Also called just ketones, ketone bodies are the manifestation of body fat metabolism. In other words, acetoacetic acid, a substance that contains ketones, is made whenever the body breaks down fat to derive energy. This fatty acid metabolism usually takes place during fasting periods, when there’s not sufficient energy available from traditional sources. However, there are several other circumstances when production of ketones may kick in.

Ketones when in limited quantity can function as a backup energy source. However, when their presence exceeds specific levels, it’s then when things go bad. Ketones are not good for the body as they turn the blood acidic, causing the person to feel extremely sick – the state often manifesting into a serious medical condition called diabetic ketoacidosis (DKA).

Generally, ketone presence is higher in diabetic individuals, especially those that have Type 1 diabetes. These are people who do not have sufficient insulin in their bodies. Keeping the ketone population under control is a crucial aspect of any diabetes management program, which is why people with diabetes are frequently asked to undergo ketone testing. Increased ketone production in non-diabetic people is not as serious a development since it’s the body’s strategy to counter starvation.

How is Ketone Made?

The human body runs on energy. Insulin is needed to convert glucose into energy. This glucose is made when the body breaks down carbohydrates. When it doesn’t have sufficient insulin to convert glucose or sugar into energy, the body breaks down fat and/or muscles. This helps create energy, but it also results in the production of ketones. When there isn’t necessary levels of insulin, glucose buildup begins in the blood and it does not enter the cells. The cells usually use glucose to make energy. But with the absence of glucose, they resort to the fat deposits. When the body’s fat is approached for energy, it gets to the liver, which then breaks the fat down into ketones.

Causes of Spiked Ketone Levels

Ketones, as aforementioned, start building when the body doesn’t have sufficient insulin (type 1 diabetes), cannot use available insulin properly (type 2 diabetes), or when there’s not a lot of food being consumed (causing problems with regard to glucose usage). People who are on weight loss diets, not eating enough, or aren’t feeling well are likely to experience ketone buildup. Consuming more food than normal can also spike ketone levels in the body.  

High Ketone Symptoms

There’s no right time or circumstance to undergo a ketone testing as that may differ across individuals. Generally, there are certain symptoms that indicate a test must be conducted; health history also has a say in this. Ketone testing is recommended during one or more of the following scenarios:

  • Blood sugar level is above 300 mg/dl
  • Hyperventilation (troubled breathing)
  • Excessive thirst and dry mouth
  • Frequent urination
  • Lack of energy and mental confusion
  • Dilated pupils
  • Vomiting, abdominal pain, or nausea
  • Pale or dry skin

Ketone Testing – Blood and Urine Testing

The ketone levels are usually tested with special blood test strips or urine sticks since little insulin means ketones would likely be present in the urine or blood.

Blood Test

The blood test is usually a more reliable or accurate method since ketones first show up in the blood. They move to the urine only after that. In fact, an individual’s blood glucose level could be more than 250 and the ketones may still not be present in the urine. Generally, an increased blood glucose level doesn’t necessarily indicate higher presence of ketones. For example, a person could have glucose levels in excess of 500 and still not have increased levels of ketones. And another individual may have just 250 ketones but much higher levels of ketones. Despite these mismatches, ketone and glucose testing are part of the same clan. Also, a blood test measures beta-hydroxybutyric acid, which is a ketone primarily responsible for DKA. 

Since there’s blood involved, blood tests for ketones are recommended in a controlled environment such as a hospital, or at home under the direct supervision of a medical professional, such as a doctor or nurse. The blood test kit usually comprises meters that use few blood drops for measurement and then exhibit the results on a screen, as numbers.

Urine Test

In a urine test, a sample of urine is poured over the strip or the strip dipped in the urine sample. The strip then takes up a certain color, which should be compared with the bottle’s testing color chart. Darker colors indicate increased ketone levels.

Urine testing entails checking acetoacetic acid levels; it’s another type of keto acid like beta-hydroxybutyric acid. However, it’s a comparatively weaker acid that makes the blood acidic only if its concentration is high. Moreover, urine testing could at times produce a false negative outcome. In other words, the ketones could have been there but the test did not detect them, as mentioned earlier. Urine testing is also slightly more time-consuming and not practical at times. For example, some people may have issues urinating, and making a kid pee is not necessarily the easiest thing to get done.  

Both types of ketone testing can be done either in a clinic or at home. But doctors often recommend a urine test.

Who Should Take the Test?

The following are people who must test their ketone levels:

  • People having type 1 diabetes with blood glucose levels exceeding 250 mg/dl in two consecutive readings.
  • Pregnant diabetic ladies must inspect their urine every morning for ketones prior to eating anything, and also if their blood glucose levels are more than 200 mg/dl.
  • The majority of adults suffering from type 2 diabetes need not be concerned about ketones; however, checking things with a doctor should be assuring.

Kids having type 2 diabetes are also not under a major ketone scare, but if the kid is going through a phase of unexpected or sudden weight loss or if the child’s blood glucose level stays constantly over 200 mg/dl, then a doctor consultation becomes imperative.

Interpreting Ketone Test Results

Ketone levels could be less than a millimole or higher than 3 millimole. Mole is a unit of measurement in chemistry, which is used for measuring things that cannot be accurately measured with standard measurement units, such as grams or milligrams.

In case the ketones measure below 0.6 millimoles for every liter (mmol/L), it’s negative and considered normal. However, if it’s in the 0.6 to 1.5 mmol/L range, the ketone level is supposedly moderate and doctor intervention is advisable. It’s a precarious situation if the ketone level falls within 1.6 and 3.0 mmol/L. Things escalate and turn into an emergency scenario when the result is 3.0 mmol/L or higher. 

Tackling Increased Ketone Levels

If the ketone test has turned out positive or if the levels are higher than normal, monitoring blood sugar and staying hydrated always are the two most important things to do. The increased water intake helps flush out excess ketones from the body. Diabetic people must frequently (multiple times a day) test their blood sugar until the ketone levels drop down.

Exercising should be refrained from since physical activity causes the fat stores in the body to burn, thereby resulting in an increase in ketone levels. There are also ketogenic diets that are designed to help keep ketone levels under control. If the ketone levels are way too high, it’s highly advisable to seek professional medical care and not resort to at-home treatments. Doctors would recommend diabetics to increase their insulin intake.

Ketones are quite widespread in our environment. In fact, several hormones in a human body are ketones. For instance, both progesterone and testosterone contain ketones. Ketones are also naturally found in plants and used widely for industrial purposes. In industries, a ketone is found in paint solvents, nylon fabric, and nail polish remover, to name a few.