Ketostix are one of the most controversial topics when you jump on the keto groups. Do they work? Do you need them? Do they help? Well, to get the answers, we need to get a little ‘sciencey’, but I’ll try to keep it simple.
Glucose is the main source of fuel for neurons when the diet is high in carbohydrates. In ketosis however, when carbohydrate intake is restricted below 30g NET per day, the liver begins producing the following ketone bodies:
- Acetoacetate (AcAc) is created first
- Beta-Hydroxybutyrate (BHB) is created from acetoacetate
- Acetone is a spontaneously created breakdown product of acetoacetate
Now, ketostix were initially designed to help diabetics avoid a condition called diabetic ketoacidosis by detecting the level of excess acetoacetate in the urine. They are accurate in this respect, in that they display the degree of ketnuria and can be a useful tool in the prevention and detection of ketoacidosis in diabetics. The issue with trying to use KetoStix for nutritional ketosis is that these aren’t what they are designed to do.
In the beginning of a ketogenic diet, acetoacetate and beta-hydroxybuterate are excreted by the liver in roughly equal levels. As time goes on, you’ll further convert more of the acetoacetate into beta-hrdroxybuterate, reducing the overall strength & volume of acetoacetate that is leftover to be excreted in urine – which is what the KetoStix are testing for.
Furthermore, as your body becomes more efficient at this process, and gets closer to fat adaptation, the volume of ketone bodies being released by the kidneys into urine also downregulates, further limiting the effectiveness of the KetoStix for someone wanting to check nutritional ketosis. If you stay on your keto diet for long enough, the primary ketone present in your urine isn’t the one that’s detected by your ketostix.
So, should you use them or not?
Well, I’ll leave this one up to you. Some people find them helpful to get started, seeing that result on the sticks can be somewhat motivating. Provided you keep in mind that you may not show a positive result on the sticks, or that it may reduce over time – I don’t see a harm in it. Personally, I only showed a result on the sticks briefly, and after subsequent investigation realised I didn’t need to – staying under 30g NET carbs is all the measurement I need to stay in ketosis.