How Can I Know If I’m In Ketosis?

1. 2013 LOW-CARB CRUISE Freedom Of The Seas May 20, 2014 By Jimmy Moore How Can I Know If I’m In Ketosis? Emerging Technology For Testing Ketones

2. Gave The ResultsOf My 1-Year N=1 Nutritional Ketosis Experiment In 2013

3. KetoClarity.com Available in hardback, Kindle, and audiobook (narrated by me) on August 5, 2014

4. Super Top Secret: Table Of Contents From The Manuscript Of KETO CLARITY

5. Using nutritional ketosis to prevent and treat diseases other than epilepsy and weight loss is a relatively new concept. Most biochemistry textbooks hardly mention ketosis except in reference to starvation and diabetic ketoacidosis. MOMENT OF CLARITY QUOTE from Dr. ZeeshanArain

6. Are You Experiencing Ketosis Neurosis? WHAT ARE MY KETONES? AAACK!

7. Or Are You In Total Ketosis Complacency? Ketosis Shmosis! WHAT ARE MY KETONES? AAACK!

8. The ketone testing technology in the urine, blood, and breath are definitely interesting and a great direction for measuring for the specific level of ketosis. MOMENT OF CLARITY QUOTE from Dr. Dominic D’Agostino

9. 1. Acetoacetate (AcAc) The primary ketone body in the urine. • 2. Beta-hydroxybutyrate(BHB) The primary ketone body in the blood. • 3. AcetoneThe primary ketone body in the breath. Ketones 101

10. 1. Acetoacetate (aka urine ketones)

11. Avoid using urine ketone test strips as a measure of keto-adaptation. This is akin to looking for banana peels in your garbage to figure out how many apples are in your refrigerator and how many of those you are eating. MOMENT OF CLARITY QUOTE from Nora Gedgaudas

12. ► Ketostix cost about $12-15 for a bottle of 50 (cut in half length-wise to double them) • ► You see a definitive color change (from beige to pink to purple) within 15 seconds if you have ketones in your urine • ► Testing is painless Pros of Urine Ketone Testing

13. ► Ketostix only measure for acetoacetate; it’s the least prevalent ketone present in the body • ► Once keto-adapted, urine ketones can disappear for many • ► Not a reliable test for long-term nutritional ketosis Cons of Urine Ketone Testing

14. My experience with urine dipsticks for testing ketones is that, because they are set up to assess for the much higher levels of ketones indicative of diabetic ketoacidosis, they can’t measure the subtle levels of physiologic ketosis. MOMENT OF CLARITY QUOTE from Dr. William Davis

15. 2. Beta-hydroxybutyrate(aka blood ketones)

16. BATTLE OF THE KETONE METERS: Precision Xtra vs. NovaMax Plus

17. Precision XtraBlood Ketone Meter

18. ► Accurate and clear testing for blood ketones • ► Sturdy and strong testing strips • ► Requires more blood for testing • ► Strong reputation for being the most reliable and trustworthy ketone measuring device currently available to consumers Precision XtraBlood Ketone Meter

19. NovaMax PlusBlood Ketone Meter

20. ► Very little blood is needed for testing • ► Test strips are cheaper than Precision Xtra ($2-4 compared with $4-6) • ► Test strips are very thin and flimsy • ► Lower ketone readings show a generic “LO” message on the meter NovaMax PlusBlood Ketone Meter

21. ► It’s the most precise (gold standard) for detecting ketones • ► No ambiguity about the results with a clear digital display • ► It tests for the active ketone (BHB) your body is using for fuel Pros of Blood Ketone Testing

22. ► Extremely expensive testing strips ($2-6/strip) • ► Availability to purchase in stores is extremely limited; purchasing online is most likely required • ► Requires a painful prick of the finger for a blood sample draw Cons of Blood Ketone Testing

23. 3. Acetone(aka breath ketones)

24. For my personal experiments with ketosis, I used a breath test detecting levels of ketones in breath since it and blood ketones are well correlated and more reliable and readily detectable than urine ketone levels. MOMENT OF CLARITY QUOTE from Ben Greenfield

25. The most exciting and cutting edge area of ketone testing right now

26. Researchers compared urine and breath ketones with blood ketones. They found acetone (the breath ketone) is “as good a predictor of ketosis” as blood. A July 2002 study published in the American Journal of Clinical Nutrition

27. Breath ketone meters are currently under development, but not yet widely available to the public

28. Homemade Arduino breath ketone meter called KetoSense

29. KetoSensewascreated by a smartSwedish electronicsengineer & blogger

30. KetoSenseis the brainchild of Jens Clarholmfrom Jenslabs.com

31. While I was still doing my 2012-13 N=1 NK experiment, I sent Jens an e-mail

32. I asked Jens if he could make me a KetoSense breath ketone meter

33. A disposable one-time use breath ketone test called Metron was under development from Akers Biosciences in 2012-2013 I helped them test this meter and showed a picture of it at the end of my 2013 Low-Carb Cruise lecture

34. Ketonix.com Ketonixcreatedby a Swede with epilepsy named Michel Lundell The world’s first commercial breath ketone meter available to the general public.

35. Michel is an engineer who was diagnosed with epilepsy in 2012

36. Michel’s epilepsy medication was doubled ten times in the first year after his diagnosis. After his family noticed a BAD personality change, he began investigating the ketogenic diet. Michel’s frustration with urine and blood ketones led him to look for alternatives. When he learned you could detect ketones in the breath, he decided to make one himself. Today that product is called Ketonix.

37. Takes place at the 2014 Epilepsy Pipeline Update Conference in San Francisco, CA and Michel has a chance to win $200,000 to further develop his Ketonix product

38. Researchers at Japan’s NTT DOCOMO are developing a breath ketone device and app for your smartphone to monitor acetone levels (ketone body in the breath) in 10 seconds. In the July 25, 2013 issue of the Journal of Breath Research

39. Invoy.com Invoy Technologies in Chandler, AZ is seeking FDA approval for their breath ketone meter

40. Biomedical Engineer Dr. Lubna Ahmad is the Founder/CEO of Invoy doing ketone studies

41. Invoy is currently waiting on FDA-approval for their blood ketone device

42. ► Easy-to-use testing method you can do practically anywhere • ► Simply blow into the meter for 15 seconds and get the results • ► Measures for ketosis without the painful prick of the finger Pros of Breath Ketone Testing

43. ► Not easily available for purchase commercially in stores or online yet • ► Interpretation of test results not consistent • ► You may get dizzy from blowing into a tube for 10-30 seconds Cons of Breath Ketone Testing

44. Wanna have your mind blown about an outside-the-box way to test for ketosis?

45. Can an alcohol breathalyzer test measure for ketosis?

46. Morning ketone levels are lower than in the evening. What this means is that if you only check ketones in the morning, you might be in ketosis even if the tests are negative. DOCTOR’S NOTE from Dr. Eric Westman

47. ► Urine ketones may be negative when blood ketones show positive • ► Ketones tend to be lower in morning, higher in the evening time • ► Over time, acetoacetate switches over the beta-hydroxybutyrate once keto-adapted; that’s why urine ketones drop and blood ketones rise Some take-home observations on testing for ketones

48. ► Determine which testing method is best for your personal goals • ► Get ready to see a lot more options coming on the market in the next few years for testing ketones in the body • ► Be vigilant in your low-carb, high-fat plan to avoid obsessing about your state of ketosis Some take-home observations on testing for ketones

49. A ketogenic diet is a great opportunity for self-experimentation. Start with Atkins Induction and manipulate variables to see how your body responds by measuring blood or breath ketones. I think this is probably the best way to know what works for you. MOMENT OF CLARITY QUOTE from Bryan Barksdale

50. KetoClarity.com Check out our brand new book Keto Clarity coming August 5, 2014