Ketones in Urine

Ketones are produced during fat metabolism and they are not found in normal urine. Insufficient carbohydrate intake during starvation or high-protein diets can lead to ketones in urine, or when a person's body cannot use carbohydrates properly, ketones may be found in his urine.

In the absence of sufficient carbohydrates, the body metabolizes fat to get the energy it needs to keep functioning and ketones are generated as a byproduct during this process. Normally, urine does not contain any ketones. Abnormal urine ketone levels can be anything from zero to 160 mg/dl.

According to the National Institutes of Health (NIH), the results are usually listed as small, moderate, or large as follows:

• Small is less than 20 mg/dL
• Moderate is 30-40 mg/dL
• Large is greater than 80 mg/dL

The factors that can trigger off this condition are mentioned below.

• Instead of glucose, the body uses fats to produce energy
• Starvation or fasting, if you have not eaten for 18 hours or longer
• Strict dieting

• Low-carb diet or high-fat diet
• Severe stress
• Severe exercise
• Excessive exposure to cold
• Loss of carbohydrates as with nausea and frequent vomiting
• Insufficient food intake

• Insulin overdose
• Diabetic ketoacidosis or poorly controlled diabetes
• Severe fever due to infection
• Eating disorders, resulting in poor nutrition like anorexia nervosa or bulimia, alcohol abuse, or poisoning from drinking rubbing alcohol (isopropanol).

Ketones are acidic and can be harmful to the body if allowed to accumulate. If one is fasting, ketone levels in the urine will increase first and then there will be an increase in ketones in the blood.

This condition present in a diabetic person indicates an insufficient supply of insulin. According to The American Diabetes Association, one should test the urine for ketones if one has diabetes and

• has high blood glucose levels (300 mg/dL or higher)
• notices the symptoms of high blood sugar (diabetic ketoacidosis) such as nausea, vomiting, or abdominal pain
• is pregnant
• is sick or feeling very stressed

This condition when found in a pregnant woman indicate gestational diabetes and may prove harmful for the fetus. During pregnancy, due to severe nausea and vomiting, moderate amounts of ketones can be found in urine.

There are several causes of protein in urine, for example, diabetes, kidney diseases, strenuous exercises, rheumatoid arthritis, leukemia, dehydration, high blood pressure, etc. High protein in urine may lead to severe health complications. Higher levels of protein in urine during pregnancy indicate an urinary tract infection or kidney disease.

Very high levels of protein and high blood pressure, detected later in pregnancy may result in preeclampsia. Presence of protein and ketones in urine point to kidney damage. Normal values of protein in urine are less than 150 mg of protein and higher values indicate kidney dysfunction. There is an increased risk of kidney stones.

A high-protein diet can be a cause of higher levels of ketones in the body. The body can use these ketones as fuel for working of some of the body organs but the brain and nervous system, run only on glucose. In such cases, the body tries to get glucose by breaking down the protein within the body which is there in the form of food and muscle.

This again increases level of ketones in the body, giving rise to a condition called ketosis. To reduce the irritation caused due to the increased levels, the kidneys will increase urinary output, resulting in frequent urination. It is therefore necessary that individuals with kidney disease should consult a physician before opting for a high-protein diet.

One may test for this condition at home too by using urine ketone test strips. If one wishes to have a more accurate reading, he/she may use some home glucose meters that test for blood ketones.

Disclaimer: This story is for informative purposes only, and should not be used as a replacement for expert medical advice.