Testing Your Ketones

How to Use Your Ketone Test Strips:

If you are already on a low carb diet, you may not show high levels of ketones on the test, even if you are doing the diet correctly. This is because your body is already utilizing the ketones for energy, so it is not showing as much free ketones in the urine. Please don’t be discouraged. The ketone tests are mostly useful for people who are new to the ketogenic diet and are entering ketosis for the first time.

• Measure your ketones every morning. 
• You can measure your ketones as often as you want, but make sure to measure them at least once a day, every morning at the same time. 
• If you’re a diabetic and you measure your blood glucose every morning, please measure your ketones at the same time.

Using the Ketone Test Strips:

• Remove one test strip from the vial, making sure to not touch the sensor pad
• After urinating for 1-2 seconds, place the end of the strip with the pad into the stream of urine
• Blot off the excess urine on a paper towel and hold horizontally for 40 seconds
• Match the test pad result to the color chart on the vial
• Discard the test strip
• Enter the value in your app

How To Care for Test Strips:

• Record the date on the vial label when the canister was first opened. 
• The strips expire in 90 days.
• Discard the vial 3 months after first opening it. Constant exposure to air may cause inaccurate readings. 
• Store in a dry place at 36-86 °F (2-30 °C). 
• Do not freeze. 
• Keep out of direct sunlight. 
• The strips should remain in the closed vial until use. 
• Do not transfer the strips to another vial. 
• Do not remove the desiccant from the vial. 
• Test strips are sensitive to prolonged exposure to moisture, heat, and light. 
• Do not touch the test pad of the strip. 
• Discard any discolored strips that may have deteriorated.

Ketone Strip Readings:

• 0-.5   mmol/L: Trace ketone levels
• .5-1.5   mmol/L:  Low ketone levels
• 1.5-4.0 mmol/L:  Moderate Ketone levels
• 4.0-8.0 mmol/L:  High ketone levels
• 8-16   mmol/L: Very high ketone levels

Urine ketone testing helps provide a general indication of ketosis, however higher or lower numbers don’t always reflect the level of ketosis. Their accuracy and reliability can vary based on several factors:

1. Hydration levels: The concentration of ketones in urine can be affected by how much water you drink. Dehydration can lead to higher ketone levels in urine, while overhydration can dilute them, making it harder to get an accurate reading that reflects the true state of ketosis.
2. Timing: Ketone levels in the urine tend to be highest in the morning and after periods of fasting. Testing at different times of the day can yield different results.
3. Type of Ketones: Urine ketone strips primarily measure acetoacetate, one type of ketone body. However, the body also produces beta-hydroxybutyrate (BHB) and acetone, which are not detected by urine strips.
4. Adaptation Period: When you first enter ketosis, urine ketone levels may be higher. Over time, as your body becomes more adapted to using ketones for energy (keto-adaptation), fewer ketones may be excreted in urine, potentially leading to lower readings despite being in ketosis.

We are using urine ketone testing as a surrogate for dietary compliance, but we won’t react to the level of ketones in the urine as long as you feel well. 

However, if you have type 2 diabetes, there is a small risk of developing diabetic ketoacidosis (DKA), if your glucose is very high and your urine ketones would also be positive. If you experience symptoms of DKA, alert your Revero coach and provider as this may require urgent medical attention and a referral to urgent care or ER.

Symptoms of DKA include: 

• Stomach/Abdominal pain
• Nausea/Vomiting
• Breath smells fruity
• Excessive thirst
• Frequent urination
• Feeling very weak
• Feeling confused or disoriented
• Blurry vision
• Rapid heartbeat