Can You Tell by Your Urine if You Are in Ketosis? 10 Signs

Medically Reviewed on 12/22/2021
Can You Tell by Your Urine if You Are in Ketosis
You can tell by your urine that you are in ketosis using over-the-counter urine ketone testing kits, which are a convenient way to check ketone levels

The main goal of a keto diet is to achieve ketosis, a state in which your body burns fat instead of carbs for energy. You can tell by your urine that you are in ketosis using over-the-counter urine ketone testing kits.

While kits can be purchased at drug stores and pharmacies, you can also ask your healthcare provider for a prescription or recommendations. Make sure to follow the instructions on the labels, as testing methods may vary with different brands.

Although the most accurate way to check if you are in ketosis is to test your blood, blood tests are expensive and unrealistic to do on a regular basis. Urine ketone testing strips are by far the cheaper and more convenient method.

How to interpret the results of ketone testing kits

Urine ketone testing kits contain beige strips that change color depending on the level of ketones in your blood. You can compare the color with the reference color chart provided in the kit to get an idea of whether you are in ketosis or not.

If ketone levels are in the moderate to severe range, seek immediate medical help. This could be a sign of a dangerous condition called ketoacidosis.

10 signs you are in ketosis

Apart from the presence of ketones in your urine, other signs that indicate ketosis include:

1. Keto breath

As your body produces more ketones, you may notice a fruity scent to your breath caused by acetone being exhaled through your breath. If this bothers you, you can chew sugar-free gum or brush your teeth a few times during the day.

2. Decreased appetite

In the initial days of the keto diet, you may feel an increase in hunger since you aren’t consuming as many carbs as before. However, as you enter ketosis, you may feel that you’re not as hungry and that you can go longer between meals.

While it’s unclear what causes this to happen, one theory is that eating more fat and fewer carbs reduces blood sugar spikes and leads to fewer cravings. Another theory is that the calorie-dense nature of high-fat foods keeps you satiated for longer and suppresses hunger.

3. Frequent urination

You may find yourself urinating more often as your body gets rid of its glycogen stores and pulls water out of your muscles. Carbohydrates act like a sponge, holding in water. When your body starts using glycogen stores in the absence of carbs, water gets removed through urination.

4. Digestive problems

As you adjust to major changes in your diet, you may suffer from digestion problems such as constipation or diarrhea. Constipation can typically be resolved by eating fiber-rich foods, such as low-carb vegetables. 

5. Dehydration

Diarrhea and frequent urination can make you dehydrated and cause symptoms such as:

In order to prevent dehydration and electrolyte imbalance, increase your fluid intake and eat low-carb foods that contain electrolytes.

If you feel like you are feeling extremely dehydrated even after taking the necessary precautions on the keto diet, do not hesitate to consult your doctor. Severe electrolyte imbalance can lead to serious problems such as seizures and coma

6. Low energy

An initial side effect of ketosis is short term fatigue as your body adapts to restricting cars and eating more fat. During this phase, the levels of fat oxidation rise and carbohydrate oxidation fall, which can cause low energy levels.

7. Trouble sleeping

Problems in falling asleep or staying asleep at night can stem from digestive problems caused by increased fat intake and decreased intake of fiber and carbs, which help you feel satiated and thus help with sleep.

Insomnia can be resolved by eating carbs at dinner so that you stay full before you go to bed. Avoid eating fats late in the evening, as they take longer to digest and may make it difficult for you to sleep.

8. Weight loss

Weight loss may be a sign that you have entered ketosis. Weight loss with the keto diet is often caused by the water loss that occurs with increased ketone levels, as well as the calorie restriction of the diet.

9. Increased focus

While the initial phase of ketosis may make you fatigued, one of the long-term benefits of the keto diet is increased focus, according to some studies.

10. Improved stamina

Studies have shown that endurance athletes exhibited improved exercise tolerance and better recovery after athletic activities while on a ketogenic diet.


The Best Diet Tips: How to Lose Weight the Healthy Way See Slideshow
Medically Reviewed on 12/22/2021
Image Source: iStock Images

Eat Right. What is the Ketogenic Diet?

Masood W, Annamaraju P, Uppaluri KR. Ketogenic Diet. [Updated 2021 Aug 22]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from:

Bailey CP, Hennessy E. A review of the ketogenic diet for endurance athletes: performance enhancer or placebo effect? J Int Soc Sports Nutr. 2020 Jun 22;17(1):33.

Batch JT, Lamsal SP, Adkins M, et al. Advantages and Disadvantages of the Ketogenic Diet: A Review Article. Cureus. 2020;12(8):e9639.

Kang HC, Chung DE, Kim DW, Kim HD. Early- and late-onset complications of the ketogenic diet for intractable epilepsy. Epilepsia. 2004 Sep;45(9):1116-23.