If you are diabetic, you may have heard of ketones before. Ketones, also called ketone bodies, are chemicals that are produced when the body breaks down fat for energy.
If ketone levels get too high, it can be a sign of a serious health problem called ketoacidosis.
Typically, ketoacidosis occurs if you have diabetes due to low insulin levels but can, more rarely, happen if you do not have diabetes as well.
In this article, we will discuss what ketones are, why you need to test for them, and treatment options if they are too high.
What are ketones?
Ketones are chemical substances that are produced by your liver when there is not enough insulin to process glucose, also called blood sugar, and are often a complication of diabetes.
Your cells normally use the hormone insulin to process glucose for energy; however, when your body doesn’t have enough insulin to use glucose as an energy source it will revert to using ketones to break down fat cells for energy instead.
The process for using ketones instead of insulin for energy is called ketone body metabolism.
High ketone production can be dangerous because your blood becomes too acidic due to excess ketones and this can lead to ketoacidosis, also called diabetic ketoacidosis (DKA) if you have diabetes.
Ketoacidosis is a serious condition that can be fatal if not treated immediately.
What are the causes for high ketone levels?
You have ketones not just if you are diabetic, although it is very rare for someone without diabetes to suffer from ketoacidosis.
When a person without diabetes has high levels of ketones in their blood it is usually because of extreme starvation or, in even rarer cases, due to a low carbohydrate diet such as the ketogenic diet.
For diabetics, high ketone levels can be caused by not taking enough insulin, skipping meals, illness, or exercising more than usual. When you fail to manage your diabetes it can cause your ketone levels to rise and potentially lead to ketoacidosis.
Please note that diabetic ketoacidosis occurs more frequently in people with type 1 diabetes opposed to those with type 2 diabetes.
What are the symptoms of high ketone levels?
The symptoms of high ketone levels depend on how quickly they develop and how high they get.
If ketones build up over a period of days or weeks, it may not cause any noticeable symptoms until ketoacidosis develops.
Ketoacidosis is a serious condition that can lead to ketoacidosis coma or death if left untreated.
Symptoms of ketoacidosis include:
- Dry mouth
- High blood glucose levels
- Extreme thirst
- Frequent urination
As the symptoms progress, you may develop even more symptoms, including:
- Confusion
- Fatigue
- Dry skin
- Red skin that is irritated
- Fruity smelling breath
- Shortness of breath
- Vomiting
- Nausea
- Abdominal pain
- Pale skin
If you are experiencing these symptoms, please talk to your doctor or health care provider to ensure you do not have ketoacidosis.
What can happen if you have high ketone levels?
There are several things that can happen to you if your ketone levels get too high. These include:
- Brain swelling
- Loss of consciousness
- Diabetic coma
- Death
These possibly fatal consequences highlight how important it is for you to test your ketone levels and see a doctor if you believe you are suffering from high ketone levels.
How do you test ketone levels?
There are two popular at-home tests that can be used to test for high ketone levels although you can also take them at your doctor’s office too. The two tests include:
Blood test
A ketone blood test can be used to measure ketone levels in your blood.
The blood test is done with a small needle that pricks your finger and collects a few drops of blood which is then placed on a strip to show the level of blood ketone bodies.
A ketone blood test can be performed at home with a ketone meter or at your doctor’s office and is very similar to a blood glucose test.
Urine test
A ketone urine test, also called ketonuria, uses a strip of paper that is placed in a cup with your urine or directly in your urine stream to measure ketone levels.
The strip will change color depending on the ketone level present in your urine. If you need to perform a ketone test on a child still wearing a diaper, you can simply press the strip onto their urine already in the diaper.
The ketone urine test can also be done at home or at your doctor’s office and is very similar to a pH strip test used in chemistry classes.
How do I interpret the ketone test results?
The results of your ketone test will show how many ketones are present in your blood or urine.
The normal range for ketones in the blood is 0.6 millimoles per liter (mmol/L) or less. If you have a ketone level of 0.6 to 1.0 mmol/L then your ketone levels are slightly high.
Any measurement from 1.0 to 3.0 mmol/L is a high ketone level, and anything above 3.0 mmol/L is very high.
If you have diabetes, it is important to test for ketones regularly, especially when you are sick, miss an insulin shot, or when your blood sugar is high.
If you test positive for high ketones, it is important to seek medical treatment immediately.
How do you treat high ketone levels?
If you have ketoacidosis or high blood ketone concentrations, it is important to seek medical treatment immediately as ketoacidosis can be fatal if left untreated.
Treatment for ketoacidosis includes:
- Intravenous (IV) fluids to replace any fluids lost from frequent urination
- Insulin therapy to manage blood glucose levels if you are diabetic
- Electrolyte replacement to replace those lost from frequent urination as they are needed for rehydration
If you are diabetic and need insulin therapy to lower your ketones levels, please continue to monitor your blood glucose levels hourly until they return to normal.
In some cases, you may need to seek medical attention and connect to an IV with insulin until your levels are normal again.
Where can I get a ketone test?
If you are interested in ketone testing, please talk to your doctor or health care provider about the best option for you.
You can also purchase ketone test strips online or at your local pharmacy. Some pharmacies may even have ketone meters available for purchase.
If you have any questions about ketone testing, please feel free to ask your doctor or health care provider.
Summary
Ketones are chemical substances that are used by your body to convert fat to a source of energy when your body does not have enough insulin.
High amounts of ketones are usually caused by diabetes, specifically type 1 diabetes, although there are rare instances where it can be caused by other problems.
The symptoms for high ketone levels and ketoacidosis usually include excessive hunger, extreme thirst, and frequent urination among many others.
To test for high ketone levels, you can take a blood or urine test either at home or at your doctor’s office. Treatment for high ketone levels can involve IVs, insulin treatment, and replacing your electrolytes to encourage rehydration.
If you have any more questions regarding ketones or ketoacidosis, please talk to your doctor or health care professional.
References and Sources:
Mayo Clinic
NIH
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Diabetic.org is devoted to producing expert and accurate articles and information for our readers by hiring experts, journalists, medical professionals, and our growing Diabetic.org community. We encourage you to read more about our content, editing, and fact checking methods here. This was fact checked by Jacqueline Hensler and medically reviewed by Dr. Angel Rivera.
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