It doesn’t even suggest that you aren’t in ketosis anymore, because it can’t. This is completely normal and does not mean you are having trouble with your diet. So quite literally, after a few weeks into your low carb ketogenic diet, you’ll likely start seeing a change in your ketone levels as measured by ketostix. Ultimately suggest that it is the result of kidney adaptation to sustained carbohydrate restriction (164-5) and leave it at that.Įven though we lack the sophisticated understanding of why kidneys downregulate ketone secretion into urine, we know that it happens and we know that the volume of acetoacetate in your serum drops as you become more fully ketoadapted. The precise reason for this downregulation is not described by Phinney and Volek, but they speculate it is to prevent wasting the minimal amount of calories contained in urine ketones. So even if you still had high-serum acetoacetate (which can be detected by ketostix), you’d still be seeing lighter colors on your ketostix because your kidneys are simply not excreting as much of them into your urine as they were previously. Your takeaway point is this: If you stay on your keto diet for long enough, the primary ketone circulating in your serum (and consequentially, present in your urine) is not detected by your ketostix.īesides the change in relative volumes of serum ketone types, as you become keto-adapted your kidneys naturally down-regulate the volume of ketones they excrete into your urine. When plasma acetoacetate concentrations begin to decrease, more of it is produced from beta-hydroxybutyrate” ( source).Īs a result of the continued conversion of acetoacetate to beta-hydroxybutyrate, the serum and urine volume of acetoacetate (the only ketone detected by ketostix) is significantly reduced. As mentioned before, beta-hydroxybutryrate is not technically a ketone. When you start restricting carbs, Phinney and Volek assert that at first your muscles use both beta-hydroxybutyrate and acetoacetate for fuel, but after awhile, they begin taking the acetoacetate and converting it to beta-hydroxybutyrate, and returning that to your serum.
These ketones are created in the liver in a roughly equal ratio (Note: Technically, acetoacetate is created by the mitochondria of liver cells, and from this beta-hydroxybutyrate is created and acetate is produced as a side product. When you first start your ketogenic diet and you are not yet fully ketoadapted, your kidneys actively excrete two types of ketones into your urine: beta-hydroxybutyrate (not technically a ketone, but it is generally referred to as one in the literature) and acetoacetate. A reduction in the volume of ketones in your urine as your kidneys reduce the amount they secreteĬhanges in the types of ketones you produce.A change in the relative volume of the ketones produced/present in your body.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 for two reasons: 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.
Of the three types of ketones (acetate, acetoacetate, and beta-hydroxybutyrate) produced by your body, ketostix only measure acetoacetate. They are considered excess, because they are removed from your serum and shunted to your urine by your kidneys. Generally speaking, ketostix measure excess ketones in your urine. A color scale for acetoacetate ketone concentrationįirst off, we need to understand what ketostix actually measure, and more importantly, what they don’t.
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