Cheaper Alternatives to Blood Ketone Testing

Blood Ketone Strips

I’ve had a couple readers reach out to me asking if there were any cheaper alternatives to blood ketone testing.  My most recent check on Amazon.com shows the Precision Xtra Blood Ketone strips going for a whopping $4-$5 per strip, although as you see from the picture above, some places exorbitantly charge up to $9.99 per strip!

This post is my attempt to go through some of the cheaper options that are available if you’ve decided that tracking ketones is important to your goals but you can’t afford the cost of these strips.

1. Find Cheaper Options for Blood Ketone Test Strips

The current gold standard for measuring how deeply in ketosis you are at home is still the Precision Xtra Blood Ketone monitoring system, and you already know how pricey this is.

Unfortunately if accuracy on a moment to moment basis is important to you, there’s no way around it: this is your only option.

To lessen the cost burden, you can do some online searches to see if you can find a better deal, although your mileage may vary depending on the legitimacy of the site.  Some reputable options I’ve come across are:

  • Ebay – You can sometimes get them for as cheap as $3 – 3.50 per strip, although it’s important to pay attention to the expiration date.  Sometimes these go for cheaper because they’re expired or near expiration.  If you’re ok with that, then have at it.
  • Universal Drug Store – This Canadian pharmacy is where I typically pick mine up.  They used to sell it for around $1.99 per strip, but have since raised the price to $2.30 per strip.  Depending on how comfortable you are with ordering from across the border, this could be a good option.  If your order is over $100, shipping is free.  A drawback is that they don’t accept Visa or Mastercard, so make sure you have your American Express handy.
  • Canada Drugs – Another Canadian pharmacy that brings the price down to $2.59 per strip if you order a minimum of 30.  If you only want 10 strips then the price jumps to $3.49.  I’ve never ordered from them so I can’t say anything else.

2. Urine Ketone Test Strips

These can be found on Amazon for as little as $0.0875 per strip and can be extremely useful if you are just getting started with ketosis.  As your body is becoming ketogenic with carb restriction, it will begin producing ketones in the blood, and since your body is still inefficient at using these, some of the excess ketones will spill out into the urine.

These excess ketones are what the urine strips detect.  You dip the stick in your pee, wait a few seconds, and then compare the color to a chart on the container.  The more purple it is, the more ketones you’re peeing out.

Easy peasy right?

The drawback however is that overtime, these can become inaccurate. The longer your body remains in ketosis, the more efficient it becomes at using blood ketones, and the less it spills out into the urine.

It’s been shown that in some settings, despite being in very deep ketosis (which the blood test strips will accurately detect), the urine test strips will show a very falsely low amount of urine ketones.

There have also been settings where you’re only barely in ketosis, but for some reason your kidneys are filtering out a lot of the ketones, and the urine test strips can give you a falsely high reading.

If accuracy is important to you, then this definitely isn’t the tool for you.  It CAN be useful if all you’re interested in knowing is whether or not you’re in ketosis but how deep you are isn’t important.  This can then serve as a sort of binary marker.

Ketosis = some shade of purple, doesn’t matter which one.

No ketosis = no purple.

3. Blood Glucose Strips

Generally the deeper in ketosis you are, the lower your blood sugar will be because firstly you aren’t taking in very many carbs and secondly your body is doing everything it can to preserve it’s glycogen.  I’ve seen blood sugars come down to the 50s and 60s in people who are in deep ketosis, and these folks are doing just fine.

The system that I use is the FreeStyle Lite Blood Glucose Monitoring System and the strips currently go for about $0.65 per strip on Amazon.  Again, Ebay can be a viable option where you can find these for down to $0.45 per strip, but again, you need to be remember to check the expiration date.

In my own case when I tracked both blood ketones and blood sugars, I noticed a trend where on days my blood ketones spiked my blood sugar fell and vice versa.  You can see the charts here tracking my numbers after 60 days and then 90 days of nutritional ketosis.

Now this wasn’t always consistent, but I can see how it can be helpful as an indirect guide to what your blood ketones are doing..

4. Ketonix Breath Ketone Analyzer

The current version of this can be picked up on the Ketonix site for $149.

I’ve written reviews of the first Ketonix and the updated Ketonix Sport and correlated the breath measurements with my blood ketone measurements, and this is what I concluded:

…I can say for certain that it is a powerful tool if you’re interested in pursuing a ketogenic diet.

It’s not going to give you the moment by moment details that the current gold standard, blood ketones, can give you, but if you use it consistently, it will give you an accurate trend of where you’re going and where you’ve been.

It can tell you if you’re getting more ketotic or less ketotic, but it won’t give you an absolute number.

It’s important to remember that individual breath acetone measurements are essentially worthless, but the trend is where the money is.

If tracking your state of ketosis is important to you then I think this is the most cost effective tool for doing so.  Since we already know how inaccurate urine dipsticks can be the longer you are ketoadapted I can’t encourage the use of these.

The [Ketonix] is perfect for you if:

  • You’re ok with just knowing your general state of ketosis (by taking consistent measurements to get an accurate trend)
  • You want to save money (this will pay for itself after 30-40 measurements)
  • You value convenience (just blow into this thing for 15 secs)
  • You’re ok with the variable calibration times (30 secs to 2 minutes)
  • You understand it’s limitations.

(To read more about how I tested it and to see the charts you can read the full review here)

Another obvious benefit is that you don’t have to handle your own pee or prick yourself each time.

Final Thoughts

If you’re just dipping your toes in the water and find the Precision Xtra Strips are just too expensive but you’re not quite ready to shell out the $149 for the Ketonix, one strategy to approach this would be to start off with the urine strips.

Once you feel that you have your diet dialed in and you’re consistently showing purple in the urine strips AND you’re ready for the next level of testing you can then pick up the Ketonix and maybe 1 or 2 boxes of the Precision Xtra strips.

Make the Ketonix the tool you use regularly so you have an idea of where you’re trending and only use the blood test strips here and there when you want to do a quick spot check.

On days the Ketonix is flashing red and you want to confirm how deep you are, break out your blood test strip.  If you’re worried that you ate something that pushed you out of ketosis, you can do a quick check with the blood test strip.

Otherwise continue on with the Ketonix.

If you don’t feel the need for the next level of testing, then just keep on trucking with the urine strips, being aware that eventually the shade of purple won’t mean anything other than just a marker telling you that you’re in ketosis.

10 Responses to Cheaper Alternatives to Blood Ketone Testing

  1. Raphi Sirt says:

    Hi BJJ Caveman,

    It’s not clear at all that the strips are only useful for keto noobs. There’s a strong argument to argue it’s not the case – if not quite the opposite! (surprised me too)

    http://itsthewooo.blogspot.fr/search/label/Ketadaption%20myths%20and%20facts%3A%20BOHB%3Aacetoacetate%20ratio%20%3B%20NAD%3ANADH%20ratio%20and%20health%20benefits

  2. Andy says:

    Hi sir!
    quick question

    why do you use 2 separate meters if precision Xtra can measure both blood ketones AND blood glucose?
    why do you use Freestyle lite for glucose?
    Also I think both meters are produced by same company (Abbott) ?

    • BJJ Caveman says:

      Good question. Because I had the free style lite first and already had a bunch of strips. Also I found that the freestyle glucose strips were cheaper than the precision xtra glucose strips.

      • Andy says:

        I am not too sure, but I think Precision Xtra has been discontinued and from now on they have various Freestyle meters. Also Freestyle strips can be used for Precision Xtra..
        I am from Europe and really don’t know which meter should I get. Precision Xtra strips are too much expensive, simply insane.
        What do you think about Nova max? it is cheaper.. Or maybe there is some other, cheaper system?

        • Andy says:

          P.S. Stephanie Keto person (Keto expert from youtube) claims that Glucose on ketosis in the morning of fasted stomach must be lower than 80 mg/dl and ketones around 1.5-2.5 mmol/l range.
          was it the same for you?
          I think you were doing carb re-feeds once a week… In theory it is impossible to keto adapt and stay in ketosis if carb re-feeds are done so often.
          Btw, thanks for your blog regarding keto rash. I had it as well, and it looked EXACTLY same and on exact places as your one. (I am talking about photo of your chest). My one completely gone after I did 2 carb re-feeds with interval of 7 days each… Didn’t came back yet, but I completely excluded Nuts and everything what is related to them. Also excluded heavy cream and all milk proteins (casein). So no more cheese (except soft/cream cheese, because it has very little of protein), no coffee, no mould cheeses such as danish blue..
          At the same time I eat a lot of kerrygold butter (as I am a Russian guy, who lives in Ireland), and also a lot of Coconut oil (both refined and extra virgin).. My calories are around 3500-5000 per day and I am still lean).. Apart from butter and coconut oil I eat 750g (raw weight)of pork belly, 1 pack 250g cream cheese, 6 whole eggs, 1-2 avocados and around 250 g of spinach/kale. Sometimes I swap pork belly with duck or chicken thighs.
          I try not to eat more that 140 g of protein, however I eat as much as I want fat (in general butter).. My total fat per day is around 300-400 gramms.
          Net carbs are <20g per day. On work days I eat 6 times during the day, on weekends 3-4 times, depending how long will I sleep

          • BJJ Caveman says:

            My glucose got down to the 80s but my ketone didnt’ stay consistenly in the 1.5 – 2.5 mmol range unless I exercised.

            You might like this post I wrote.

            Regarding Carb refeeds, I would disagree that it’s impossible. I found that depending on how rigorous I worked out, I could get back into ketosis within 3-4 days.

            Here’s a record of my ketone tests during my Carb Nite experiment, which is basically ketosis with one day of carb refeeds.

            Regarding your experience with Keto Rash, would you be interested in writing something up and sharing it on my Keto Rash website?

            Also, I’d like to ask what you’re trying to achieve with regard to staying keto? Throwing down 3500-5000 kcal per day is quite a lot!

        • BJJ Caveman says:

          Jimmy Moore did some comparisons with the Nova Max early on in his Ketosis experiment and found them to be less accurate… I think that’s why most people don’t use them anymore, despite them being more affordable.

          Cheapest way probably would be to go with the Ketonix

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