If you are reading this you are likely to be trying to achieve ketosis by following a Keto diet. Whether you are doing so for weight loss, diabetes, therapeutic purposes, or general health benefits, your chances of success can be greatly enhanced by using a ketone & glucose meter.
We spent over 40 hours researching and learning about the different ketone & glucose meters available in the market so you don't have to. We concluded that the Keto Mojo offers the best all-around package in a ketone and glucose meter.
Read more about our research and methodology here.
The Keto Mojo is the darling meter of the growing global keto community. Keto Mojo is a start-up that is challenging the incumbents in the meter market by making ketone and glucose tracking more affordable and accessible. By pairing the meter with an app, the Keto Mojo also makes tracking easier. A nice bonus is the large library of keto-related content the company publishes on its website.
We really liked the Fora 6 Connect for its ease of use, accuracy, and consistency. Their testing strips incorporate gold for higher reading responsiveness & reliability. The product’s mobile app allows you to tag readings with food items for better tracking. The Fora 6 is manufactured directly by ForaCare.
The Precision Extra has long been considered the “gold standard” in glucose and ketone meters. As a result, it is widely used in the medical community. The meter is manufactured by Abbott, a large pharma company, adding to its medical reputation. While the meter is accurate and reliable, the testing strips are much more expensive than the Keto Mojo or Fora 6 Connect ones.
What is a blood Ketone & Glucose Meter?
You can measure ketones in three different ways: through your blood, urine, or breath. Blood ketone measurements are considered to be the most accurate. A Ketone meter is easy to use and will give you a precise reading in seconds. More importantly, blood ketone test strips measure the concentration of Beta Hydroxybutyrate (BHB) in your system. This is the main ketone body produced by your metabolism when you are in ketosis. Most health benefits from the keto diet are attributed to the effect that higher levels of BHB have on different aspects o your metabolism.
By comparison, urine strips measure Acetoacetate. This is a ketone body that does not have a big direct effect on your metabolism. Similarly, breath analyzers measure acetone, which is considered a “byproduct” ketone. Acetone breaks down quickly because it is very small in molecular weight. Like Aceroacetate, Acetone also does not have a significant effect on metabolism.
In other words, both urine strips and breath analyzers are measuring your state of ketosis indirectly. Both Acetoacetate and Acetone can be valid as proxies for the presence of BHB, but they are secondary markers.
Another drawback of traditional urine strips is that they are sometimes hard to read accurately. That is because you have to match the color they turn to on a scale. This can sometimes be trickier than it sounds.
These are some of the reasons why we concluded that a blood meter is the way to go to track your ketone and glucose levels.
Why should you use a ketone & glucose meter?
Having success with a Keto diet really requires you to track two key biomarkers: blood ketones and blood glucose. A good ketone meter allows you to measure both. In fact, we excluded from our selection list any meter that could not support both types of tests.
The reason you should track these two biomarkers closely is that everyone is different. We all have different responses to similar types of foods. We each need specific amounts of fats, proteins, and carbohydrates to really elicit the right response from a ketogenic diet. So, it’s important to have accurate data to make the right decisions about what foods to eat and which items you should pass on.
The other huge benefit of owning a ketone meter is that it helps with compliance. A ketone meter provides you with clear and immediate feedback on where you are vis a vis your diet goals. By keeping track of how your metabolism is performing, you will be incentivized to stick to your diet guidelines.
Seeing the needle moving towards your goals can be incredibly motivating. This effect is mirrored in many of the comments we found in Reddit and Facebook groups. Here is a representative sentiment from a newly minted meter user:
"Finally seeing hard data (I’ve used the urine dipstick and breath meter measurements as well) that I can really trust has made getting into, and staying in ketosis so much more fun and enjoyable. I feel accountable and I love the feeling of seeing the numbers reflect my disciplined nutrition. I feel so much more comfortable experimenting with foods, exercise, and timing since I have such accurate information to guide me." -Gary p.
How does a Ketone & Glucose Meter Work?
All meters work in pretty much the same way. You place a drop of blood on a new testing strip that has been inserted into the meter through a port hole. The testing strip has three key components:
(1) Sample Chamber.
This is where the blood enters the strip. The chamber design, in part, determines how much blood is required to get an adequate reading. A narrow chamber can induce capillary action, a force that rapidly channels a drop of blood to the strip’s reaction center. The chamber is often covered with a window that gives the user a visual cue that the strip is properly loaded with blood.
(2) Reactive enzymes
This is the chemical mixture that turns glucose or ketones into an electric signal. The mixture consists of two basic parts, the enzyme and the mediator, among other ingredients. The enzyme is a protein that reacts with the glucose or ketones in the blood and triggers an electron exchange. The enzyme passes these electrons to a mediator, which is a molecule that in turn passes the electrons onto the test strip’s circuit.
Electrons from glucose or ketones travel through a network of wires from the sample chamber to the meter. The meter counts the electrons as current and calculates how much glucose or ketones it took to generate that much electricity. The meter displays that number on its screen.
A reading can take 5-10 seconds. One thing to keep in mind is that most meters will only be able to read the test strips from the same manufacturer. In fact, whenever you open a new batch of test strips, most meters will require you to insert an accompanying coding strip. This allows the meter to be calibrated with the new set of strips.
It seems that for a long time, the testing meter market was using a razor + blades type model. This meant that the value of the meter was relatively low compared to the cost of the testing strips.
However, the market has changed fairly quickly with the entry of Keto-Mojo. By pricing their testing strips a lot lower than the industry norm, Keto-Mojo has made the market much more dynamic. This move created downward pressure on the price of both meters and their corresponding test strips.
Are these meters accurate?
The best way to determine your blood ketone levels is through a lab test. As mentioned above, for in-home testing, ketone meters are more accurate than urine strips or breath analyzers. While in the last 18 months there have been a number of new breath meter products based on technological advances, the clear consensus is that blood meter is still the “gold standard” for accuracy.
Blood ketone and blood glucose meters are considered medical devices and are therefore regulated by the FDA. The FDA’s accuracy standard for this type of meter is that they must show results that are within 20% of a laboratory standard 99% of the time.
In our research we found two things: in general, most meters are fairly accurate in reading blood ketone and glucose levels, as the FDA guidelines would suggest. At the same time, we also noticed that all meters once in a while will throw off a reading that seems inconsistent.
For example take a look at the results of this benchmarking test performed by Dr. Andreas Eenfeldt, MD also known as the Diet Dr. The purpose of the test was to benchmark the accuracy of a sample of meters against results from a test lab. For this exercise, he used Quest Diagnostics.
Dr. Eenfeldt did three tests at different levels of ketosis (low, medium, and high) drawing samples simultaneously and comparing the results. For consistency, he took two readings with each meter for the three scenarios.
It is interesting to note that it is at the high level of ketosis that the widest variations are observed between the meter test results vs. those obtained from the lab test.
All meters seemed to perform more precisely at a medium level of ketone concentration. This is the levels you are most likely to be the majority of the time, unless you are following a very low carb variation of the keto diet (max. 15-10 grams of carbs per day).
Overall, the Precision Xtra was slightly more accurate than the other meters, but the difference, in the end, was quite slight.
Many factors can affect the accuracy of your meter’s results. These include temperature, levels of other substances (such as ascorbic acid) in your blood, traces of other elements on your skin (such as food residue), water, and heat. The age of your test strips may also be a factor as these can expire. When purchasing testing strips through resellers, make sure you validate the expiration date of the strips. Also, if test strips are not individually packaged, make sure the container is well capped to minimize oxidation.
What about reliability?
Perhaps just as important as accuracy, is the question of consistency of ketone meter readings. This refers to the meter’s ability to provide the same measurement when taking sequential readings. Arguably, meter reliability can be more important than accuracy. Ultimately knowing what helps you move the needle up or down is more important than getting a super precise reading of your blood ketone or glucose levels.
One simple way to test the consistency of a meter is to take two measures out of the same blood sample (i.e. two blood drops from the same draw). It is clearly best to also use two strips from the same batch.
After looking in detail at the available meter reliability comparisons we did not find very big, consistent differences between the different meters we studied. It is clear that all meters will give you a slightly different reading. But most of the time these measures tend to converge around the same value.
One solid comparison of keto meter reliability we analyzed, was carried out by Dr. Ryan Lowery. The comparison entailed taking three consecutive measures across 6 different meters to gauge the variability in readings for each one. These are the results for each of our top picks.
The FORA-6 yielded very consistent readings…..
The Precision Extra also scored readings that were quite consistent. Worth noting that the actual ketone values shown by the Precision Xtra is significantly different than the one given by the FORA-6.
The Keto-Mojo meter was the most erratic of the bunch. Dr. Lowry was surprised by the third reading, which was substantially different than the first two. This led him to go for a fourth measure, which landed close to #3, therefore splitting the results.
Dr. Lowery was a bit taken aback by the results. This is in part because he seemed partial to the ethos of the Keto-Mojo company and their contribution to the development of the keto space. We agree that company values are important. The result did give us pause. However, our analysis of Keto-Mojo’s customer satisfaction and service levels gives us confidence that if our Keto-Mojo meter was acting erratically, the company would be very responsive. They also back the product with a lifetime warranty.
What are the key features to consider
From a technology perspective, most meters out there pretty much work the same way. The differentiation may come in the architecture of the test strips, but we believe that the effects on performance in practice ara probably marginal. In fact, it is pretty clear that some meters marketed under separate brands come from the same “white label” manufacturer.
Given that functionally all products perform the same measurements, the features to pay the most attention to are:
Can test for both ketones and glucose
We were surprised to learn that not all keto meters support blood glucose readings. We’re not sure why some manufacturers would make this product choice, considering that tracking blood sugar is so important.
The reverse is also true. There are dozens of glucometers in the market. Most of them, however, do not read ketones. For our selection, we simply did not consider meters that wouldn’t support both ketone and blood glucose test strips.
The cost of testing strips
Meters are calibrated to work with the strips from the same manufacturer. Once you choose your meter you are committing to purchasing your strips from the same company.
Ketone strips can be range from $0.66 to $4.99 each (for the Precision Xtra when bought directly from Abbott). By comparison, glucose test strips are much less expensive. These range from $0.36 to $1.60 each.
Taking frequent measurements (in the morning, before and after a meal, before and after working out), is very helpful to get a more granular understanding of how our metabolism operates. So you don’t want the cost of a test strip to constrain you. Even a small difference can add up over time.
In our judgment, after spending all this time analyzing the category, we conclude that the cost of replacement strips is probably as important as the actual accuracy of the meter. If you are stingy with your use of test strips you will most likely not be getting the most out of your tracking.
While meters can store many measurements (the standard seems to be 1,000), the data ends up stuck inside them unless you transcribe it or pull it out via CSV. The latest meters are now integrating Bluetooth syncing capabilities with an app. This makes it much more convenient to visualize your trends and share your data with your other health apps.
It is a sign of the traditional / “old school” nature of the manufacturers in the meter space that there are still many products that don’t come with built-in connectivity. This is also manifest in the quality of the mobile apps of our top picks. The apps are functional for tracking your data with some charting capability. The biggest benefit is being able to pool your ketone and glucose data with other health data that you track. We expect the qualtiy of the apps to improve over time.
How to use a Ketone Meter?
All meters to test your blood ketones or blood glucose work in pretty much the same way. They are simple to use and the whole procedure can be done in under 60 seconds.
The first step is to ensure the finger you are going to draw blood from is clean. For this purpose, it is recommended that you wash your hands with warm water and swab your finger with some alcohol.
Next, you need to prepare your lancing device by loading a new lancet. Most lancets come with a dial that allows you to adjust the depth of the needle. While most of us don’t like to picture the thought of pricking ourselves with a needle to draw blood, the process in real life is pretty painless.
Once the lancing device is ready, you load a fresh testing strip. The meter will beep and/or indicate on the screen that is ready to take a measurement. You are ready to activate the lancet.
To ensure ease of draw, you may want to rub or pinch your finger for a few seconds to ensure blood comes to the surface. For optimal readings, it is recommended that you avoid a lot of activity right before you take your blood ketones or glucose measurements to avoid spikes or distortions.
When taking a glucose measurement it is also recommended that you discard the first drop of blood that you draw because there might be some interstitial glucose in the first droplet. To get an accurate glucose reading you want to make sure that you are measuring capillary glucose.
Once you draw a drop of blood, you are ready to apply it on the end of the test strip. The best way to do this is by placing the edge of the testing strip right next to the blood droplet and let it draw it in through absorption. The meter will beep once it the blood makes it on to the electrode in the test strip.
Typically readings take between 5 to 10 seconds (glucose test results are quicker). Once you have the reading. you press the eject button on the meter to dispose of the used test strip.
All meters will store your reading history onboard the device. Fortunately, Bluetooth connectivity is starting to become a basic feature.
The Keto Mojo
The Keto Mojo was the meter that popped up the most in our research. It seems to be the upstart in the field. Until the keto diet went mainstream, the meter market was a bit sleepy. Specifically, Keto-mojo disrupted the market by significantly dropping the cost of the testing strips. Before they came along, strips could go for as high as $4.99. Keto-Mojo’s costs $0.99.
We also believe that Keto Mojo has built a big following as a result of the company’s significant investment in keto-focused educational content. Their site is full of useful information on the benefits and practice of keto diets. The company claims the endorsement of many keto thought leaders including Dominic D’Agostino, Dr. Nasha Winters, and Dr. Stephen Phinney, among others.
The kit comes with everything you need to get started:
- the meter
- 10 Ketone tests strips
- 10 Glucose test strips
- Lancing Device
- 10 Lancet
Cost of Additional testing strips
The meter has is bluetooth capability that allows you to sync with the Keto Mojo app and track your history. The app looks pretty basic right now. As you can see in the screenshots, you can monitor trends for ketones and glucose. You can also export your data via CSV.
The most common complaints we saw in customer reviews were around: (1) error readings on testing strips (causing customers to waste strips); and (2) inconsistent sequential readings. The percentage of 1-star reviews is 15%, (which exceeds our threshold of 5%). The flipside of this is that their customer service gets good reviews and the company offers a money-back guarantee.
Learn more about this product here.
The Fora 6 Connect
The Fora 6 Connect gets very good reviews in terms of accuracy. This might we attributable to the fact that they use gold in their sensing strips. Gold is a highly sensitive conductor, that can also speed up the reading. The product is manufactured by ForaCare, an American company focused on the design and development of medical devices to track diabetes, hypertension, COPD, and chronic heart failure.
Once the Foera 6 takes a reading, you press an eject button that releases the test strip and automatically activates the Bluetooth sync and then turns the meter off. That means you can then pick up your phone and the reading will have already synced (see below).
One cool feature of this ketone meter is that it features a useful port light for the strip. This allows you to slip a testing strip into the meter without any fiddling.
Cost of Additional testing strips
The app allows you to track and chart historical readings. It also includes a meal journal so you can track readings along with what you ate. This is very useful for troubleshooting your diet.
All in all we really liked this product. The only drawback is its cost of ownership vs. the Keto Mojo. We can live with the idea that the meter is a bit more expensive. But so are the testing strips, so the difference in cost with other products like the Keto-mojo builds over time.
Learn more about this product here.
The Precision Extra
The Precision Extra has been in the market for a long time and is considered to be one of the gold-standards in the field. It is known for its reliability and consistency in readings. Perhaps that is why it invariably comes up in meter recommendations. It is made by Abbot, a big pharma company. Which, could be taken as a proxy for quality. By the same token, this seems to translate into less accessible customer service as we garnered from negative customer reviews.
While the Precision Xtra may be more reliable, it is a no-frills meter. It does not have bluetooth capability, therefore no accompanying mobile app to visualize your data.
Cost of Additional testing strips
What you potentially gain in precision from this meter, you lose in ownership costs. If you want to source the testing strips directly from Abbot, they can be prohibitively expensive.
You can find much cheaper testing strips for the Precision Xtra sold on Amazon. Ketone strips go for $1.20 per unit and glucose strips for $0.53. However, if you choose to go down this route please be careful. We’ve seen complaints that these strips have expiration dates that are coming up too quickly, or have already expired. The mercahnts on Amazon are distributors, not Abbot directly. Make sure you validate expiration dates before you buy!
Learn more about this product here.
We would love to hear from you! Let us know if you have any questions regarding ketone meters. If you are already using one, let us know your experience so far!
We spent over 40 hours researching and reviewing everything we could around ketone meters. Below we list the sources we found the most valuable:
Dr. Ryan Lowery – In Depth Ketone & Glucose Meter Review & Comparison
Dr. Annette Bosworth, MD – Measuring Ketones- Key to KETO Success
Diet Dr. – Which is the best ketone meter in the market
Keto Connect – Keto-Mojo Review | Comparing to Precision Xtra for Accuracy
Keto Fasting LIfe – Battle of the Blood Ketone Testers
Black Sheep Keto – Battle Of The Blood Ketone Meters: Keto Coach VS Keto Mojo VS KetoSens
Thomas DeLauer Keto Diet Guide: How to Measure your Ketones Properly
Dr. Darren Schmidt, DC – Testing ketones in the blood. Keto Mojo and Precision Xtra
Keto Kitchen Collection How Do I Use TESTING KITS To Make 100% Sure I’m In Ketosis?