Testing for Ketones

June 10, 2020

Testing for Ketones

By: @kimdautrich

Testing Blood Ketones

Depending on how in depth you want to go with the ketogenic diet, there are ways to determine whether or not you are in ketosis. The most accurate way to test for ketones is going to be through a blood sample using a meter and test strip. Blood ketone meters calculate the amount of beta-hydroxybutyrate, or BHB, within the blood. This blood test is very similar to one that diabetics use to check their blood sugar. The ketones blood test process is done by using a small finger, sticking that finger with a needle, and producing a drop of blood to land on the test strip. For optimal weight loss, it is said that a blood ketone level would be between 1.5-5 millimoles per liter of blood (mmol/L). Some articles state that nutritional ketosis would be between 0.5-1.5 mmol/L. The average blood sugar among individuals is typically between sixty to one hundred milligrams per deciliter (mg/dL). Everyone’s body is different, and there are variables that come into play when we talk about utilizing and producing ketones (Ryan 2019). 

Let's compare these numbers to ones that may be diabetic. Diabetic ketoacidosis (DKA) can be life threatening for someone with diabetes. This is when their ketone levels become dangerously high, ranging between fifteen to twenty-five mmol/L, as well as blood sugar over two hundred mg/dL (Ryan 2019). 

You are not required, nor am I going to recommend, to jump right into blood ketone testing when you first start. The process of experimenting and learning what works for your body can become very addictive, time consuming, and frustrating. Some use this method of ketone testing if they are doing a vigorous cut in weight, plan on going into competition, or they are thinking about adopting a modified ketogenic diet. If you decide to test your blood ketone level you must be consistent with the time of day. For example, ketone levels are at their lowest in the morning and then peak later in the day. Being consistent will allow you to find a pattern within your diet, as well as what you are doing day-to-day, that allows you to modify as you go. I will discuss further details on blood ketone testing in future posts. Today’s post was to educate on the basics, and to give you a better understanding on blood ketone testing. 

So, as I said before, testing for ketones is not something you have to do when adopting the keto lifestyle change. I can tell you from experience your body will “feel” the difference when you are in ketosis despite what numbers or test strips show. Sounds hard to believe but once you feel ketosis and experience it you will understand what I am talking about! There are two other methods on testing ketones which I will get into with future posts.

Testing Urine Ketones 

In previous posts I have talked about the importance of testing your blood ketones. Today I will discuss the use of urine ketones. Urine ketone test strips can be purchased on Amazon for about six dollars. Although this test is much cheaper than purchasing a blood meter it is also known to be the least reliable method. For new individuals just starting out, I think this is the best way to start.

Urine test strips detect ketones through our urine. As the stored fat becomes broken down into ketones they are excreted through the urinary system. As we know urine production is a process and does not occur immediately. You can eat a few slices of pizza, urinate, and still test positive within several hours. That is why there are many false positives, and misconceptions about urine test strips for ketone detection. If you are strictly sticking to a keto diet and are curious as to where you are in the process then urine test stripes are sufficient enough. I only used urine test strips throughout my whole journey on keto. I began urine testing around five days after I started this lifestyle. I successfully achieved positive results within seven days, along with weight loss, so that is why I stuck with the urine ketone test strips.

If you decide to check for urine ketones, be consistent with your timing. Levels will be lower in the morning and peak later in the day. On the bottle description of the urine ketone test kit there is a light to dark color range representing no ketones to high levels of ketones. To complete the test, you must first urinate on the test strip, then wait forty seconds, and finally read the results (Dolson 2019). This urine test is a super simple process! Just to reiterate the urine test is all approximated and not one hundred percent accurate. Please note that hydration plays a large role in your urine test results. I wanted to talk about the urine ketone testing and offer this option because it can be used as a tool to guide you, as well as holding yourself accountable.

Eventually as your body becomes “fat adapted,” using these ketone test strips may begin to test negative to only trace amounts of ketones. This simply means that your body is efficiently using your ketone bodies. Unless you have cheated on your diet then this may mean that you are not in ketosis. A large part of the keto lifestyle is to be honest with yourself and not straying from your diet. Track your meal and document them properly leaving no room for excuses. Remember that every single person’s body is different and unique in its own way! Embrace your unique body and take charge of the changes. I promise you that this keto lifestyle is going to be a learning experience from beginning to end.

So, as I said before, ketone urine testing is not something you have to do routinely to live the keto lifestyle. If you are looking for maximal weight loss and maintaining a strict ketogenic diet, then either urine or blood ketone testing would be an option for you to consider. Either way choose the method that works best for you!



Ryan, S. 2019. Simply Keto. N.p.: Tuttle Publishing.

Dolson, L. 2019. “How to Test Your Urine for Ketones: Instructions for Using Home Urine Ketone Tests.” Very Well Health, September 3. https://www.verywellhealth.com/how-to-test-your-urine-for-ketones-2241626