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Ketone Bodies (Urine)

Does this test have other names?

Ketone test, urine ketones

What is this test?

This test is used to check the level of ketones in your urine. Normally, your body burns sugar for energy. But if you don't have enough sugar in your body for energy, your body burns fat instead and makes substances called ketones. The ketones end up in your blood and urine.

It's normal to have a small amount of ketones in your body. But high ketone levels could result in serious illness or death. Checking for ketones keeps this from happening. 

Why do I need this test?

You may need this test if you have a high level of blood sugar, which can happen if you have diabetes. People with diabetes often have high ketone levels because they don't make enough insulin. Or their body doesn't respond well to insulin, and they can't use the sugar in the blood for energy. If you have high blood sugar levels and type 1 or type 2 diabetes, it's important to check your ketone levels.

People without diabetes can also have ketones in the urine if their body is using fat for fuel instead of glucose. This can happen with chronic vomiting, extreme exercise, low-carbohydrate diets (ketogenic or keto diets), or eating disorders.

Checking your ketones is especially important if you have diabetes and:

  • Your blood sugar goes above 300 mg/dL

  • You abuse alcohol

  • You have diarrhea

  • You stop eating carbohydrates like rice and bread

  • You're pregnant

  • You've been fasting

  • You've been vomiting

  • You have an infection

Your healthcare provider may order this test, or have you test yourself, if you:

  • Urinate frequently

  • Are often quite thirsty

  • Have muscle aches

  • Are tired (fatigued)

  • Have weight loss

  • Have shortness of breath or trouble breathing

  • Have nausea, vomiting, or belly (abdominal) pain

  • Are confused

  • Have a fruity smell to your breath

What other tests might I have along with this test?

Your healthcare provider may also check for ketones in your blood if you have high levels of ketones in your urine.

If your healthcare provider suspects you have diabetes, they may order other urine or blood tests to check for these substances:

  • Blood sugar (glucose)

  • Protein

  • Acid level (pH)

  • Blood ketones

What do my test results mean?

Test results may vary depending on your age, gender, health history, and other things. Your test results may be different depending on the lab used. They may not mean you have a problem. Ask your healthcare provider what your test results mean for you.

Some ketone tests give the results in numbers. Others only tell you if your ketone levels are trace, small, or large. If your test strip gives you a number, you can learn your normal range. Normal results vary depending on your condition. Talk with your healthcare provider about your results and what levels are dangerous for you. Ask what you should do when your numbers are in the dangerous range. Don't hesitate to ask your provider to write down the directions. 

How is the test done?

This test can be done at home or in a lab using test strips. Collect your urine in a clean container and put a test strip in it. The strip changes color as it reacts to the ketones.

If you do this test at home, keep a record of the results to report to your healthcare provider at your next visit.

Does this test pose any risks?

This test poses no known risks.

What might affect my test results?

Exercising strenuously, taking certain medicines, and following a special diet, such as a low-carb or high-fat diet, may affect the test. Ask your healthcare provider if you should skip any foods before taking the test.

How do I get ready for this test?

You may have to take this test if your fasting blood sugar levels are high. Ask your healthcare provider when you should take the test and if you should fast, especially if you do this test at home. Be sure your healthcare provider knows about all medicines, herbs, vitamins, and supplements you are taking. This includes medicines that don't need a prescription and any illegal drugs you may use.

Online Medical Reviewer: Chad Haldeman-Englert MD
Online Medical Reviewer: Raymond Turley Jr PA-C
Online Medical Reviewer: Tara Novick BSN MSN
Date Last Reviewed: 9/1/2022
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