What Does Large Ketones In Urine Mean – Ketones are produced when the body uses stored fat instead of glucose to produce the energy it needs to function, a metabolic state called ketosis. But why are ketones found in urine during pregnancy?
The presence of ketone bodies in the urine is called ketonuria (1). Hormonal changes during pregnancy can affect the body’s resistance to insulin, which affects glucose metabolism (2). This change prevents cells from using the glucose in blood sugar to produce energy. Instead, it causes cells to use stored fat for energy, which produces ketones.
What Does Large Ketones In Urine Mean
Ketones are produced in the urine for a number of reasons. Although trace amounts of ketones can occur during pregnancy, prolonged excess ketones in the urine can be a sign of gestational diabetes and the body’s inability to produce enough insulin during pregnancy. If diagnosed early, the condition can be treated to keep both you and your baby healthy.
Ketones In Urine: Causes, Symptoms, Tests And What It Means
Research has shown that ketonuria is a common symptom during pregnancy and can be caused by prolonged fasting or starvation or vomiting (3). Urinary ketones have also been reported to be detected throughout pregnancy. Therefore, if traces of ketone bodies are found during pregnancy, it may not be related to gestational diabetes.
However, this study also concluded that women with clinical symptoms of prediabetes or showing signs of gestational diabetes may have gestational diabetes. (1).
If urine ketones indicate a poor maternal condition, such as poor kidney function, if urine ketones are elevated, complications of diabetic ketoacidosis (DKA) may result, and your doctor is the best person to understand and explain. In diabetic pregnancies, fetal loss may result (3), (4).
XA condition (the thyroid producing too much thyroid hormone) can also lead to increased ketone bodies in the urine (9).
Ketones Urine Test
It is important to know whether urine ketones are harmful to the fetus. This will be discussed in the next section. Can Ketones Harm Your Baby?
Yes, they can, but only if the test results consistently show abnormal ranges. Studies have shown that ketone bodies can easily pass through the placenta and the XA temporal organs formed near the uterine wall during pregnancy, providing nutrients and oxygen to the fetus, and affecting the fetal central nervous system. It showed abnormal embryonic growth, reduced size and distorted internal organs.
Group XA nerve fibers, which serve as a connection center between the left and right hemispheres of the brain (hippocampus)
X Located between the nose and lungs, the muscular organs that control sound and sound, the lateral ventricles of the brain, and the thymus
What Are The Ideal Ketone Levels For Ketosis?
Located behind the breastbone, it is a gland that supports T lymphocytes, which are critical to the immune system. However, research on the effects of ketones on fetal development is limited (5).
Regardless, you can test your urine for ketones at home and track your ketone levels daily.
Because elevated urine ketone levels may indicate a clinical cause, your doctor may recommend a clinical diagnosis if you notice any of the following symptoms.
You can also test your urine for ketones using test strips available at many pharmacies. Use it on your first urine of the day for the most accurate results. Ideally, trace (5) should read negative.
Optimal Keto Levels: Know Your Ketone Zone
With this kit, you can test it at home. First, collect a urine sample in a clean container and dip a test strip into the sample. Take it out and let it sit for a few minutes. When the color of the striped pad changes, compare it to the color card (5) on the kit bottle. See your doctor if your urine ketone levels are moderate or high.
The ketonuria test is used to detect a pre-existing ketonuria state. Your doctor may order blood tests to find out if you have gestational diabetes. If your doctor finds out that you have gestational diabetes, he or she can recommend dietary and lifestyle changes to maintain normal blood sugar levels throughout pregnancy.
The following section outlines some precautions for controlling urine ketone levels during pregnancy.
Call your doctor if you have a history of ketosis and experience symptoms such as fever, vomiting, diarrhea, unexplained blood sugar spikes, and sudden spikes in urine ketones (10).
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A ketone body concentration of less than 0.5 millimeters (millimolar) is considered normal during pregnancy. Overdose can be due to a variety of reasons, such as prolonged exercise, poor diet or a ketogenic diet (7).
Diabetes is one of the risk factors for the presence of ketone bodies in the urine. Even people without diabetes produce ketones in the urine if the body uses fat instead of glucose to function. Other causes of ketones in the urine of nondiabetics may be chronic vomiting, strenuous exercise, eating disorders, or low carbohydrate diets (8).
Yes. Starvation or not eating for a long period of time is thought to be one of the causes of ketones in the urine.
Urinary tract infections (UTIs), infections such as pneumonia, Covid-19, and certain skin infections can lead to ketone bodies in the urine, especially diabetic ketoacidosis (11) (12).
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Chronic excess of ketone bodies in the urine during pregnancy may indicate gestational diabetes, although ketone bodies are rare during pregnancy. While trace amounts of ketones can be corrected with diet and lifestyle changes, high levels of ketones in the urine require immediate medical attention. Early treatment can also reduce the risk of your baby having pregnancy problems. Avoiding skipped meals, frequent small meals and high-protein foods, exercise, and physical activity can also help prevent excess ketones during pregnancy.
Gestational diabetic ketosis (DKP) is a serious condition that can be life-threatening if left untreated. Physiological changes during pregnancy may make some women with GDM more receptive to DKP. The infographic below provides more information on symptoms and management options.
Articles are written after analyzing scientific works of authors, experts and institutions. Our references include resources established by authoritative institutions in their field. You can read more about the veracity of the information we provide in our editorial policy.
1. Helen L. Robinson et al. Ketone bodies in maternal urine during pregnancy in overweight and obese women; Journal of the Royal Society of Medicine
Ketones, Diabetic Ketoacidosis, And Type 1 Diabetes
6. Alice. A. Gibson et al; (2020); Urine volume meters fail to accurately detect mild ketosis during a low-energy diet; Wiley Online Library
7. Qian Meichen et al.; Effect of elevated ketone bodies in pregnant women with abnormal glucose metabolism on maternal and infant outcomes Diabetes Obesity Metabolic Syndrome
PhD. Karishma Bhatia completed her Masters in Obstetrics and Gynecology from Maulana Azad Medical College (MAMC) and is currently practicing in Rohini, North Delhi. He also completed DNB, MNAMS and Fellowship training in Gynecological Laparoscopy (Kieel, Germany) and Reproductive Medicine. He has over five years experience in his field and is a life member of AOGD, FOGSI, ESAG. More
Shreeja holds a postgraduate degree in chemistry and a diploma in drug regulation from the University of Mumbai. Prior to joining, he worked as a research analyst for a leading international pharmaceutical company. His interest in medical research fueled his passion for writing research articles. As a writer with over two years of experience, she aims to… more Urine is mostly water with some excreted minerals. The main components of human urine are water, urea, chlorine, sodium, potassium and creatinine. Urine may also contain other ions and organic and inorganic compounds.  The presence of cells and molecules such as blood, glucose, and proteins may indicate a pathological condition. But what about urine ketones? this is normal? Or is this a symptom of a larger problem?
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On a standard high-carbohydrate diet, the body uses glucose (derived from carbohydrates) as a source of energy. In the diet, carbohydrates are limited, so the body must burn fat as a fuel source. Fatty acids are broken down into ketones. Excess ketones (more specifically acetoacetate) are excreted through the urine. 
Detecting ketones in urine during a low carbohydrate diet or intermittent fasting is completely normal and does not indicate a pathological condition. In fact, it’s one of the easiest and most non-invasive ways to test at home. 
Small amounts of ketones in your urine are normal, even if you’re not on a diet. As mentioned above, fasting increases the amount of ketone bodies that can be excreted in urine. Every time you sleep, you don’t eat, so you fast for more than 8 hours. If you don’t eat right after waking up or before bed, you’re inadvertently doing intermittent fasting, which may raise your ketone levels. 
However, higher levels of ketones in people who do not follow a low-carb diet or fast can indicate diabetes.
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