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Ketogenic diet therapy should be monitored to achieve effective results. There are three different methods for checking and monitoring ketosis. I’ll explain each then give examples of how my patients have selected the one to suit their needs. Urine ketones (acetoacetate) is the simplest and cheapest but least accurate of all methods. This method may be “good enough” for people who are monitoring themselves at home and are able to get a more specific level at their doctor’s office. This is not precise because it measures the ketones that are cleaned out of the blood by the kidneys. It's a measurement of past, not current ketosis. Another reason that its considered a "crude" metric of ketosis