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  1. #1
    Cryptocode's Avatar
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    Ketone level in Urine Analysis

    Does anyone know what the ketone level in Urine would be for a PB person who is in Ketosis?

    I was given a urine analysis because I had a bout of acute diarrhea and Kaiser has now added a Ketone count to their standard repertoire. Miy test named: URINALYSIS, AUTOMATED (WITH MICROSCOPY IF INDICATED, NO CULTURE) came back:

    GLUCOSE, UA Negative mg/dL - - - - - <30 (Neg)
    KETONES, UA Negative mg/dL - - - - - 10 (1+)
    CRITICAL LEVEL FOR GLUCOSE+KETONES? Not Applicable

    Can anyone translate this for me?
    "When the search for truth is confused with political advocacy, the pursuit of knowledge is reduced to the quest for power." - Alston Chase

  2. #2
    Paleobird's Avatar
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    Ketones in your urine are pretty irrelevant if you are in ketosis. In ketosis you are burning the ketones not excreting them. This is why the ketostix only really work as you are transitioning to keto.

    If you want a metric that is meaningful you can always get a blood monitor. (Personally I'm not up for multiple finger stabs just for more data. I know when I am in ketosis by how I feel.)

    Kaiser is probably doing this measure because there are so many people who are diabetic (or might be headed there). They are really checking to help prevent ketoacidocis which is a whole different beast from ketosis.

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    Cryptocode's Avatar
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    Thanks, Paleobird.
    "When the search for truth is confused with political advocacy, the pursuit of knowledge is reduced to the quest for power." - Alston Chase

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    I agree with Paleobird, and I have to say that the last time I was really serious about being in ketosis, the blood monitor and (very expensive) test strips proved invaluable. The cheapest I have found were about 2$/strip, so a box of 10 were around 20 bucks if I remember correctly. So if you wanted to test every day for a month, could get pricey. But it tells you if you are burning ketones and at what level. If you don't mind spending the money, its worth it. I've never used the urine strips but from what I've heard, they are useless at detecting ketosis properly.

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    Cryptocode's Avatar
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    I've never tried to be in Ketosis. That's why I was surprised to see ketones present in the urine. Now having googled and read a bit, I find that this testing is being done on the theory that having ketones present means you have insufficient insulin and therefore are probably diabetic. A further test is the CRITICAL LEVEL FOR GLUCOSE+KETONES about which I could find almost nothing, but which I'm guessing would be a test for high glucose and high ketones would mean you were surely diabetic.

    Most of the descriptions I read include certain exceptions, one of which was if the person was eating a low carb and high protein (never high fat) diet.

    Another possible exception was in dehydration, which I was at the time.
    "When the search for truth is confused with political advocacy, the pursuit of knowledge is reduced to the quest for power." - Alston Chase

  6. #6
    Paleobird's Avatar
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    Yes. This is why diabetic blood monitors also monitor ketones. If you are diabetic, ketoacidocis can be deadly.
    http://www.wisegeek.com/what-is-the-...toacidosis.htm

    Dehydration could do it right there. Another reason why measuring urine ketones is notoriously unreliable compared to blood.

    Kaiser is going for the cheap and dirty method of testing, though. SOP for them (I have Kaiser too.)

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    critical DKA figure are a BG over 13mmol/L combined with ketones over 1mmol/L, both values are capillary blood and figures higher than these indicate big trouble.
    you, my friend, are fine
    my blood levels run between 2 and 4
    Last edited by CarbDodger; 07-29-2013 at 09:10 AM.
    When I'd had enough of the grain and starched based 'diabetic eating for health' diet (eating for health, my ass!) my weight was 242.5 lbs. On starting primal- 18th April 2013 weight : 238.1.
    27th July 2013. weight after 100 days 136.9 weight lost 101.2lb ; that's 105.6lbs since I stopped the 'diabetic eating for health'
    new journal http://www.marksdailyapple.com/forum...ml#post1264082

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    Cryptocode's Avatar
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    Thank you my friends. I'm finally feeling better, no longer dehydrated, and the acute diarrhea is abating. It's interesting to know Kaiser is using the 'cheap and dirty' method. I've always thought they did.

    I've save Dodger's DKA numbers for reference, I didn't find that anywhere.
    "When the search for truth is confused with political advocacy, the pursuit of knowledge is reduced to the quest for power." - Alston Chase

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    Urine dipsticks are the way virtually ALL labs do urinalysis. There are multiple chemical pads on the test strip that turn different colors and show pH, glucose, protein, ketones, bilirubin, blood, other items. It is a screen. They are not being "cheap" by using the dipstick; virtually noone quantifies ketones in urine anyway.

    Diabetic ketoacidosis (DKA) is a severe medical emergency and we docs are understandably nervous about it. Hopefully as the nutritional ketosis data keep coming in, my colleagues will become more astute about what ketosis without glucose on the dipsticks means. The kidneys start spilling glucose into the urine at blood levels in the mid-100's (mg/dl). DKA patients have glucose levels in the several hundreds.

    I spent a couple of minutes looking for correlation studies between urine dipstick and blood beta hydroxy butyrate levels. I did not find anything in "ketogenic diets" like many of us do; the studies were in diabetics and in kids on antiseizure ketogenic diets. Yes, ketosis treats seizures! The dipsticks measure acetoacetate rather than BOHB. It looks like a heavy (4+) on the dipstick is pretty good for a "therapeutic" level of BOHB but otherwise they don't correlate well. Too bad; dipsticks for ketones are cheap, over the counter, and don't require a fingerstick.

    Doc Jim
    10/2/12: 169 lbs, 37"waist
    Now: low 150's, 33" waist
    Blog: http://paleopathologist.com/

  10. #10
    Paleobird's Avatar
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    Hi Doc Jim. Ketosis does indeed treat seizures.

    I did a whole thread about epilepsy and ketosis. I have been able to reduce my meds by 25% with total seizure control.

    http://www.marksdailyapple.com/forum/thread64225.html

    What kind of doc are you?

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