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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 have diabetes, you may not have enough insulin for the sugar in your bloodstream to be used for fuel. When this happens, your body burns fat instead and produces 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?

People with high levels of blood sugar often have high ketone levels. 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, 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 or tired

  • Have muscle aches

  • Have shortness of breath or trouble breathing

  • Have nausea or vomiting

  • 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, he or she may order other urine tests to check for these substances:

  • Glucose, or blood sugar

  • Protein

  • pH, or acid level

  • Blood ketones

What do my test results mean?

Many things may affect your lab test results. These include the method each lab uses to do the test. Even if your test results are different from the normal value, you may not have a problem. To learn what the results mean for you, talk with your healthcare provider.

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.

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 does not pose any known risk.

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 avoid 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. Also 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 illicit drugs you may use.

Medical Reviewers:

  • Taylor, Wanda, RN, Ph.D.
  • Ziegler, Olivia W., MS, PA