Ketones in Urine: Why They Appear and What They Indicate

Ketones are produced normally by the liver as part of the metabolism of fatty acid in the body. Normally ketones cannot be seen in urine because it will totally metabolize by the body.

ketone urine test strip

Ketones are produced normally by the liver as part of the metabolism of fatty acid in the body. Normally ketones cannot be seen in urine because it will totally metabolize by the body but if glucose intake is not enough as a source of energy fats will be burn and become the sources of energy of the body. When the fats burn and turn to energy there is an increase in the production of ketones.

If you are following Ketogenic diet a dietary plan which uses fats as the main source of energy and cutting off the carbohydrate intake your ketones level will rise than its normal level it can and can be seen even in your urine. During this diet plan, it causes physiological ketosis but it does not mean your ketones in your blood are high instead the ketones in the blood are lower than uncontrolled Diabetic Ketoacidosis (DKA).

To make sure about your ketones level that is present in your urine you can conduct tests such as urine tests using strips. You should test your urine according to the instruction of the manufacturer of the brand of the strips. To make sure that your test is legit you should use a clean, fresh and uncontaminated sample.

To perform the urine test you need a clean container for your urine sample and deep the strip to the fresh and clean urine sample. To be able to interpret the result to compare the result to the color chart where normal and high ketones indicate. If you have ketones in your urine it called Ketonuria.

Normal ketones of urine on a daily bases should be in 3-15mg. Poor or high ketones may interpret by different factors such as poorly controlled diabetes, Diabetic Ketoacidosis (DKA), starvation such as no eating about 12-18 hours, Anorexia nervosa, alcoholism and bulimia nervosa, vomiting for a long period of time and sudden weight loss.

Sometimes the result of the test is false positive and false negative and this should be treat by your doctor so that your urine can be tested properly to be able to know if your ketone in the body is high or low. If your ketone level is low to moderate or very high you need to call your doctor for emergency medical attention.

What Cause Ketones High Level?

The human body is run by glucose when your body did not have enough glucose to convert as energy our body will start to burn fats to turn it into energy. Usually, this happens when your body does not produce enough insulin to help your cells to absorb glucose. It will also happen when you are following a low carb diet like ketogenic diet.

Fat breakdown in the body results in creation of ketone is a normal process of the body. To people who don’t have diabetes, insulin and other hormonal problem is not on the high risk of having high ketones but people who are suffering from diabetes are at risk of building ketones in the body.  

If this condition left untreated with those people who are suffering type 1 diabetes is a high risk of developing diabetic ketoacidosis (DKA) in some cases those people who are suffering from type 1 diabetes will also develop this condition. DKA sometimes caused by an underlying condition such as severe stomach bug, in this case, your doctor will prescribe for different treatments for underlying causes.

Symptoms of Ketone Build-up

  • Dry mount
  • Blood sugar may rise to greater than 240 milligrams per deciliter.
  • Constant urination
  • Always feeling thirsty

For severe cases and left untreated symptoms may progress

  • Over-fatigue
  • Confusion and not able to concentrate
  • Fruity breath
  • Nausea and vomiting
  • Have trouble in breathing
  • Stomach pain
  • Flush skin like having a fever


What Will Happen if your Ketone Level is Very High?

When your ketone is too high that it should be it can cause your blood too acidic that may result in Diabetic Ketoacidosis (DKA) and DKA can cause serious effects on the body such as.

  • Brain swelling
  • Sudden collapse or loss of consciousness
  • Coma/diabetic coma
  • And even death

It’s very important to watch Out of our health. If you have diabetes do not undergo a low carbohydrate diet because it’s dangerous for you. Not all people are suitable for low carb diet. Before you enter any diet plan you should ask your doctor first to make sure that everything is okay and nothing to worry.  

Treatment for High Ketone Level

Treating your high ketone level well helps you to avoid being admitted to the hospital. Talk to your doctor and follow his instructions on managing your condition. But if the symptom persists you should seek medical help.

Intravenous fluid replacement

Frequent urination can result in dehydration because of too much fluid loss in the body and glucose in the body is also washout. Hydrating with IV fluid is very helpful to replace the loss fluid and to dilute glucose to your blood


Insulin is usually for those who are suffering from diabetes but insulin will be given via IV in an emergency situation especially when your glucose in the body is to low. Insulin is given to a patient to excess glucose in the blood and turns it into energy. If your blood acid and level of ketone will return to normal level insulin medication will be stopped.

Preventing High Ketone Level

To be able to avoid having a high ketone level you should prevent it by checking your sugar level frequently especially if you have diabetes about six times a day. Follow a balanced diet plan. You should eat healthy foods and a good source of energy. You should also eat foods that can make enough glucose in the body to convert as energy to avoid burning of fats for energy purposes. If you have severe diabetes do not undergo a low carb diet unless instructed by your doctor. Seek a second opinion if you are not contented with the explanation and medication given to you by your doctor or medical provider.

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