How do I test to see if I am in ketosis?

As biohackers, we at HVMN are keen to measure our key biomarkers. You may have seen our video ‘Seeing is Believing’ where HVMN CEO, Geoff Woo measures his blood BHB levels using a blood prick after a drink of HVMN Ketone. Measuring ketone levels is an excellent biomarker to track whether you're fasting, following a low-carbohydrate, ketogenic diet, or taking exogenous ketones.

Why should you care about how deep in ketosis you are? The amount of ketones in your blood can tell you what levels make you feel best and align with your goals the most.

When following a keto diet, body fat stores are broken down, and fatty acids begin to flow in your bloodstream. It's a great idea to test your blood ketone levels for weight loss and other health benefits of ketosis. If you're trying to lose weight on a low-carb diet, moderate ketone levels could be an indicator of whether you're headed on the right track for fat loss. In "The Art and Science of Low-Carbohydrate Living", Jeff Volek and Stephen Phinney state that nutritional ketosis is defined by ketones ranging from 0.5 to 3.0 mM.

There are three methods that you can use to measure your own level of ketosis, with this data you have the power to optimize your personal biohacking protocol:

1. Blood Prick (BHB Measurement)

Pros:

  • Most accurate way to measure ketosis in mmol/L
  • Measures BHB rather than acetoacetate or acetone

Cons:

  • You need a handheld device (i.e., Precision Xtra or Keto Mojo) and test strips, which can be expensive.
  • You have to take a finger prick blood sample which can be bothersome and invasive.

When measuring BHB using a blood meter, you’re getting the most accurate measurement available. Those with diabetes commonly use the same procedure and the same blood meters to measure their blood glucose levels. It's critical for diabetics to control blood sugar levels and avoid extremely high levels of ketones, or ketoacidosis. This level of high ketones can be very dangerous. Ketoacidosis occurs when ketones are > 20 mM. Testing blood ketone levels and glucose levels can help inform you about your insulin levels as well. The meters measure glucose or ketone levels depending on which test strips are inserted.

You take the blood sample yourself by pricking your finger with a lancet, squeezing the blood onto the ketone strip that’s inserted into a blood ketone meter, and recording the BHB value shown on the meter. Using blood BHB might seem like an easy, obvious choice to measure ketone levels. However, pricking your finger multiple times a day might not be realistic for your lifestyle. If that’s the case for you, there are still other options.

2. Urine ketone test strips (Acetoacetate)

Pros:

  • Cheap
  • Widely available in pharmacies
  • Non-invasive

Cons:

  • Less accurate than blood
  • Over time the body adapts to excrete fewer ketones in the urine.

Urine ketone test strips are easily accessible at your local Walgreens, CVS pharmacy and on Amazon. Urine testing was designed to measure acetoacetate, one of the three ketone bodies. It turns out this is not the best indicator of being in ketosis as it doesn’t account for blood BHB levels. Also, urine is a waste product so what’s displayed on the urine strips is what your body is excreting, not necessarily the best indication of how well your body is utilizing ketones for fuel.

Especially as you become more keto-adapted, you will excrete less ketone bodies through urine. This means that the more you would want to measure ketone levels, the less accurate the urine strips will become. Therefore, urine ketone strips may be a cheap way to get a general sense of whether you’re headed toward the right direction. Hydration can affect these ketone readings as well as they can dilute the concentration of ketones in urine.

3. Breath acetone meter

Pros:

  • Once you have purchased the device, it is free each time you test.

Cons:

  • You need a handheld device (i.e Ketonix)
  • Less accurate than blood meter

Breath ketone meters are relatively new to the market for testing ketone levels. These meters specifically measure the amount of acetone that is excreted through your breath. In comparison to the first two options, breath acetone meters are consistent for measuring plasma ketone levels. However, there haven’t been enough studies done to confirm the accuracy of breath acetone meters in relation to ketone levels.

We strongly recommend that you get a blood test and test your ketone levels if you are trying to get into nutritional ketosis or if you are using exogenous ketones like HVMN Ketone. Fat burning mode is tough enough to get into as it is, so track ketone levels to make sure you're in ketosis. Ketone readings don't tell the whole story, but they are a large piece of the puzzle of taking advantage of ketosis. That way you will know what is really going on in your body and to what degree. Let us know in the comments how you like to track your ketone levels!

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HVMN Co-founders Michael Brandt and Geoffrey Woo