Discover Exactly What To Eat To MakeYour Body Burn More Fat

Do You Need Ketosis Strips To Succeed On Keto?

Louise Hendon | July 12
Do You Need Ketosis Strips to Succeed on Keto #keto #article

When you’re just starting out on the Ketogenic diet, you simply can’t escape the word ketones.

The conflicting advice you’ll run across concerning the importance of measuring ketone levels can also be highly confusing so we’re here to simplify things today.

We’ll investigate whether monitoring your ketone levels is necessary if you want to enjoy the full and wide-ranging benefits of Keto.

More specifically, we’ll laser in on ketosis strips so you can see whether analyzing your urine using these simple strips is an effective method of monitoring those ketone levels.

So what are ketones in plain English, then?

What are Ketones?

Ketones are an energy source produced when glucose is not readily available. A healthy liver can generate over 185g of ketones every day. (National Center for Biotechnology Information)

Of the many potential ketone compounds, your body forms only 3 of these naturally. Acetoacetate, BHB and acetone are not only ketones but also ketone bodies. For the purposes of a Keto diet, it’s these ketone bodies we’re talking about rather than the broader family of ketones.

On a ketogenic diet, fat and ketones become your body’s primary sources of fuel.

By slashing your carb intake your body turns to your reserves of fat for energy. As stored fat is broken down, the liver starts to produce ketones which help fuel organs such as the brain, heart, and muscles.

“At this point, not only is the body doing the natural thing, and burning off fat, it’s also powering up the brain with a super efficient fuel,” according to Dr. David Perlmutter, M.D.

Your body can produce ketones naturally when you follow a Keto diet, and you can also take supplements that increase your blood ketone level.

We’ll glance now at these main ketone bodies…

Different Types of Ketones

As mentioned, your body produces 3 ketone bodies: acetoacetate, BHB and acetone.

  • Acetoacetate (AcAc): During the process of ketogenesis, AcAc is the first ketone body your body produces.
  • Beta-hydroxybutyrate (BHB): Once your body has fully transitioned to Keto, BHB becomes by far the most profuse ketone body, responsible for fueling your brain and your muscle cells.
  • Acetone: The least abundant of the 3 ketone bodies, you might notice fairly high quantities of acetone when you’re just starting Keto and your body is adapting.

Note: BHB has a slightly different chemical structure and it’s not actually a ketone but a carboxylic acid. Because of the way it performs, BHB is generally considered a ketone body despite this technicality.

Do You Need Ketosis Strips To Succeed On Keto?


When we’re looking at measuring ketones, it’s monitoring the levels of these 3 ketone bodies we’re interested in.

Why Are There Ketones In Urine?

When your body is producing ketones it’s common for 10-20% to end up being excreted in your urine. (2)

Since ketone bodies are not normally present in urine, if detected it’s a sure sign your body is using fats instead of carbs for energy.

Ketones can also make their way into your urine if your body is producing them to excess. Unless you’re diabetic, this is not something to be concerned about. If you are a type 1 diabetic – or, less commonly, a type 2 diabetic – too many ketones can trigger a dangerous condition called ketoacidosis.

It’s all well and good knowing what ketones are but how can you check those levels?

How Do You Check Your Ketones?

There are 3 principal methods of monitoring your ketones:

  • Urine Test
  • Breath Test (Listen in to our podcast episode on this with Dr. Alexis Shields)
  • Blood Test

In order to measure ketone levels in your urine, you’ll need some ketosis strips.

What Are Ketosis Strips?

If you want to measure the ketones in your urine, the simplest approach is to use ketosis strips, also commonly called ketone strips, or ketone test strips.

These are readily available and we’ll walk you through where to get hold of them if you decide you want to try this.

How Do Ketosis Strips Work?

The strip is exposed to a sample of collected urine. Depending on the proportion of acetoacetate, the strips react chemically and change color accordingly.

There’s a simple color-coded chart on the packaging outlining possible outcomes ranging from “negative” to “large”.

If the strips turn very dark purple, this corresponds with one of the upper segments indicating high (“large”) levels of ketones. For anyone new to the Keto diet, this is a strong indicator of nutritional ketosis.

Once you are more accustomed to Keto, you’ll notice a far paler shade of purple or pink when testing. This is normal as your system starts to more efficiently produce ketone bodies with less waste. (3)

No color change at all suggests you are not in ketosis.

Do You Need Ketosis Strips To Succeed On Keto?

What is The Purpose of Ketone Test Strips?

The core purpose of these cheap, user-friendly urine strips is to help confirm whether or not you’re in ketosis when you’re just getting underway with a Ketogenic diet.

The more time you spend following Keto, the more you’ll become aware of the way in which different foods can influence your ketone levels. As with any positive changes you bring about for the sake of your health, it often takes a while to make a full transition.

How Do You Use Them?

Using ketone strips couldn’t be easier.

Pee in a container then dip the strip into the urine or hold the stick in the urine stream to bring about the chemical reaction necessary for monitoring levels.

After 15 seconds you compare the color on the strip to the color-coded chart on the package to determine whether your body is producing ketones.

Are Urine Ketone Strips Accurate?

Although they’re very easy to use, ketosis strips are not entirely precise.

Registered Nurse Kyla Schmieg, RN, weighs some of the pros and cons. “These strips are very cheap, and cost about a quarter each. However, they are not as accurate as a blood ketone meter because it takes longer for ketones to reach urine and hydration can also effect results.”

Studies also suggest that while the level of acetoacetate in your urine is roughly comparable with that in your bloodstream, it’s only approximate. (4)

Pros of Ketone Test Strips

  • Extremely cheap
  • User-friendly
  • Widely available

Cons of Ketone Test Strips

  • Lack of accuracy
  • Can affect your motivation if you don’t see positive results

Using urine strips might give you some idea of whether or not you’re in ketosis, which can be helpful when just starting a Keto diet, but they are not built for precision.

Where to Get Ketosis Strips?

If you do opt to use ketosis strips to give you a ballpark ketone reading, you can find them in most pharmacies. Strips are also available online.

Bearing in mind the general drawbacks of urine strips we’ve highlighted, a couple of the more popular brands you’ll encounter are Smackfat and Ketostix.

So having established that keto strips are not the optimum way of gauging whether or not you’re in ketosis, what else can you do?

Using keto strips but no luck? Check out this video on why that may be the case:

Other Ways to Measure Ketosis

As we mentioned earlier, ketone bodies are not only detectable in urine but also in your breath and blood. (5)

You can easily measure ketones with a breath meter or a blood meter.

Do You Need Ketosis Strips To Succeed On Keto?

Breath Meters

If you prize accuracy and you have a more fluid budget, it’s worth considering a breath meter if you need to measure your ketone levels.

How Do They Work?

Breath meters are not cheap but they are reusable so you won’t get any of the ongoing costs you’ll encounter with ketosis strips.

By exhaling into this meter, you’ll get an idea of the level of acetone in your breath. Using the meter is straightforward.

How Do You Use Them?

The device itself is powered by USB or by Bluetooth and a mobile app.

Once you’ve started the meter and allowed it to warm up, just blow into the small stick for 10-15 seconds or so and you’ll soon see the level of acetone in your breath.

Pros of Breath Meters

  • Super-simple to use
  • Reusable, reducing ongoing costs
  • Delivers readings with greater precision than urine testing

Cons of Breath Meters

  • A more expensive option upfront
  • Requires a bit of technical savvy to set up the computer or app interface.

What Brand of Breath Meter Should You Try?

Ketonix is one of the leading brands offering a range of accurate, competitively-priced breath meters along with a repair service for your peace of mind. (6)

Blood Meters

Although breath meters are more accurate than urine strips, if precision is paramount, there’s no substitute for a blood meter.

How Do They Work?

Blood ketone meters can be used to measure either blood glucose or ketones. The difference comes in the strips you need to buy. When used to monitor ketones in your bloodstream, it’s the BHB that’s measured.

The strips that measure blood ketones cost $1 or $2 each. These have come down in price quite a bit over the last several years but the cost can add up, especially if you want to test multiple times a day.

How many ketones do you need to be in a state of ketosis? Certified Keto Coach Lori Ballen says, “Blood ketones between 0.5 and 3.0 mmol/L are generally a sign that you are in ketosis.”

When you’re measuring with a precise blood meter it can be tempting to chase higher ketone levels.  However, Dr. Andreas Eenfeldt M.D., says that more ketones are not necessarily better. “Values of over 3 mmol/L aren’t neccessary. That is, they will achieve neither better nor worse results than being at the 1.5-3 level. Higher values can also sometimes mean that you’re not getting enough food.”

How Do You Use Them?

Insert the correct strips into your device.

Prick your finger with the lancet device, and touch the end of the strip to the drop of blood that emerges on your finger. Then check the reading of your blood ketone levels.

Pros of Blood Meters

  • The most accurate and precise method of checking for ketosis
  • Easy to operate

Cons of Blood Meters

  • Initial cost of the meter can be expensive, and the strips can add up in price.
  • Need to prick yourself and draw bloodNeed to prick yourself and draw blood

What Brand of Blood Meter Should You Try?

Precision Xtra is one of the most reputable and popular blood meters at your disposal if you want to measure your ketone levels. These are the blood ketone strips that work with with this meter.

What If Strips Aren’t Showing Ketosis?

Assuming you’ve decided to press ahead and measure the ketone levels in your urine, what should you do if you get a negative ketone reading?

Do You Need Ketosis Strips To Succeed On Keto?

Firstly, don’t become disheartened. Following the Keto diet can bring about a shower of positive health benefits that do not hinge on being in ketosis.

You should also remember that urine strips are the least accurate of all ways to measure ketones.

In terms of taking action to move yourself toward ketosis, drill down on your macros since too many carbs or too much protein can affect ketosis.

Also, remember all the benefits that made you want to try Keto in the first place. (7) If you are finding that shifting to Keto is bringing you a range of positive benefits, stop using the strips and reap the rewards rather than obsessing over numbers.

Do You Have to Use Ketosis Strips?

Bottom line, you do not need to use ketone test strips.

Not only are the urine strips unreliable, the overall effect of monitoring your ketone levels can actually cause you to become disheartened instead of simply embracing a healthy lifestyle and diet.

Rather than trying to game the strips by manipulating your food choices, grasp the positives of the ketogenic diet.

Don’t Panic About Reading Ketone Levels…

Keto strips don’t provide accurate ketone readings.

If you want to measure ketone levels for whatever reason, use a blood meter for the most precise results.

It’s definitely not necessary to measure ketones in order to experience all a Keto diet has to offer, so relax and enjoy how good you feel!

Pinterest Image For Do You Need Ketosis Strips to Succeed on Keto?

Please pin the image below so that you and others can quickly and easily refer to the list and find out whether ketone test strips are really necessary.

Do You Need Ketosis Strips to Succeed on Keto #keto #infographic

Louise Hendon

Louise holds a Bachelors and Masters in Natural Sciences from Cambridge University (UK). She attended Columbia University for her JD and practiced law at Debevoise & Plimpton before co-founding Louise's Foods, Paleo Living Magazine, Nourishing Brands, & CoBionic. Louise has considerable research experience but enjoys creating products and articles that help move people just a little bit closer toward a healthy life they love. You can find her on Facebook or LinkedIn.