Urine MULTISTIX analysis interpretation
[UPDATED OCTOBER 2022]
(These can be bought from my online shop here - Multistix)
Multistix Reagent strips can be used to test urine for glucose, ketones, specific gravity, blood, pH, protein, nitrites and leucocytes. All these are clues to disease of the kidneys, urinary tract and other problems such as diabetes. Urine testing should always be undertaken in any case where the diagnosis is in doubt.
The dipsticks should be kept at all times in the sealed container. Heat, cold, moisture and light will spoil the sticks. Do not touch the coloured squares, not because they are poisonous, but because moisture on your fingers may spoil the test. A full pot of 25 sticks can be kept for up to 12 months, but check the “use by" date.
Take a look at one of the sticks. The colours on the stick should correspond with the colours on the left-hand side of the chart (except for specific gravity, which matches the colour on the right-hand side of the chart). For example, glucose should be a greeny-blue, ketones a pale pink, specific gravity a yellow, blood a pale yellow, pH an orange, protein a pale-yellow, nitrites a buff colour and leucocytes a pale cream colour. If the sticks are not these colours to start, then they may have gone off and you shouldn't use them.
You need to check the reading for each substance at the correct time so be prepared to measure the time accurately, i.e. have the colour chart and a watch ready. Make a record of your reading on a piece of paper for future reference.
To use a stick, collect a sample of urine into clean jar. Dip one multistix into the sample, hold for a couple of seconds, remove the stick and knock off the drips. Compare the colours with those on the colour chart.
1. Glucose — at 30 seconds look at the colour of the glucose square. If there is any glucose (or sugar) present it will change colour, possibly to a dark brown. Any amount of glucose in the urine needs further investigation by your GP – you may be diabetic.
2. Ketones — at 40 seconds look at the ketone square—if ketones are present then they will have changed to a purple colour. Having ketones present is desirable because it indicates that you are in ketosis - please see The Paleo Ketogenic Diet - what to eat, being in ketosis, macros and fasting
3. Specific gravity tells you how concentrated the urine is and simply reflects how much or little you are drinking. In chronic renal failure, the kidney cannot concentrate urine and it is always weak with a low specific gravity (dark green).
4. Blood — a trace of blood appears as green flecks, but excessive blood is a dark-green colour. Any amount of blood in the urine needs further investigation by your GP. This can be suggestive of infection, stones, autoimmunity or tumours. This test is extremely sensitive and, for example, the slightest contamination from a sample given by women at period time could cause this to go abnormal.
5. pH — this tells you how acid or alkali the urine is. It can be used as a guide to hyperventilation as it goes greeny blue (alkali) in people who hyperventilate.
6. Protein — if protein is present then the colour changes to a bottle-green. Protein is a sign of disease of the renal tract — almost any kidney disease can present with protein in the urine.
7. Nitrites — if nitrites are present then a pink colour shows. Nitrites are created when bacteria in the urine convert urea to nitrite – nitrites usually mean infection – see below
8. Leucocytes — if these are present in large amounts as for example in infection, then there is a colour change to purple.
Nitrites and leucocytes — these two tests together may suggest infection of the urinary tract. If one or other are positive then you must see your GP so that s/he can send a sample of urine off for microscopy and culture to see which bug is there and to which antibiotic it is sensitive. If you have symptoms such as fever, pain on peeing, urgency, constant desire to pee, feeling ill etc then an antibiotic should be started at once on a “best guess” basis (usually trimethoprim). If there are no symptoms then it is reasonable just to monitor the situation for a while. Urine testing with multistix is an extremely useful test to do on children who have a high temperature because urine infections are often overlooked as a possible cause of fever.
These tests are not perfect – there may well be false positives and false negatives. For example nitrites may test negative even in the presence of infection because the urine has not been in the bladder long enough for the bacteria to convert urea to nitrite. Also, for example megadosing with ascorbic acid (the acid form of vitamin C) may stop the glucose square reacting to sugar. Moreover, for example, some drugs may block or enhance reactions. However Multistix are very useful as screening tests and help one to decide whether further help is required.
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