What Does Ketone Levels in Urine and Blood mean?

What is ketones?

Ketones are end products of burning fatty-acids (fats) in the body, the medical term is (fatty acid metabolism).
Ketone bodies in urine are Acetone, acetoacetate and beta-hydroxybutyric acid.
Ketones in the body urine and blood come from liver and completely processed and only negligible amount appear in urine, but when carbohydrates in unavailable or he body unable to use Carbs. then the fatty acids become the predominant source of body fuel.
As the body increases its usage of fatty acids, the burning product increased, I mean ketones of course, and liver will leave excess amounts to go out by urination, that’s why you have plus ketone in urine.

What does ketonuria mean?

The disease in which ketones are present in urine is called “ketonuria”
Ketonuria is a medical condition in which ketone bodies are present in our urine
How do you know you have ketone in urine?
Simply by smelling fruit-like odor from the breath and on the urine sample especially children with type 1 diabetes, this is due to acetone, a direct by-product of the spontaneous decomposition of acetoacetic acid.
ACETONE is often described as smelling like fruit or like some nail polish remover that contains acetone.
Sometimes the odor is more subtle due to lower concentrations of acetone.

Ketone Levels

Presence of ketones may be considered a healthy sign and may be a harm indicator, just learn how to know the relationship between ketone levels and your health.
Optimal ketone levels offer many health benefits, also used as health indicators for who doing weight loss, physical and mental performance.

Normal Ketone levels

Normal healthy person will not show ketone bodies in his/her urine test.
The normal human body uses carbohydrates to make energy units that fuel brain, muscles, and other cells, in some unusual cases the body uses fats instead carbohydrates to produce energy, burning fats will produce more acetone and ketonic bodies.
Low ketone level in urine is insignificant and can’t considered as a disease or anything.
Diabetes patient with type 2 may not show ketone in urine unless urinary sugar become highly elevated
Please read: urine sugar levels chart

Urine Ketone Levels Chart

Ketone bodies finding in urine is a direct measure of ketone level.

  1. Trace ketone in urine is less than +1 and lower than 20 mg/dl, considered negative ketonuria.
  2. A mild Ketone (Plus one +1)  is a value 20 – 29 mg/dl.
  3. A moderate high ketone (plus two ++2) is a value of 30–40 mg/dl.
  4. A marked high ketone Plus three +++3) is a finding of 80 mg/dl or greater.
urine ketone levels chat

urine ketone levels chat

High ketone levels in urine

Urine test usually seen positive for ketone in patients with sever diabetes mellitus, so that urine results show high glucose and high ketone, but there are some unusual cases whereas urine has only ketone high levels without glucose in urine, such cases include:
Keto Diet or Ketogenic diet
Applying “high fats low carbs diet” will lead to high ketone levels in urine, urine ketone test used as a monitor test for keto diet.
Read more at: what is ketogenic diet?
Fasting for long period:
Presence of ketones in a healthy fasting person is a good indicator, as his body uses its alternative sources of fuel.
Very long period of fasting can aggressively consume and deplete all sources of energy and ketonic bodies in the urine will be a very important indicator when a starved person starts to heal.
Losing weight:
What happens when you start a weight loss program?
Weight loss means carbohydrate burning more than usual, so the body compensates for a lack of energy source by burning fat instead of carbohydrates, the accumulated fats will be reduced and carbohydrates stopped accumulation, thus the body loses weight, but burning fats will produce acetone in blood and urine.
Measuring ketone in urine will help you make decision about your Weight Loss Diet, read about Keto Diet Plan
Presurgical patients and Acutely ill patients
These people receive many IV solution bottles (glucose), thus ready-glucose enters the blood without using much insulin, body response is made by burning fats and may be proteins, thus ketones come to the scene.
Also a patient stay for longtime in hospital can develop ketone bodies in his urine as a result of increased fatigue and reduced nutrient led by the course of the disease.
Pregnant women
Pregnant females have an additional fuel machine, the fetus of course, so that you may find acetone-like in urine of some pregnant females not all of them of course.

Diabetes without ketone in urine

There is a case where there’s glucose in urine but no Ketone in urine is present, called hyperosmolar hyperglycemic nonketotic syndrome (HHNS).
Also know as Hyperosmolar Hyperglycaemic State (HHS): when glucose in blood being high it usually seen in urine, and ketone as well as a result of alternative usage of carbs, therefore the urine of a diabetes patient has a relative amount of both glucose and ketone.
However, after glucose in blood exceeds 1000 it might be a doubt when lab technician can’t find positive ketone in urine.
So that, HHNS is a medical syndrome following extremely high glucose levels and doesn’t show a ketone value in the urine.
You can explore: Blood Glucose Levels Chart
Acetone and ketone bodies in urine come from excessive burning fats due to diabetes, ketogenic diet, or other stress situation made to the body organs, common characteristics are fruity-breath and fruit-like-odor urine. Also urine test is enough to detect the ketone level in your urine.

Dr.Megan Ralf

A Medical laboratory Scientist who devoted his life to medical and laboratory sciences, writes his everyday expertise dealing with various pathological conditions through laboratory diagnosis of different body fluids, also participating in many workshops for first aids, infection control, and urgent care. Also Dr Megan Ralf coaching many medical teams.

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