40 Mg/dl Ketones In Urine Keto Diet

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Urine Testing And Keto Adaptation

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Maybe youve been using urine test strips for a significant amount of time to measure the success of your ketogenic diet, and now begin to notice a change in your results, despite your habits staying relatively the same. Dont blame the strips.

In this case, your metabolism has just changed, something reflected in the strips. When you initially start a low-carbohydrate diet, youre teaching the body to rely on fat-based fuel sources rather than carbohydrates, which most of us have been using as our primary energy sources for our entire lives.

This necessitates an adaptation period , and so for the first few days or weeks of a ketogenic diet, you wont be great at efficiently producing or utilizing ketones for energy. Despite producing some ketones, you arent quite yet a proficient fat burner.

This is why ketones will appear in the urine. Since they all arent being used, theyre filtered into the urine, rather than being reabsorbed or utilized.

As you become more keto adapted, skeletal muscle actually starts to oxidize fatty acids directly. This then leaves more ketones available for our big juicy brains, and other organs that cant use fats Kapelner2015,Volek2011 This means that someone who is better at using ketones will get a lower result on a urine ketone test than they should, maybe even a negative result. Where blood testing might give a high ketone reading, urine test strips might tell another story.

How Can Ketones In Urine During Pregnancy Be Prevented

Sometimes it cant be prevented or is beyond your control. However, there are things you can do to help keep your ketones at a healthy level:

  • Dont skip meals or try to diet during pregnancy.
  • Eat frequent snacks.
  • Stay hydrated. You should increase your water consumption during pregnancy.
  • Exercise a moderate amount every day.

How The Test Is Performed

Urine ketones are usually measured as a “spot test.” This is available in a test kit that you can buy at a drug store. The kit contains dipsticks coated with chemicals that react with ketone bodies. A dipstick is dipped in the urine sample. A color change indicates the presence of ketones.

This article describes the ketone urine test that involves sending collected urine to a lab.

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Is 80 A Good Ketone Level

Its well above target. As weve seen above the ideal ketosis level is much lower between 0.3 to 3 mg/dL. According to Carb Manager higher levels of ketones can be as a result of fasting, protein restriction, exercise, exogenous ketone supplementation, or some combination of either.

The best thing to do is to find the root of the issue and fix it so you can go back to the 0.3 to 3 mg/dL level. After all, higher ketone levels do not mean more weight loss.

What Does Moderate Mean On Ketostix

Ketostix Ketone Urine Analysis Test Strips

Moderate on ketostix means the concentration of ketones is moderate .

You can know the concentration of the ketone is moderate through the color guide provided on the ketostix container. It shows different shades that indicate the level of ketones concentration.

The color you get from the urine test can also be matched with a specific number or range listed. The guide goes from small to moderate to large and shows the level of ketone concentration.

The results and the color you get on the ketone test strip indicates the following measurements of ketones in the urine.

  • Small: < 20 mg/dL This is a normal indication of ketones in the urine. At this level, there is nothing to worry about. Its recommended to monitor and maintain this level as much as possible.

According to the ketostix color palette, this range should give a color between the lighter shades on the far left of the color palette. This would often be from beige to cream or white.

  • Moderate: 30 to 40 mg/dL The moderate level of ketones indicates fat metabolism and weight loss, but this does not mean an insulin deficiency like hyperglycemia.

However, when a diabetes patient has this level of ketone concentration, its recommended to speak to the doctor or diabetes educator on what to do to reduce the concentration of ketones.

This is because the moderate level of ketones is not something to be worried about. However, if the level of ketones reaches the next level, it can quickly lead to diabetic ketoacidosis .

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Why You Should Test For Urine Ketones

Before going into the process of measuring for urine ketones, lets discuss the reason why we are able to even measure urine ketones in the first place. Arent ketones present in the blood?

For the most part, yes.

Glucose, ketones, and other crucial nutrients like minerals are present at varying amounts in the blood. Eventually, blood will pass through the kidneyour bodys filtration system. In the kidney, small molecules are filtered into the urine, while others are reabsorbed back into the circulation. Ogobuiro2019 This process is important, especially when we are talking about ketones. This reabsorption process prevents what would essentially be a waste of energy. You cant utilize ketones if theyre flushed down the toilet.

At low concentrations, most ketone bodies are reabsorbed by the kidney. However, when blood ketones begin to rise, some ketones begin getting filtered out. Thus, ketone bodies show up in the urine.

For this reason, if youre on a keto diet or fasting and producing ketones, a simple urine test may provide a quick snapshot of your endogenous ketone productiona proxy for how much fat youre using. Laffel1999 That is, higher ketones mean more fat burning.

What about exogenous ketosis? Another way to get into ketosis is using exogenous ketone supplements. Does urine testing work for ketosis achieved this way?

Ketone Supplements And Acute Ketosis

There are multiple companies marketing various forms of ketone supplements , each touting theirs as better than the competition. Depending on the dose, they do work to rapidly elevate blood ketones. The result is a transient âacute ketosisâ that does not require a ketogenic diet or any carb and protein restriction. Supplemental ketones are absorbed from the gut and rapidly appear into the circulation usually peaking within an hour. This acute ketosis does not involve increased hepatic ketogenesis unless the product also contains medium chain fats. In fact, ketone supplements likely decreases endogenous ketone production.10 The level of ketosis varies depending on the form and the dose, but concentrations can easily reach the higher end of nutritional ketosis if very high doses are consumed or ketone supplements are ingested while in nutritional ketosis . The effect of ketone supplements is short-lived lasting a few hours, thereby requiring repeated dosing to achieve sustained high levels of ketosis.â

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Trace Ketones In Urine Test: How To Interpret The Results

Ketones are chemicals that are produced when the body breaks down fat for an energy source.

When there are high levels of ketones in your urine, it can mean that you are not getting enough insulin and that you may have diabetes.

There are several symptoms of ketoacidosis, which is a complication caused by high levels of ketones in your blood, that we will detail below.

If you think you may have ketoacidosis, it is important to see your doctor right away. In this article, we will discuss the process of getting a urine test for ketones and how to interpret the results, even if there are only trace amounts.

How To Control Moderate Ketone Concentration

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One can use several methods to control the moderate level of ketone concentration and bring it down to a normal level. Drinking plenty of water can help flush ketones out of your body.

Since a high ketone concentration can mean high blood sugar, one may need insulin therapy. If you are already on insulin, then you should call your doctor to discuss adjusting your dose. By lowering your blood sugar level with insulin, you will also reduce your concentration of ketones.

Also, its advised to get a doctors recommendations on what they recommend when there is moderate or high ketones concentration.

When ketostix show moderate levels, you should watch for several signs to avoid these levels from going higher and leading to DKA. Early signs of DKA include:

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What Happens During A Ketones In Urine Test

A test to detect ketones in urine can be administered at home or in a lab. Sometimes patients are asked not to eat or drink for a specified amount of time before they take the test.

When testing in a lab, patients are advised to wash their hands and then clean their genital area via a sterile cleansing pad. Patients must then collect 1 to 2 ounces of urine into a container, and give the sample to the appropriate healthcare provider.

Patients can also test for ketones in urine at home by doing a spot test, which uses urine test strips. You can capture the urine in a clean container and dip the test strip into the container, or you can urinate directly onto the test strip. Follow the instructions to see how long after testing you should read the color of the strip. Then compare the strip color with the color chart on the bottle.

Moderate Amounts Of Ketones In Your Urine

Moderate amounts of urine ketones will show results of 30 to 40 mg/dl and are a cause for concern as this could indicate that ketoacidosis is developing.

If you have diabetes and are experiencing any of the symptoms listed above, please seek medical attention right away and do not exercise as it can exacerbate conditions.

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How Can You Measure Ketone Levels

You can measure your ketone levels during ketosis in one of three ways:

  • Urine ketone strips: Urine ketone strips are relatively inexpensive and can give you a rough idea of ketone levels in your body, although results may be slightly inaccurate.
  • Blood ketone tests: Blood ketone tests are the most accurate and most expensive way of measuring your ketone levels. They are performed using a kind of blood glucose meter that also helps test for ketones.
  • Breathalyzer: A breathalyzer can detect ketones in your breath. Results are less accurate than blood ketone tests but more accurate than urine ketone strips. While the initial cost of a breathalyzer device is pretty high, its still a one-time investment that allows you to check your ketone levels frequently without worrying about additional costs each time you want to do a test.
  • In order to determine what ketone levels are optimal for each type of test, speak to your doctor.

    Why Ketone Levels Arent Everything

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    When you measure your ketones and get a positive result, it can be a real confidence booster. It says youre going in the right direction.

    Taking the interpretation beyond that, however, may be problematic. First of all, science still hasnt figured out the optimal level of ketones. We can say with some confidence that you dont want 0 mmol/L BHB , and that 0.5 to 3.0 millimolar BHB appears to be the green zone for nutritional ketosis. But we cant say that 1.8 mmol/L is better than 0.8 mmol/L.

    In fact, some folks see declines in blood ketones over time on Keto, despite positive results in all other areas. Why is this happening? It might be a beneficial increase in ketone utilization. In other words, fewer ketones are in the blood because more ketones are being utilized by muscle and brain tissue. It might be a sign of Keto-adaptation.

    In addition, lifestyle factors like fasting and exercise can impact ketone levels, temporarily skewing levels one way or the other.

    Simply fasting overnight may cause ketone levels to rise by .1 to .5mM. Longer fasts of up to 48 hours of fasting may result in ketone levels of 1 – 2mM, even if you werent in ketosis beforehand. Extended fasts may increase ketone levels even further.

    Similarly, anecdotal reports suggest that anaerobic exercise may decrease ketone levels while aerobic exercise may increase them.

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    How Are Ketones In Urine Treated When Youre Pregnant

    It depends on the cause. If you have gestational diabetes, you’ll need to change your diet to manage glucose levels. Your provider may prescribe insulin if diet alone doesn’t help. If you have morning sickness accompanied by chronic vomiting, your provider may prescribe medication to help with nausea or have you get IV fluid hydration.

    If ketones in your urine are due to inadequate nutrition, your healthcare provider may recommend eating more calories or eating more frequently.

    The following dietary tips will help to keep your ketones at a healthy level:

    • Don’t skip meals.
    • Drink a lot of water or other fluids to stay hydrated.
    • Eat at least three meals and three snacks daily. Having a snack before bed has been associated with lower ketone levels.
    • Eat a variety of carbohydrates .
    • Include protein in each meal. Some good choices are eggs, beans, meat or tofu.

    Target Ketone Levels For Weight Loss

    After starting the keto diet, it takes your body a few days to burn through its carbs, which are stored as glycogen in your liver and muscles. Once these carb stores are gone, youll switch to producing ketones from either dietary fat or stored body fat to burn as energy .

    At that point, you may have detectable levels of ketones in your blood. Blood ketone levels while on the keto diet typically range from 0.5 3.0 millimoles per liter .

    These levels are the optimal range for nutritional ketosis the state in which your body can use stored fat for energy most effectively, helping boost weight and fat loss .

    Note that theres a condition called diabetic ketoacidosis. It only occurs in people with diabetes and is characterized by extremely high levels of blood ketones alongside extremely high blood sugar levels .

    However, the blood ketone levels seen in ketoacidosis are typically 1015 times higher than those of nutritional ketosis. Also, ketoacidosis is often accompanied by severe symptoms, whereas nutritional ketosis is safe for most people .


    Optimal blood ketone ranges for nutritional ketosis are 0.5 3 millimoles per liter . Nutritional ketosis is safe for most people and should not be confused with ketoacidosis, a severe complication of diabetes.

    Net carbs refer to the total number of carbs minus the amount of fiber.

    Once you shift into ketosis, your body can produce ketones for energy from either dietary fat or stored body fat .

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    What Does It Mean When You Have Ketones In Your Urine During Pregnancy

    Ketones in urine during pregnancy occur when your body breaks down fat and uses it for energy. This happens when you dont have enough glucose in your blood or don’t absorb glucose correctly. Your body prefers to use glucose for energy. Without glucose, your body uses fat instead. This breakdown of fat produces ketones. Your kidneys release ketones, and it shows up in your urine and blood. Having ketones in your urine is called ketonuria. Treatment for ketonuria during pregnancy depends on the cause. Your pregnancy care provider can tell if you have ketones in your pee with a simple urine test .

    If you have ketones in your urine during pregnancy, it may be a sign that you arent consuming enough calories or that you have gestational diabetes. Your healthcare provider is the best person to decide whether the amount of ketones in your urine requires immediate treatment. You can usually manage your ketone levels with diet and lifestyle changes or medication.

    Ketones and gestational diabetes

    Untreated diabetes during pregnancy can lead to high levels of sugar crossing into the placenta and to your baby.

    Measurements Of Ketone Concentrations

    Urine ketone concentrations were measured using over-the-counter reagent strips , which determine the presence of AA upon reaction with nitroprusside salt. The end of the strip was passed through the urine stream and the colour then compared to the colour chart provided with the product 15 s after the reaction.

    Blood ketone concentrations were measured using an electrochemical capillary blood monitor device with the corresponding individually foil-wrapped test strips for BHB. Each test strip contains three electrodes and the test is automatically initiated upon the application of enough blood. Subjects were advised to clean and dry their fingertips before each prick with the single-use lancing devices provided with three depth settings . After insertion of a test strip into the device, a drop of blood was applied to the assigned spot and the BHB concentrations were read from the display and recorded.

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    Is 09 Ketones Ok

    A value of less than 0.6mmol/L is considered normal. 0.6 to 1.5mmol/L indicates that you are at a slightly greater risk of DKA and that you should retest in 2 hours time. If your glucose level is between 1.6 and 2.9mmol/L, you are at elevated risk of developing DKA and should consult your diabetes team or doctor as soon as possible.

    What Is A Dangerous Level Of Ketones In Urine

    Modified: May 10, 2022 by John Coleman · This post may contain affiliate links ·

    The level of what now? If this is your first time hearing or reading about it, dont worry. We have you covered! Ketones are essentially a by-product of burning fat in the body. The presence of ketones in urine has been a topic of hot debate among ketogenic dieters and health experts. Some people say that ketones in urine after a high-fat meal are completely normal.


    In contrast, others believe that it indicates diabetic ketoacidosis when high levels of ketones are found in your urine. But before we jump to conclusions, lets get the facts straight, shall we?

    In this article, you will learn everything you need to know about ketones in urine, what a dangerous level of ketones in the urine is, common symptoms you should look out for, and how to prevent ketone formation . So, enough chit chat, and lets dive right into it.

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