Ketones ... urine testing worthwhile? ... now confused

T2#Me said:

Saw a movie where Ben Bikman recommended ketones tracking (urine dips) as a way of shadow tracking insulin ... as in high ketones = low insulin = all good ... he said it is rough and ready but the only way you can (kind of) measure insulin at home, so it is much better than nothing ... he does it himself, so ...

I was thinking to give it a try, to avoid stabbing the fingers for a while, however I also read here and elsewhere that (1) urine tests are notoriously unreliable (2) urine tests get unreliable anyway the longer you use them, as the body gits gud with ketosis ...

So, it's difficult to know if it is worthwhile to start ...

I would appreciate any thoughts ... thanks in advance

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I know a lot of people say the urine strips are not a reliable gauge of your ketone levels/state.
For me, I have found the urine strips to be a good measurement tool.
I use it in conjunction with my blood ketone meter.
I use the meter once or twice a week due to cost factors, and use my Urine Ketone test strips multiple times a day.
I have been in Ketosis for months, I also need to add that, my BG readings are sometimes as low as the upper 2s without any discernible hypo symptoms. So for me the assertion that being able to detect ketones in urine, means one has not fat adapted does not ring true in my case.
I am most certainly not being powered by glycogen, since my BG is very low, I have hardly any appetite, and I have enough energy to walk miles daily as part or my daily exercise activity without any issues.
My point is that, I have found the urine strips to be a good indicator, of whether one is in Ketosis or not. It will not give you the numerical values, however as an indicator of whether you are in Ketosis or not, I have found it to be a good and reliable resource.

I have a brand I get on eBay for £1.99 for a pot of 50... its the URS - 1K
I also have even been able to discern what each colour on the chart, will correspond to when I test with my blood ketone meter.
So thus far, I have found the urine strips to be accurate and reliable in my own case.
The urine ketone test strips most certainly saves me money, because I can test to make sure I am still in ketosis multiple time a day.
Example, yesterday I went overboard on the cheese, half expecting to be adversely affected regarding my state of ketosis.
But multiple tests both yesterday and today, has reassured me that I have nothing to worry about, and that I am still deep in ketosis.
They most certainly do the job.

'Stabbing fingers' measures glucose not insulin.

As to ketostix, I suppose it depends on your goals and how far you are prepared to track. Ketostix are imo not an alternative to using a glucometer, they can tell you if you are producing ketones but they are poor at telling you if you are actually using those ketones or if they are being wasted. A blood ketone monitor will tell you but this is quite expensive to run.

If your goal is being in ketosis most/all of the time then they are useful but it must be noted that a person who is in ketosis may be using all of the ketones they produce so urine dips may show no ketones whatsoever (as happened to me). It is worth repeating that ketostix are useful alongside monitoring blood glucose levels but not as an alternative.

I bought some of the sticks not long ago to have a look see.... was fairly low car at that time.... and detected absolutely nothing...
Will be giving it another go, later in Nov, when I will be returning to very low low carb and see what it shows.

Guzzler said:

'Stabbing fingers' measures glucose not insulin.

As to ketostix, I suppose it depends on your goals and how far you are prepared to track. Ketostix are imo not an alternative to using a glucometer, they can tell you if you are producing ketones but they are poor at telling you if you are actually using those ketones or if they are being wasted. A blood ketone monitor will tell you but this is quite expensive to run.

If your goal is being in ketosis most/all of the time then they are useful but it must be noted that a person who is in ketosis may be using all of the ketones they produce so urine dips may show no ketones whatsoever (as happened to me). It is worth repeating that ketostix are useful alongside monitoring blood glucose levels but not as an alternative.

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T2#Me's question is with regard to the information given by Dr Benjamin Bikman in this video, as per the role of Insulin in metabolic processes.
Note especially @ 20:44mins into the video, the question T2#Me asked is with regard to the information Dr Bikman gave at that point.
I believe T2#ME is not asking about measuring blood glucose, rather its about if the urine test strips will deliver the same level of accuracy/reliability within the context of what Dr Bikman suggests in the video.

I also believe that the efficacy of the Urine strips is sometimes dependent on how they are stored prior to purchase. I remember buying a pot of 50strips, which did not work. I was tearing my blond tresses out believing I was not in Ketosis, only for me to test with a blood Ketone meter, and I was reading well above 2mmol/l
luckily I have not had that problem again.

brassyblonde900 said:

T2#Me's question is with regard to the information given by Dr Benjamin Bikman in this video, as per the role of Insulin in metabolic processes.
Note especially @ 20:44mins into the video, the question T2#Me asked is with regard to the information Dr Bikman gave at that point.
I believe T2#ME is not asking about measuring blood glucose, rather its about if the urine test strips will deliver the same level of accuracy/reliability within the context of what Dr Bikman suggests in the video.

I also believe that the efficacy of the Urine strips is sometimes dependent on how they are stored prior to purchase. I remember buying a pot of 50strips, which did not work. I was tearing my blond tresses out believing I was not in Ketosis, only for me to test with a blood Ketone meter, and I was reading well above 2mmol/l
luckily I have not had that problem again.

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And of course if you are colour blind or not.

brassyblonde900 said:

T2#Me's question is with regard to the information given by Dr Benjamin Bikman in this video, as per the role of Insulin in metabolic processes.
Note especially @ 20:44mins into the video, the question T2#Me asked is with regard to the information Dr Bikman gave at that point.
I believe T2#ME is not asking about measuring blood glucose, rather its about if the urine test strips will deliver the same level of accuracy/reliability within the context of what Dr Bikman suggests in the video.

I also believe that the efficacy of the Urine strips is sometimes dependent on how they are stored prior to purchase. I remember buying a pot of 50strips, which did not work. I was tearing my blond tresses out believing I was not in Ketosis, only for me to test with a blood Ketone meter, and I was reading well above 2mmol/l
luckily I have not had that problem again.

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I have viewed the video above (Ben is a favourite of mine to watch/listen to). I used a well known brand of dip sticks but I was tearing my brunette (ahem! Grey) tresses out over the money wasted as I now believe that at the time I bought them and tested I was already fat adapted so was showing no change. There's no way of proving this, though. A blood ketone monitor would prove that I am (mostly) in ketosis now but do I want an additional number to track? Not particularly, it would be interesting but no more than that for me.

I've posted before about my (mainly lack of)\ results with ketostix, but essentially I only ever saw very low readings when I was working on getting into ketosis, and then I stopped getting anything other than the basic "no ketones present" colour result. However , and after just under five years pretty low carbing I do see some ketones if I test blood or breath (and I can sometimes taste them too ) but often only at fairly low levels, and I believe since i have other indIcators that I'm pretty well fat adapted, that I'm using most of the ketones I may be producing, and for me that's all that matters: ketones are for me a means to an end and not an end in themselves. And since being fat adapted is (supposed to be!) our normal state and one that is very difficult to get "kicked out of" as opposed to the possibly more fragile state of ketosis, I no longer worry about checking them. I'm in the position of being a mainly fat burning, but also a dual fuel "machine" so I'll be going in and out of ketosis all the time depending on the fuel at hand: easily processed carbs first, then dietary fat and finally stored fat. I eat few carbs, no longer have a migrainey, befuddled zombie brain but a nice clear and often very active one, rarely get particularly hungry, and can (unless I'm ill) keep my glucose levels low and stable. So that's me sorted, but my glucose meter is mainly my most reliable guide.

But you've been offered opposing viewpoints, @T2#Me: and what you choose to do regarding ketones depends on exactly what you are wanting to check them for, so if you think it's a good idea, then go ahead. Ketoxstix are pretty cheap and cheerful, so there's not much to lose either way. However, as @Guzzler pointed out,they definitely NOT a replacement for a glucose meter,...

Robbity

T2#Me said:

. . . . . . . he said it is rough and ready but the only way you can (kind of) measure insulin at home,

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Measuring insulin is a useful way of knowing how your pancreas is doing, but it doesn't give you much idea of what your BG is.

I have had 3 c-peptide tests done in the last 5 years, self funded, with Genova Diagnostics, and I my last one was 1.82 (up from 1.75) and within the "normal" range of 1.1 - 4.4. During that time my BG has been either all over the place or nicely between 5 and 7. I have also had blood tests to show that I am in a state of ketosis although I don't track it.

T2#Me said:

Saw a movie where Ben Bikman recommended ketones tracking (urine dips) as a way of shadow tracking insulin ... as in high ketones = low insulin = all good ... <snip>

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2 out of 3 isn't bad.
However from an insulin resistance test whilst in ketosis I showed low insulin and raised BG so that was not all good.

If you are running on ketones you don't need much insulin because there isn't much glucose to control.

High ketones and low insulin go together (ask a newly diagnosed T1) but your pancreas needs the ability to release insulin fast enough to keep your BG levels in the normal range.

There is also the possibility that something else isn't working 100%, for instance the mechanism to stop insulin being released by the pancreas may be kicking in too early or too aggressively.

At this point in the thinking my head usually explodes.

I have very well controlled normal blood glucose levels. I lost 33% of my weight 4 years ago and have maintained since then. In the almost 5 years since diagnosis I haven't once checked my ketones. I have never felt the need. I have no idea if I am in ketosis or not, and really don't care one way or the other. Whatever I am doing is working for me. I eat somewhere around 30g carbs. Maybe up to 50g some days. I no longer count them.

I very rarely test for ketones, and the originsl testing was through curiosity.
I knew I should be in ketosis so I bought some Ketostix and tested. They showed ketones.
I then thought that ketones in the urine just show that the kidneys are chucking some out, not that any are left in the blood, so bought a tester. This showed blood ketones roughly in line with the Ketostix.
So mainly a sanity check to show that my body was behaving as expected (which is not a given when you have T2).

Bluetit1802 said:

I have very well controlled normal blood glucose levels. I lost 33% of my weight 4 years ago and have maintained since then. In the almost 5 years since diagnosis I haven't once checked my ketones. I have never felt the need. I have no idea if I am in ketosis or not, and really don't care one way or the other. Whatever I am doing is working for me. I eat somewhere around 30g carbs. Maybe up to 50g some days. I no longer count them.

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I'm with you on this @Bluetit1802 and then recently I began to wonder, so got some sticks.... and they told me I had zip, which I actually think is a good thing... they either not getting formed or getting hoovered up as food again.... and so, letting it rest..... until the next time my curiosity gets the better of me.

hankjam said:

I'm with you on this @Bluetit1802 and then recently I began to wonder, so got some sticks.... and they told me I had zip, which I actually think is a good thing... they either not getting formed or getting hoovered up as food again.... and so, letting it rest..... until the next time my curiosity gets the better of me.

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Mine get tested once a year by the nurse when she does a urine dip. Nothing shows.

I have a meter that can test for ketones when I do test for ketones which is rarely I use that at I have a distrust of urine testing strips I have used them but found it difficult to get the level right from the colour.