Keto Testing With Urinalysis Strips: A Quick Guide

Urinalysis strips are a cheap and convenient way to test for ketosis. They are made from a type of paper that changes colour when it reacts with urine. The strips measure acetoacetate, the second most abundant ketone that the body excretes through urine. To use the strips, you should wash your hands, urinate into a small, clean container, dip the test end of the strip into the urine sample, wait for the strip to change colour, compare the colour with the chart on the test package, and then wash your hands again. The darker the colour, the more ketone bodies are detected in your urine.

How to collect a urine sample for keto testing

Collecting a urine sample for keto testing is a straightforward process. Here is a detailed guide on how to do it:

Firstly, it is important to wash your hands and clean your genital area. For men, this involves wiping the tip of the penis with a disposable cleaning cloth. For women, gently open the labia and clean from front to back using a sterile cleansing pad. This step is crucial to prevent germs from the penis or vagina from contaminating the urine sample.

Next, as you begin to urinate into the toilet, hold a clean collection cup in the urine stream. Collect about one to two ounces of urine, following any markings on the cup as a guide. Once you have finished urinating, seal the cup securely to prevent any spillage or contamination.

If you are unable to provide a mid-stream sample, an alternative method is to urinate directly into a clean container. This method is known as a "clean-catch" sample and is often used in laboratory testing.

After collecting the urine sample, it is important to follow any specific instructions provided with your keto testing kit. Typically, you will immerse the absorptive end of the testing strip into the urine sample for a few seconds. Remove the strip and wait for the specified time outlined in the package instructions for the colour to develop.

Finally, compare the colour of the testing strip to the colour chart provided with your kit. This will indicate the concentration of ketones in your urine, ranging from no ketones to high concentrations. Remember to dispose of the urine sample and the used strip appropriately and always wash your hands before and after the test.

How to use a urinalysis strip to test for ketones

To use a urinalysis strip to test for ketones, follow these steps:

Step 1: Wash your hands.

Step 2: Pee into a small, clean container, then dip the test end of the strip into the urine sample. Alternatively, you can pass the end of the strip briefly through your urine stream.

Step 3: Wait for a few seconds (or as indicated on the test package) for the end of the strip to change colour.

Step 4: Compare the colour with the colour chart on the test package.

Step 5: Discard the urine testing strip. Then wash your hands.

• Urine testing strips are non-invasive and the most convenient ketosis testing method that provides results in seconds.
• If you test daily, you can do it in the morning or evening, preferably at the same hour.
• Ketone test strips are made from a type of paper that changes colour as it reacts with your urine. They measure acetoacetate (AcAc), the second most abundant ketone which your body excretes through urine.
• The optimum level for ketosis falls between 0.5 and 2 mmol/L.
• Ketone test strips are a cheap and simple way of detecting ketone levels.

How to interpret the results of a urinalysis strip

Interpreting the results of a urinalysis strip is simple. The strips will have a light beige colour, which darkens with high levels of ketones. The deeper the colour, the more ketone bodies are detected in your urine.

• Negative (no ketones): You are not in ketosis at all.
• Trace (0.5 mmol/L): This means light nutritional ketosis.
• Small (1.5 mmol/L): This means light nutritional ketosis.
• Moderate (4.0 mmol/L): Ketones increase further as a result of exercise or fasting.
• Large (8.0 mmol/L): Usually a result of prolonged fasting, not sustainable in the long term.
• Larger (16 mmol/L): Usually a result of prolonged fasting, not sustainable in the long term.

Note: mmol/L stands for millimoles per litre, and it refers to the concentration of ketones in a specific amount of liquid—in this case, your urine.

The optimum level for ketosis falls between 0.5 and 2 mmol/L. However, as you can see from the interpretations above, higher ketones are not necessarily better for everyone. While high ketone levels (5 mmol/L and above) can lead to more significant weight loss, this may eventually result in nutrient deprivation and a loss of muscle mass.

If you are following a low-carb, high-fat keto diet to attain weight loss and improve metabolic health in general, ketone levels above the optimum range (0.5 and 2 mmol/L) would be unnecessary unless prescribed by your healthcare provider for medical reasons. Potential reasons for higher target levels include ketosis as a tool for diabetes or blood pressure management.

Other factors that can affect your urine ketone test results include:

• Adaptation: As you maintain a ketogenic lifestyle, your body adapts, and with that, it becomes more effective at utilising ketones as its fuel source. This means ketones are less likely to spill over into your urine. You might actually be at a deeper level of ketosis, but it doesn't show in your test results.
• Dehydration: One randomised controlled trial found a direct proportion between serum ketone concentration and the level of dehydration. The more dehydrated a subject was, the higher their ketone levels. Ensuring good hydration when testing for ketones helps produce more accurate and consistent results.
• Expired test strips: Check the expiration date of your urine test strips. Strips usually expire within 3-6 months after you open the sealed bottle container. Last but not least, store the bottle in a cool, dark place, away from direct sunlight to preserve their quality.
• Time of day: A NIH study showed that early morning or after dinner had the highest and most reliably detectable levels of ketones.

How to dispose of urinalysis strips after use

Urinalysis strips are used to test for a range of conditions, including kidney function, diabetes, liver disease, and urinary tract infections. The strips are dipped into a urine sample, and the colour of the strips is then compared to a reference chart to determine the results. This type of testing is simple, inexpensive, and non-invasive.

After use, it is important to dispose of urinalysis strips properly to avoid any potential health and safety risks. The disposal method may vary depending on local regulations, so it is recommended to check with your local regulatory agencies. Here are some general guidelines for disposing of urinalysis strips:

• Check if the specimen contains visible blood: If the urine specimen being tested contains visible blood, it is considered biohazardous and must be handled according to the specified biohazardous waste disposal guidelines.
• Dispose of non-biohazardous specimens: If the specimen does not contain visible blood and the test strip was not used to test a biohazardous substance, the specimen and the test strip can typically be discarded in the regular trash. However, it is important to empty the urine into a sink or toilet before disposing of the container in the trash.
• Follow local regulations: Different states and counties have varying regulations for the disposal of bodily fluids and testing devices. It is crucial to consult your state and county department of health, as well as the local landfill, to understand the specific regulations that apply to your location.
• Understand federal guidelines: According to the Federal Bloodborne Pathogens Standard (1910.1030), only body fluids that are visibly contaminated with blood are considered potentially infectious. Urine that does not contain visible blood is not classified as potentially infectious.
• Dispose of unused test strips: It is important to check the expiry date of unused test strips before using them. Test strips typically expire six months after the bottle is opened. Unused test strips that have expired should be disposed of according to local guidelines for chemical waste.
• Dispose of contaminated materials: Any materials that come into contact with the urine specimen, such as cotton balls or syringes used for collection, should be disposed of in a designated clinical waste bin or as per local regulations for contaminated materials.
• Handle with care: Direct contact with bodily fluids should be avoided. Appropriate personal protective equipment (PPE) should be worn during the testing procedure, and good hand hygiene practices should be maintained before and after the procedure to prevent cross-infection.

How to store urinalysis strips to ensure they remain effective

To ensure that urinalysis strips remain effective, it is important to store them correctly. Here are some guidelines and tips for storing urinalysis strips:

• Keep the strips in their original packaging or a sealed container: Storing the strips in their original packaging helps maintain their effectiveness by protecting them from moisture and other environmental factors. If you need to transfer them to a different container, ensure that it is airtight and sealed tightly.
• Store in a cool, dry place: Urinalysis strips should be stored in a cool, dry environment to prevent moisture buildup, which can affect their accuracy. Avoid storing them in humid environments or areas with temperature fluctuations.
• Avoid exposure to direct sunlight or extreme temperatures: Direct sunlight and extreme temperatures can degrade the strips and affect their performance. Keep them away from heat sources and direct sunlight exposure.
• Use desiccants: Consider adding desiccants, such as silica gel packets, to the storage container to absorb any moisture and extend the strips' shelf life.
• Check the expiration date: Urinalysis strips have a limited shelf life, so it is important to check the expiration date to ensure they are still effective. The expiration date is usually printed on the packaging or the strip itself.
• Keep them away from chemicals: Avoid storing urinalysis strips near chemicals, cleaning agents, or strong odours, as these substances can interfere with the strips' accuracy.
• Handle with clean hands: When handling the strips, ensure your hands are clean and dry to prevent any contamination.
• Follow the manufacturer's instructions: Always refer to the instructions provided by the manufacturer for specific storage guidelines and precautions.

Frequently asked questions