How to Test Ketones with Urine Strips or Lab Clean Catch

How a Ketone Urine Test Is Done

A ketone urine test is performed by analyzing a urine sample collected through a clean-catch laboratory procedure or by using an over-the-counter home test strip. According to MedlinePlus, a ketones in urine test measures the level of ketones present in a urine sample.

For a lab test, the sample is collected by the clean-catch method. This process requires individuals to wash their hands, clean the genital area with a sterile wipe, urinate for a few seconds into the toilet, collect at least an ounce or two in the collection container, finish urinating into the toilet, and securely cap the container. MedlinePlus says to tell the provider about bleeding hemorrhoids or a menstrual period before the test.

Home testing kits are available at most retail pharmacies without a prescription. Home kits contain ketone test strips, which an individual uses by holding a test strip directly in the urine stream or dipping it into a cup of urine collected through the clean-catch method. MedlinePlus notes that home test kits can be accurate if a person follows the package instructions exactly. A healthcare provider might instruct a patient to fast or follow other specific preparation steps prior to testing. MedlinePlus states that there is no known medical risk associated with taking a urine ketone test.

Why Ketone Levels Rise in Urine

Ketones accumulate in blood and urine when bodily cells cannot obtain sufficient glucose and break down fat for fuel instead. Under typical metabolic conditions, human cells use blood glucose for energy. When cells are unable to access adequate amounts of glucose, the body shifts to breaking down stored fat for cellular energy, producing acids called ketones.

When fat breakdown accelerates, ketones build up in both the bloodstream and the urine. MedlinePlus notes that having some ketones in urine is normal. However, high levels may signal that the blood is too acidic (ketoacidosis). The most common type is diabetic ketoacidosis (DKA), a medical emergency that often develops quickly and can be life-threatening.

MedlinePlus also names these higher-risk situations: vomiting or diarrhea lasting a long time, alcohol use disorder, starvation, eating disorders, certain digestive diseases, exercising too hard for a long time, and pregnancy.

Who Receives Ketone Testing

Diabetic ketoacidosis is most common in type 1 diabetes, but people with type 2 diabetes can also develop it.

MedlinePlus says a provider recommends home testing when frequent testing is needed. Vomiting or diarrhea that lasts a long time and eating disorders are also on MedlinePlus's list of higher-risk situations.

MedlinePlus names alcohol use disorder, which can cause alcoholic ketoacidosis, among the higher-risk situations.

Reading Ketone Urine Test Results

Ketone urine test results may be a number or may be reported as small, moderate, or large.

What constitutes a normal result varies depending on an individual's diet, physical activity level, and underlying health history. Because dietary choices and physical exertion change how the body burns fuel, MedlinePlus emphasizes that patients should talk with a healthcare provider to understand what is normal for their specific situation and what their test results mean.

Ketoacidosis Symptoms and Warning Signs

MedlinePlus identifies early signs of ketoacidosis as urinating frequently, experiencing extreme hunger or extreme thirst, dehydration, and developing headaches.

Severe symptoms include nausea, vomiting, abdominal pain, confusion, difficulty breathing, extreme fatigue or sleepiness, and a distinct fruity odor on the breath. MedlinePlus cautions that large amounts of ketones can be life-threatening and advises seeking immediate medical help when severe symptoms appear.

Ketone Testing on a Ketogenic Diet

Some people on a ketogenic diet use home test strips. A ketogenic diet consists primarily of foods containing little or no carbohydrates. Restricting carbohydrates compels the body to consume fat instead of glucose for energy, which may raise ketone levels.

MedlinePlus says some people use home test kits on a ketogenic diet to try to lose weight. A ketogenic diet may not be right for people with certain medical conditions. MedlinePlus advises individuals to consult a qualified healthcare provider before starting a ketogenic diet.

Questions for a Clinician

Ketone testing questions can go to a clinician through the clinician directory for guidance. MedlinePlus says to talk with a provider about what is normal and what results mean.

See also: exogenous ketones.

See also: GLP-1 side effects.

Where to Find Ketone Test Kits