Keto Urine Tests: Are They Reliable?

Ketone urine tests are used to measure ketone levels in the body. Ketones are produced when the body breaks down fat for energy, instead of using blood glucose. This can be due to a variety of reasons, including diabetes, low-carb diets, fasting, and certain medical conditions. The test can be done at home or in a lab, and typically involves dipping a test strip into a urine sample and comparing the resulting colour to a chart. While the test is generally considered less accurate than a blood ketone test, it can still be a useful tool for monitoring ketone levels, especially for those with diabetes who are at risk of developing diabetic ketoacidosis (DKA), a serious and potentially life-threatening complication.

How do keto urine tests work?

A ketone test can be done at home or in a lab and is used to measure ketone levels in your urine. Typically, the cells in your body use blood glucose (or blood sugar) for energy. This glucose comes from the food you eat—your body breaks down most of the food into glucose and releases it into your bloodstream. If your body doesn't have enough glucose, it will start breaking down fat for energy instead, producing an acid called ketones, which can build up in your blood and urine.

Having some ketones in your urine is normal, but high ketone levels may indicate that your blood is too acidic, a condition called ketoacidosis. This is a medical emergency that can be life-threatening. Therefore, ketone tests are especially important for people with diabetes, as they can help find high ketone levels early so that treatment can be administered promptly.

Urine ketone tests are typically done using test strips, which can be purchased over-the-counter at pharmacies, supermarkets, or online. These strips are relatively inexpensive and usually come in packs of 50 to several hundred. The process of using these strips is as follows:

• Wash your hands and, if necessary, clean your genital area with a cleansing wipe.
• Collect your urine sample in a small container.
• Immerse the absorbent end of the strip into the sample for a few seconds.
• Wait for the amount of time specified on the package for the strip to change colour.
• Compare the colour of the strip to the colour chart provided with your test kit. The colour will correspond to the concentration of ketones in your urine, which can range from no ketones to high concentrations.

It is important to note that urine ketone tests are not as accurate as blood ketone tests. Additionally, the results of a urine ketone test can vary depending on factors such as how diluted your urine is. For the most accurate results, it is recommended to test your urine in the early morning or several hours after dinner.

When should you test for ketones in your urine?

If you have diabetes, your doctor will probably tell you to test your ketones when:

• Your blood sugar is higher than 250 milligrams/deciliter (mg/dL) for two days in a row.
• You're sick or you've been injured.
• You want to exercise and your blood sugar level is over 250 mg/dL.
• You've missed an insulin injection.
• You're on your period.
• You've been unable to eat.
• Your insulin pump stops working.

If you have type 1 diabetes, it is recommended that you have ketone testing supplies on your prescription. People with insulin-dependent diabetes should take a ketone test:

• Any time your blood sugar is over 17 mmol/l (300 mg/dl).
• If sugar levels have repeatedly been over 13 mmol/l (230 mg/dl).
• If you are unwell and have any of the symptoms of ketoacidosis.

If you are pregnant and have been diagnosed with gestational diabetes, test your ketone levels every morning before you eat breakfast.

If you are on a keto diet, you can use urine strips to test your ketone levels. These are a cheap and convenient way of finding out if you are in ketosis.

What do abnormal results mean?

Abnormal results on a ketone test can indicate a range of issues, from the beginning of ketone buildup to more severe problems that require immediate medical attention.

If you test for ketones in your urine and the results indicate a small amount, it may be the beginning of ketone buildup. In this case, the American Diabetes Association (ADA) recommends testing your urine for ketones again in a few hours.

If the test results show moderate or large amounts of ketones in the urine, this is a danger sign. The ADA advises contacting your healthcare provider right away and refraining from exercising, as it can worsen the effects.

Moderate levels of ketones in the urine are typically between 30 and 40 mg/dL.

High levels of ketones in the urine can be a sign of diabetic ketoacidosis (DKA), a severe complication of diabetes. DKA is often the first sign that a person has diabetes before receiving an official diagnosis. It is important to seek immediate medical help for DKA, as it can lead to a diabetic coma or even death.

If you are testing for ketones due to diabetes, your doctor will likely advise you to test for ketones every 4 to 6 hours when you experience any of the following:

• Blood glucose level above 240 milligrams per deciliter (mg/dL)
• Vomiting or feelings of nausea
• Other illnesses, such as a cold or flu
• Dry mouth or constant thirst
• Fruity-smelling breath
• Extreme fatigue
• Skin appears flushed
• Difficulty breathing

Additionally, if you are testing for ketones in babies or toddlers who wear diapers, clean cotton wool can be used to capture their urine.

What are the symptoms of ketoacidosis?

Diabetic ketoacidosis (DKA) is a serious and potentially life-threatening condition that requires immediate medical attention. It is a complication of diabetes and occurs when the body doesn't have enough insulin to turn blood sugar into energy. This causes the body to break down fat for fuel, resulting in a buildup of ketones in the blood and urine.

The symptoms of ketoacidosis can develop slowly and then progress rapidly, sometimes within 24 hours. Early signs include urinating much more than usual, extreme hunger or thirst, and high blood glucose levels. As the condition progresses, more severe symptoms can appear, such as:

• Fast, deep breathing
• Fruity-smelling breath
• Muscle stiffness or aches
• Nausea and vomiting
• Difficulty breathing
• Feeling very tired or sleepy
• Confusion

If you are experiencing any of these symptoms, it is crucial to seek immediate medical attention, especially if you have diabetes or are at risk of developing it. Left untreated, ketoacidosis can lead to a diabetic coma or even death.

What are the risks of keto urine tests?

There are no known risks associated with keto urine tests. The tests are easy to use and can be done at home or in a lab. The test itself is simple and involves no discomfort, as it only requires a urine sample.

However, it is important to note that high ketone levels in the urine can indicate a serious health condition called ketoacidosis, which is a medical emergency. Ketoacidosis is most commonly associated with diabetes, particularly type 1 diabetes, but it can also occur in people without diabetes due to factors such as heavy alcohol consumption, eating disorders, starvation, or certain digestive diseases.

Therefore, while the test itself is risk-free, it is crucial to take any necessary actions if the results indicate high ketone levels, as this can be life-threatening.

Frequently asked questions