How to Measure Ketosis & What are Keto Sticks & 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.

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.


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.
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  • 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 body will also become more optimized in ketone production.
  • You should notice a dark purple color when you’re newer to the ketogenic diet. If you’ve been on keto for many months, you’ll probably see a much lighter color. Many people assume this is a bad thing, but it’s usually not. Your body has just become more efficient at creating the ketones that fuel your body. If you’ve been following a ketogenic diet for a long time, it can be common for the sticks to give a false negative result.
  • The biggest advantage to measuring ketosis with urine sticks is that they are incredibly cheap and typically very easy to find.
  • The biggest disadvantage to these is their accuracy. Besides being inaccurate if you’ve been in ketosis for a long time, the sticks can also give varying results based on your hydration. If you’re properly hydrated, many times the sticks will read a much lighter color than if you were dehydrated.

What do the colors on the strips mean?



The level of ketones in your urine determine what color your ketone test strips change to:

  • If the color on the strip remains the same, then no ketones are found in your urine.
  • If the color of the strips turns a dark purple, then the levels of ketones in your urine is high.

How to read the results and what do they mean?

Before diving into this, how do you use a ketone urine strip?  All you have to do run your pee on the urine strip then wait to see what the color will change to or better still, urinate into a clean container and dip the test strip into the urine.

You read the result of your ketone test by watching out for what color the strip changes to. Hold your strip under the key, look for that color which matches your strip. If the color is dark purple, it indicates that there is a very high level of ketone present in your urine. There are cases where the color that shows on your strip is lighter purple to pink areas consistently, then you are fine.

Below are some reasons why your strip continuously shows up the lighter colors:

  1. Period of the day you take your ketone test.
  2. Your body’s natural placement.
  3. Ketones weakened by increased hydration.
  4. Sports activities can decrease ketone readings because your body is its ketone provider for food.

What do your results mean?

Any traceable amount of ketones may mean that there is a build-up of ketones. You should consider testing again in a few hours.

Moderate or large amounts are a sign of danger because they can mess with the chemical balance in your body and even lead to poisoning it. Refrain from exercising if your test shows moderate to large levels of ketones with your blood glucose high. You will need better management of your diabetes.

Normal/negative Less than 0.6 millimoles per liter
Derate 0.6 to 1.5 mmol/L
High 1.6 to 3.0 mmol/L
Very high Greater than 3.0mmol/L

Advantages of reading your ketones through a strip

  • It is convenient.
  • It is cheap.
  • It is easy to see read your levels of ketones.
  • It is important to know whether your body is diving towards the state of diabetic ketoacidosis
  • The results are easy to understand.
  • It is portable.

Disadvantages of reading your ketones through a strip

  • The urine sticks aren’t always accurate. They can give incorrect readings when testing. This can be due to ace inhibitors that can cause false positives when using urine tests that contain nitroprussides. Taking drugs to treat painful urinary infections turns urine purple can also give a false reading. Using Depakote, a medication, can also have this effect. A test can be inaccurate if urine has been sitting in the bladder for an elongated period of time.
  • Concentration of urine can also cause inaccurate results.
  • Ketone strips are not in the business of detail. They do not amount exactly the number of ketones in the blood or urine. They do not measure all types of ketones.
  • Fluctuations might occur after waking up, eating and after exercises

Measuring Ketones with Breath Meters

  • Breath ketone meters are becoming more and more popular because of their simplicity. You connect it to your computer via USB and blow into it. From there, it measures the acetate in your breath – giving a good indication of your ketone levels.
  • They range from $150-200, so they are a pretty expensive upfront cost. We recommend that if you’re new to ketosis, you wait to buy one until you’re at a more advanced level. While breath meters are expensive upfront, it is much cheaper than the regular purchases of blood ketone strips. In the long-run, the most economical value for the results would be a breath analyzer – since you can reuse it as many times as you want.
  • Research shows that there is a pretty good correlation between acetate in the breath and the level of blood ketone meters, but can vary as you get deeper into ketosis. While they are much more accurate than the urine sticks, they can vary widely against the results of a blood ketone meter. This can sometimes lead to incorrect results, which may be misleading at times.


Measuring Ketones with Blood Meters

  • Blood ketone meters are the more accurate way to measure your level of ketosis. They show an exact and real-time measurement of the ketones in your blood, which is considered the “gold standard.” The biggest drawbacks of the blood strips are that they can get expensive quickly. They cost about $1 per strip, and most insurance providers don’t cover them.
  • Some slight drawbacks of blood ketone meters are their accuracy per device and their failed readings. Blood ketone readings will vary (though not greatly) between device and strips, even if they’re from the same brand. They can also occasionally fail readings, which means a wasted strip.
  • Remember as well that you do have to prick your fingers to draw a sample of blood for each reading. If you’re squeamish or don’t like to take blood, this may not be the best option.


Optimal Ketosis and Ketone Readings

  • Ketosis has many varying degrees, which indicate the number of ketones you are producing in your blood. As a rule of thumb, the higher the level of ketone production – the better the weight loss will be.
  • Since the most accurate way to measure ketones are through blood meters, we’ll be using them as our primary example. Typically, if you range below 0.5 mllimole ketones per liter of blood, you are not considered to be in ketosis.

Here’s a quick guide on the ranges; optimal weight loss will be in the “deep ketosis” range:

  • Light Ketosis: 0.5 mmol/L – 0.8 mmol/L
  • Medium Ketosis: 0.9 mmol/L – 1.4 mmol/L
  • Deep Ketosis (best for weight loss): 1.5 mmol/L – 3.0 mmol/L

If you’re within deep ketosis ranges, you don’t have to strive for even higher readings. If you’re falling over the 3.0 mark, you won’t have any better or worse results than if you had a reading in the 2.5 range. Frequent high readings can sometimes show a lack of calories in your diet (ketosis also happens during starvation when the body needs to break down stored energy).




The information contained or presented on this website is for educational purposes only, not for any kind of medical treatment.


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