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What are ketones?

Ketones are molecules produced by the liver from the breakdown of fats that can be used by the body as a source of energy when there is not enough glucose to fuel the body.  

What do ketones in urine mean?

Ketones are produced by the body from fat when there is not enough glucose to be used as fuel. Ketones in the urine may be a result of intentional low-carbohydrate dieting or fasting to get the body in a state of ketosis. 

Elevated levels of ketones in the body may be associated with certain medical conditions including diabetes, pregnancy, pneumonia, infections, heart attacks, stroke, sepsis, and thyroid issues. 

High ketones in the urine may be present when the body requires additional energy such as fevers, burns, or breastfeeding. 

What are ketone drinks?

Ketone drinks are supplement drinks that provide the body with an external (exogenous) source of ketones. These ketones are usually in the form of ketone esters or ketones salts. 

While the ingredients and tastes of various ketone drinks may slightly differ, a common claim found among them is that by consuming them a person will increase the levels ofbeta-hydroxybutyrate (BHB), the main form of ketone bodies, in their blood. 

Ketone drinks are often aimed at athletes who undergo intense workouts or individuals who for numerous reasons are not able to practice a traditional keto-like diet. 

What level of ketones indicate ketosis?

Ketosis is a metabolic state in which the body begins to break down fat to form molecules known as ketones to be used as fuel in the absence of sufficient glucose. It usually takes 2 to 4 days of very low carbohydrate consumption (usually less than 50 grams per day) to enter a ketosis state. 

A state of ketosis is usually identified by symptoms such as headaches, fatigue, nausea, bad breath (“keto breath”), and increased thirst. Ketosis may also be measured by urine, breath, or blood tests. 

Blood ketone levels above 0.5 mmol indicate the body is in a state of ketosis while ketone levels of 1.5-3.0 mmol are considered to be “maintaining ketosis”. Urine strips, which are primarily used to detect a diabete-related condition called diabetic ketoacidosis, measure acetoacetate, the first ketone body that is produced during the body’s transitioning from using glucose as the primary fuel source to ketones. During this early-stage transition ketones may be urine but they are rarely in later stages which makes urine strips less reliable for measuring nutritional ketosis compared to breath or blood tests.

Related Terms

Lactase Gluten

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Photo of Kristin Ricklefs-Johnson

Medically reviewed by:

Kristin Ricklefs-Johnson, Ph.D., RD

Kristin is an RDN who also earned her Ph.D. in Nutrition from Arizona State University with an emphasis on insulin resistance, lipid metabolism disorders, and obesity. She completed her post-doctoral fellowship at Mayo Clinic where she focused on nutrition-related proteomic and metabolic research. Her interests include understanding the exact mechanism of action of various genetic variations underlying individual predispositions to nutrition-related health outcomes. Her goal is to help all individuals prevent chronic diseases and achieve long, healthy lives through eating well.

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