Ketones in Urine: Test, Symptoms, Causes and Treatments

Ketones in the urine indicate that the body has shifted from using glucose as its primary energy source to using fat from the liver. This shift typically occurs when you’re following a low-carb diet, and it’s what happens to your body when it’s deprived of carbohydrates that it needs to burn as fuel.

Ketones are a type of organic compound, also known as ketone bodies. The ketones are produced in your blood and urine when you deprive your body of enough insulin. Additionally, when extra excess ketones are built up in your blood, they spill over into your urine. This is a medical condition called Ketonuria.

Ketones are eliminated in the urine with no problems, but if too many are produced and sent to the kidneys, they can be detected in the urine using ketone test strips. This article examines the symptoms, causes, and treatments of ketones in urine in greater detail.

Ketones in Urine
Ketones in Urine: Symptoms, Causes, and Treatments

The Production of Ketones

The human body produces blood sugar (glucose), the primary energy source, using simple carbohydrates from starch, fiber, and sugars.

The body later transforms excess glucose into glycogen, stores them in the liver and muscles, and uses them to fuel the body’s energy. However, when the body does not have sufficient blood sugar for energy (ketosis), it uses fats to replace glucose.

First, the fats are released from their cells through the combination of low-level insulin and normal glucagon and epinephrine levels. Then, the fats go through blood circulation into the liver, where they are produced as ketones.

Moreover, the production of ketone at its low level in the body is not a problem. It is the standard adaptation of the body of a person that has no diabetes to starvation, primarily due to fast, exercise, or rare consumption of carbohydrates.

This process is also called ketogenesis. Ketones fuel the body’s energy and regulate blood sugar levels. However, high levels of ketones (ketosis) can be dangerous and life-threatening situations to the body for someone with diabetes. This condition makes the blood more acidic, which results in a health issue called diabetic ketoacidosis (DKA).

What are the symptoms of Ketonuria?

Ketonuria is a medical term that means the presence of ketone bodies in urine.

The presence of ketones in the blood and urine, if beyond average, is a sign of severe health problems. This condition is one of the most urgent reasons people seek health care. People with this condition develop symptoms like

  • Fatigue
  • Confusion/poor concentration
  • Nausea
  • Increased thirst
  • Increased urination
  • Vomiting
  • Abdominal pain
  • Fruity-smelling breath
  • Unusual smelling urine
  • Fainting
  • Feeling or being sick
  • Flushed skin

What causes high levels of Ketones in Urine?

1. Exercising

Exercising can increase urine ketones because your body uses energy to break down and burn the fat you store in your muscles. As a result, you might be dehydrated and urinate more frequently after exercise. This can also lead to increased ketones if your body doesn’t have enough stored glycogen to burn as fuel and break down the fat you eat.

2. Diabetic Medication

Medications used to treat diabetes may also increase the number of ketones in your urine. The most common drug that causes this is metformin, but other medicines and therapeutic agents, such as insulin, can also cause this side effect.

3. Eating disorder

Eating disorders are psychological illnesses that cause you to lose weight or adopt unhealthy eating habits intentionally. This can cause deficient insulin levels, increasing ketones in the urine.

If you’re not eating enough food or taking in enough nutrients, then you may be more likely to become dehydrated and lose water weight (which could lead to dehydration). This can also increase the amount of ketone production in the urine.

4. Diarrhea and Constipation

If you have diarrhea or constipation, this can cause your body to excrete excess ketones in the urine. It will help if you drink plenty of water while having these symptoms so that your bowels can move adequately and your urine will be more dilute when you urinate.

5. Low-carbohydrate dieting

When you follow a low-carbohydrate diet or eat fewer carbs, your body starts burning fat for fuel instead of carbohydrates, which may cause higher levels of ketones in your urine.

6. Overeating protein

Overeating protein can increase the production of ketones in your urine due to dehydration from excess water loss from the kidneys. Even though only a portion of protein is converted into glucose, which is used for energy by the body, all protein is broken down into amino acids that are then turned into glucose by the liver or converted directly into fat (lipolysis).

When you eat excess protein, it can lead to increased levels of ketone bodies in your urine as well as dehydration.

7. Fasting

Fasting can also cause an increase in ketones in urine because, during fasting, your body burns its fat stores for energy rather than glucose from carbohydrates or sugar from food sources like fruits or vegetables.

8. Starvation

Starvation can cause high levels of ketones in urine because it causes the body to use its fat reserves for energy. When you are starving, your body will begin burning muscle tissue as fuel instead of fat.

This reaction is a normal response to starvation. The body will burn whatever it can get its hands on to stay alive, including muscle tissue and other organs like the kidneys.

When you eat something that contains carbohydrates, such as bread or pasta, your body uses these carbohydrates as fuel and stops using protein and fat as energy sources. When no food is available, the body breaks down proteins (and other non-essential tissues) into amino acids, which are then used for energy or stored as fat for later use if necessary.

9. Pregnancy

Pregnancy is another condition that can lead to high levels of ketones in urine due to increased insulin production during pregnancy. This condition leads to increased glucose excretion by the kidneys in pregnant women.

Pregnant women should eat healthy foods to ensure adequate nutrition and not experience any issues during and after pregnancy.

10. Alcohol use disorder

Alcohol use disorder can lead to high levels of ketones in the urine. Alcohol has a diuretic effect, which reduces the amount of sodium in the body, and causes your kidneys to excrete more water than sodium. This can lead to high levels of ketones in the urine.

Ketones in Urine Test
Ketones in Urine Test

What are Ketones in Urine Tests?

The ketone in urine test is a test that checks for a high level of ketones in your urine. High levels of ketones can indicate dehydration and a lack of essential nutrients, particularly electrolytes. It is also a simple, cheap, and reliable way to diagnose diabetes.

This test is performed on a urine sample obtained from the patient. The number of ketones in the urine can be measured by adding sodium acetate (acetone) to the urine sample and then measuring the color change.

What happens during Ketones in urine tests?

The discovery of ketones in your urine means nothing. It’s normal to have them because your glucose level is low. But you have a high amount of ketones in your urine calls for an emergency.

When there are too much of ketones in your urine, it shows how acidic your body is – ketoacidosis. Then you discover you have fruity-smelling breath and unusual-smelling urine. You may also observe a burning sensation when passing urine and the feeling that you need to urinate but not produce any urine.

Don’t hesitate to have a ketone urine test when these occur. You either do it yourself with your test kit or go to the test center.

If proper attention is not given on time, it may worsen and result in DKA, hyperglycemia, high blood sugar, or organ damage. All these health issues are dangerous and life-threatening to your health.

What does an abnormal result for a Ketone in Urine Test mean?

The results of the ketone urine test can either be negative or abnormal. Negative results for ketone in urine tests imply that the ketones are at an average level (standard) in your body. However, abnormal test results reveal the presence of ketones in your urine.

If this test shows that the occurrence of ketones is within 0.6 mmol/L or below, it means ketones are at an average level. But when the test indicates that the detection of ketones is at 0.6 mmol/L to 1.5 mmol/L, it means you should consult your doctor.

Nevertheless, you should take it more seriously if the test result for ketones in the urine is more than 1.6 mmol/L in the body. This result implies that you risk being diagnosed with diabetic ketoacidosis (DKA).

Ketones in Urine Test Analyses

  1. Negative level of ketones: ≤ 0.6 mmol/L
  2. Abnormal level of ketones: 0.6 mmol/L – 1.5 mmol/L
  3. High Abnormal level of ketones: > 1.6 mmol/L

How to prevent a high level of ketones in the urine

You can do a few things to avoid high levels of ketones in the urine.

  • First, drink plenty of water. The amount of water you need to drink depends on your metabolism, but it’s generally recommended that you have about two liters per day for an average adult. This will help flush out urea (produced when muscles break down protein) and other toxins from your body.
  • Second, eat foods high in potassium (e.g., bananas). Potassium helps lower blood pressure and keeps your heart healthy by regulating fluid balance in your body.
  • Third, avoid caffeine and alcohol (because they dehydrate you). Caffeine has been shown to decrease urinary sodium excretion, which can lead to dehydration and elevated blood pressure levels. Alcohol also increases urination, so if you’re already drinking too much water, then this may be causing the problem as well!
  • Fourth, work on a balanced diet plan. This is probably the easiest thing to do when preventing high levels of ketones in your urine. Just ensure you get enough nutrition, protein, and fats from foods like meat, fish, and eggs. You also need to ensure you get enough vitamins and minerals from foods like fruits and vegetables.
  • Fifth, have ketone testing kits at home. Ketone testing kits are available online or in most pharmacies. These will tell you if your body has been using fat as an energy source instead of carbs. If this happens, you will produce more ketones. This will lead to symptoms such as dizziness or nausea.


As the name suggests, Ketones in Urine are ketone bodies present in urine that can be associated with high-fat, low-carbohydrate diets such as the ketogenic or Atkins diet.

These ketones may indicate specific metabolic changes that may pose serious health risks. Maintaining healthy glucose levels is vital for everyone, especially those with diabetes.

You should also get tested by your doctor if you suspect that you might have Ketones in your urine and act accordingly to any medical advice given by them to avoid further complications down the line.

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