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Ketones In Urine: Causes And How To Test In 2024

Jessica Holbrook

Updated on - Written by
Medically reviewed by James Harmeyer, CPhT/PN1-NC

ketones in urine

You may have heard that a ketogenic diet is one of the best ways to lose body fat and control your blood sugar. While this is true, the ketogenic diet is difficult to maintain, and the diet is much less effective if you can’t keep your body in ketosis.

A good way to monitor whether or not you are keeping your body in light nutritional ketosis is to monitor urine, breath, or blood ketone levels. Using a test kit to look for ketones can help guide your dietary choices and determine if your low-carb diet is optimized to help you meet your fat-burning goals. 

Urine testing can also be helpful for diabetes management, allowing people to check for ketones in the urine that may indicate impending problems caused by low insulin levels or high blood glucose.

Ketones In Urine: How To Test

When you are eating a high-fat diet or practicing intermittent fasting, you can use special test strips to help you figure out if you are in ketosis. Urine tests are inexpensive, easy to use, and can be found in most drug stores. 

Breath ketone meters are also convenient for monitoring ketone levels in the body. Blood tests are the most accurate way to monitor for ketosis, but they are also the most expensive.

Ketones In Urine Meaning

ketones in urine
Urine testing is the least costly ketone test. Photo: Lothar Drechsel/Shutterstock

You may have heard of tests that can look for ketones in the urine. Keto diet plans can make the ketone levels in your urine rise, but what does ketones in urine mean?

When you eat a ketogenic diet or extremely low carbohydrate diet, your body breaks down fat for fuel instead of using carbohydrates for energy. This process produces ketone bodies that circulate in your blood.

When you have ketones in your urine, you know that your body is burning body fat for fuel. This can help you know for sure that you are not eating too many carbohydrates when you are using a ketogenic diet to lose weight. Combining keto and intermittent fasting can help you lose weight more quickly than using either one alone.

What Causes Ketones

When you eat a keto diet, your body produces ketone bodies. When you have fasted for multiple hours or strictly limited your carbohydrate intake, your body starts to release fat from fat cells to be used for energy instead of glucose. The fat released travels to the liver, where it is processed and becomes a ketone unit[1].

Keto Charge reviews state that this supplement can help you get into ketosis faster.  Keto charge blends ketones and glycine amino acids that help the body continue to use fat for energy, even while you are eating. Many customers state that using this supplement helped them lose weight faster when added to their ketogenic diet.

Ketosis Vs. Ketoacidosis

It is important to note that nutritional ketosis is not the same as ketoacidosis. Ketosis is a condition where your body uses fat for fuel. It is safe and can be maintained for long periods of time. There are many health benefits associated with being in ketosis.

Ketoacidosis, however, is a dangerous condition that is a medical emergency. Diabetic ketoacidosis usually occurs in type 1 diabetics when they don’t have enough insulin and their blood glucose cannot get into their bodies cells. Usually, blood glucose levels are extremely high in diabetic ketoacidosis.

This causes the entire body to become acidic. Ketoacidosis can lead to dangerously low blood pressure and even death if left untreated.

If you experience any of the following, seek medical attention immediately:

  • Rapid breathing with fruity breath
  • Excessive thirst
  • Lightheadedness
  • Confusion
  • Dizziness

Reasons To Test For Urine Ketones

Some people follow a low-carb diet and still struggle to lose weight. This may be because their body is still using carbohydrates for energy. A ketogenic diet is most effective for weight loss when your body gets into ketosis.

Ketone production happens differently for every person. Some people have to decrease their carbohydrate intake more than others in order to elevate ketone levels and burn fat for energy. When you measure ketones, you can know for sure what carbohydrate intake will allow you to maintain ketosis.

Testing ketones daily can give you guidance on adjustments you may need to make to your diet or provide you with insight into what kinds of supplements work well for your body.

Even the best keto pills do not guarantee that you’ll get into ketosis. Rather than just hoping that your diet or supplements will get you into ketosis, you can check your ketone levels to make sure you are on the right track.

The Way To Test Ketones In The Urine

A urine test is an easy way to monitor for elevated ketone levels in your body. Urine test strips are fairly inexpensive and can be easily purchased online.

You can get an accurate measure of ketones in your urine by following these steps:

  • Wash your hands thoroughly
  • Open the test strips
  • Hold the strip in your urine stream, or place it in a urine sample for a few seconds
  • Wait for the urine strips to change color
  • Compare the color of your urine test strip to the color chart
  • Interpret the results according to the package instructions

To accurately monitor changes in your urine ketones, try to use your urine test strips at the same time each day. The Journal of Nutrition and Metabolism states that the best time to test urine ketone levels is first thing in the morning and post-dinner.

Advantages And Disadvantages Of Urine Ketone Testing

There are several advantages to using a simple urine test to check yourself for ketosis.

Following a ketogenic diet, intermittent fasting program, or both can be very challenging. Testing your ketone levels at home can guide your diet plan to optimize weight loss and ensure that you are getting the most benefit from all of your hard work and discipline.

People who depend on fasting to get into ketosis will probably wonder how long intermittent fasting takes to work. Testing your ketone levels on fasting days can help you figure out a fasting schedule that works for you.

While there are many advantages to using a urine test to check for nutritional ketosis, there are a few disadvantages to keep in mind.

Urine tests may show false positive test results if you are taking medications like levodopa, valproic acid, certain antibiotics, or vitamin C supplements. If you let your urine sit for too long, you may get a false negative result.

Alternatives To Measuring Ketones

Breath Testing

If you are serious about your keto journey, you might consider investing in a ketone breath meter. The American Journal of Clinical Nutrition[2] states that breath testing is at least as accurate as urine testing for measuring ketone levels.

Not only is breath testing as accurate as urine testing, it is more convenient. You can bring your breath meter with you to check ketone levels anytime during the day without needing privacy or a bathroom.

While breath meters were originally created to help people with type 1 diabetes who struggle with regulating their blood sugar, they have become a popular and effective tool for monitoring excess ketones produced by eating a ketogenic diet.

Blood Testing

Blood Testing
Blood tests are very accurate but expensive. Photo: RomanR/Shutterstock

According to the National Center for Biotechnology Information[3], blood testing is the most accurate way to measure ketosis. While it is the most accurate, taking a blood test every day is not realistic for most people.

A blood test is usually reserved to check ketone levels for patients in the hospital who are suffering from diabetic ketoacidosis.

Conclusion

If you want to make the most of your ketogenic diet, you should invest in a tool to measure ketones in your urine or breath.

Keeping track of your ketones can help you make adjustments to your diet, like cutting out more carbohydrates or extending your intermittent fasting windows. Making sure you are in ketosis will ensure your body is burning fat for energy instead of using sugar or carbohydrates.

Breath and urine testing are convenient and accurate ways to keep an eye on your ketones and meet your health goals.

Frequently Asked Questions

What does it mean to have ketones in your urine?

Having ketones in your urine means that your body is burning fat for fuel instead of carbohydrates.

What is the most accurate way to check for ketosis? 

A blood test is the most accurate way to find out if your body is in ketosis. 

What is diabetic ketoacidosis? 

 Diabetic ketoacidosis happens when someone does not have enough insulin to get energy into cells. It is an extreme version of ketosis and can be very dangerous. It usually occurs in people with type 1 diabetes. 

Can I still lose weight if I don’t have ketones in my urine? 

You can still lose weight if you are not in ketosis. However, you will lose weight faster if you eat enough carbs to get your body into ketosis. 


+ 3 sources

Health Canal avoids using tertiary references. We have strict sourcing guidelines and rely on peer-reviewed studies, academic researches from medical associations and institutions. To ensure the accuracy of articles in Health Canal, you can read more about the editorial process here

  1. Ucsf.edu. (2023). Ketones :: Diabetes Education Online. [online] Available at: https://dtc.ucsf.edu/types-of-diabetes/type2/understanding-type-2-diabetes/how-the-body-processes-sugar/ketones/
  2. Musa-Veloso, K., Likhodii, S.S. and Cunnane, S.C. (2002). Breath acetone is a reliable indicator of ketosis in adults consuming ketogenic meals,,. [online] 76(1), pp.65–70. doi:https://doi.org/10.1093/ajcn/76.1.65.
  3. UK), C. (2015). Ketone monitoring and management of diabetic ketoacidosis (DKA). [online] Nih.gov. Available at: https://www.ncbi.nlm.nih.gov/books/NBK343337/#:~:text=Furthermore%2C%20after%20an%20episode%20of%20ketoacidosis%2C%20where%20measurement%20of%20blood%20ketones%20may%20provide%20a%20more%20accurate%20assessment‌
Jessica Holbrook

Written by:

Jessica Holbrook, RN

Medically reviewed by:

Jessica is a registered nurse with a masters degree in research and education. She loves to help people understand how to take charge of their health. She has cared for patients in all stages of life including newborn babies through patients at the end of their life. Jessica currently works in the cardiothoracic ICU managing patients on ECMO. She is also part of a medical transport team and is a new nurse and patient educator. She loves helping people reach their full potential.

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