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With easy to use, inexpensive Urinalysis Reagent Strips, you can quickly test your pee at home and obtain some interesting and useful information!

How Urine Test Strips Work

Urine test strips, aka Urinalysis Reagent Strips, consist of a plastic or paper strip a few millimeters wide, with several small square fabric pads on the strip which react when exposed to urine, changing colors depending on the concentration of various compounds in your pee.

How to Use

Collect a few ounces of your urine in a jar or other glass vessel, and do the testing right away while it’s fresh. I use a small glass spice jar for this, and it just lives in the bathroom, ready for me to use when it’s time to test! I recommend testing at the same time(s) of day each time, and testing at least weekly (and up to a few times a day if you’d like!), with first thing in the morning being the #1 priority.

  1. To begin, open the stopwatch function on your phone or another device (but don’t start it yet), and also open the camera on your phone, so they are both quickly and easily accessible.
  2. Lay a piece of paper towel on the surface you’ll be using.
  3. Then, stir the urine sample with a clean butter knife or small spoon, and immediately dip the test strip into the urine sample for about 5 seconds.
  4. Tap the strip on the edge of the jar as you take it out, to remove excess pee.
  5. Lay the test strip, color pad side up, on the paper towel.
  6. Immediately start your stopwatch.
  7. Open the camera on your phone, and, watching the stopwatch, take a pic of the test strip at 30 seconds, 45 seconds, 60 seconds, and 2 minutes, to capture the colors at those time markers.

Now, referencing the correct photo for the appropriate time stamp for each urinary marker, compare the colors on your test strip pics with the chart on the bottle:

Things Your Pee Can Tell You About Your Body

OK, now here’s the fun part. Let’s jump into what exactly you can learn from a 10 parameter urinalysis test strip, and recommended next steps based on your results. Starting at the top – ie. the result farthest from your hand, when holding the test strip as indicated in the above image:

Leukocytes

On a urine strip, the leukocytes test looks for the presence of leukocyte esterase, which is present in white blood cells like monocytes and granulocytes. White blood cells are part of the immune system, and are responsible for helping fight infections and other diseases. High numbers of leukocytes often indicate an infection (usually viral or bacterial), and/or elevated levels of inflammation. If you have elevated leukocytes on your urine test strip, then a basic set of bloodwork and a consult with your doc are recommended next steps. You might also want to check out my articles The Best Immune-Boosting Foods and Immune-Boosting Fire Cider.

Nitrites

High nitrite level in the urine can indicate possible asymptomatic infections caused by nitrate-reducing bacteria. For example, some bacteria that most commonly cause urinary tract infections, such as Escherichia coli, Enterobacter, Klebsiella, Citrobacter and Proteus, have enzymes that convert the nitrate present in urine to nitrite. Same recommendations apply here as in #1.

Urobilinogen

Your intestinal bacteria convert the bilirubin that is excreted by the bile duct into your intestine into urobilinogen and stercobilinogen. Part of the urobilinogen is reabsorbed in the intestine and then circulated in the blood to the liver where it is excreted. But some of this recirculated urobilinogen is filtered out by the kidneys and appears in your urine.

Any deterioration in liver function reduces your ability to process the recirculated urobilinogen, and the excess that remains in the blood is filtered out by the kidneys and appears in your urine. So high urinary urobilinogen is usually an indicator of a stressed liver. Time to clean things up with CleanKeto and my super-effective cleanse, Dr. Emily’s 10-Day Detox!

Protein

Optimally, urine contains very little protein. “Proteinuria” (protein in your urine) is often associated with early kidney disease, but it can also indicate muscle damage (ie. from hard workouts), or dehydration. If your test strip indicates protein in your urine, spend a few days very conscientiously hydrating yourself really well (see my guide How Much Water Should You Drink? for details), with pink sea salt and/or electrolyte drops added to your water to assist with hydration. Then, see if the proteinuria recedes. If so, then it was likely just a case of dehydration. If it remains despite good hydration + sea salt/electrolytes, further investigation into your kidney function is advisable, as it’s much easier to turn things around early on, especially with the kidneys. Order yourself this basic set of bloodwork and have Dr. Emily do a Functional Blood Chemistry Analysis for you, and you can tell you a lot about your overall health and wellness, including kidney function.

pH

This is one of the most useful markers on the urine test strip, as urinary pH has wide-ranging indications for health.

The pH of urine typically varies between 4.5 and 8, with the first morning urine generally being more acidic and the urine produced after meals generally being more alkaline. The higher the number, the more basic (alkaline) your urine is. The lower the number, the more acidic your urine is. Optimal urinary pH is 7.0; however, the tested average is 6.0, so acidity (aka metabolic acidosis) is very common. Foods that tend to make our systems and thus our urine more acidic are: CAFO meats, non-organic foods, all grains, dairy, sweeteners (natural and artificial), processed foods, and alcohol. Other factors that tend to increase acidity are dehydration, chronic stress, exposure to environmental toxins, various medications, and electrolyte and other mineral deficiencies.

If your urinary pH is below that optimal level of 7.0, you almost certainly need more plain filtered water, and more electrolytes, in the form of pink sea salt and/or unflavored, unsweetened electrolyte drops.

If drinking more plain filtered water + sea salt/electrolyte drops regularly for a few days doesn’t bring your urinary pH all the way up to 7.0, then consuming more magnesium-rich foods and/or taking a good quality, highly absorbable magnesium supplement is often helpful. This is generally a great idea anyway for achieving and maintaining optimal health, since most people are deficient in magnesium due to depleted soils and the prevalence of chronic elevated stress levels.

Another quick trick for improving systemic and urinary pH is to have some lemon-water just before meals – ex. 1 Tablespoon of lemon juice in 4-8 oz of water. Even though lemon juice is itself acidic, it has an alkalinizing effect on the blood and urine. It’s also a good digestion booster, helping to better break down foods for improved assimilation of nutrients. Good stuff! Just remember, if you are doing intermittent or extended fasting, lemon will break your fast, so only have it inside (or at the start of) your eating window.

If good hydration + sea salt/electrolytes and increasing magnesium intake don’t get you to 7.0 urinary pH, it’s time to look at your breathing. Acidic urine can indicate obstructed sinus pathways and/or mouth breathing, leading to a lower absorption of oxygen, increased systemic inflammation, and increased utilization of electrolytes. For this issue, there’s a fairly simple fix – square breathing:

square nasal breathing

plus mouth taping:

These two together are a powerful combo that contributes greatly to overall health. This is partly because of improved sleep quality (and who couldn’t use that??), and partly from improved oxygenation, among many other benefits.

Check out James Nestor’s excellent book Breath for lots of fascinating info on this important topic!

If your urinary pH is above 8, this can often indicate infection, particularly UTI (urinary tract infection) – the same recommendations as #1 apply in that case.

Blood

Blood can be present in your urine either in the form of intact red blood cells (hematuria) or as the product of red blood cell destruction (hemoglobinuria). Hematuria produces cloudy red urine, and hemoglobinuria appears as a clear red in the urine. The presence of intact red blood cells in your urine typically signifies some kind of blood loss in the lower part of the urinary tract, like the urethra, bladder or ureters, and high hemoglobinuria or hematuria can indicate kidney inflammation. Either way, a visit with your doc is in order.

Specific Gravity

Like pH, this is another very important marker in your urine test. The specific gravity (SG) of urine is a measure of the density of the substances dissolved in your urine, and indicates your kidneys’ ability to balance water content and excretion of wastes. The less water is in your urine and the greater the concentration of the particles in your urine, the higher the specific gravity. Optimal SG is 1.005 to 1.030. High specific gravity typically indicates your level of dehydration, with higher levels signaling greater dehydration. High SG can also indicate a higher level of toxin burden in the body, and/or a higher level of toxin excretion (such as happens during a cleanse like my program Dr. Emily’s 10-Day Detox).

As with #s 4 and 5, plentiful hydration with plain filtered water + pink sea salt or electrolyte drops should be your first response to an elevated SG. Do that regularly for a week – if that doesn’t do the trick, then it’s time to give your body some extra help with housecleaning, by doing CleanKeto and/or Dr. Emily’s 10-Day Detox.

(Note that elevated protein level in urine from a hard workout will also produce slightly elevated specific gravity results. In that case, test again in a few days, when your body has had time to more fully recover. And remember, one or two hard workouts per week – with 3-4 days between – is plenty for achieving and maintaining optimal health, and more can actually do more harm than good, not giving your muscles ample recovery time, and also stimulating excess levels of the stress hormone cortisol).

Ketones

The term ketones (or ketone bodies) refers to three different products involved in the metabolism of fatty acids: acetone, acetoacetic acid and beta-hydroxybutyric acid.

Unless you are newly on a Keto (very low carb) diet, elevated concentrations of ketones are not usually found in your urine, since most ketones are completely metabolized to produce ATP (energy), carbon dioxide and water. However, low carbohydrate intake and/or burning a lot of fat (dietary or from your body stores) can lead to high urinary ketones, since ketones are a by-product of the metabolism of fat. This especially happens when first getting started with a low carb diet, and the body isn’t yet great at using all those ketones for fuel – the excess fuel gets dumped into the urine (this is a bit like pouring gasoline into a gas tank with a hole in it).

In other words, in most cases, excess ketones are simply wasted calories that you didn’t metabolize/utilize.

If you’re in ketosis, and have been eating a high-fat diet and/or have been restricting carbohydrates for a while, you’re probably keto-adapted, and this means that even when you are in ketosis, urine strips aren’t going to show any ketones, because you’re burning them for fuel rather than excreting them. Note: Keto-adaptation can happen in as few as two weeks into a low-carb or Keto diet, and after just a few days when returning to Keto after a period of higher carb.

All of that to say, if you have ketones in your urine and you are eating low carb, your body is likely still working on adapting to burning fat for fuel. Give it a couple of weeks, and those urinary ketones should disappear. If you have ketones in your urine and you aren’t low carb, however, this is cause for concern – go see you doc asap.

Bilirubin

Bilirubin is a normal by-product of red blood cell recycling. However, bilirubin can appear in your urine when this normal recycling is altered due to obstruction of the biliary ducts (ex. due to insufficient bile production, or blocked flow due to thick bile) or when kidney function is impaired. These issues can allow bilirubin to escape into circulation. Elevated urinary bilirubin is an early indication that your liver is overworked and stressed out, and it’s time to clean house – again, great ways to accomplish that are CleanKeto and/or Dr. Emily’s 10-Day Detox.

Glucose

Under normal conditions nearly all excess glucose in your system that makes it as far as your kidneys is reabsorbed by your kidneys. But if your blood glucose level increases dramatically and/or you have diabetes, the capacity of the kidneys to reabsorb glucose can be exceeded. This threshold is typically between 160-180 mg/dl, and when hit can cause glucose to appear in urine. So if you see elevated glucose in your urine, your blood sugar regulation is impaired and needs attention, asap. For more info on how to address this issue naturally, stay tuned for my upcoming 2-part article series, Reversing Type 2 Diabetes Naturally.

Summing Up

As you can see, this simple, inexpensive urine test – which is quick and easy to perform at home – can give you a lot of really useful information that can guide you toward making appropriate and effective changes that can greatly improve your overall health and well-being.

Would you like more ideas for next steps to take on your holistic health journey? Then check out my Roadmap to Optimal Health, as well as my collection of articles, podcast episodes, and healthy, easy, delicious recipes.

Eat well, be well, and enjoy! 😊