Is it possible to show ketones in urine, and not be in ketosis?

(Tom) #1

It may sound silly, but is it possible to show ketones in urine without being in ketosis?

I started using the urine strips with success, before moving on to a breathe meter. But now I’m questioning the accuracy of the breath meter.

I started my paleo keto journey 7 weeks ago today, and have been 100% perfect to the diet. After 5 weeks of using urine strips I moved on to a breath meter as I heard it was better.

The breath meter constantly gives very high results (between 8-9), but now when I check my urine it says there is just a trace of ketones. This is very confusing.

I have been eating a lot of fat bombs lately (peanut butter mixed with coconut oil and 85% chocolate), but my reading still say I’m in ketosis.

Is it possible I am just on the edge of ketosis and not actually getting the benefits, as I’m eating too many fat bombs?

I don’t feel energised, or have clarity in my thoughts, which is disappointing as that’s why I started this new way of life 7 weeks ago.

Any advice on this?

#2

The urine strips only test for one type of ketone:

Of the three types of ketones (acetate, acetoacetate, and beta-hydroxybutyrate) produced by your body, ketostix only measure acetoacetate . This is extremely important to understand, because it turns out that your body produces different quantities of these different types of ketones depending on how long you’ve been in ketosis. If you’ve been in ketosis for a while, you’re going to see a reduction in the “intensity” of what you register on your ketostix…

#3

How much fat you eat has nothing to do with ketosis. Ketosis is driven by how many carbs you eat.

I avoid fat bombs, because I’m trying to lose weight. I need to keep carbs low, because I want to stay in the ketosis. I need to make sure I get enough proteins, because my body needs it. After that, it’s pretty much based on how hungry I am. If I’m not hungry, I don’t need to eat any fat bombs. The fats macro is not a goal to be reached, because my stored body fat can make up for fats I don’t eat. Hunger should tell me if I need more.

If nothing else, hunger has to be a consideration because if a way of eating leaves you consistently hungry, it won’t be sustainable.

(Bacon is a many-splendoured thing) #4

I strongly doubt it. It’s more likely that you would be in ketosis and not showing ketones in your urine.

Remember that ketones in breath and urine are being wasted, and there is not a direct relationship between the two measurements. For one thing, the breath meter is measuring exhaled acetone, and the urine strips are measuring excreted acetoacetate. And just to confuse us further, blood meters measure β-hydroxybutyrate! All three ketone bodies are found in all three locations, but for some reason, this is how the measurements are done. This is further compounded by the fact that we cannot measure ketone turnover (i.e., how many ketones are being made and consumed), so all we can measure is what’s circulating in the blood or what’s being wasted in breath and urine.

Also, for the record, bear in mind that the limit of accuracy for home measuring devices is generally around ±20%, so there is a lot room for variability in the readings you get.

(KCKO, KCFO) #5

Ketosticks are great at letting you know if you are dehydrated. Not so great at measure ketosis. Atkins stopped recommending them ages ago.

As you become fat adapted you want to burn the ketones and not pee them away so much. Keep Calm and Keto On, you are probably doing just fine.

(Tom) #6

It’s frustrating to think that my body is ‘wasting’ the ketones. After 7 weeks with no breaks in ketosis… how much longer could it possibly take to feel the benefits?

(Bacon is a many-splendoured thing) #7

You said your urine measurement is now lower, which means your kidneys are getting better at scavenging ketones from the urine, and your liver is getting more efficient at matching production to need.

As for how you are feeling, what are your symptoms? If you are noticing a drop in athletic endurance, be patient, because your muscles need time to re-adapt to metabolising fatty acids in place of glucose. Generally this process takes 6-8 weeks, but in some people it takes even longer. You will know that you have fat-adapted when your performance returns to (or exceeds) your pre-keto levels.

Personally, I don’t feel particularly energized on keto, as many people describe. The reason is that I started from a baseline of some sort of unknown fatigue syndrome (the result of a bad viral infection in 2006), and the added energy from my ketogenic diet has brought me back to what I remember as my normal, pre-2006 level. Since I can now mow the lawn without having to spend the following two days in bed, I’ll happily settle for normal energy, thank you!

Your ketone level is regulated by your carbohydrate intake by means of two mechanisms. The first is the hormone glucagon, which signals the liver to make glucose (gluconeogenesis) and ketones (ketogenesis). The other mechanism is the hormone insulin, which keeps gluconeogenesis and ketogenesis from getting out of control. When we eat a large amount of carbohydrate, there is no need for glucose to be made in the liver, so glucagon secretion drops. Also, a high level of glucose in the blood is dangerous, so one of the functions of the insulin response to glucose is to drive it out of the blood and into muscle (to be metabolised) and fat tissue (to be stored as fat).

You can see that when we eat a high amount of carbohydrate, we have no need to have the liver make glucose. Nor do we want the muscles to be metabolising ketones when we have a lot of glucose to get rid of. This is why insulin rises to inhibit ketogenesis and gluconeogenesis. On the other hand, when we eat very little carbohydrate, a rise in glucagon stimulates the liver to make the very small amount of glucose we need to have circulating in our blood (about 4 grams at any one time) and to provide ketone bodies for tissues to use in place of glucose (the muscles, by the way, actually prefer fatty acids over ketones, and will pass up both glucose and ketones in order to save them for the cells that actually need them). The key datum is therefore the ratio of insulin to glucagon in the blood. A low ratio signals a ketogenic environment, a high ratio the opposite. If you are not consuming glucose (in the form of carbohydrates and sugar) and are still walking around breathing, your liver is producing ketones.

(Michael - When reality fails to meet expectations, the problem is not reality.) #8

First question: what breath device are you using to measure BrAce? If it’s not a Ketonix or Levl, it’s useless. There are lots of breathalizers designed to measure BA (blood alcohol) that by a fluke of sensor design also detect acetone (or maybe isopropanol). Many of these are being sold as ‘keto breathalyzers’ and they are useless. Maybe we’ll have more useful devices sooner or later. Who knows? If it’s a Ketonix, then ‘8-9’ is not ‘very high results’. That would be 8-9ppm which is about as low as you’re going to go while in ketosis. For example, when I check BrAce with my Ketonix my ‘normal’ range is 20-40 ppm.

As pointed out already, breath contains acetone which is one of the breakdown products of acetoacetate (the other is CO2). Urine contains primarily acetoacetate, but can also contain both acetone and β-hydroxybutyrate in small amounts. If you are excreting acetoacetate in urine, then it follows that you are producing more acetoacetate than using, and might logically expect some of it to breakdown into acetone before it gets to the kidneys. Thus, if you have a positive urine test you should expect measurable BrAce as well. How much of each? Who knows? If you measured consistently for a few weeks you might discover how your system deals with it. Or not. It’s very dynamic!

You can have a null urine test and measurable BrAce. That simply means that excess acetoacetate is breaking down before it gets to the kidneys.

Bikman thinks it part of the process of eliminating fat from your body. Those ‘wasted ketones’ started out as fat in adipose tissue. Seems like a pretty good deal to piss and breathe away some of your excess fat. No? Also, if you think about it, when acetoacetate ‘breaks down’ the energy contained in the molecule has to go somewhere. It’s probably being used to help maintain your overall temp at 98.6. Maybe?

(Bunny) #9

You can have ketones in your urine and you could be breathing ketones.

If you have been doing the ketogenic diet for a long time like 6 months and your still seeing high numbers over 0.8 (BHB blood measurements) that means your not really using them (for fuel) and your not fat adapted (yet?), your simply evacuating (breathing and urinating) excessive ketones from oxidation of dietary fat and body fat.

That is why you don’t;

…have the benefit of BDNF factors (neuroplasticity, neurogenesis, neural-repair) yet!

(Michael - When reality fails to meet expectations, the problem is not reality.) #10

I think you will find this of interest:

(Allie) #11

Simple. Just means your body is using them as fuel rather than creating them and not knowing what to do with them, so peeing them out. Pee sticks are not helpful, throw them away.

#12

Yup, being “in” ketosis means your liver is making ketones because of lowered carb intake. If somebody that eats strict keto eats a piece of chocolate cake, their body will immediately start working on all that sugar since it’s an easier fuel source than the ketones. The ketones don’t just disappear, they’ll SLOWLY be nipped away at while the sugar becomes your primary fuel for a while but your liver wont make any more so you won’t be in ketosis. A blood test will show them for quite some time before they’re gone. I could eat a loaf of bread, swig some mouthwash and your breath meter would register off the charts ketones because all it knows is it sees breath alcohols. Doesn’t mean much.

Ultimately unless you’re doing keto for medical reasons that actually benefit from high ketone levels you’re wasting your time measuring them, they don’t matter and more doesn’t equal faster fat loss. Have you’re diet right and let it do it’s thing. That’s where your results are coming from. If you want to track something track your dietary intake from the macro and micro nutrients levels. That will show you what you’re doing and if you run into problems and just want to know when you feel best, when you loose more fat, when you have more energy etc you’ll actually have something controllable to look back at.

#13

I never felt changes regarding these, I got other benefits when I got fat adapted, very good ones.
After 7 weeks so maybe you still aren’t there, some people get it earlier, some later and who stays keto for long often says it can get deeper and change more… Be patient. If you eat properly, you should be in ketosis, no matter what non-reliable things like urine keto strips say.

Fat bombs only go against ketosis if you eat so many that the carbs in them become a problem as far as I know.

Stay on keto and be patient. Not everyone experiences the same things.

(KCKO, KCFO) #14

They will show you how dehydrated you are. You could load up on carbs for days, if you are not getting hydrated they will appear at a high level. I could never trust them.