What are ketones?
Ketones, also called ketone bodies or keto acids, are a type of water-soluble compound produced from the fat breakdown in the body. They are formed in the liver in conditions when there is a deficiency of carbs or glucose to meet the body’s energy requirements. They act as an alternative source of energy for the body.
Production of ketones mainly occurs in conditions, such as fasting or dieting. In such situations, the body has a low level of insulin (the hormone that lowers glucose levels in the body) but normal levels of its opposing hormones, glucagon and epinephrine. These hormonal changes in the body cause the release of fats from the fat cells (adipocytes). The released fats then travel through the bloodstream to reach the liver where they are acted on by several enzymes to form ketone units. The ketone units are then released into the blood circulation. From the bloodstream, they are picked up by various tissues including the muscles and used as a fuel for various functions. Ketone formation is a normal adaptation of the body in response to starvation. In people without diabetes, ketone formation is under a check and the blood sugars also do not exceed the normal range. This is because the pathways are regulated by the correct balance of insulin, glucagon, epinephrine and other hormones. In individuals with diabetes, however, there is an insulin deficiency (especially type 1 diabetes), which may lead to the buildup of insulin to dangerous levels.
Why are ketones bad?
Although ketones are a normal product of metabolism, they may be produced in excess in certain situations, such as diabetes. Individuals with type 1 diabetes are particularly at risk of excess ketone formation called diabetic ketoacidosis or DKA. People with type 2 diabetes may also get DKA. This happens especially in conditions such as infections and treatment with steroids. DKA could also appear later in the disease when the insulin release from the pancreas reduces to extremely low levels. In such situations of insulin deficiency in the body, the fat cells keep releasing fat into the circulation and the liver continues to make more and more ketone units. The unchecked increase in ketoacid levels lowers blood pH to a dangerous level, a condition called ketoacidosis or DKA. This is a medical emergency and urgent medical attention must be sought. Increased ketone levels in the blood can lead to
- Acidosis, which initiates multiple organ dysfunction
- Electrolyte imbalance
- Dehydration and shock
- Abdominal pain
- Rapid breathing
- Nausea and vomiting
- Dry or flushed skin
- Muscle soreness
- Dizziness and confusion due to swelling around the brain
- Coma and even death if untreated due to organ failure
How do you test for ketones?
Ketone levels can be checked in the urine and blood.
Urine test for ketones
This is the most traditional, but least accurate way of checking ketones. The test can be done in a lab or at home. Several over-the-counter ketone kits are available that contain strips to check the ketone levels in the urine. Follow the instructions given on the kit to measure the ketone levels accurately. The test results may be a particular number or listed as "small," "moderate" or "large," which denotes ketone levels. The results may vary depending on a person’s activity levels and diet. Consult a doctor to know what the results may mean.
Blood test for ketones
This is a more accurate test for measuring ketone levels in the body. The test may be done in the lab or by using an at-home ketone blood test kit. Follow the label instructions carefully when using a kit at home.
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