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Blood Ketones Test

Last updated July 23, 2019

Approved by: Krish Tangella MD, MBA, FCAP

Blood Ketones Test is used to measure the amount of ketones in blood. Ketones are toxic chemicals produced as a result of fat metabolism, when glucose is not available for energy.

What are the other Names for this Test? (Equivalent Terms)

  • Ketone Bodies Test
  • Plasma Ketone Test
  • Serum Ketone Test 

What is Blood Ketones Test? (Background Information)

  • Blood Ketones Test is used to measure the amount of ketones in blood. Ketones are toxic chemicals produced as a result of fat metabolism, when glucose is not available for energy
  • Glucose is normally metabolized in the body for energy. If sugar (glucose) is not sufficiently available in the diet, to provide energy to the body, or if the body cannot utilize the sugar present in the body (as with type I and type II diabetes), fat is metabolized in the body producing ketones
  • Ketones accumulate in the body leading to a condition, called ketosis, and ultimately ketoacidosis. Ketoacidosis is a potentially life-threatening condition, commonly seen during uncontrolled type I diabetes. The blood sugar may reach very high levels in diabetic patients; especially during an infection, illness, pregnancy, etc. resulting in ketoacidosis
  • The common causes resulting in ketosis or ketoacidosis are:
    • Uncontrolled type I diabetes and sometimes, type II diabetes
    • Starvation, fasting, or eating disorder, like anorexia nervosa or bulimia
    • Alcoholism or alcohol poisoning
    • High-fat low-sugar diet
    • Pregnancy
    • Vigorous exercising 

What are the Clinical Indications for performing the Blood Ketones Test?

Following are the clinical indications for performing a Blood Ketones Test:

  • The test is frequently performed during uncontrolled type I diabetes, when ketoacidosis is suspected. This condition is called diabetic ketoacidosis (DKA)
  • It is used to screen, detect, and monitor patients, with ketoacidosis

The common signs and symptoms suggestive of ketoacidosis are:

  • Increased thirst
  • Frequent urination
  • Rapid and deep breathing, shortness of breath
  • Fruity odor of the breath
  • Dehydration
  • Weakness and fatigue
  • Nausea and vomiting, abdominal pain
  • Confusion
  • Coma 

How is the Specimen Collected for Blood Ketones Test?

Following is the specimen collection process for Blood Ketones Test:

Sample required: Blood

Process: Insertion of a needle into an arm vein.

Preparation required: No special preparation is needed prior to the test. However, some medications may interfere with the test results and hence, the healthcare provider should be informed about all current medications that you are taking, before the test. 

What is the Significance of the Blood Ketones Test Result?

The significance of Blood Ketones Test is explained:

  • If the levels of ketones in blood are more than 1.5 mmol/L (millimoles per liter), it indicates a high risk of developing ketoacidosis
  • Levels lower than 1.5 mmol/L, suggests some degree of ketosis
  • Absence of ketones in blood, or levels lower than 0.6 mmol/L, indicates normal results. However if the suspicion of ketosis or ketoacidosis is high, the test may be repeated

The test results are usually evaluated alongside blood glucose levels. 

The laboratory test results are NOT to be interpreted as results of a "stand-alone" test. The test results have to be interpreted after correlating with suitable clinical findings and additional supplemental tests/information. Your healthcare providers will explain the meaning of your tests results, based on the overall clinical scenario. 

Additional and Relevant Useful Information:

  • Acetoacetate, acetone, and beta-hydroxybutyrate, are the three types of body ketones. Beta-hydroxybutyrate is the main type found in the body that is tested, during diabetic ketoacidosis
  • 3 types of tests are used to measure ketones bodies. These are:
    • Blood Ketone Testing done in the laboratory; it is a reliable test
    • Through a hand held ketone monitor; used as a screening test
    • Urine ketone analysis (done via test strips); it is a screening test
  • Blood test is more accurate than urine testing. These test measures 1 or 2 or all 3 types of ketone bodies
  • Sometimes, especially during diabetic ketoacidosis (DKA), a testing for only beta-hydroxybutyrate is ordered

Certain medications that you may be currently taking may influence the outcome of the test. Hence, it is important to inform your healthcare provider, the complete list of medications (including any herbal supplements) you are currently taking. This will help the healthcare provider interpret your test results more accurately and avoid unnecessary chances of a misdiagnosis.

References and Information Sources used for the Article:

Reviewed and Approved by a member of the DoveMed Editorial Board
First uploaded: July 19, 2014
Last updated: July 23, 2019