Those useless ketostix.... (or are they?)

RalfLott
RalfLott Posts: 5,036 Member
Q about the much-maligned pee sticks no one seems to like -

Is it remotely possible they're better at pinpointing dehydration than other signs, such as dry lips (could be meds, anxiety) and thirst (could be meds, anxiety, salty food), which may not even be present?

Here's a ref: http://www.lowcarb.ca/tips/tips011.html

Replies

  • Sunny_Bunny_
    Sunny_Bunny_ Posts: 7,140 Member
    I've always said the urine strips have always worked for me but I don't drink much liquids. I certainly don't believe I'm dehydrated, but I do not aim to get a certain amount of water each day. I just drink when I'm thirsty. I don't particularly buy into the idea that drinking lots of water like its my job is good for me.
  • wabmester
    wabmester Posts: 2,748 Member
    They work fine for me. What they tell you is that you've got ketones in your pee. That also tells you that you're losing sodium, which is probably more useful to know. So, yeah, if you're not replenishing that lost sodium, then you'll lose water and be somewhat dehydrated and have low blood volume.
  • TheBuffster40
    TheBuffster40 Posts: 23 Member
    Work OK for me. I'm sure measuring blood ketones would be more accurate but I'm not a science project. Just need a decent ish yardstick
  • Foamroller
    Foamroller Posts: 1,041 Member
    Sorry to burst your bubble. From my understanding the ketostix are only useful the first couple of weeks. So be aware what they can do and can't do.

    After the body get more efficient using ketones, people have experienced no purple on stix, but having NK showing BHB measured by blood at the same time. Ketostix don't measure the useful ketone. They measure the past not the present. Exercise can influence the result.

    Here's a pretty good overview:
    https://www.reddit.com/r/keto/comments/2wsu0u/psa_when_and_how_to_use_ketostix_on_a_ketogenic/
    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.

    IME, I find it more useful to pay close attention to symptoms such as hunger, cravings, antsy restless feeling, how calm I am, brain fog, forgetfulness, depression, focus, easy to get out of bed, tiredness, inflammation, bloating, tummy issues (IBS) etc. In other words if I notice the body is starting to revert to how it USED to be...it's time to reassess my eating habits and eliminate/dial down stuff.

    If you can afford to use the blood ketone meter, that's currently the gold standard. However, ketone levels are not synonymous with fat loss. You can be keto all day, but maintain scale weight. Still need a deficit for that, I'm afraid. If you wanna know exact ketone levels out of curiosity or therapeutic methods due to illness like epilepsy, then measuring blood levels is the way to go. I hope this clarifies things.
  • Sunny_Bunny_
    Sunny_Bunny_ Posts: 7,140 Member
    Foamroller wrote: »
    Sorry to burst your bubble. From my understanding the ketostix are only useful the first couple of weeks. So be aware what they can do and can't do.

    After the body get more efficient using ketones, people have experienced no purple on stix, but having NK showing BHB measured by blood at the same time. Ketostix don't measure the useful ketone. They measure the past not the present. Exercise can influence the result.

    Here's a pretty good overview:
    https://www.reddit.com/r/keto/comments/2wsu0u/psa_when_and_how_to_use_ketostix_on_a_ketogenic/
    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.

    IME, I find it more useful to pay close attention to symptoms such as hunger, cravings, antsy restless feeling, how calm I am, brain fog, forgetfulness, depression, focus, easy to get out of bed, tiredness, inflammation, bloating, tummy issues (IBS) etc. In other words if I notice the body is starting to revert to how it USED to be...it's time to reassess my eating habits and eliminate/dial down stuff.

    If you can afford to use the blood ketone meter, that's currently the gold standard. However, ketone levels are not synonymous with fat loss. You can be keto all day, but maintain scale weight. Still need a deficit for that, I'm afraid. If you wanna know exact ketone levels out of curiosity or therapeutic methods due to illness like epilepsy, then measuring blood levels is the way to go. I hope this clarifies things.

    Ive always heard this, but here I am 390 days later and I can turn those things the darkest purple just like I did on day 2. I guess that could mean that my body doesn't use ketones efficiently but I think it's more likely that theory doesn't hold water, but people do. :wink:
  • Foamroller
    Foamroller Posts: 1,041 Member
    edited June 2016
    @Sunny_Bunny_ It could also mean that the stix don't give universal readings...so we don't really know what we really are measuring on an individual basis. I'm not dismissing the stix. But I think there's been reported too many things that might confound the readings, to make them a reliable source for accuracy.

    Edit: Many on the posts on r/keto is about people panicking cause they think the stix show they're NOT "in ketosis" anymore. This is totally unecessary keto anxiety. So for the most part the false negatives is just another thing people have to be informed about. If you feel the stix correlates to what you ate or not, then you are free to use them as you see fit :)
  • wabmester
    wabmester Posts: 2,748 Member
    edited June 2016
    Foamroller wrote: »
    Sorry to burst your bubble. From my understanding the ketostix are only useful the first couple of weeks. So be aware what they can do and can't do.

    After the body get more efficient using ketones....

    Just one of the many myths around "keto."

    You will see the highest levels in urine in the first couple weeks, which is why you need to pay the most attention to sodium in the first couple weeks.

    After that, the urine level goes down. Not because you're utilizing more ketones, but because the kidneys adapt.

    Ask yourself why the body would ever waste an energy source in the first place.

    It's because of the acidity of ketones. Kidneys are responsible for acid-base balance. They are "surprised" by all of that acid you're making, so four things happen:
    1. Uric acid levels go up in the blood
    2. Ketones are wasted in the urine
    3. Sodium accompanies ketones for ion coverage
    4. Water follows sodium out

    As the kidneys adapt:
    1. Blood uric acid levels drop
    2. Fewer ketones are dumped
    3. Less sodium is dumped
    4. Kidneys start producing more ammonium to save sodium
    5. Less water weight is lost

    But you'll always lose SOME ketones in the urine as long as you're making a bunch in the blood. The more you make, the more you lose. Acid-base balance. So urine levels track blood levels pretty well, it's just that they're much higher in the first two weeks or so.
  • Sunny_Bunny_
    Sunny_Bunny_ Posts: 7,140 Member
    So it just goes back to the idea that the test strip is highly affected by concentration/dilution of the urine i.e. hydration.
    If you know that you're eating in such a way that you must be making ketones and your strips are showing a negative, it's incredibly likely your sample was too diluted to detect acetoacetate.
    That's really the simplest explanation.

    They really are just a novelty anyway.
    No one should consider them too important or use them as a measure of your ability to lose weight with your plan. It can certainly be encouraging to that thing turn purple, but it could also just mean that you're urine isn't very dilute and you're dehydrated. You could drink a couple glasses of water and get a negative a short time later and it means nothing about your actual ketone production.
  • KetoTheKingdom
    KetoTheKingdom Posts: 33 Member
    edited June 2016
    Work OK for me. I'm sure measuring blood ketones would be more accurate but I'm not a science project. Just need a decent ish yardstick

    If you pay attention to what food and medicines go into your system and what comes out, you are a science project. You can choose whether to observe or ignore some effects, but others will seize your attention, like it or not.
  • wabmester
    wabmester Posts: 2,748 Member
    Even blood levels just give you a small snapshot in time of what's going on. It'd be more interesting if you could measure continuously, and measure both arterial levels and venous levels so you know your utilization rate.

    That's essentially what Cahill did in the 60's:
    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC292907/
  • RalfLott
    RalfLott Posts: 5,036 Member
    In a sense, we're all science projects on the keto bus.

    It's figuring out how to tell if we're taking the smoothest route that's the challenge.
  • RalfLott
    RalfLott Posts: 5,036 Member
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  • Violet_Flux
    Violet_Flux Posts: 481 Member
    I've been low-carb since August last year, and like @Sunny_Bunny_ I can still turn the stix dark purple (if I measure mid-day).

    I sometimes question just how accurate / usefull they are, but I still use them 2 or 3 times a week. FWIW I had quite a bit of carbs Sunday, about 80g, and Monday I still got a read of 8 mmol/L (second darkest purple) on the strip.

    I don't believe I'm dehydrated. I drink to thirst but that's still 12 - 14 cups a day. And re. dehydration, I was told once that an easy 'tell' is if your pee is dark, that's a sign of dehydration. When it's clear, you're sufficiently hydrated.
  • EryOaker
    EryOaker Posts: 434 Member
    I don't need the stix anymore... I can taste and smell the ketones in my breath. Yuk, I know.
  • retirehappy
    retirehappy Posts: 4,756 Member
    edited April 2017
    I got an el cheapo breathalyzer and tossed the stix. After the first couple of weeks they never changed color, turned greyish, which isn't on the chart even. Probably a bad batch, but they were driving me crazy because ever so often, one would show up as the lowest level on the chart.
    According to my breathalyzer I am in the lower range of nutritional ketosis most of the day. Since that is my goal, I am happy with that. Might go to blood testing but this is much easier and I can easily carry it with me anywhere and use it without any skin pricks involved. Love that.

    Did I mention it is even cheaper than the stix?????
  • Liadin123
    Liadin123 Posts: 67 Member
    edited April 2017
    I'm new and all, and I know the blood tester and breath tester is the best way to go, but, I ordered some "Pee on a Stick" Ketosis dohickies - (I'm old, I'm allowed to say DooHickey!) - and I was happy to say I was a nice dark pink and well into Ketosis. It may not be something to rely upon forever, but it managed to put me in a good mood.. and let me know I was at least on the right track. The scale isn't moving so it was something I could point to and say "HEY something is WORKING here!".

    *edit* - I am very well hydrated for what it's worth. If anything I'd think the ketones would be diluted?
  • CarlyIrene415
    CarlyIrene415 Posts: 27 Member
    I've used them for over 10 years and they've always been really accurate for me. Although, bad breath is an even better indicator, lol...
  • DietPrada
    DietPrada Posts: 1,171 Member
    I've used them for the last 4 years. Not to measure the "amount" or "how in ketosis I am" but rather just as a tool to keep me honest, like getting on the scales each morning. I've noticed the couple of times I've gone out for a meal and had carbs, they're no longer pink/purple. They're also a good alert if you sneak something like a "net carb" item into your diet and you want to know if it's affected your ketosis.
  • RalfLott
    RalfLott Posts: 5,036 Member
    I've used them for over 10 years and they've always been really accurate for me. Although, bad breath is an even better indicator, lol...

    Just playing >:)'s advocate - how do you know that they're accurate?
  • elize7
    elize7 Posts: 1,088 Member
    I've used them several times over the course of time. For some reason, and it's the same with daily weigh-ins: if it's good news, it motivates me, and if it's bad news it makes me more determined to get back in good graces asap. Winning!
    Doesn't even matter if it's accurate! Lol.
    I stopped using them when i got into maintenance, and regained 25 pounds. Never again!
  • Violet_Flux
    Violet_Flux Posts: 481 Member
    So yesterday, a friend and I had a big sushi lunch. We hadn't seen each other in about 4 months and we're both low-carb but it was a special treat. We didn't hold back, enjoyed all the maki and nigiri we could eat, white rice and all. And we had some of the hot selections too - general tsao chicken, beef & broccoli, complete with sugary sauces. I logged (after the fact) everything I could remember, and it came to over 130 grams of carbs at the end of the day. (Though I was still under-budget for calories.)

    After the meal, we went for a 2km hike through the woods to atone for our carb sins. :sweat_smile:

    No worries, I figured it was a science experiment. I wanted to learn a) how a big carb blow-out would feel, b) how long I'd feel it, and c) how long it'd take to get back into ketosis -- I planned to test myself with ketostix every day this week to see how long before I started showing positive again.

    Today was back to business as usual, I had my morning coffee, an hour or so work-out on the bike, broke my fast a little later than usual, then tested an hour or two after eating. I got the 2nd darkest colour on the ketostix.

    So I'm wondering, do ketostix do false-positives much? Or is it possible I'm already in ketosis again after eating a week's worth of carbs yesterday?

    FWIW I don't feel any different today. I felt bloated immediately after we ate yesterday but that had passed by the end of our hike.
  • 2t9nty
    2t9nty Posts: 1,626 Member
    I have (oddly perhaps) never used them. I weigh every day and check my bg about 5 times a day. I keep the carbs under 20 net per day, and I figure if I am not in ketosis, I never will be. I just don't need any external validation on that particular metric.
  • Sunny_Bunny_
    Sunny_Bunny_ Posts: 7,140 Member
    Steph_Maks wrote: »
    So yesterday, a friend and I had a big sushi lunch. We hadn't seen each other in about 4 months and we're both low-carb but it was a special treat. We didn't hold back, enjoyed all the maki and nigiri we could eat, white rice and all. And we had some of the hot selections too - general tsao chicken, beef & broccoli, complete with sugary sauces. I logged (after the fact) everything I could remember, and it came to over 130 grams of carbs at the end of the day. (Though I was still under-budget for calories.)

    After the meal, we went for a 2km hike through the woods to atone for our carb sins. :sweat_smile:

    No worries, I figured it was a science experiment. I wanted to learn a) how a big carb blow-out would feel, b) how long I'd feel it, and c) how long it'd take to get back into ketosis -- I planned to test myself with ketostix every day this week to see how long before I started showing positive again.

    Today was back to business as usual, I had my morning coffee, an hour or so work-out on the bike, broke my fast a little later than usual, then tested an hour or two after eating. I got the 2nd darkest colour on the ketostix.

    So I'm wondering, do ketostix do false-positives much? Or is it possible I'm already in ketosis again after eating a week's worth of carbs yesterday?

    FWIW I don't feel any different today. I felt bloated immediately after we ate yesterday but that had passed by the end of our hike.

    False positive is impossible. Ever.
  • Violet_Flux
    Violet_Flux Posts: 481 Member
    False positive is impossible. Ever.

    Thanks @Sunny_Bunny_ that's good to know.

    I was at the 2nd darkest on the stick again today so I figure my 'carb tolerance' must be pretty high. Not gonna keep pushing it just in case, but maybe one "treat" day a month like that will be ok.
  • medic2038
    medic2038 Posts: 434 Member
    2t9nty wrote: »
    I have (oddly perhaps) never used them. I weigh every day and check my bg about 5 times a day. I keep the carbs under 20 net per day, and I figure if I am not in ketosis, I never will be. I just don't need any external validation on that particular metric.

    I've been doing low carb (off and on, and various forms) for about 5 years. So I really don't get any of the associated changes most people do when they go in. I remember when I started I used to have "sweet saliva", but even that i don't notice anymore.

    I use them more or less to double check, right now I'm doing a little higher carbs (<50g/day) so use them to kind of find where my threshold is.
  • Jabba2Hans
    Jabba2Hans Posts: 4 Member
    Wish I had seen this thread before buying keto strips. Been low carbing for a month and went keto a week ago. Currently dealing with a bad virus and had 120g worth of carby comfort foods yesterday. Tested this morning and it showed the 2nd to darkest purple, while all the other days showed only pink. Makes no sense to me. I should've spent my money on extra beef sticks. 😂
  • ccrdragon
    ccrdragon Posts: 3,374 Member
    Jabba2Hans wrote: »
    Wish I had seen this thread before buying keto strips. Been low carbing for a month and went keto a week ago. Currently dealing with a bad virus and had 120g worth of carby comfort foods yesterday. Tested this morning and it showed the 2nd to darkest purple, while all the other days showed only pink. Makes no sense to me. I should've spent my money on extra beef sticks. 😂

    @Jabba2Hans

    Actually, it makes a lot of sense. When you use the strips, you are really looking at the amount of ketones that your body is discarding (you ARE checking your urine). In the example that you have given, you just ate a bunch of carbs, and your body will ALWAYS prioritize carbs as an energy source over any other available energy source. So, since your body wasn't using the ketones for energy, it was discarding more of them giving you the darker color on the strip.

    That is the basic problem with the strips - they can only measure the amount of ketones that your body is getting rid of, not the amount that your body is creating and/or using for energy. Any color on the strip indicates that your body is creating ketones, but the darkness/lightness of the strip is basically meaningless, except in very specific examples like the one given here.