Starting on keto is very exciting and testing to see if you are in ketosis is a huge milestone. I find it motivating when I prick my finger for a blood test and can actually see I have ketones in my system. It’s good to see your hard work and efforts paying off.

Some things to keep in mind when you decide whether you want to test and which method of testing you’ll be using: 

• If you are new to keto or your first week on keto, you should be in ketosis by day five. If you are not in ketosis by day five, something else might be going on, and you’ll need to do some troubleshooting. Go over and review the labels of some of the foods you’re eating. Make sure your carbs are below 20 grams per day or book a session with me to help you find out what might be going on.
• Testing for ketones can become a highly complex subject, and depending on your goals, you can decide which method of testing works for you or whether you’ll test at all.
• Testing ketones and glucose is more complex when you have diabetes, reversing Insulin Resistance or doing keto as an adjunct therapy for chemotherapy.

The Three Methods of Testing for Ketones: Urine, Blood and Breath

There are a couple of ways to test for ketones, and I will briefly touch on each of them in this post as well as highlighting the pros and cons of each. Keep in mind that this post and the methods discussed will primarily focus on the average person who is new to keto, wants to lose weight and is interested in knowing the different methods of testing. 

Going By Tell-Tale Signs

I mentioned, “if you decide to test at all”. Yes, some people choose not to test, and that is perfectly okay.

The most accessible and most inexpensive method of testing is with a ketone urine test strip. But, if you decide you don’t want to test, the easiest and “cost you nothing” way of knowing whether you are in ketosis or not is a few tell-tale signs:

• You’ll have stinky breath or keto breath.
• You may have a metallic or cotton wool taste in your mouth.
• A fruity smell on your urine.
• You’ll have more energy.
• You’re losing weight.
• Your brain feels “switched on”, and you have improved mental clarity.

The Next Best Method of Testing

It’s your first week on keto; you’ve been following the meal plan and keeping track of your food intake. Your carbs are below 20g per day and you have all the tell-tale signs above. But, you want to see and know for sure if you are in ketosis or not.

TESTING METHOD #1: KETONE URINE TEST STRIPS

Using ketone urine test strips is what I usually suggest when you start out on keto. The urine test strips are inexpensive. One can buy 100 strips for under R200-R300. Most Clicks and Dischem stores stock the urine strips or you could simply buy it from Takealot.

When ketone levels in your body increase past a useful point, they get excreted through urine. You can easily measure this excess amount of ketones with a urine strip.

Pros: It’s easy to test at home. It’s inexpensive and quick.

Cons: Not entirely reliable. Especially in the long run, and things like hydration can influence the reading. 

TESTING METHOD #2: KETONE BLOOD METER

Testing your ketones via a blood meter requires pricking your finger with a small needle for a blood sample. By pricking your finger with a lancet and squeezing a drop of blood onto a test stick using a ketone meter, you can effortlessly test the level of ketones in your blood. The ketone measured via this method is called Beta-Hydroxybutyrate.

Pros: This is the gold standard of testing and the most reliable and accurate method of testing ketones in your body. 

Cons: A bit invasive for some people. If you are afraid of needles, pricking your finger can be intimidating. Another downside to blood meter testing is that the ketone strips can be expensive.

TESTING METHOD #3: BREATH KETONE MONITOR

Using a breathalyzer to measure your ketones, measures the ketones in your lungs. The ketones expelled through breathing into the breathalyzer are called acetone, and the breath meter is specifically designed to measure these ketones. The Ketoscan mini is a nifty little device and a great option if you find the finger pricking invasive. 

Pros: It’s quick and easy to test. Testing is inexpensive in the long run compared to ketone blood test strips.

Cons: Pricey initial investment. 

In Conclusion

This post simply discusses the three methods of testing, but it usually leads to many more questions like; should you measure ketones, and what level of ketones is best?

Whether you decide to test at all,  or which tools you want to invest in, is entirely up to you. I started out with ketone urine test strips. Over the years, I invested in both of the other two and have done an in-depth Youtube review of the Ketoscan mini. The gold standard, though, still remains the ketone blood meter, and at some point, I do believe it is a good investment if you are serious about improving your overall health markers such as Type 2 Diabetes and Insulin Resistance.