Ketone meters

This is just a thought I had this morning- to really asses how one is going with the keto diet, we really need to measure blood ketone levels to keep it between 1.5-3 mmol/L, as suggested by Volk and Phinney. And I was thinking back on how everyone is different with different tolerances etc. The calculators seem OK, but once again, everyone is different and the only was to know if one is in ketosis is to measure blood ketone levels.

I know the keto sticks are really not that accurate, so I started looking to buy one here in Australia. Looks like they retail for upwards of $50 & the strips are quite expensive too. In the U.S., they appear to be giving them away for free. (see here _https://www.abbottdiabetescare.com/products/patient/pxtra-overview.html).

The only post I could find on ketone meters was this one here, and the meter used was Precision Extra.

Because so many of us are on the diet, and it's what we advocate for optimal health, instead of purchasing them all spearately, I'm wondering if it would be something that the QFG would be interested in purchasing (or seeing if they can get them free) in bulk along with keto strips, that the forum can buy off QFG? Gaby is also in the process of preparing a document on the keto diet as a resource, which may also be published as was the Life is Religion book. So would it be an idea to have a 'Keto Kit' with the booklet, meter and some strips to get people started?

If this is a bad idea, mods feel free to delete this post, as I don't want to add noise.

I am looking into purchasing this ketone and glucose meter. It is also offered for free if you buy two boxes of strips which costs $20 per box.

I looked at that too, they don't ship to Australia however :(

I'm also not sure if there's a huge variation in the precision and calibration of these meters, it would be obviously be preferable to have that gives accurate readings. Also maybe others can chime in here, but it seems like the meters test plasma levels as opposed blood ketone levels, as is mentioned here:

Ketosis is a matter of degree. It's something that gets higher and lower. Home blood ketone meters measure one of the three ketones that the body uses as fuel, beta-hydroxybutyrate (β-OHB). As shown in the first graph below, in average people, β-OHB can range from trace amounts to about 6 mmol/L. But the graph shows blood levels of β-OHB. Home meters show plasma levels. A blood level of 6 is equivalent to a higher plasma level.

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_http://paleohacks.com/questions/132885/any-experience-with-blood-ketone-meters.html

In Jimmy Moore's video, he explains he uses Abbott ketometer. The talk was given in Australia and people from the public told him that the strips were cheaper there. That is the only problem with this experiment, the strips are very expensive. Emmerich uses another brand whose strips seem to be cheaper. Whatever you can get a hold should be okay though, as long as it involves pricking the finger.

If you contact an agent from Abbott or whatever lab offers these gadgets, you can find out if they could arrange to give the little machine for free because... they make their money back with the strips. You guys can explain this is for a ketogenic diet long-term experiment. Perhaps trying through Abbott's website (or another lab which offers it) would yield more contact info. Worth trying to see if some money could be saved. I got mine for free through an Abbott representative.

Since the strips are expensive, testing once you think you are ketoadapted, and then experimenting occasionally with menus and veggies to see how off you go of your ideal level seems to be the key.

Those of you who love these experiments, it would be nice if you can get this. Those who might tolerate more carbs can find out once and for all how much they tolerate while staying on an ideal range of ketosis.

I'll post my experiments once I feel I'm ketoadapted. I'm still having transitioning symptoms such as mild pains (autophagy discussed on the Ketogenic diet thread) which stopped like 2 days ago. I'm starting to pee more normally and that kind of stuff.

Gaby said:

In Jimmy Moore's video, he explains he uses Abbott ketometer. The talk was given in Australia and people from the public told him that the strips were cheaper there. That is the only problem with this experiment, the strips are very expensive. Emmerich uses another brand whose strips seem to be cheaper. Whatever you can get a hold should be okay though, as long as it involves pricking the finger.

If you contact an agent from Abbott or whatever lab offers these gadgets, you can find out if they could arrange to give the little machine for free because... they make their money back with the strips. You guys can explain this is for a ketogenic diet long-term experiment. Perhaps trying through Abbott's website (or another lab which offers it) would yield more contact info. Worth trying to see if some money could be saved. I got mine for free through an Abbott representative.
<snip>

Click to expand...

Abbot Labs have an office in Australia, so I will give them a call first thing Monday. They sell the Precision Xtra, & this is what their blurb had to say:

Precision Xtra Overview

The Precision Xtra Blood Glucose & Ketone Monitoring System was designed for easy testing. Intuitive setup and simple icon-driven menus help simplify blood glucose monitoring. In addition, the Precision Xtra system tests both blood glucose and blood ketone all with the same meter — using the Precision Xtra blood glucose test strips and Precision Xtra blood ketone test strips.

The Precision Xtra System—For Simple, Everyday Testing
Simple 2-Step Testing
Insert strip, add adequate blood sample, and test begins
Simple Icon-Driven Menu
Intuitive setup and easy navigation
Simple-to-Use Buttons
Easy to review result—with ability to scroll back and forth

Precision Xtra Test Strips—Test Blood Glucose and Blood Ketone with the Same Meter!
No Coding Required
No coding means one less step1
Precision Xtra Blood Glucose Test Strips
Fast 5-second test time and small 0.6 microliter blood sample size
Precision Xtra Blood Ketone Test Strips
10-second test time and 1.5 microliters blood sample size
Easy Blood Sample Application
End-fill or top-fill with visual confirmation
Foil-Wrapped Test Strips
Designed to prevent contamination errors due to exposure to air, moisture, or contamination

Click to expand...

_https://www.abbottdiabetescare.com/products/patient/pxtra-overview.html

Arwenn said:

Abbot Labs have an office in Australia, so I will give them a call first thing Monday. They sell the Precision Xtra, & this is what their blurb had to say:

Click to expand...

Yeah, that is the good thing with these gadgets, you can test both ketones and glucose in your blood. The glucose strips are much more cheaper and you can do a lot of experimentation with those. Generally speaking, if a person has over 85 mg/dl of sugar in their blood while fasting, that is already too high.

I have Abbott's FreeStyle Optium which is basically the same thing, probably an older model. But whatever you can get a hold from your local pharmacy (if not a lab) should do fine. People can get the thingies for pricking the finger as they are made in such a way that it doesn't involve pain. The gadget usually comes with some. One just have to get over the idea of pricking the finger though :P

I do not have any experience with Abbot Labs. I did use Nova dual glucose and ketone measuring meter for some time when I was getting into the ketogenic diet. Apart from being more expensive, the ketone strips worked a lot worse for me than the glucose strips. One prick and one strip gave me blood glucose readings; however following the same procedure, it took me 3 or 4 ketone strips to get a blood ketone reading. The ketone strips often gave an error message. I got tired of pricking myself repeatedly to get ketone readings and stopped doing it after some time.

obyvatel said:

I do not have any experience with Abbot Labs. I did use Nova dual glucose and ketone measuring meter for some time when I was getting into the ketogenic diet. Apart from being more expensive, the ketone strips worked a lot worse for me than the glucose strips. One prick and one strip gave me blood glucose readings; however following the same procedure, it took me 3 or 4 ketone strips to get a blood ketone reading. The ketone strips often gave an error message. I got tired of pricking myself repeatedly to get ketone readings and stopped doing it after some time.

Click to expand...

Thanks for that feedback obyvatel, that's exactly what I'm after. It's obvious that some meters will work better than others -from what I've seen on the net, the ones from Abbot Labs seem to be easy to use and fairly accurate. The other alternative is to actually get a blood test, but I want to be able to experiment with certain ratios of foods, and chart my glucose and ketone levels. It'll be handy for testing the kids as well.

Arwenn said:

obyvatel said:

I do not have any experience with Abbot Labs. I did use Nova dual glucose and ketone measuring meter for some time when I was getting into the ketogenic diet. Apart from being more expensive, the ketone strips worked a lot worse for me than the glucose strips. One prick and one strip gave me blood glucose readings; however following the same procedure, it took me 3 or 4 ketone strips to get a blood ketone reading. The ketone strips often gave an error message. I got tired of pricking myself repeatedly to get ketone readings and stopped doing it after some time.

Click to expand...

Thanks for that feedback obyvatel, that's exactly what I'm after. It's obvious that some meters will work better than others -from what I've seen on the net, the ones from Abbot Labs seem to be easy to use and fairly accurate. The other alternative is to actually get a blood test, but I want to be able to experiment with certain ratios of foods, and chart my glucose and ketone levels. It'll be handy for testing the kids as well.

Click to expand...

That is interesting. For Abbott's FreeStyle Optium ketone meter, you do need to place a more generous blood drop than you would do for the glucose reading. But I never thought that some of these gadgets would have these error problems.

I've used the Precision Ultra to test both glucose and ketones and didn't have a problem with the gadget's functioning.

Just a tip on if you are gonna test both glucose and ketones:

The strips have to be in the machine before you put blood on them. You put the strip in and a little droplet signal will show up when the machine is ready for the sample.

Since the ketone strips usually require more blood, do it first then do the glucose testing. After you clean your finger put your hand down to let gravity offer more assitance, milk (press on your finger and "sqoosh" it out) the blood out of your finger to put on the ketone strip. Wipe your finger (just to keep it neat and make easier to get the next blob of blood on the second strip) while the reading for ketones is processing. When you get the reading, immediately put in the glucose strip and milk your finger for blood again and apply to glucose strip.

Remember to deliver the poke off to the side of your fingerpad, not directly in the center. If your fingerpads are tough or calloused you may have to dial up the number on the lancet device. The higher the number, the harder the poke the lancet will deliver.

Hopefully, this will save having to poke yourself twice and will prevent wasted strips.

After much ringing around today (none of local pharmacies stock ketone meters ), I managed to get Abbot Labs to send me the Freestyle Optimum. I should receive that in the next few days, so I'm looking forward to getting some (hopefully accurate) results.


Now I need to hunt for some ketone strips....

In comparing ketone meters, I found this on Jimmy Moore's website:


[quote author=Jimmy Moore's Living La Vida LoW-Carb blog]
Precision Xtra vs. NovaMax Plus: Ketone Meter Evaluation

With the rise in interest in the n=1 experiment I’ve been blogging about since May 2012, so many of you have begun testing your own blood ketones to see how well you are doing in pursuit of reaching that glorious state of “nutritional ketosis.” Attaining blood ketone levels of 0.5-3.0 millimolar is the optimal level for producing an appropriate level of beta-hydroxybutyrate to commence fat-burning and to serve as an excellent alternative fuel source for your brain and body for optimal performance according to what Dr. Stephen Phinney and Dr. Jeff Volek outline so beautifully in their outstanding MUST-HAVE 2012 book The Art & Science Of Low Carbohydrate Performance. If you haven’t already picked up your own copy of this book, then I cannot recommend it highly enough to you as an invaluable resource in your pursuit of living an optimally healthy low-carb lifestyle.

As people have been shopping around for their own blood ketone meter, I’ve been getting a lot of e-mails from readers who have asked me for my recommendation between which of the two major ketone meters they should get to test their blood levels. Is there any difference between the Precision Xtra and NovaMax Plus blood ketone meters? I’ve personally tried both of these meters and have been using the Precision Xtra results to document my n=1 experiment.

Let’s take a closer look at the PROS and CONS of each:

**Precision Xtra Blood Ketone Meter**

PROS:
- Accurate and clear blood ketone measuring
- Sturdy and strong test strips
- More precise than urine ketone testing

CONS:
- Requires more blood than glucose testing
- Test strips can be quite expensive
- Not available for purchase in stores

**NovaMax Plus Blood Ketone Meter**

PROS:
- Very little blood required for a reading
- Test strips are cheaper than Precision Xtra
- More precise than urine ketone testing

CONS:
- Test strips are very thin and flimsy
- Lower readings are not detectable
- Not available for purchase in stores

One other issue to keep in mind when deciding which meter to get was brought to my attention by a researcher who is using both of these ketone meters with people simultaneously to see how close the two readings are. Knowing your blood ketone level is an essential part of getting into nutritional ketosis, so accuracy is the key. According to this researcher, the NovaMax Plus was “frustrating” because it gave a generic “LO” reading quite often requiring retesting which he says “gets expensive” quickly. He’s currently talking with the manufacturer about these issues.

At the same time, he notes that the Precision Xtra is “far superior” for both accuracy and displaying the proper levels of blood ketones. In all the testing he’s done as part of his research, the results from this meter “best matches our assays” which he says is “the most effective method.” He wanted to make sure my readers who might decide to test their blood ketones were aware of these issues he has found. Here are some photos of the discrepancies he found between the Precision Xtra (on the left) and NovaMax Plus (on the right) ketone meters:
{couldn't find a way to post the pictures, refer to his site}

Interesting, eh? It’s curious that even at 0.6 on the Precision Xtra, the NovaMax Plus showed “LO” although this would be considered on the lower end of nutritional ketosis. This doesn’t help you if you’re trying to GET into nutritional ketosis and may even discourage your efforts to do this in earnest. We don’t want that to happen. With this information about the two blood ketone meters, I wondered if the same discrepancies would show up for me since I tend to show higher ketone levels. Here were the results of my two separate tests of the same blood sample measured at the same time: {refer to his site for pictures}

While they’re still not the same, the difference isn’t quite as stark as with the lower levels of blood ketones. Still, it’s good to know what you’re getting yourself into if you decide to go with the NovaMax Plus over the Precision Xtra ketone meter. My personal preference has been the Precision Xtra despite the extra costs involved. Knowing my ketone levels down to the precise tenth of a millimolar is scientifically important for my n=1 testing and the accuracy of my nutritional ketosis experiment. I’m testing daily, but others of you are testing once or twice a week. So knowing your precise levels of blood ketones is critical. I can imagine seeing a “LO” reading on the NovaMax Plus which many of you have reported seeing makes you want to pull your hair out. I hope this helps you make an informed decision if you decide to conduct your own test of this concept for yourself.[/quote]

_http://livinlavidalowcarb.com/blog/precision-xtra-vs-novamax-plus-ketone-meter-evaluation/1591

Odyssey said:

I've used the Precision Ultra to test both glucose and ketones and didn't have a problem with the gadget's functioning.

Just a tip on if you are gonna test both glucose and ketones:

The strips have to be in the machine before you put blood on them. You put the strip in and a little droplet signal will show up when the machine is ready for the sample.

Since the ketone strips usually require more blood, do it first then do the glucose testing. After you clean your finger put your hand down to let gravity offer more assitance, milk (press on your finger and "sqoosh" it out) the blood out of your finger to put on the ketone strip. Wipe your finger (just to keep it neat and make easier to get the next blob of blood on the second strip) while the reading for ketones is processing. When you get the reading, immediately put in the glucose strip and milk your finger for blood again and apply to glucose strip.

Remember to deliver the poke off to the side of your fingerpad, not directly in the center. If your fingerpads are tough or calloused you may have to dial up the number on the lancet device. The higher the number, the harder the poke the lancet will deliver.

Hopefully, this will save having to poke yourself twice and will prevent wasted strips.

Click to expand...

Thanks for the handy tips, Odyssey. I must say I'm not looking forward to poking myself to draw blood, but I'll get over it soon enough :)

Arwenn said:

Thanks for that feedback obyvatel, that's exactly what I'm after. It's obvious that some meters will work better than others -from what I've seen on the net, the ones from Abbot Labs seem to be easy to use and fairly accurate. The other alternative is to actually get a blood test, but I want to be able to experiment with certain ratios of foods, and chart my glucose and ketone levels. It'll be handy for testing the kids as well.

Click to expand...

Thanks for creating the thread, Arwenn. It's a great idea. I will also use these devices to the intensification of experimentation with the diet.
What nice would be have heavy metals meters at home!.

l apprenti de forgeron said:

Thanks for creating the thread, Arwenn. It's a great idea. I will also use these devices to the intensification of experimentation with the diet.
What nice would be have heavy metals meters at home!.

Click to expand...

Thank you l apprenti de forgeron, & yes it would be nice to have a home test for heavy metals! I have ordered glucose & ketone test strips (should receive it early next week), & will report back here with my findings. I'm looking forward to being able to fine tune the keto-diet around the readings I get from the ketone meter. :)