Keto Diet: What To Do When Results Stall

Ketostix are urine strips that can be used to measure ketosis. They are a cheap and convenient way of finding out if you're in ketosis, but they are not always accurate. While they can be useful when you start a keto diet to keep you motivated, they can be misleading as you get deeper into ketosis and your body adapts to using ketones for fuel. This is because the strips only measure one type of ketone, acetoacetate, and as your body gets better at using ketones for fuel, it produces less of this type. As a result, the strips may indicate that your urine contains only trace amounts of ketones, even though you are still in ketosis. If you want a more accurate reading, blood keto strips are a better option, but they are more expensive.

Ketostix only work for 1 of the 3 ketones and that ketone is produced less as you progress towards fat adaptation

Ketostix are urine test strips that measure the concentration of ketones in your urine. They are considered a useful tool for beginners to identify whether they have achieved ketosis. However, they are not an accurate way to measure the amount of ketones you are producing.

Ketostix only work for one of the three types of ketones produced by your body: acetoacetate. The other two are acetate and beta-hydroxybutyrate. As you progress towards fat adaptation, your body produces less acetoacetate, which is why Ketostix may stop working.

As you continue your keto diet, your body will start to convert acetoacetate into beta-hydroxybutyrate, which is not detected by Ketostix. Additionally, your kidneys will start to down-regulate the volume of ketones they excrete into your urine. This means that even if you have high levels of acetoacetate in your serum (and consequently, in your urine), you may still see lighter colours on your Ketostix.

Therefore, Ketostix are not a reliable indicator of ketone production as you progress towards fat adaptation.

Ketostix don't confirm your efforts

Ketostix only work for 1 of three ketones and that ketone is produced less as you progress down towards fat adaptation. So in a sense it is a good thing that they aren't registering for me now, then.

The science of ketone production is interesting and complex. Don't use ketostix for keto dieting. Use net carb count only.

The confirmation is your health and how you feel. I do feel much better. I used to be literally addicted to sugar. I drank red wine daily as well. Since starting keto I haven't had a drop of booze and I've been able to pass up the mountains of Snickers and Peanut M&Ms all over my workplace without any gnashing of teeth or bitter wailing. Yay keto!

Try to change your mental motivation to be how you feel, how your clothes fit, and ignore the sticks. Keto doesn't require them.

I know they are not the be all end all, but it was very motivating for me to not stray from my diet when I saw the visual confirmation that keto was working.

My clothes are looser. I can fit into a skirt that would NOT fit over my hips before. My shirts have lots of extra material bunching up at the waist. Those things help, but somehow are much less satisfying than the purple stick.

Just an FYI that purple color doesn't confirm you're in ketosis, say you're out, you'll excrete unused ketones.

Wonder what it takes to manufacture these little dudes?? I could make a friggin mint -_-

Haha, I'm always looking for a new hustle myself. I paid about $10 for a package of 120 that only promises to work for 60 days.

Ketostix are a good tool to measure whether you're in ketosis during the first few weeks of going keto

Ketostix are easy to use and provide quick results, usually within 15 seconds. They are also relatively inexpensive and can be purchased online or at local pharmacies. However, it's important to note that ketostix have a short shelf life and tend to last only two to three months once opened. Additionally, they are not a precise way to measure ketone levels and are more of a rough guide. If you're looking for a more accurate measurement of ketone levels, you may consider investing in a blood ketone meter, although these can be quite pricey.

Overall, ketostix can be a helpful tool for beginners to determine whether they have achieved ketosis. However, as your body adapts to the keto diet, the information provided by ketostix becomes less useful, and you may want to rely on other indicators such as how your clothes fit, how you feel, and your weight loss progress.

Ketostix are unreliable

Ketostix are also unreliable because they are sensitive to stuff. The reactive agent on the ketostick (sodium nitroprusside) is sensitive to light, humidity, air, gravity, and certain types of politics. Sometimes the amount of reactive agent on the blotter pad of the ketostix is not always consistent, which can lead to deeper or fainter readings.

Ketostix are also unreliable because they are a rough tool at best. The ideal situation would be one where trace ketosis (as measured by Ketostix) is maintained, since this is the lowest level of ketosis that can be measured while still ensuring that one is truly in ketosis.

Lastly, ketostix are unreliable because they can be obsessive. In the same way that the presence of ketones can be psychologically reassuring, the absence of ketones can be just as psychologically harmful. It is easy to mentally short-circuit by checking the Ketostix all the time.

Ketostix are a misleading crutch

Ketostix only measure excess levels of acetoacetate, which is not the type of ketones that correlate with nutritional ketosis.

Ketostix may show negative ketones when your blood ketones are high and then may show positive ketones when your blood ketones are low.

Misinterpretation of what they show is one of the most common unnecessary causes of keto anxiety and wasted time. You can be perfectly successful on a ketogenic or low-carb diet without ever measuring ketones.

Ketostix were designed to help diabetics avoid ketoacidosis, which is a dangerous condition involving very high blood sugar and very high serum ketones. If you have near-normal blood sugar and serum ketone levels consistent with nutritional ketosis, you don't need to worry about this.

Ketostix only measure excess levels of acetoacetate, which is not the type of ketones that correlate with nutritional ketosis.

The ketones that correlate with nutritional ketosis are known as beta-hydroxybutyrate. This type can be measured only with a blood ketone meter.

There is a built-in time lag. Ketostix are measuring what has happened in the past since it takes a while for the kidneys to produce urine.

Exercise can influence how many excess ketones are excreted.

You can be in nutritional ketosis even when Ketostix show no excess acetoacetate. In the keto-adapted state, very little acetoacetate ketones will be excreted in urine even though blood ketones may be high.

Note that it takes a period of four to six weeks of being in ketosis every day in order to become keto-adapted. Someone who is keto-adapted has adapted to using fat as the primary fuel for muscles and various organs. The keto-adapted brain uses ketones in place of glucose for most of its energy needs. When keto-adapted, most acetoacetate is not excreted. Instead, muscles convert it to beta-hydroxybutyrate and return it to the blood for use by the brain.

If you have a medical condition that makes monitoring blood ketone levels necessary or if you are a numbers geek with spending money, you may be interested in purchasing a ketone blood meter and test strips for measuring beta hydroxybutyrate in your blood. The test strips cost somewhere between $2 and $5 per strip.

There are a few meters to choose from.

Precision Xtra - https://www.abbottdiabetescare.com/products/patient/pxtra-overview.html

Nova Max Plus - http://www.novacares.com/nova-max-plus/

CardioChek Home - http://www.healthchecksystems.com/CardioChek.cfm#home

Most use one of the first two listed (Precision Xtra or Nova Max Plus). Some say that the Precision Xtra is the more accurate of the two. I've found that readings from these two track fairly closely with each other. The Nova Max Plus has cheaper test strips.

To detect nutritional ketosis, look for a reading between 0.5 and 5.0 mmol / liter. Some experts recommend aiming for a level of 1.0 to 5.0 mmol / liter.

Another option is the Ketonix Sport breath meter. This meter measures acetate in the breath. It does not require test strips.

Acetate forms when acetoacetate spontaneously breaks down to acetate. According to Volek and Phinney (page 165 of The Art and Science of Low Carbohydrate Living), it should be linearly correlated with blood ketones. In practice, it is not as accurate as the blood meters in part because it is difficult to breathe in the same way every time you test.

Ketonix Sport (order direct from Sweden) - https://www.ketonix.com/index.php/product/sport

Again, remember that you can be perfectly successful on a ketogenic or low-carb diet without ever measuring ketones whether in urine, blood, or breath.

In the final analysis, ketone concentrations are what they are. Chasing ketone concentrations often becomes as unnecessary and distracting as Ketostix. Unless you are treating epilepsy, cancer, or other medical condition, the concentration of ketones do not matter too much. You can achieve weight loss and a sense of well-being even with lower levels of ketones.

Focus on how you feel, not on the number. Use ketone meters for interest and experimentation, but don't let the results stress you out.

Frequently asked questions