Welcome to 2021, we have the ability to track everything from our body weight and body fat, REM cycle, heart rate variability and daily steps, to metabolic markers like blood glucose, blood ketones and a host of other health identifiers. With all of this innovation, you would think we'd have figured out this whole 'health' thing by now.
The problem is, as we continue learning and innovating, our environment continues changing, making it difficult to know what is actually relevant. Even when we can describe what is important for individual health and why it is relevant, there is disagreement on what to do after. Self-experimentation is key to learning about your body and bio-individuality. Testing different health markers will help you connect the dots and hopefully arrive at the root cause of your problems or at least help adjust your approach.
I have been testing ketones since I first started a ketogenic diet in 2016. Back then, urinating on a strip to test ketones was a rite of passage. We soon found out these strips weren't a long-term solution because they test for acetoacetate, one of the three ketone bodies, along with beta-hydroxybutyrate and acetone, in the urine, causing readings to change over time. You may be eating a certain way and checking your ketones during the first month, and your strips can show that you are in ketosis. Then, all of a sudden, without you changing your diet, you may notice that you aren't at the same level of ketosis, or in ketosis at all. These are likely false negatives.
As your body adapts and becomes more efficient at utilizing the ketones being created by your liver, less acetoacetate will show in the urine. This is why blood ketone meters are the gold standard for blood ketone testing. They test for beta-hydroxybutyrate in the blood, which is more accurate and reliable over time.
So, when is it best to test ketones? First, you need to figure out your specific reason for testing.
Let's talk about a few scenarios where ketone testing is extremely beneficial. The first, and most important scenario is chronic disease management. Whether you have an autoimmune, neurological, metabolic disease, or a combination of these, ketone testing would allow you to objectively gauge the success of your protocol. In this scenario, I would also recommend testing blood glucose at the same time. When you have these two numbers, you can figure out your glucose ketone index (GKI), which correlates with favorable outcomes if the number is low enough. All you do is divide your blood glucose number by your blood ketone number.
The GKI can tell you the relationship between your blood glucose and blood ketones at anytime, as well as your metabolic health. If you are above 9, you may still have some time before your body reaches a fat-burning state, or you may have dropped out of ketosis for some reason.
If you are at 6-9, this is a moderate level of nutritional ketosis. This is where many people who are following a ketogenic diet tend to fail, unless they become more restrictive to aim for a lower number. If you are trying to reverse insulin resistance, or are obese and wanting to burn as much fat as possible, you would likely aim for a 3-6 GKI. Anything less than 3 is a high level of ketosis, ideal for those with more serious conditions.
Two other scenarios where ketone testing would be helpful are when starting or re-starting a ketogenic diet, or testing how a specific stimulus affects your blood ketones. Here are some experiments you can do: different training styles (aerobic vs. anaerobic), new foods you are
introducing into your diet and new fasting protocols you are implementing. When it comes to your daily habits, there are endless possibilities that can affect your metabolic state and knowing how you react metabolically will provide you with a deeper knowledge of your unique body.
Just be very specific with what you are testing and control for outside factors that may
affect the test, such as hydration levels and sleep. When comparing test results, you want to test at the same time and under the same conditions to compare apples to apples. In conclusion, there is no general time when it's best for everyone to test their ketone levels. The best time to test is going to be up to your specific needs, just keep it consistent.
When comparing meters and strips, pay attention to the price of the strips as they will be an
ongoing expense. You'll also want to make sure the strips are individually sealed, as this will
ensure the test is reliable. Check out this video for an explanation of this concept, as well as a good comparison of several meters. I've personally used the KetoCoach blood ketone meter for two years now. It checks all the boxes for me as far as pricing, reliability and ease of use.
Additionally, the Fast Coach app offers fitness challenges, educational content and a bunch of features that help me track my experiments and health history. One of the best features being a community overflowing with support, accountability, and positivity.
About Author
Danny is currently a coach for KetoCoach's FastCoach app. A native of Miami, Florida, Danny received his bachelor's degree in political science from Columbia University in 2004, where he played football and was a three-time Dean's List recipient. Danny earned his Master's of Science in Human Performance from the University of Florida, where he worked with the national championship men's basketball team along with the tennis and golf programs. Shortly after, Danny became the Strength & Conditioning Coordinator for Virginia Commonwealth University basketball.
