Ketostix! Yes, No, Maybe!?

Typical ketostix result
Typical ketostix result

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.┬áIf 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?

Given they aren’t particularly useful unless you’re diabetic – probably not. You’ll see better returns spending that money on a gym membership!