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Precision Xtra vs. NovaMax Plus: Ketone Meter Evaluation

With the rise in interest in the n=1 experiment I’ve been blogging about since May 2012 (read my latest updates about it here, here, here and here), so many of you have begun testing your own blood ketones to see how well you are doing in pursuit of reaching that glorious state of “nutritional ketosis.” Attaining blood ketone levels of 0.5-3.0 millimolar is the optimal level for producing an appropriate level of beta-hydroxybutyrate to commence fat-burning and to serve as an excellent alternative fuel source for your brain and body for optimal performance according to what Dr. Stephen Phinney and Dr. Jeff Volek outline so beautifully in their outstanding MUST-HAVE 2012 book The Art & Science Of Low Carbohydrate Performance. If you haven’t already picked up your own copy of this book, then I cannot recommend it highly enough to you as an invaluable resource in your pursuit of living an optimally healthy low-carb lifestyle.

As people have been shopping around for their own blood ketone meter, I’ve been getting a lot of e-mails from readers who have asked me for my recommendation between which of the two major ketone meters they should get to test their blood levels. Is there any difference between the Precision Xtra and NovaMax Plus blood ketone meters? I’ve personally tried both of these meters and have been using the Precision Xtra results to document my n=1 experiment.

Let’s take a closer look at the PROS and CONS of each:

**Precision Xtra Blood Ketone Meter**

PROS:
- Accurate and clear blood ketone measuring
- Sturdy and strong test strips
- More precise than urine ketone testing

CONS:
- Requires more blood than glucose testing
- Test strips can be quite expensive
- Not available for purchase in stores

**NovaMax Plus Blood Ketone Meter**

PROS:
- Very little blood required for a reading
- Test strips are cheaper than Precision Xtra
- More precise than urine ketone testing

CONS:
- Test strips are very thin and flimsy
- Lower readings are not detectable
- Not available for purchase in stores

One other issue to keep in mind when deciding which meter to get was brought to my attention by a researcher who is using both of these ketone meters with people simultaneously to see how close the two readings are. Knowing your blood ketone level is an essential part of getting into nutritional ketosis, so accuracy is the key. According to this researcher, the NovaMax Plus was “frustrating” because it gave a generic “LO” reading quite often requiring retesting which he says “gets expensive” quickly. He’s currently talking with the manufacturer about these issues.

At the same time, he notes that the Precision Xtra is “far superior” for both accuracy and displaying the proper levels of blood ketones. In all the testing he’s done as part of his research, the results from this meter “best matches our assays” which he says is “the most effective method.” He wanted to make sure my readers who might decide to test their blood ketones were aware of these issues he has found. Here are some photos of the discrepancies he found between the Precision Xtra (on the left) and NovaMax Plus (on the right) ketone meters:

Interesting, eh? It’s curious that even at 0.6 on the Precision Xtra, the NovaMax Plus showed “LO” although this would be considered on the lower end of nutritional ketosis. This doesn’t help you if you’re trying to GET into nutritional ketosis and may even discourage your efforts to do this in earnest. We don’t want that to happen. With this information about the two blood ketone meters, I wondered if the same discrepancies would show up for me since I tend to show higher ketone levels. Here were the results of my two separate tests of the same blood sample measured at the same time:


While they’re still not the same, the difference isn’t quite as stark as with the lower levels of blood ketones. Still, it’s good to know what you’re getting yourself into if you decide to go with the NovaMax Plus over the Precision Xtra ketone meter. My personal preference has been the Precision Xtra despite the extra costs involved. Knowing my ketone levels down to the precise tenth of a millimolar is scientifically important for my n=1 testing and the accuracy of my nutritional ketosis experiment. I’m testing daily, but others of you are testing once or twice a week. So knowing your precise levels of blood ketones is critical. I can imagine seeing a “LO” reading on the NovaMax Plus which many of you have reported seeing makes you want to pull your hair out. I hope this helps you make an informed decision if you decide to conduct your own test of this concept for yourself.

  • http://twitter.com/DominicDAgosti2 Dominic D’Agostino

    Thanks for posting this Jimmy

    • LLVLCBlog

      It’s my pleasure! THANKS buddy!

  • Buzz

    I noticed the “lo” with my Novamax as well. Very frustrating. Although it did register as low as 0.2–once.
    Do you know of any places that sell the Precision Xtra ketone strips at some type of a discount? They cost about twice as much as the Novamax which I can get for about $2.75/each

    • LLVLCBlog

      If you don’t want to buy a boatload of them, then the best price I’ve found is $2-2.50/strip from the online Canadian pharmacies. Google it! :)

  • LLVLCBlog

    The researcher directly measured in his lab.

  • Martin

    I am using yet another device: GlucoMen LX Plus+. I bought in Germany where I am currently living. Here’s the website:
    http://www.berlin-chemie.de/Patienten/Diabetes/Kunden-Service-Diabetes/Blutzuckermessgeraete/GlucoMen-R-LX-Plus
    It does both glucose and ketone testing. Seems to be doing fine for low ketone readings (after visiting Oktoberfest my ketone readings went down to 0.5 for a week, well once a year it’s not a problem I guess ;-) ).
    Ketone strips cost EUR 17 per 10 pieces, 1.7 EUR per one measurement. Glucose strips are around 30 EUR per 50.
    It does not seem to require too muc blood, I manage to get both readings, one after another, with just one piercing. The strips are quite robust and easy to handle.

    • http://twitter.com/JuliaHarKoll Julia

      You lucky thing! Here in sweden they cost more like 30€! (note to self: buy ketone test strips from Deutschland…)

  • roadrunner

    How does one distinguish ketosis from burning body fat from ketosis from burning dietary fat? If it is just from burning dietary fat then I presume one will not lose weight.

    • LLVLCBlog

      It’s doing both.

    • Jonathan Duncan

      Can’t distinguish source. But if you are in ketosis then you are going to be sourcing from body fats within a few hours after eating unless you are snacking all day or eating 10,000 Calories. It’s a cycle that fluxes and the net + or – at the end of the day or week is what matters for weight loss.
      Eat 2000 Cal in one sitting, you’ll start burning dietary fat and storing fat. When that supply runs out due to storing or burning, you’re back to burning stored fat. Hopefully more than you stored.

  • digby

    I find the PrecisionXtra does measure bg a bit high, but Abbot sent me a testing solution, and I’m going to work with it a while longer. Blood etones are about what I’d expect, but I don’t have anything else to measure against. I guess the main thing is tracking. Abbott has offered a one time replacement if I’m not happy; but I want to give it another week of trial.

  • http://www.facebook.com/profile.php?id=1273611229 Baron Von Cruzer

    I’ve looked at both companies’ websites. The NovaMax doesn’t seem to have an option for loading the readings into a computer. The Precision Xtra does have that option, but Windows only. Booh!!!

  • Sabu137

    Who knew different meters use different strips? Everyone. Well, I didn’t. I bought Precision strips, but when they arrived, realized my meter was, yes, the Novamax. So, I have both systems and will use up one set before I do the next box. Despite years of low-carb, I’m starting at .3. Could explain a lot. Shopping for avocados tomorrow.

    • LLVLCBlog

      My reading was exactly the same when I started. Be encouraged.

  • http://www.facebook.com/GrantsSingleMothers Butch Pornebo

    ATM I can not afford the cost of ketone strips, in the future I will, BUT I want to keep track of my blood glucose numbers immediately.

    Between Precision and Nova, which of the 2 is more accurate in measuring blood glucose levels ?

    • LLVLCBlog

      I like the Precision Xtra better.

  • Sonya

    I just got my free NovaMax in the mail, thanks to you, Jimmy! I tested today and my BG was 114 (not good for an insulin resistant person) 2 hours after lunch and my ketones at 1.3 – (which I think is good but not where I want to be) – I’m eating very little carbs, low protein and think I must be having too much fat since the scales aren’t moving.

    I can mentally adjust for the differences between the Precison Xtra and the NovaMax keton measurements but it’s the BG I’m concerned about – do you think there’s the same discrepancy? Because if so, then my BG is higher than the NovaMax shows and that’s not good.

    Thanks so much for ALL the information you share here and on all your podcasts!!

    • LLVLCBlog

      Your ketone levels are pretty good. I wouldn’t say you’re eating too much fat. Email me what you’re currently eating and when.

  • TNTitan89

    I just received an order from UDS, and they look perfectly legit to me. The strips expire 2013/12. I ordered them on 10/14 (Sunday), they called me to confirm the order on Monday, and they arrived here in TN on 10/23.

  • Stuart Hechinger

    Abbot Labs wanted to send me a 5th imprison xtralong to replace it again as I got K-7 errors, the other ones would not work with their own control solution or would not read, and I wasted a few weeks and hours with their time wasting questions and them not understanding what is wrong and even went as they instructed to the pharmacist to have them check it but it failed. they sent me one small package last time with the meter and the replacement strips and a large box with only a return envelop in it. To say the least I do not want to deal with them anymore. Did I tell you they also sent me meters where the battery was low. So I’m going to return it to the pharmacy and get the other one.

  • Michelle

    I ordered the free Nova Max and the Precision Xtra. Tonight I compared the readings with the same blood. The Nova read 90 while the Precision read 74. I’m done with the Nova except to continue using the remaining strips tor entertainment value. I’m glad it was free! Thanks for all the information.