Large Ketosis...is that bad? My urine test says 8.0 Large. I know lower is optimal but if my goal is weight loss isn’t a higher level better

I see you posted yesterday, but I hope you got it sorted out since. 8.0 is indeed very high, and from this graph is looks as if you're in risk of ketoacidosis. Are you diabetic? Get yourself seen to by a pro, please. Ketoacidosis is a dangerous condition, so higher isn't better in this case.

Are you getting enough water in? Sometimes when you're dehydrated you will show as Large.  Make sure you're getting in enough water and electrolytes! 

Please remember to chase results not ketones....

Is testing for ketosis necessary?

No. 

All about Ketostix

Can urine testing strips be used to monitor nutritional ketosis? The short answer: no.

Urine testing strips (commonly referred to by the brand name Ketostix) are intended for type 1 diabetics to monitor for a condition known as diabetic ketoacidosis or DKA. DKA is a life-threatening condition for diabetics which occurs when both blood glucose and blood ketones are high. However, if you are not an insulin-dependent diabetic, your body cannot go into DKA.

Ketostix measure excess levels of one type of ketone body, acetoacetate, in the urine. While in nutritional ketosis the body produces three types of ketone bodies: acetone, acetoacetate, and beta-hydroxybutyrate (BHB). As the body becomes fat adapted two things happen: it becomes better at using ketones and it starts converting acetoacetate into BHB. This means that there will be less excess ketones and less of the only type of ketone measured by Ketostix. source.

Some people mistakenly assume that more ketones = more weight loss. This is false. Urine ketone concentration is highly dependent on a person’s level of hydration - someone who is eating a ketogenic diet and drinking a lot of water might not even register as having ketones in their urine. Urine concentration also only shows ketones that the body determined were “excessive” and excreted in the urine. Testing your urine does not provide any insight into the current state of ketogenesis in your body and bloodstream.

Urine ketone testing can produce both “false positives” and “false negatives.” As stated above, as your body adapts to using fat and ketones more efficiently, there are fewer excess ketones made and consequently, fewer excess ketones excreted in urine. This can result in a “false negative” on the strip if someone who has been eating keto for awhile uses one and sees no result, again as discussed above. This does not mean you are not in ketosis, just that your body is using its ketone production system more effectively.

At the same time, if you eat a large amount of carbs and then test urine, the Ketostick may say that there are a large amount of ketones, which would be a “false positive” of being in a ketogenic state. This is because the body has switched to using the ingested carbs as the first source of fuel and is dumping all of the excess ketones out in urine, as the body will preferentially use glucose for energy instead of fat and ketones. We note this because testing after a high-carb meal may show a lot of ketones being excreted, but again, that does not mean your body is currently in ketosis – in fact, if you just ate a high-carb meal, there is essentially no chance that you are still in ketosis. We note that Keto is becoming an increasingly popular diet and, unfortunately, some companies are using this popularity to their advantage by promoting misinformation about what is necessary to “do keto correctly.” Urine test strip marketing now often includes statements aiming the product at keto dieters as well as diabetics. This is an unfortunate side effect of the popularity of keto and the status of keto dieters as an untapped market. We encourage you not to fall for these predatory advertising methods, as they are solely being used to sell unnecessary products to people doing keto. Again, urine test strips/Ketostix are in no way required to “properly” pursue a ketogenic diet, and cannot be used to accurately monitor nutritional ketosis.

The long and short of it is that if you consume less than 20g net carbs for more than 24-48 hours you are either in ketosis or you are dead. Unless you are attempting to manage a known medical condition there is absolutely no need to test for ketosis/levels of ketones. Monitor your inputs not your outputs and chase results, not ketones.

Dobbz Interesting, thank you. 

Dobbz said:
We encourage you

 Just made me wonder if you're one of the people behind Carb Manager? :o)

Dobbz said:
However, if you are not an insulin-dependent diabetic, your body cannot go into DKA.

Not many know this, not even A&E staff, but a T2 diabetic on SGLT2 inhibitors can go into DKA. A rare side effect, but it does happen. https://www.gov.uk/drug-safety-update/sglt2-inhibitors-updated-advice-on-the-risk-of-diabetic-ketoacidosis

Unfortunately patients are often not informed of this risk.