What ketones?
Ketones are chemicals made by our body’s liver, and are present in our bodies independently from the diet we follow.
Both ketones and blood sugar (or blood glucose) are energy sources for the body. By default, our body prefers glucose as an energy source. When we eat food, the pancreas releases insulin. Insulin enters the blood, which transports glucose to the body’s cells for energy.
When glucose is absent, the body starts burning ketones for energy. The name of this process is ketosis.
3 Ketones Types
- Beta-hydroxybutyrate (BHB): BHB is around 78% of the total ketone bodies in our blood.
- Acetoacetate (AcAc): AcAc is around 20% of total ketones in the body.
- Acetone: Acetone is only 2% of total ketones.
How to measure?
- A blood ketone meter is the the most accurate way to measure ketone bodies. Measurement: beta-hydroxybutyrate, in mmol/L. Light Ketosis: 0.5-1 mmol/L. Optimal Ketosis: 1.0-3.0 mmol/L.
- A breath ketone meter is also quite an accurate tool. Measurement: acetone in parts per million (ppm). Ideal levels are often considered 5-30 ppm, but during keto diet levels may be as high as 75 ppm.
- Urine test: you dip a test strip in urine. The colour on the strip shows the urine ketone level. Use the colour chart to find the level of ketones in the urine. Measurement: acetoacetate. Negative = 0, Trace = 1, Small = 2, Moderate = 3, Large = 4, Very large = 5.
If you compare all 3 methods, blood and breath are more accurate ones. Urine tests, though simple and inexpensive, are less accurate. It may not show ketosis as your body adapts to a keto diet. Urine test shows delayed result; does not show current ketone level. Also hydration can affect the result. Urine tests do not give an exact number of ketones.
Ketone levels vary for different people. For example, keto diet starters have higher ketones levels than the ones who have adapted to the diet.
Exogenous Ketones
There are two different types of ketone bodies. The ones our body produces naturally are endogenous ketones. Artificially produced ones we can take as a supplement are called exogenous ketones.
They usually come in the form of Beta Hydroxybutyrate. Because it’s the easiest molecule out of all 3 natural varieties to turn into a nutritional supplement (3 endogenous ketones types are described in the beginning of this article).
They could give you an increased boost in energy. It happens because your body converts them into energy sources relatively fast.
Supplements also help with keto flu symptoms. But remember on their own exogenous ketones will not make you lose weight. They have to be accompanied with a keto diet and regular exercise.
Ketones can be dangerous for people with diabetes. This is because the body can’t regulate insulin, glucagon, and other hormones during diabetes. It’s extremely important to consult your doctor before you start a keto diet to evaluate possible risks and your overall physical health and suitability for it.
Symptoms of high ketones levels
- Frequent urination
- Increased thirst
- Dry mouth
- High blood sugar
More information about keto diet for people with diabetes can be found here: https://freeketoeasy.com/diabetes-ketosis/
Keto diet and pregnancy
Keto diet is not good during pregnancy. Ketones in urine during pregnancy are quite usual. In small amounts they are not harmful.
Expecting mothers with diabetes are being closely monitored by health professionals.
What is ketonuria?
Ketonuria happens when a person has high ketone levels in urine. This condition is also called ketoaciduria and acetonuria.
Ketone bodies are types of acids. Ketonuria is most common in people with type 1 diabetes, it can also happen during pregnancy or breastfeeding.
If ketone levels are high for a long period of time, the blood becomes acidic. It can harm your health
| Result | Recommendations |
| < 0.6 millimoles per liter | Normal urine ketone level |
| 0.6 – 1.5 millimoles per liter | Higher than normal; another test is recommended in 3 hours |
| 1.6 – 3.0 millimoles per liter | Moderate urine ketone level; it is recommended to call the doctor |
| > 3.0 millimoles per liter | Very high level; go to the hospital |
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