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What is Ketonuria?

Mary McMahon
Updated Feb 20, 2024
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Ketonuria is a term which describes the presence of ketone bodies in the urine. Ketones, as they are also known, are produced in the body as part of the breakdown of fatty acids. When they are present in the urine, it indicates that the body is burning fat for energy. There are a number of reasons why someone can develop ketonuria, with this symptom sometimes being a cause for concern. In diabetic patients especially, ketones should not be found in the urine.

It is possible to test for ketonuria with a test strip which can be dipped into a urine sample, or held under a stream of urine while someone urinates. These test strips react to ketones in the urine, changing color to indicate whether or not ketone bodies are present, and at what concentrations. This test is instant and very convenient, and it can even be administered at home by people who might have reason to monitor for ketone bodies.

In patients with diabetes mellitus, if there are ketones in the urine, it suggests that the diabetes is not well controlled. When switching types of insulin, the ketone body test can be used to confirm that the medication is working well. Ketonuria can also occur as a result of starvation, heavy exercise, an imbalanced diet, hyperthyroid syndrome, pregnancy, lactation, fever, or simple fasting. In fact, it is not uncommon for hospitalized patients to have ketonuria.

This symptom appears when the body is not able to utilize carbohydrates. In the case of a patient with diabetes, the body is not metabolizing the carbohydrates properly, so the body is burning fat for energy. In other patients, the body may not be getting enough carbohydrates, or stress may be causing the body to use up its energy from carbohydrates and turn to fat for additional energy. When people have ketonuria, they also commonly express ketones in their breath, with the breath having a distinct sharp odor.

When someone has ketonuria, it is important to find out why. The condition may be relatively benign and not a cause for concern, or it may be worrying. A patient interview may be conducted to find out what the patient last ate and when, how heavy the patient's exercise has been lately, and so forth. The interview will also be used to determine whether or not the patient has an underlying medical issue which could be contributing to problems with carbohydrate utilization.

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Mary McMahon
By Mary McMahon

Ever since she began contributing to the site several years ago, Mary has embraced the exciting challenge of being a WiseGeek researcher and writer. Mary has a liberal arts degree from Goddard College and spends her free time reading, cooking, and exploring the great outdoors.

Discussion Comments
By anon304798 — On Nov 21, 2012

I have been on the Atkins diet for over five years and was born a type II diabetic which is why I do not eat any carbs. Apart from the distinct smell when I urinate the ketones away, there are no side affects.

This diet has not only helped me lose weight but it stopped all of the symptoms of my diabetes.

I believe the secret to good health and a long life is a zero-carb diet and an aspirin a day. Throw in a 30 minute walk a day and you'll live until you're 100.

Trust me that your breads, pastas, cakes, potatoes, sugar and your wind producing veggies are not doing you any good at all. You will be fat, bloated and end up with all sorts of health problems. I never even get a cold anymore.

Living off body fat is natural because that's why we store it. Living off sugar from carbs is abnormal and none of your body fat is used; it just sits there like flab. Look at a grossly obese person and now ask yourself does that person eat carbs or fats? The answer will always be carbs.

So do yourself a favor and eat zero carbs and once you get used to it and the large variety of food available, to you then reap the benefits.

I don't even suffer from Atkins breath and that too seems like a myth invented by the very people who don't want you to stop spending your money on carbs and of course, vegetarians hate us healthy meat eaters who have iron in our blood.

By jholcomb — On Sep 04, 2011

@ElizaBennett - My mom was on a low-carb diet a few years ago and I was really worried about her; she developed a strange odor. I looked into it and yes, a very low carb diet causes the same problem as diabetic ketoacidosis.

Basically, what's happening is that your body is burning its own fat stores for fuel. In diabetes patients, that's because their bodies have trouble metabolizing carbs (glucose). For people on very low carb diets, it's because they don't eat enough carbs, so their bodies turn to fat instead.

Advocates of low-carb diets will tell you that this state is not harmful, but the mainstream medical community feels that it's very dangerous (as I told my mother). The buildup of ketones can damager your organs and contribute to gout, and eating a really excessive amount of protein is bad for your kidneys.

I've actually been trying to reduce my carbs and replace them with veggies and plant protein, but there's a lot of ground between the standard American diet (which is extremely carb-heavy) and Atkins-type diets.

By ElizaBennett — On Sep 04, 2011

Ketonuria is a diabetes complication, but I feel like I read somewhere that ketones in your urine are also a side effect of very low carb diets. Basically, you starve your body for carbohydrates to the extent of messing with your body's chemistry.

Is a really low carb diet harmful?

Mary McMahon
Mary McMahon

Ever since she began contributing to the site several years ago, Mary has embraced the exciting challenge of being a...

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