra step to the process: First, the fatty acids travel to your liver where they’re broken down into ke Continue reading >>
Ketone Bodies (urine)
Does this test have other names? Ketone test, urine ketones What is this test? This test is used to check the level of ketones in your urine. Normally, your body burns sugar for energy. But if you have diabetes, you may not have enough insulin for the sugar in your bloodstream to be used for fuel. When this happens, your body burns fat instead and produces substances called ketones. The ketones end up in your blood and urine. It's normal to have a small amount of ketones in your body. But high ketone levels could result in serious illness or death. Checking for ketones keeps this from happening. Why do I need this test? You may need this test if you have a high level of blood sugar. People with high levels of blood sugar often have high ketone levels. If you have high blood sugar levels and type 1 or type 2 diabetes, it's important to check your ketone levels. People without diabetes can also have ketones in the urine if their body is using fat for fuel instead of glucose. This can happen with chronic vomiting, extreme exercise, low-carbohydrate diets, or eating disorders. Checking your ketones is especially important if you have diabetes and: Your blood sugar goes above 300 mg/dL You abuse alcohol You have diarrhea You stop eating carbohydrates like rice and bread You're pregnant You've been fasting You've been vomiting You have an infection Your healthcare provider may order this test, or have you test yourself, if you: Urinate frequently Are often quite thirsty or tired Have muscle aches Have shortness of breath or trouble breathing Have nausea or vomiting Are confused Have a fruity smell to your breath What other tests might I have along with this test? Your healthcare provider may also check for ketones in your blood if you have high levels of ketones in your urine Continue reading >>
A New Toy Measuring Blood Ketones
I just got a new toy: a device for measuring blood ketones. This is a far more exact and reliable measurement than testing for urine ketones using cheap dipsticks. Ketosis is of course the state the body is in when eating very low carb. Ketones, made from fat, will then fuel the brain instead of glucose. So who needs one of these gadgets? Perhaps nobody. Obviously it’s easy to eat LCHF without it. This is for curious nerds (like me) and for those who want definite proof that they are eating so little carbs that insulin levels are low and fat burning is maximized. A ketone level somewhere between 1.5 – 3 is said to be an optimal level for maximizing weight loss. It means that insulin levels are very low. As you can see my first measurement was 0.2, after a caesar sallad dinner. I’m not surprised as I’ve probably eaten at least 50 grams of carbs a day lately. I will try it out fasting in the mornings during the coming days. Perhaps I’ll try being really strict with the carbs for a while to see what happens. Have you tried one of these or are you interested in doing it? Continue reading >>
Measuring Ketosis With Ketone Strips: Are They Accurate?
Many people following keto diets want to be in ketosis, a natural state in which the body burns fat for fuel. For this reason, people are curious about whether they are doing enough (via carb restriction) to achieve this state. As a result, ketone strips are a popular tool that numerous people use as a way of measuring ketosis. However, just how accurate are they? And how do they compare to alternate methods of measuring ketones? What is Ketosis? Anyone following a standard high-carbohydrate diet will be burning glucose for energy. However, the body can use both carbohydrate and fat for fuel (1). When carbohydrate intake is very low, the body switches to burning fat for energy. As this happens, our body enters a state of ketosis. Ketosis is a natural biological state during which our body burns fat for fuel. While we are “in ketosis,” our blood levels of ketones—a by-product from the breakdown of fats—rise. Measuring these ketones (also known as ‘ketone bodies’) can, therefore, provide a hint as to how deeply our body is (or isn’t) in ketosis. For this reason, ketone strips—which measure the level of ketones—have become increasingly popular in recent times. Key Point: Ketosis is a biological state where the human body burns fat rather than carbs. What are Ketone Test Strips? For people who want to know if they’re in ketosis, ketone test strips are a cheap and simple way of detecting ketone levels. They are otherwise known as ‘ketone sticks’ and work by urinalysis to tell us the volume of acetoacetate in our urine. If you don’t know what acetoacetate is, then let’s start at the beginning. First of all, there are three types of ketone body; Acetoacetate Acetoacetate is one of the two main ketone bodies, and it is present in urine. We can test f Continue reading >>
3 Ways To Measures Ketones: Which Is Best?
Intro: the age of Do-It-Yourself at-home medical technology The medico-technological age we’re in goes by many names, such as biohacking, self-experimentation or the quantified self. A lot of it is about tracking biochemical markers and performance metrics that can tell you something about your past and present state, usually in an attempt to predict or change it in the future. Ketones are one such biochemical marker of metabolism that can be measured in blood, breath and urine (see our What’s a ketone? section for more details). Some people use a ketogenic diet to manage cancer, epilepsy, obesity or diabetes and may find it helpful to monitor their ketone levels. Alternatively, they may simply be curious and interested in physiology. Whatever the case may be, since ketones can be measured in blood, breath and urine, which method might you chose for your circumstance and why? Measuring blood ketones The ketone bodies measured in blood are acetoacetate and is β-hydroxybutyrate (BhB), the latter being the most commonly measured. A well-known at-home device for doing so is the Precision Xtra. It can also measure blood glucose using glucose-specific strips. The portable device can measure BhB concentrations ranging from 0.1 mmol/L (1.0 mg/dL) to 8 mmol/L (or 83.3 mg/dL). Measuring blood ketones is the most accurate method compared to breath and urinary ones but the ketone strips are still quite expensive. One case in which blood ketones are measured is when doctors ask their diabetic patients to monitor their blood BhB levels so as to stay below 0.6 or 1.5 mmol/L. These doctors are worried that a rise above these levels may lead to a pathological condition called diabetic ketoacidosis (DKA). DKA is distinct from the normal physiological state of ketosis, where insulin 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 >>
Measuring Ketosis: What Are Keto Sticks And Keto Strips?
Ketosis is a metabolic state where the liver breaks down fat to produce ketones. Ketones, on a ketogenic diet, are the primary fuel source for the body. If you’re new to the ketogenic diet and you still have questions, consider reading our Comprehensive Beginner’s Guide to Keto > There are three main ways to measure the ketones in your body, all of which have their advantages and disadvantages. The most common ways to measure are: Blood Ketone Meter. Very accurate but the strips are extremely expensive. Breath Ketone Meters. More accurate than the urine strips, but can sometimes vary in accuracy. Cheaper than blood strips in the long-run. Urine Stricks. This will answer the question “Am I in ketosis?” but will not provide an accurate measure of blood ketones. Scroll down to read a more in-depth analysis of each, and what we recommend for you. Measuring Ketones with Urine Sticks Urine sticks will always be the cheapest and easiest way to measure ketosis. For beginners, this should cover everything you need – there is no point in getting more complex blood strips so early on when you are still trying to understand the nuances of a ketogenic diet. Ultimately, keto sticks are very easy to use – you hold the sticks in your urine stream for a few seconds, and within 10-15 seconds you should notice a color change in the strip (if you are in ketosis). The color of the stick typically is measured in red: light pink being low in ketone production and dark purple being high in ketone production. While keto sticks can be ideal for a general answer to the question “Am I in ketosis?”, they aren’t precise with their accuracy. They measure the acetoacetate in your urine, which is an unused ketone by the body. As you get deeper into ketosis and your body adapts, your b Continue reading >>
Ketone Testing
Tweet Ketone testing is a key part of type 1 diabetes management as it helps to prevent a dangerous short term complication, ketoacidosis, from occurring. If you have type 1 diabetes, it is recommended that you have ketone testing supplies on your prescription. Ketone testing may also be useful in people with other types of diabetes that are dependent upon insulin. Why test for ketones? Ketones are produced by the body as an alternative source of energy to sugar. The body produces ketones by breaking down fats, this process is known as ketosis. Ketones may be produced as part of weight loss, however, it’s important for people with diabetes on insulin to note that ketones can be produced when the body has insufficient insulin. When the body has too little insulin, it means that cells of the body cannot take in enough sugar from the blood. To compensate for this, the body will start to break down fat to provide ketones. However, if a high level of ketones is produced, this can cause the blood to become acidic which can lead to illness and even potential danger to organs if not treated in time. This state is referred to as diabetic ketoacidosis. Where can I get ketone testing kits and sensors? The most accurate way of testing for ketones is to use a meter that measures blood ketone levels. The following blood glucose meters are able to test blood ketone levels in addition to blood glucose levels: Abbott - FreeStyle Optium Neo Menarini - GlucoMen LX Plus If you take insulin, you should be able to get these prescribed by your GP. You can also test urine for ketone levels, however, urine ketone testing is not as accurate as blood ketone testing as the levels of ketones in the urine will usually only reflect a level of up to a few hours previously. When to test for ketones? Continue reading >>
Ketones Urine 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. Continue reading >>
What Are Ketones And Their Tests?
A ketone test can warn you of a serious diabetes complication called diabetic ketoacidosis, or DKA. An elevated level of this substance in your blood can mean you have very high blood sugar. Too many ketones can trigger DKA, which is a medical emergency. Regular tests you take at home can spot when your ketone levels run too high. Then you can take insulin to lower your blood sugar level or get other treatments to prevent complications. What Exactly Are Ketones? Everyone has them, whether you have diabetes or not. Ketones are chemicals made in your liver. You produce them when you don't have enough of the hormone insulin in your body to turn sugar (or “glucose”) into energy. You need another source, so your body uses fat instead. Your liver turns this fat into ketones, a type of acid, and sends them into your bloodstream. Your muscles and other tissues can then use them for fuel. For a person without diabetes, this process doesn’t become an issue. But when you have diabetes, things can run out of control and you build up too many ketones in your blood. If the level goes too high, it can become life-threatening. Who Needs a Ketone Test? You might need one if you have type 1 diabetes. In this type, your immune system attacks and destroys cells in your pancreas that make insulin. Without it, your blood sugar rises. People with type 2 diabetes can also get high ketones, but it isn't as common as it is with type 1. Tests can show you when your level gets high so you can treat it before you get sick. When Should You Test? Your doctor will probably tell you to test your ketones when: Your blood sugar is higher than 250 milligrams/deciliter (mg/dl) for two days in a row You're sick or you've been injured You want to exercise and your blood sugar level is over 250 mg/dl Continue reading >>
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Checking For Ketones
There are two ways to test for ketones. Both have advantages and disadvantages. Decide which is right for you and seek immediate medical attention if you test positive. Check your urine or blood for ketones if you are sick or have symptoms of ketoacidosis. If the test is positive, you need immediate medical care. There are two ways to test your body for ketones. How to Check for Urine Ketones Urine Ketones: Examples: Ketostixs® or Chemstrips® Urine is applied to reagent strip and the color change shows the level of ketones. Disadvantages: Color changes are categorized as trace, small, medium, and large only Dehydration can affect results CAUTION: Be sure to get individually foil wrapped urine ketone test strips! Test strips rapidly loose their accuracy once they are exposed to the air. By using individually foil wrapped strips, only the strip you are using is exposed to the atmosphere. How to Check for Blood Ketones Blood Ketones: Example: Abbott Precision Xtra® Quantitative ketone (beta-hydroxybutyrate) is measured. The normal level is less than 0.6 mmol/l. Check the manufacturer’s package insert for an explanation of results and more information. CardioChek, BioScanner 2000, and other blood ketone testing devices are also available. Advantages: Results are more accurate and reflect ketone levels at the time the test is done vs. lag time found with the urine testing Disadvantages: Self-assessment Quiz Self assessment quizzes are available for topics covered in this website. To find out how much you have learned about Monitoring Your Diabetes, take our self assessment quiz when you have completed this section. The quiz is multiple choice. Please choose the single best answer to each question. At the end of the quiz, your score will display. If your score is over 70 Continue reading >>
