🧪 Ketones in Urine – Results Explained

Ketones in urine can appear when the body burns fat for energy instead of sugar. Learn what ketones mean, common causes, and when they may signal a medical problem. 

Ketones in Urine 

🧠 What Does “Ketones in Urine” Mean? 

Finding ketones in urine usually means one of two things:

• Your body is not getting enough sugar to use as fuel
  
  

• Or your body cannot properly use the sugar that’s available
  
  

This is most commonly related to:

• Diabetes
  
  

• Fasting
  
  

• Low-carbohydrate diets
  
  

• Illness or dehydration

📊 What Is a Normal Result? 

On a urine test, ketones are usually reported as:

• Negative – normal
  
  

• Trace – small amount
  
  

• Small / Moderate / Large – increasing levels
  
  

Normal result:

👉 No ketones should be present in urine

Any positive result is considered abnormal.

❓ Common Causes of Ketones in Urine 

Ketones can appear for many different reasons.

Diabetes-related causes:

• Poorly controlled diabetes
  
  

• Not enough insulin
  
  

• Diabetic ketoacidosis (DKA)

Non-diabetes causes:

• Fasting or skipping meals
  
  

• Very low-carbohydrate diets
  
  

• Prolonged vomiting
  
  

• Fever or illness
  
  

• Pregnancy
  
  

• Dehydration
  
  

• Heavy alcohol use
  
  

• Strenuous exercise

🚦 When Are Ketones Dangerous? 

Ketones are especially concerning if you have diabetes.

High ketones with high blood sugar can mean:

👉 Diabetic Ketoacidosis (DKA)

This is a medical emergency.

Warning Signs of DKA include:

• Very high blood sugar
  
  

• Nausea or vomiting
  
  

• Abdominal pain
  
  

• Fruity-smelling breath
  
  

• Rapid breathing
  
  

• Confusion
  
  

• Extreme thirst
  
  

• Frequent urination
  
  

If these occur, urgent medical care is needed.

🧪 How Are Ketones Tested? 

Ketones are most often found on:

• A standard urinalysis
  
  

• Home urine ketone test strips
  
  

• Blood ketone testing (more accurate)
  
  

Doctors may check ketones when someone has:

• High blood sugar
  
  

• Symptoms of illness
  
  

• Unexplained nausea or vomiting

👩‍⚕️ What Usually Happens Next? 

What your doctor does depends on the situation.

If you have diabetes:

Your doctor may:

• Check your blood sugar
  
  

• Adjust insulin or medications
  
  

• Test blood ketones
  
  

• Look for signs of infection or illness

If you do NOT have diabetes:

Your doctor may look for causes such as:

• Recent fasting
  
  

• Diet changes
  
  

• Dehydration
  
  

• Pregnancy
  
  

• Stomach illness
  
  

Often the ketones resolve once the underlying issue is corrected.

⚠️ Important to Know 

Small or trace ketones are common with:

• Low-carb diets
  
  

• Mild illness
  
  

• Temporary fasting
  
  

But moderate or large ketones should always be taken seriously, especially in people with diabetes.

💬 Common Questions 

Can dehydration cause ketones in urine?

Yes.
Dehydration can make ketones more likely to appear.

Do ketones always mean diabetes?

No.

Many people without diabetes can have ketones from:

• Dieting
  
  

• Fasting
  
  

• Vomiting
  
  

• Illness

Are ketones bad if I’m on a keto diet?

Mild ketones can be normal on a ketogenic diet.
However, large amounts or symptoms like nausea and weakness should still be evaluated.

How can ketones be reduced?

Depending on the cause:

• Drinking fluids
  
  

• Eating carbohydrates
  
  

• Treating illness
  
  

• Adjusting diabetes medications

🧩 How Ketones Fit With Other Kidney Tests 

Ketones are usually checked along with:

• Glucose in urine
  
  

• Blood sugar levels
  
  

• Urinalysis results
  
  

• Electrolytes
  
  

• Kidney function tests
  
  

Together, these help determine whether ketones are harmless or a warning sign.

✅ Bottom Line 

Ketones in urine:

• Are not normally present
  
  

• Often appear during fasting or illness
  
  

• Can be a serious sign in people with diabetes
  
  

• Should always be evaluated if moderate or large
  
  

If you have diabetes and ketones in your urine—especially with high blood sugar—contact a healthcare provider right away.

Related Pages

• Urinalysis Results Explained
  
  

• Electrolytes and Kidney Function Explained
  
  

• Protein in Urine Explained
  
  

• Blood in Urine Explained
  
  

• Diabetes and Kidney Health Explained