In This Article
In This Article
Ketones are chemicals produced in the liver. They serve as an alternative energy source when low in sugar or glucose, the body’s primary energy source.
Think of it this way. Ketones are like the emergency cash in your wallet. Sugar or glucose is your credit card. While some depend on their cards because of the convenience, there are situations where they don’t work.
You can use ketones to spend energy when sugar or glucose aren’t available or don’t work. When your body is unable to use sugar or has none of it to burn, it turns to ketones.
Ketones are a safety net for your energy needs.
Ketones are made in your liver using fat.
When you’re not eating a lot of carbohydrates, your body turns to fat for energy. Your body breaks down fat into fatty acids, and then these fatty acids are assembled into ketones, which serve as energy packets for your body.
Ketones are your body’s way of ensuring a backup energy source.
Your body naturally makes a small amount of ketones every day. However, some diseases can cause ketone levels to rise.
Ketones leave the body through urine. High levels of ketones in the urine (ketonuria) mean your body cannot use glucose as its primary fuel.
This usually occurs in people with uncontrolled diabetes (especially type 1 diabetes). Other conditions such as pregnancy, heart attack, and starvation can also cause ketonuria.1
There are two ways to test your ketone levels: blood and urine.
A blood ketone test measures the level of ketone bodies in your bloodstream. It is done using special strips and a blood ketone meter device.
Doctors use a blood test to measure ketone levels and make important treatment decisions.2
The test result can help doctors understand what's happening in your body. Monitoring your ketone level is recommended when following a ketogenic diet or having diabetes.
A blood ketone test can give a glimpse of your metabolic state. It's important to consult with a healthcare provider immediately when doing blood ketone testing, especially if the results are high.
A ketones in urine test is a simple and easy way to determine the ketone level in your body. You can do this using an at-home urine test kit. It involves placing a urine test strip in a urine sample.
You’ll need to observe how the color of the urine test strip changes. Depending on the amount of ketones, the urine strip changes color. You can compare the color with a reference chart to tell the general level of ketones in your urine.
Some test kits can give direct results about your ketone level. It could output information such as having low, normal, or high ketone levels.
At-home ketones in urine test provides the following advantages over blood testing:
However, it’s important to note that urine tests can’t measure your precise ketone level like a blood test can. They can only show you the range your levels have been in since you last used the bathroom.3
A ketones in urine test can tell you if you have no ketones, which is normal for most people. However, your results may also show anywhere from trace amounts to high ketone levels.
A ketone test can tell you whether you burn fat or sugar for fuel. If your ketone levels are high, your insulin levels are low, and your body has switched to burning fat (ketosis).
Let’s look at the most common ways to develop elevated ketone levels.
The most common cause of high ketones is diabetes. People with diabetes have issues making and processing insulin, which can affect ketone levels.
This is why a ketones in urine test is part of a routine checkup. If you have diabetes, doctors would recommend ketone testing if your blood sugar is above 300 mg/dL.
When blood sugar levels are this high, it often means insulin is dangerously low and ketone levels are high. This can put you at risk of developing diabetic ketoacidosis.1
Diabetic ketoacidosis (DKA) is a severe and potentially life-threatening diabetes complication. It occurs when the body can’t make enough insulin.
Ketones build up in the bloodstream during DKA, which causes the blood to turn acidic. This can cause damage to the kidney, brain, and other organs.4
Signs and symptoms of DKA include:
In pregnant women, elevated maternal urinary ketones are a sign of gestational diabetes. Gestational diabetes is a type of diabetes that occurs only during pregnancy.
Regular exercise is great for your health. However, too much can overwork your body.
Too much exercise can cause both blood sugar and insulin levels to drop. Low insulin forces your body to burn fat, causing your ketone levels to rise.
If your blood sugar is too low (hypoglycemia), you may experience symptoms such as:
Ketones can build up in your blood if you’re dehydrated. The higher your ketone levels, the more dehydrated you are.
The most common way to become dehydrated is by simply not drinking enough water. Dehydration can also occur if you’ve been vomiting or have diarrhea.
Excessive sweating from exercise or sauna use can dehydrate you as well. Other causes of dehydration include:
High ketone levels aren’t always signs of an underlying health condition or poor health. This is especially true if you’re on a weight-loss diet.
Low-carbohydrate diets, intermittent fasting, and keto diets like Atkins can all cause your body to enter a state of ketosis. Ketosis is when your body burns fat and produces ketones for energy.
Ketosis can help you lose weight and make your body more efficient at burning fat. It also enables you to avoid significant increases in blood sugar levels that can trigger junk food cravings.5
If your ketone levels are normal, your body burns fat, and your weight loss diet works.
Studies show that the best time to test for ketones is in the early morning (after you wake up) and at night (after dinner).6 If you’re monitoring your ketone levels at home, you should:
Regular ketone testing can be helpful for people who are on low-carbohydrate diets or keto diets like Atkins. It can tell you whether you need to make changes for effective weight loss.
A ketone test isn’t usually part of a routine checkup. But you may want to consider testing if:
An at-home ketone test can help you assess your health. Your results can help you decide which steps to avoid complications or improve your current health.
You can also test for ketones if you’re on a keto, low-carb, or fasting diet—or if you’ve been using weight loss apps that promote identical diets. This can help you find out if they’re working.
Use urine test strips that instantly measure your ketone levels in numbers.
High ketone levels can lead to some health dangers, including:
DKA can be a life-threatening health problem, especially for people with diabetes. It happens when there's not enough insulin to control blood sugar levels.
This health issue is due to having a high concentration of ketones in the blood, very high blood sugar, and severe dehydration.
You might feel extremely thirsty, pee a lot, have nausea, vomiting, stomach pain, and confusion. In the worst cases, you might end up in a coma or even lead to death.
Excessive ketones can make your blood more acidic, a condition called metabolic acidosis.
This puts extra stress on your organs, especially your kidneys. It may result in symptoms such as nausea, vomiting, rapid breathing, and confusion.
Ketosis can impact your body’s electrolyte balance. Severe imbalance can affect heart rhythm and muscle function. Because of this, you might experience problems like heart palpitations, muscle cramps, and weakness.
Excess ketones are removed from the body through urine, which means you pee more. This can lead to dehydration over time.
Prolonged dehydration can lead to problems like kidney strain and reduced blood volume, potentially causing kidney damage.
If you stick with a super low-carb keto diet for a long time and have a high level of ketones, it can affect your bones because you might not get enough calcium.
If unmanaged, it can lead to worse bone problems like osteoporosis.
High ketone levels can lead to impaired cognitive function, confusion, and difficulty concentrating. In severe cases, it could even lead to coma.
If you ever feel any symptoms of having high ketone levels, talk to a healthcare provider immediately. Consider it a medical emergency, especially if you have diabetes.
If you're on a keto diet, check in with a doctor or dietitian to ensure you do it safely.