Please explain WHY urine strips are not helpful after a certain point

(Whitney) #1

First, the background - I’ve been in ketosis and eating 20 net grams of carbs or less per day since end of April 2017 (going on 5 months now). I feel great, I’ve lost weight, I’ve dragged two other people into giving this WOE a try, etc. I am within 10 pounds of my goal weight. I do not own a breath analyzer or blood meter for ketones, mainly because I don’t want to shell out the money for them and the thought of pricking my finger even a couple of times a week is unpleasant. I can’t even watch when they do it at the Red Cross before I donate blood. I use the urine test strips (cheap, fast, easy), which are almost always positive even five months into Keto. They have also helped me realize that I had eaten some “hidden” carbs in restaurants a couple of times, so I’m a fan. Also, in case it matters, I do not and never have taken a exogenous ketone supplements.

Question - WHY does everyone always recommend to not use the urine strips? The best answer I have seen is that, as you become fat adapted, less ketones will spill into your urine, meaning you could be in ketosis, but still have a “negative” urine test result. However, this clearly isn’t happening with me. My urine strips always show a good healthy level of ketones. So why would I want to switch over to testing blood or breath? And secondary question, if I am still having so many ketones in my urine, even 5 months after going keto, does this say anything about my fat adaptation status?

Note: I get that the urine strips are testing ketones that are “spilling” over, and therefore not being used by the body. And that ketones in the blood are in circulation and theoretically will be used for actual energy needs. But since weight loss is my goal, as long as my body is burning fat to produce ketones, I’m happy.

Thanks!

(Allie) #2

Because your body adapts and learns how many ketones to make so you stop peeing them out, basically.

(Whitney) #3

I appreciate your response, but I don’t think you read all of my question. I have NOT stopped peeing them out. Even at 5 months of Keto, I am still regularly getting positive urine test strip results that show 2.0 and 2.25 mmol/L ketone levels, which is perfectly in the optimal nutritional ketosis range.

And thanks for the link, but the only reasons this article gives is to show why a person can be in ketosis, but get NEGATIVE urine test strip results. All my urine test strips are positive, at least 95% of the time, and when they are not, I can generally find an explanation for why.

So it makes me wonder if I am not fat adapted (although I should be, based on diet, length of time, amount of weight loss, etc.) or if my body doesn’t convert to acetoacetate to beta-hydroxybutyrate very well or something weird like that.

(Marta Loftfield) #4

@KetoWhitney some people don’t stop registering ketones on urine sticks. I am one of them.

I am definitely fat adapted. I would not worry about it

(Allie) #5

I still pee them out form time to time, especially first thing in the morning (dehydration) and when I’m fasting. I’ve heard of others who have also been keto for several years still getting positive results. The results you’re getting matter more than the colour of a stick.

(Bob M) #6

I haven’t used urine strips for years, as they stopped indicating anything, even when both blood and breath indicated I was in ketosis.

As long as they still work, I’d keep using them.

(LeeAnn Brooks) #7

People produce different amounts of ketones, even if eating the exact same things. Some high, some low.

The advice not to worry about the color of pee strips is really aimed at those who don’t produce enough to waste them. There’s nothing wrong or harmful with producing more than you need. You will simply pee them out as you are doing.

But for people who no longer see color, it means they are producing enough for energy needs but no more.

#8

I was just thinking about the exact same thing! I’ve been doing Keto for 7 months now and still reliably turn ketostix purple - dark purple if I am fasting (5-8mmol range).

Perhaps I’m converting more from fat than my body actually needs? Maybe that’s beneficial for weight loss? No idea. The worry as you say is that it means I’m not fat adapted but I don’t think that can be true if the definition of fat adapted is to function well, without hunger, whilst eating keto - as I definitey do.

I have noticed that I get quite tired and cold during the first couple of days of a fast. Also I don’t ever really get this mential clarity bonus everyone seems to talk about. Signs of not being fat adapted after all maybe?

(LeeAnn Brooks) #9

I would say you’re definitely fat adapted.

What people have to understand is everyone is different. No two people are going to have exactly the same reactions to Keto or the same benefits. When someone goes through a laundry list of possible side effects of a drug, for example, it doesn’t mean everyone will experience them all or even a single one, but some will.
The same goes for the laundry list of benefits of Keto. As it does for how much ketones someone will produce. Making more than you need is neither beneficial or harmful. It simply means you make more than you need. It’s not going to help you lose weight faster.

The only caveat I would say is that those who make high amounts of ketones tend to deplete electrolytes more and need to replenish more often.

(Katie the Quiche Scoffing Stick Ninja ) #10

This.
This makes perfect sense as to why you can be fat adapted, get large readings on ketostix during fasting.
You’re simply making a sh!tload of ketones, some in the blood, some in the urine etc.

(Whitney) #11

This is very intriguing to me. My friend and I have both been Keto for 5 months and feel great, no more cravings, losing weight, etc. But we also both have never experienced this magical mental clarity bonus. And we both still have positive (pink/purple) urine test strips on a regular basis. So with you, me, and her, we have n=3 :joy: I wonder if there is an actual correlation there and what the mechanism would be. Out of curiosity, do you ever take exogenous ketones? Neither my friend nor myself have ever taken them. All of our ketones are produced in our bodies from fat metabolism. I’ve been wondering lately if I actually started taking exogenous ketone supplements, if that would give me this magical clarity boost.

#12

Interesting! Well that sounds like a correlation, but what on earth would be happening behind the scenes? Maybe there are other correlations - have you ever done a genetic test e.g. 23andme? have you done extended fasting, if so how did you feel on it?

No I’ve never taken exogenous ketones either, but given that our bodies are spilling loads extra anyway do you think it’d do anything or just all come straight out again?

(Whitney) #13

I have not done a genetic test like 23&Me. My mom has, and I can look at her results and know that there is a 50% chance that she passed something to me, but that’s not really the same as having it done personally. I’ve not fasted longer than about 22 hours and normally just stick to IF. I have a healthy BMI and am only about 10 pounds from my goal weight (although a DEXA last week told me that I am still 36% body fat because I don’t have a lot of muscle…ouch) and so I have never thought that an extended fast was for me. I’m also trying to get pregnant, which is another reason I’ve not tried extended fasting. As for the exogenous ketones, I think they would probably make for expensive pee. :joy: But if I ran across someone who would give me a free sample, I would probably give them a try just out of curiosity.

#14

To answer your initial question, the one (out of three) types of ketones the body makes is the only one the strips detect, and that particular one (acetoacetate, maybe, I don’t remember) in most people will decrease over time, becoming undetectable on the strip. Then people think they’re not in ketosis when they really are. If you’re still getting a color change, don’t worry about it. But the only point is that if you stop seeing a color change, don’t worry about that either.

(Banting & Yudkin & Atkins & Eadeses & Cordain & Taubes & Volek & Naiman & Bikman ) #15

I do not recommend their use because newbies tend to get very excited about a deep purple color and highly anxious about a light color. The color of the stick is irrelevant, since it’s only measuring wasted ketones, not used ones like the breath meter or even blood concentration (which is less useful than breath). The color of the stick can also be influenced by the user’s level of hydration. If you are following the advice of, say, Dr & Dr. Eades, and drinking until you float, you will never get a dark color unless you are in ketoacidosis, which is bad mojo for T1 diabetics. There may be other reasons why it is lilac today and royal purple tomorrow, that aren’t necessarily related to carbohydrate intake or the state of your krebs cycle.

Additionally, the testing agent on the stick is prone to degrade, giving people new to ketogenic dieting another avenue of anxiety.

The final thing is that I grew up in a ketogenic era when we viewed gluconeogensis as a benefit, not a problem and did not view ketosis as the goal of the diet. Measurement of ketones was considerably poorer then, limited to urine strips, so focusing on ketones in the urine, a fraught measure as described above, was not really the way to go. I still think it better to chase results with the scale and tape measure rather than optimal ketone utilization. If you eat right, you’ll be fine, regardless of the color of your pee stick.

There are a very limited number of people in the world who should be doing a ketogenic diet for the purpose of having a high ketone number. And of those, none of them are particularly well served by the measurement of acetoacetate, with the exception of the T1 diabetics, who generally don’t go into ketoacidosis from carbohydrate restriction.

(Whitney) #16

Great point. I typically only see the dark color after a particularly grueling (4 miles or more) run. That doesn’t happen very often, but I’ve always assumed it was because I hadn’t fully rehydrated yet.