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What Does Ketones in Urine Mean?
Updated on August 16, 2022
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Diet / Weight Loss
What Does Ketones in Urine Mean?

Your body normally burns sugar (glucose) as its main energy source. 

When your cells can’t get enough, your body burns fat for energy instead. This produces compounds called ketones.

What Are Ketones?  

Ketones are a type of acid that your liver makes from fat. They can be used as an alternative energy source to glucose. 

Your body naturally makes a small amount of ketones every day. Certain diseases and health conditions can cause their levels to rise. 

Ketones are removed from the body through urine. High levels of ketones in the urine (ketonuria) means your body is unable to use glucose as its primary fuel. 

This usually occurs in people with diabetes. But other conditions can cause ketonuria as well.1

What Does Ketones in Urine Mean? 2

Testing Ketones in Urine vs. Blood Ketones

There are two main ways to test your ketone levels: blood tests and urine tests. Each one has their pros and cons.

Blood Ketone Testing

Ketone levels are usually measured with a blood test since they are found in the bloodstream. This requires a blood sample, which is processed by a lab.

Blood tests allow you to measure your ketone levels without waiting for them to show up in your urine. It’s the most accurate way to test ketone levels. 

However, it’s invasive and may be more expensive than other methods. Doctors use blood tests when they need to measure your current ketone levels precisely in order to make important treatment decisions.2

Urine Ketone Testing

You can also test your ketones with an at-home urine test. These tests involve placing a test strip in a urine sample. 

Next, you’ll be observing how the color of the strip changes. You can compare the color with a reference chart to tell the general level of ketones in your urine.

At-home urine testing has some advantages over blood testing, including:

  • ConvenienceConveniency. The test can be performed from the comfort of your home
  • You don’t need to draw blood
  • It’s less expensive
  • You don’t need any skill or technical experience to use the test

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 are in. 

Urine tests also don’t reveal your current ketone levels. Instead, they measure your average level since the last time you used the bathroom.3 

What Are Normal Ketone Levels in Urine?

A urine test can tell you if you have no ketones, which is considered normal for most people. However, your results may also show anywhere from trace amounts to high ketone levels.

  • Trace Ketones — 20 mg/dl or below
  • Moderate Ketones — 30 to 40 mg/dl
  • High Ketones — more than 80 mg/dl

What Your Ketones Says About Your Health

A ketone test can tell you whether you’re burning fat or sugar for fuel. If your ketone levels are high, it means your insulin levels are low and your body has switched to burning fat (ketosis). 

Let’s take a look at the most common ways you can develop elevated ketone levels.

1. Maybe You Have Diabetes

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 urine ketone testing is part of a routine checkup. If you’re diabetic, doctors usually 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 serious 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: 

  • Stomach pain
  • Extreme thirst
  • Urinating more than normal
  • Nausea and vomiting
  • Breath that smells “fruity”
  • Confusion
  • Weakness and fatigue

In pregnant women, elevated ketone levels are a sign of gestational diabetes. Gestational diabetes is a type of diabetes that occurs only during pregnancy. 

2. You’re Exercising Too Much

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:

  • Dizziness
  • Shakiness
  • Hunger
  • Feeling tired
  • Excessive sweating
  • Fast heartbeat

3. You’re Dehydrated

Ketones can build up in your blood if you’re dehydrated. In fact, the higher your ketone levels, the more dehydrated you are. 

The most common way you can 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:

  • Diabetes
  • Kidney disease 
  • Certain medications such as diuretics and laxatives

4. Your Weight Loss Diet Is Working

High ketone levels aren’t always a sign of an underlying health condition or poor health. This is  especially true if you’re on a weight loss diet. 

Low-carb diets, intermittent fasting, and keto diets like Atkins can all cause your body to enter a state of ketosis. Ketosis is the process in which 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 helps you avoid large increases in blood sugar levels that can trigger junk food cravings.5 

If your ketone levels are normal, this means your body is burning fat and your weight loss diet is working. 

What Is the Best Time to Test Ketones in Urine?

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:

  • Perform the test at the same time each day
  • Compare your results

Regular ketone testing can be helpful for people who are on low-carbohydrate or keto diets like Atkins. It can tell you whether you need to make changes for effective weight loss.

Should You Test for Ketones At Home?

A ketone test isn’t usually part of a routine checkup. But you may want to consider testing if:

  • You have diabetes and show signs of diabetic ketoacidosis (DKA)
  • Your latest blood glucose test says your levels are above 300 mg/dL
  • You are pregnant (especially if you’re in the 2nd or 3rd trimester)
  • You’ve been vomiting or have diarrhea

An at-home ketone test can help you assess your health. Your results can help you decide which steps you can take 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 the same diets. This can help you find out if they’re working.

Make sure to use test strips that instantly measure your ketone levels in numbers. 

We recommend the Vessel Wellness Test because it does exactly that. Besides testing for ketones, it also checks your nutrition, hydration, and stress levels. 
Your results will be ready within minutes and appear on the Vessel app. You can use the app to understand what your test results mean, and learn how to correct them.

Resources

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  1. Ketone Bodies (Urine).” University of Rochester Medical Center. “Blood Ketones: 
  2. Ketones in Blood.” MedlinePlus.
  3. Measurement, Interpretation, Limitations, and Utility in the Management of Diabetic Ketoacidosis” The Review of Diabetes Studies
  4. Ketone Testing.” Diabetes.co.uk.
  5. Food cravings during acute hypoglycaemia in adults with Type 1 diabetes” Physiology and Behavior
  6. Monitoring for compliance with a ketogenic diet: what is the best time of day to test for urinary ketosis?” National Center for Biotechnology Information: National Library of Medicine.
Will Hunter
Will Hunter
Content Contributor
Will is a content writer for KnowYourDNA. He received his B.A. in Psychology from the University of California, Los Angeles. Will has 7 years of experience writing health-related content, with an emphasis on nutrition, alternative medicine, and longevity.
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