Originally published on HVMN by Justin Liau, Michael Brandt and Nate Martins

HVMN lives on the bleeding edge of science. We try to stay up to date on the best methods to enhance human performance, including how to measure personal biomarkers. It’s a core principle at HVMN, an ethos to help anyone be the best version of themselves.

It’s also something we practice. CEO and Co-founder, Geoffrey Woo, measures his blood BHB levels using a blood reader device after drinking HVMN Ketone. These ketone levels are an excellent biomarker for tracking the effectiveness of fasting, ketogenic dieting, and exogenous ketones.

But there’s more than one way to test ketosis.

Why should you care about how high your ketone levels are?

HVMN takes a systems engineering approach to human performance: optimize inputs to achieve desired performance outputs.

Understanding blood ketone levels adds transparency and data fundamental to biohacking. It offers insight into where you might feel best, or help optimize diet to achieve personal goals. Many people monitor blood ketone levels while on the keto diet or taking exogenous ketones to verify that they’re actually in ketosis.

Setting a baseline while on the keto diet is helpful, especially if you’re using the keto diet for weight loss and other health benefits like controlling metabolic syndrome. For those on the low-carb, high-fat keto diet trying to lose weight, moderate ketone levels could be an indicator measurement of your dietary needs to reach those weight loss goals.

When on the keto diet, fat stores are broken down and fatty acid concentrations increase in the bloodstream. Those fatty acids are turned into ketones in the liver. When ketone levels exceed 0.5mM, that’s considered to be a state of “ketosis.” Nutritional ketosis is defined as blood ketone levels ranging from 0.5 - 3.0mM by pioneering ketone scientists Jeff Volek and Stephen Phinney in “The Art and Science of Low-Carbohydrate Living.”1

There are three methods to measure ketone levels; with this data, you’ll have the power to optimize your biohacking protocol.

Blood Testing

Pros

Most accurate way to measure ketosis in mmol/L (mM)
Measures BHB, the predominant ketone in the body, rather than acetoacetate or acetone

Cons

You need a handheld device (i.e., Precision Xtra or Keto Mojo) and test strips, which can be expensive relative to other techniques
You have to take a finger prick blood sample which can be bothersome and invasive at first until you get used to it

When testing blood using a BHB/glucose meter, you’re getting the most accurate measurement available. The meters measure glucose or ketone levels depending on which test strips are inserted. Those with diabetes commonly use the same procedure and the same blood meters to measure their blood glucose levels. It's critical for people with diabetes to control blood sugar levels and also to avoid dangerously high levels ( > 20mM) of ketones, known as ketoacidosis.

A blood BHB/glucose meter provides the most accurate measurement available. These meters measure glucose or ketone levels depending on which test strips are used. Those with diabetes commonly use the same procedure and the same blood meters to measure their blood glucose levels. It's critical for people with diabetes to control blood sugar levels and also to avoid dangerously high levels ( > 20mM) of ketones, known as ketoacidosis.

Using a blood ketone meter device is simple. You’ll need the device itself, compatible test strip, a lancet device (to pick the finger), lancets (needs to prick the finger) and an alcohol swab for sanitation.

To take a reading, follow these steps:

Remove the cap from the lancing device and insert the lancet into the device
Rotate the tip of the cap of the lancing device and set it to the desired depth of puncture
Arm the lancing device by sliding the control button until you hear a click
Insert a strip into the reader
Swab the tip of your left index finger with a sterile wipe
Place the lancing device firmly on your left index fingertip
Press the button on the lancing device to puncture your fingertip
Gently squeeze your fingertip to extract a large drop of blood
Hold the reader and touch the bottom of the strip to the blood sample
Hold the reader in place and allow the strip to absorb the blood sample

Wait a few seconds for the reader to analyze the sample

All things considered, using a blood meter might seem like the obvious choice to measure ketone levels. But the finger prick and cost may lead you to explore other avenues for testing. Here are a couple more options.

Urine Testing

Pros

Relatively inexpensive
Widely available in pharmacies
Non-invasive

Cons

Less accurate than blood
Over time the body adapts to excrete fewer ketones in the urine

Urine testing was designed to measure acetoacetate–one of three ketone bodies. But it doesn’t account for BHB, so urine testing may not be the most accurate measure of ketosis.

Since urine is a waste product, what’s displayed on the ketone urine strips is what the body is excreting. By nature, that may not be the best indication of how well the body is utilizing ketones as fuel. As you become more keto-adapted, you’ll excrete fewer ketone bodies through urine. Hydration status can also affect these ketone readings, and leads to inconsistent results–as relative hydration level can dilute the concentration of ketones in urine.

It comes down to this: urine ketone stirps are a cheap and easy way to get an understanding of early ketone levels, but for long-term use, they’re not the most accurate option.

Breath Testing

Pros

After purchasing the device, it’s free each time you test

Cons

You need a handheld device (e.g. Ketonix)
Less accurate than blood meter

Breath ketone meters are relatively new to the market for testing ketone levels. They specifically measure the amount of acetone excreted in breath, providing readings that relate well to blood ketone levels at low concentrations.

But the research is limited. There haven’t been enough studies done to confirm the accuracy of breath acetone meters at higher levels, such as the level achieved after drinking HVMN Ketone. Acetone is the simplest and smallest of the three ketone bodies.

Choosing the Right Ketone Meter for You

In general, we recommend testing ketone levels if you’re trying to achieve nutritional ketosis or using exogenous ketones like HVMN Ketone.

If you're interested in achieving ketosis almost immediately, try our flagship product, HVMN Ketone. Blood ketone levels after using HVMN Ketone can reach 6mM, making it one of the most advanced ketone products on the market. You can try it here. Try consuming the product and testing blood ketone levels after to see the impactful results.

Fat burning mode via the ketogenic diet is tough to maintain–so it’s helpful to monitor ketone levels to make sure your efforts are worthwhile. While ketone readings don’t paint the whole picture of ketosis, they’re a large piece of the puzzle. You’ll have more transparency into what’s happening inside the body, developing an understanding of how fast and the level of ketosis you’re able to achieve.

Over time, some people develop intuition around what diet or routines lead to a given ketone level, but it’s helpful to establish a periodic basis for using an accurate ketone measurement device to get reliable objective data.

Top 3 ways to test for ketosis