When you are on a ketogenic diet, it is important to track and monitor your progress. This way, you will know for sure exactly what changes are happening in your body as you move through the process.
Many people ask the question “How do I Know if I am in Ketosis”.
There are a number of ways to tell if you are actually in ketosis both with and without using fancy testing devices and strips. We will talk about several common things that can occur in your body during the transition to ketosis without using devices and strips. However, it should be noted that using blood meters and urinary strips are by far the best most accurate ways to be certain, therefore we will cover those aspects as well.
Ketosis is not just some magical occurrence that happens by eating a few low carb foods. It is an entire process that fundamentally alters the way your body uses the fuel from your diet. This affects every single aspect of your life, including your energy levels, how you sleep, your brain activity, and possibly even improvements to various side affects you may be experiencing due to medical issues.
This is a comprehensive guide to “How Do I Know if I am in Ketosis?”, so here are some links, ie a “Table of Contents” to skip to specific topics that pertain to your personal situation.
What is Ketosis?
First let’s talk about what ketosis is and why it would matter in the first place if you are in ketosis. Think of your body as a car. Your car needs fuel to operate. Let’s pretend you could choose between 2 different fuel types to run the engine. Fuel Type A works pretty good but it has a lot of contaminants and contents that can lead to further damage in the rest of the cars parts, and causes the car to act more sluggish. Fuel Type B works even better, and it may not always be perfect, but it’s far cleaner and increases the performance of the car, the way the manufacturer intended. Also, imagine Fuel Type B contains substances than can actually repair some of the damages caused by Fuel Type A.
When going on a ketogenic diet, we are essentially choosing to switch our fuel type from Type A to Type B. The problem is, sometimes our bodies may take a little while to adjust to the new changes.
If we stick with it long enough, our bodies can adapt and break through the other side. Now, understandably, this may sound like a bad thing. Many people may feel like “if I have to force my body to accept it, then it must not be healthy!”. In fact, it’s actually the other way around. For several generations now, our society has slowly moved away from our hunter gatherer lifestyles and diet, and moved towards more high carb/sugar convenience foods.
We flipped the switch to Fuel Type A long ago, so our bodies are used to the bad fuel we have been getting. With a ketogenic diet, we are attempting to actually switch the flip back to Fuel Type B, the way nature (the manufacturer) originally intended.
The prominent fuel source most of us use in today’s world is carbohydrates (mostly sugar), which would be Fuel Type A in our car analogy. Flipping to Fuel Type B would mean using mostly Fat for fuel
Is Ketosis Dangerous?
As mentioned above, ketosis is a process of moving away from Sugar as fuel to using fat for fuel. Most people use a process called Glycolosis, which means the body will break down glucose and make ATP. With ketosis, we are using a process called Gluconeogenesis, which is a way for the body to create the glucose it needs without consuming it in our diet.
But our Brains Need Glucose!
This is 100 percent true. Your brain needs glucose, but did you know that your body can create all the necessary glucose it needs for your brain on a keto diet? Your body, more specifically the liver, can undergo a process called Gluconeogenesis. In fact this is the entire purpose of doing this type of diet. In our car analogy, this would be Fuel Type B.
When people say “but the brain needs glucose, therefore I need to eat carbs”, you can point out Gluconeogenesis.
Learn more about Gluconeogenesis vs Glycolosis here.
What about Ketoacidosis?
Ketoacidosis is a real thing that should not be taken lightly, and it often comes up when people mention they are doing keto. If you haven’t had that conversation with someone yet, I assure you, it will happen eventually.
It’s important to understand exactly what ketoacidosis is and I will give you brief overview here, but you can check out this great article about keto diets and ketoacidosis here.
The main takeaway is that ketoacidosis is mostly common for people with Type 1 Diabetes If you have Type 1 Diabetes, please stop here and consult a medical health professional on how to proceed (if at all) with a ketogenic diet.
Not to say it can’t happen with non diabetic individuals, but it is extremely rare.
Ketoacidosis is a condition that occurs, as a result of ketosis, when the body can not produce enough insulin, which is an issue with mostly Type 1 Diabetics.
How Do I know if I am in Ketosis?
Sign #1. Increase in Urination and Weight Loss During Ketosis
One common characteristic of being in ketosis, is increased urination and weight loss. We are putting both these factors together for a reason. They can both happen for the exact same reason. In the very beginning stages of your ketogenic diet, your body will begin to shed itself of excess water through urine and sweat. This is normal, and it makes sense if you think about it. The reverse would be water retention due to weight gain, which is caused by eating a high carbohydrate diet.
The majority of the initial weight loss you experience will be water loss, and maybe a bit of fat. This is why many people just starting out with keto get discouraged, and feel like they are not making progress on the diet. They report that the scale is going down which is good, but they don’t seem to be losing actual fat. This will come in due time. Remember, this is a process, and your body is going through physiological changes.
It should be noted of course, that often times, we think an increase or decrease in something is occurring, when it’s actually a type of placebo taking place. Before doing a ketogenic diet, you may not have paid attention to how often you had to urinate or how much your weight fluctuates. After some research on the internet, you found out that increased urination was a sign of being in ketosis, then you noticed your urination patterns.
It is absolutely true that increased urination and weight loss can be signs of ketosis, I am simply pointing out the importance of logging and journaling your keto journey. It doesn’t have to be a fancy excel spreadsheet (though it’s great fun for us spreadsheet nerds). It can be a simple notebook or day planner.
If it’s not too late, it’s wise to track your normal urination patterns and weight fluctuations for at least a week or so under normal conditions, before you start your ketogenic diet. This way, you can get an actual tally to compare before and after.
Sign#2. Transitioning to Ketosis can cause Keto Flu
Many of these ketosis signs can actually be thought of as temporary stages. This is one of them. Signs of ketosis like keto flu, are not permanent. The keto flu is something you may (or may not) experience while going through a transition period. Things will be great on the other side.
Most Common Symptoms of Keto Flu
- Headache
- Constipation
- Foggy Brain
- Diarrhea
- Weakness and Fatigue
These symptoms are mostly anecdotal and collected from the general keto community and there is little in the way of actual scientific literature on the subject.
Not everyone experiences keto flu, and in fact, there are ways to actually prevent it. Don’t worry, the keto flu is not some badge of honor that you absolutely must get through in order to take this journey.
Avoid the Keto Flu
- Drink plenty of water. Most of the systems of keto flu are the result of all that water loss. Offset these changes by staying hydrated. It’s also important to mention that hydration is more than just water. Electrolytes/salt are a vital part of this process. The same concept applies to staying hydrated on hot summer days.
Most people believe that water alone is good enough, but while that’s mostly true, it also helps include adequate amounts of electrolytes like salt to your diet, and in some cases to your water. As gross as that may sound. Be careful not to add too much of course. - Plan to to get an adequate amount of sleep. Your body is going through a big change that it’s not used to, and it will need to tap into energy reserves. There’s a lot going on inside of you 24/7 like fighting back disease and repairing tissue. This take a lot of biological resources, and sleep is very important during this transition period.
- Eat more fat. I know you are already trying to do that, hence why we are doing that in the first place, but be mindful of your fat intake and actually increase it if necessary.
Sign #3. Ketosis can cause “Keto Breath”
Keto breath is the result of acetone being released when you exhale. This is a byproduct of the process of using fat for fuel rather than sugar. Not everyone will experience keto breath, but it is a good indicator that someone is in ketosis.
For some people, the breath may smell fruity or “syrupy”, and in some unfortunate cases a bit on the “nail polish smelling” side.
Sign #4. Ketosis and Changes in Sleep
This is another sign where we need to understand there’s a temporary bad side, then a long term good side. Transitioning into ketosis, or your first days of ketosis, may lead you to have some sleep issues. The most common sleep issue is insomnia. Again, I will point, this is usually temporary, as your body is adjusting to it’s new fuel source.
Once you are past this stage, or are fortunate to never experience this stage in the first place, you should actually notice an improvement in your ability to fall asleep, and an overall improvement in your sleep cycles throughout the night.
Some people on ketosis have noticed that their restless leg syndrome goes way.
In the case of some people with sleep apnea, they claim improvements in their sleep as well. However, it should be noted that it is unknown if it’s the state of ketosis that that directly improved the state of sleep, or if the weight loss itself is impacting the symptoms of sleep apnea. Either way, the end result is a good night sleep, or at least better.
Sign #5. Measuring Ketones Using a Blood Meter
I know most people reading this came here for “How to know if I am in Ketosis without testing?”, and I hope I have covered that above. The thing is though, the ultimate best way to know for sure is to test your blood levels for ketones. If you do not have a blood meter today, that’s ok. Perhaps later down the road you will get one and come back here for reference.
If you are worried about affording a blood testing machine, check with your doctor and health insurance agency about being prescribed. Where I live, I was able to get my blood meter covered and just had to buy testing strips.
How Blood Meters Work: A Brief Overview
If needles and blood make you queasy, then perhaps this method is not for you.
If you are in the market for a blood testing meter for keto, make sure to get one that will test both ketones and blood sugar. This will give you a lot more data opportunities to track your diet and how different foods affect you specifically, because every human is different, and there is no “one size fits all” keto plan (even though some gurus out there try to sell you one).
You should always think of the keto diet (or any diet for that matter) as a science experiment that you are conducting on yourself. If you think back to grade school science, we learned to control for variables. If you eat a whole bunch of foods with no intent and purpose in mind, you will have a tough time determining what works and what doesn’t.
As an example, you may hear people arguing about whether or not a potato is good for you or not. You will even hear people within “low carb” and “keto” communities debating if it should count as low carb, or keto, or dirty keto. If you should avoid them because they are starches, or include them because they are “root vegetables” and that makes it ok.
I’ve come to the conclusion in my life that my body is my responsibility, and it’s important conduct these experiments in my own kitchen, rather than just blindly follow someone on the internet (don’t blindly follow anything I say either, please do your own research).
In my kitchen I have a blood testing meter and strips for both ketone testing, and blood glucose testing. Let’s take our potato example. Should I include or not include it in my keto journey because the internet said so?
I test my blood results before, and multiple results after eating the potato. If it causes by glucose levels to be abnormally high, I now know to be cautious about potatoes.
As for how the blood meter actually works, it’s a bit nerve racking at first, but eventually you get used to it. The testing strips have these little microchips on one end of them that slides into the machine, much like a card in a debit machine.
You then use a needle called a lancet. The technology these days is actually pretty impressive. When you hear “needle”, you think of just stabbing yourself with it. These are spring loaded devices that you can set the levels on to be more or less tough. You hold it to the side of your finger and press the button. The spring loaded action will give you a super fast little poke. Just enough to make a tiny hole in your skin.
Sometimes you need to squeeze the skin a bit to get the blood flowing. Once you have a but of blood on your finger, you essentially wipe on the end of the strip. The machine will relatively quickly give you a read out. Often times it’s good to give it a couple tests to ensure the accuracy.
Keep a journal beside your testing kit “station” to make notes on time and date, what you ate recently, and the readout the machine gave you.
Sign #6. Detecting Ketones Using Urinary Strips
We won’t spend too much time discussing urinary strips as they are pretty straightforward and the instructions are usually pretty clear on the back.
Testing your urine for ketones is not as accurate as testing the blood, but it is far better than “winging it” so to speak. At least you will have a bit of scientific data to help confirm if you are in ketosis along with the other signs discussed above.
Just like it sounds, you will dip the urine strips into a container of your urine, and wait for the color changes. You will match the color of the strip to the chart on the box to determine the levels. This is not a binary yes or no question, there is typically a range of colors, a spectrum if you will to determine the amount of ketones in your urine.
How Long Does it Take to Get Into Ketosis?
The average adult will take 2-4 days of strict keto to enter into ketosis, but this is a broad reaching average. Everyone is different of course. Do not get discouraged if it takes you a bit longer while others are bragging about doing it in 24 hours. Be patient.
In Summary
So to sum it all up, your body is going through a lot of changes when you switch over into ketosis.
You may experience an increase in weight loss and water loss that presents itself as increased urination.
You may experience something called the keto flu with headaches, constipation/diarrhea/general stomach issues, weakness and tiredness.
You may have insomnia for a while in the beginning, then experience better sleep.
You may experience Keto Breath, a fruity smell when you exhale due to acetones.
You can confirm if you are in ketosis more accurately and definitively using a blood ketones meter.
You can confirm you are in ketosis (but less reliably), using urine testing strips.
