Ketones in urine: Symptoms, Causes and Treatment

Ketones or ketone bodies are acids that can be synthesised in the body when it doesn't have enough insulin or when it breaks down fat for energy. While the presence of ketones in urine can indicate a severe health issue, it's essential to understand the underlying causes & when to seek medical attention. This article will explore the basics of ketones in urine, including what they are, what causes them, and how to check for ketones in urine.

What are Ketones in Urine?

Ketones are a byproduct of fat metabolism. When the body doesn't have enough glucose (sugar) for fuel, it breaks down fat for energy. This process produces ketones, which can then be detected in the urine. Ketones are typically present in small amounts, but high levels can indicate a more severe condition.

Causes of Ketones in Urine

There are several common reasons for ketones in the urine, including:

• Diabetes: People with diabetes, especially type 1 diabetes, may develop ketoacidosis, a severe condition where the body secretes high levels of ketones due to a lack of insulin.
• Starvation or Fasting: When the body doesn't have enough carbohydrates to use for fuel, it will start to break down fat, producing ketones.
• Low-carb Diets: Following a very low-carb diet, such as the ketogenic diet, can also cause ketones to build up in the body.
• Illness or Stress: Certain illnesses, such as the flu or a severe infection, can trigger the body to produce more ketones. Stress can also contribute to higher ketone levels.
• Prolonged Vomiting or Diarrhoea: Having diarrhoea or vomiting for a long time may cause the body to run out of glucose, leading to ketones in your urine.
• Alcohol Use Disorder: Long-term excessive alcohol consumption can cause the breakdown of fat, leading to alcohol-related ketoacidosis.

What is a Normal Ketone Level in Urine?

Normal ketone levels in urine are typically very low and often undetectable. However, what is believed to be "normal" can vary depending on the testing methodology & laboratory used. Generally, a urine ketone level of less than 0.6 mmol/L is considered within the normal range.

Symptoms of Ketones in Urine

The ketones in the urine can sometimes be accompanied by specific symptoms, including:

• Fruity or acetone-like breath odour
• Nausea and vomiting
• Abdominal pain
• Fatigue and weakness
• Increased thirst and urination
• Confusion or difficulty concentrating

Complications of Ketones in Urine

High ketone levels in the urine can lead to several serious complications, including:

• Diabetic Ketoacidosis (DKA): This is a fatal condition. It happens when the body produces high levels of ketones due to decreased insulin levels. DKA can cause coma and even death if left untreated.
• Dehydration: The body's attempt to flush out excess ketones can lead to severe dehydration, further exacerbating the underlying condition.
• Kidney Damage: Prolonged high levels of ketones in the urine can damage the kidneys over time.

Treatment for Ketones in Urine

The treatment for ketones in the urine will depend on the underlying cause. In general, the primary goal is to address the root problem and reduce the production of ketones. The following are some general urine ketones-positive treatment options:

• Insulin Therapy: For people with diabetes, adjusting insulin dosages or administering insulin can help lower ketone levels.
• Fluid and Electrolyte Replacement: Drinking plenty of water and replenishing electrolytes can help address dehydration and flush out excess ketones.
• Dietary Changes: Increasing carbohydrate intake or following a balanced diet can help reduce ketone production.
• Medication: In certain situations, healthcare providers may prescribe medications to help manage ketone levels.

When to See a Doctor

It's essential to seek medical attention if you are ketone positive in urine, especially if you are experiencing any of the associated symptoms. Uncontrolled ketone levels can be a sign of a severe underlying condition & should be addressed promptly. Your doctor can perform the necessary tests and provide appropriate treatment.

Prevention of Ketones in Urine

To help prevent the development of high ketone levels in the urine, consider the following strategies:

• Manage Diabetes Effectively: Have tight control of blood sugar levels through insulin therapy, diet, and lifestyle changes.
• Avoid Prolonged Fasting or Very Low-carb Diets: Consult with a doctor before switching to any restrictive diet to ensure it is safe for your needs.
• Stay Hydrated: Drink optimal water to help flush out excess ketones.
• Manage Stress and Illness: Seek medical attention for any underlying health conditions or significant stress that could contribute to ketone production.