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What are Ketone Bodies?

By Gayle R.
Updated Mar 03, 2024
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Ketone bodies, also called acetone bodies or simply ketones, are any of three compounds produced when the liver metabolizes fatty acids. The three types of ketone bodies — acetoacetic acid, beta-hydroxybutyric acid, and acetone — are released into the bloodstream after metabolism occurs. Acetoacetic acid and beta-hydroxybutyric acid are used for fuel by the brain and muscles, but the body can't break down acetone and therefore excretes it in the urine. Excess acetone or ketones in the blood and urine can be a sign of a serious metabolic disease, and doctors often use the measurement of ketones as a tool in the diagnosis of such diseases.

In healthy individuals, the body uses mostly carbohydrate metabolism to fuel its cells. If sufficient carbohydrates are not available, such as during extreme starvation, the body begins metabolizing fats into ketone bodies to provide the necessary fuel. High levels of ketones in the urine, a condition called ketonuria, indicate the body is using mostly fat for its energy.

Another condition that will produce increased levels of ketone bodies is Type I diabetes — a severe form of diabetes mellitus. Individuals with diabetes mellitus are unable to efficiently metabolize glucose, typically because of insufficient insulin or insulin resistance. Their bodies will begin metabolizing fats and proteins to make up for the lack of available glucose for energy.

When doctors suspect diabetes, one of the first things they will check for is excess ketones in the urine. Performed with a simple urine dipstick, the test can quickly alert doctors to a metabolic disorder such as diabetes. High levels of ketones can also cause a person to have an acetone or fruity smell on their breath. Further tests of blood glucose levels can confirm the disease. The urine ketone tests are also useful in helping diabetic patients maintain proper diet and medication for optimal control of the disease.

Ketonuria may help signal possible complications during extreme fasting or fad diets, or during pregnancy. Testing of pregnant women is important because ketonuria has possibly been linked with some fetal deaths. Physicians also routinely screen acutely sick patients and patients who are preparing for surgery for indications of possible metabolic problems.

The presence of ketones in the blood or urine is not only a signal of metabolic problems. Ketones themselves can be dangerous in high levels. Without treatment, extremely high levels of ketones in the blood and urine can lower the blood's pH and cause a condition called ketoacidosis. It occurs most often in people with uncontrolled diabetes mellitus and is exacerbated when high blood glucose levels, caused by lack of available insulin, further acidify the blood. Ketoacidosis can lead to ketoacidic coma or death.

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Discussion Comments

By ZipLine — On Feb 12, 2014

@ysmina-- No there are other symptoms. Along with the scent of breath, the odor of urine may also change because the body is getting rid of acetone through breath and urine during ketosis. Also if the body stays in ketosis for long, there will be weight loss, lack of appetite, mental confusion or memory problems as well. Some people actually experience more energy during ketosis. But the major symptom of ketosis is the weight loss. This is why people lose weight on low-carb diets. Since ketone bodies are associated with the cellular metabolism of fats, these diets rely on ketosis for weight loss. It's also a major symptom of type 1 diabetes for the same reason.

You might have a hard time noticing ketosis symptoms yourself, especially if they are not severe. The best way to know is to use the test sticks or see a doctor for a urine test.

By ysmina — On Feb 11, 2014

Can I know if I have ketosis without ketones testing? Is a fruity breath the only symptom of the condition?

By serenesurface — On Feb 10, 2014

As far as I know, checking ketones in urine is extremely important for a type 1 diabetic. My cousin has diabetes and she uses ketone test sticks regularly. A few times, her ketone levels were extremely high and she immediately went to the hospital. I think the results can be detrimental if this isn't treated soon. So it's not enough for diabetics to only check their blood sugar levels.

I don't think ketosis occurs in type 2 diabetics usually.

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