A Beginner’s Guide to Ketones


The human body primarily uses glucose for energy. 

If ‌your‌ ‌cells‌ ‌don’t‌ ‌get‌ ‌the‌ ‌glucose‌ ‌they‌ ‌need‌,‌ or‌ the body doesn’t have enough insulin to use glucose, then your‌ ‌body‌ ‌begins‌ ‌to‌ ‌burn‌ ‌fat‌ ‌instead. Your liver converts this fat into ketones, a type of acid, and sends it into the bloodstream for muscles and other tissues to use as fuel. This is all very normal and known as Ketosis.  You may even feel symptoms of ketosis like headache or fatigue.  In a person without diabetes, insulin, glucagon, and other hormones prevent blood ketone levels from getting too high. However, people with diabetes are at risk for ketone accumulation in their blood.  This can disturb the balance of ketone in the body and create risks. 

Related: Vivoo Ketone Box

Why do ketones form?

 Ketone is one of the essential fatty acids in the body. The liver creates ketone production. Normally, the body produces only small quantities of ketones. Starvation, a ketogenic diet, or some chronic conditions like diabetes may result in increased ketones forming in the blood and eventually spilling into the urine. Then problems arise.

The body needs the energy from glucose to function comfortably. To provide this energy in the body, sugar must be produced. If enough sugar is not produced in the body, the cells will start to burn fat. As the cells in the body begin to burn fat, the production of ketones in the body intensifies.

energy for ketones

What does the presence of ketones in the urine mean?

Predominantly, people with diabetes may have insufficient insulin in their bodies or the existing insulin may not be used properly. These disorders prevent sugar (glucose) from being transported to cells efficiently and can’t be used as energy.  Instead of glucose, fats and proteins are used as energy sources, and ketones emerge as their waste product. A buildup of too many ketones in the blood is known as ketoacidosis and the body tries to remove it through the urine.  Diabetics who have a high amount of ketones in their urine are likely to have high blood sugar levels.

For persons without diabetes, ketones in the urine can result when the body doesn’t have enough sugar to produce sufficient energy.  Instead of sugar, fat and fatty acids begin to burn as energy.  Factors such as following a ketogenic diet, not eating regularly, and infections can cause ketones.

Followers of the Keto Diet

Ketosis is when ketones in the blood rise above normal levels. In this state, the body uses its own stored fat as an energy source throughout the day. When followed correctly, this low-carb diet raises blood ketone levels. The body undergoes many biological adaptations on a ketogenic diet, including decreased insulin and increased fat distribution. When this adaptation occurs, the liver produces large amounts of ketones to provide more energy to the brain. At the same time, fat burning reaches its maximum. As intended, ketones may start to appear in the blood and urine- ketosis has begun.

For those who don’t

Ketones in the urine (ketonuria) are a medical condition that occurs after fats are broken down for energy use. Excess ketones result as a waste product from this breakdown and try to escape the body through urine. Under normal circumstances, ketones aren’t found in the urine, and the body keeps only a small number of ketones in the blood. Diabetes can cause ketone levels in the blood to get too high and the blood can become acidic. This condition is called diabetic ketoacidosis and threatens the health of those affected.

diet for ketones


Causes of ketones in the urine include: 

  • Diabetes
  • Uncontrolled blood sugar levels
  • Disrupting insulin use
  • Skipping meals
  • Not eating enough
  • Not paying attention to nutrition
  • Diabetic Ketoacidosis
  • Fever onset by disease, such as rheumatoid arthritis
  • Sepsis
  • Patients with severe burns  
  • Excessive alcohol consumption
  • Pregnancy
  • Prolonged hunger
  • Eating disorders
  • Fasting
  • Infectious diseases
  • Long-term exercises
  • Diuretic drugs


If ketones are found in the urine, the following symptoms may occur:


  • Dry mouth
  • Strong sense of thirst
  • High blood sugar level
  • Frequent urge to urinate
  • Prolonged nausea
  • Excessive vomiting
  • Confusion and inability to focus
  • Shortness of breath
  • Rotten fruit smell on breath
  • Excessive sleepiness

sleepiness for ketones

Why is it important to track ketones?

When following a ketogenic diet or other low-carb diets, it is important to monitor the effectiveness of the diet. On the other hand, while not following a similar diet, increased ketone levels in the body can indicate some problems.

More Info For Followers of the Keto Diet 

The ketogenic diet or keto diet is the general name for low-carb diets that turn the body into a burning machine. While ketogenic diets have many benefits in weight loss, health and performance, they can sometimes have side effects like weakness and fatigue.  People who follow the ketogenic diet should monitor their ketosis levels. This gives them information about whether or not the body has reached optimal ketosis.  This can be done by analyzing the ketones in the body over a period of time and making a comparison. When doing so, it’s important to measure the ketone level every day at the same time.  It is more productive to analyze eating breakfast.

Optimal Achievement and Maintenance of Ketosis

Optimal ketosis is when your body is most efficiently using its sources of fat for fuel. Most people following a ketogenic diet experience various side effects during the process of reaching optimal ketosis.  These side effects are typical “keto flu,” occasional dips in energy levels, and weight loss plateaus.  When people keep their commitment, they can reach the optimum level of ketosis.

After the body adapts to ketosis, ketones won’t be found in the urine anymore. Uric acid levels in the blood elevate and the kidneys get the drift of what’s happening, stop leaking the ketones, and start leaking the uric acid instead.

Over time, our uric acid levels return to normal, a key sign of keto-adaptation.  The body has adapted, adjusted, and accepted the keto diet.

Here are the reference ranges that Vivoo use for ketosis;

  • Negative: 0 mg/dL 
  • Trace: 5 mg/dL
  • Optimal: 15-50 mg/dL
  • High: 50-150 mg/dL

Ketones without Keto Diet

Ketones that accumulate in the blood can disrupt the balance of the body.

Excretion of ketones accumulated in the blood occurs through the urinary tract. This happens when the body doesn’t have enough insulin or isn’t able to use its insulin properly. Ketone bodies, the waste product formed from burning fat as energy, first begin to pass into the blood and, as their amount increases, into the urine.  The presence of a high ketone level in the blood can be understood by checking the level of ketones in the blood or urine. Performing these control measures will allow you to take precautions should you have an elevated level.

If you are not following the ketogenic diet, here are the reference ranges for urine ketones that Vivoo use:

  • Great: 0 mg/dL
  • Moderate: 5-15 mg/dL
  • Weak: 15-150 mg/dL

How to Improve High Ketone Levels

If you are not following a ketogenic diet, but receive high ketone results from the Vivoo app, all factors that affect ketone formation should be eliminated.  Furthermore, drinking plenty of water help reduce ketone levels in the body.  Also, it’s important to eat regularly and not skip meals, take in enough carbohydrates, and sleep well.

How often should the presence of ketones in the urine be monitored?


The‌ ‌ketogenic‌ ‌or‌ ‌keto ‌diet‌ ‌is‌ ‌a‌ ‌low-carb,‌ ‌high-fat‌‌, and‌ ‌moderate-protein‌ ‌diet.‌ ‌A ‌common‌ ‌goal‌ ‌of‌ ‌people‌ ‌on‌ ‌the‌ ‌keto‌ ‌diet‌ ‌is‌ ‌to‌ ‌achieve‌ ‌ketosis,‌ ‌a‌ ‌natural‌ ‌state‌ ‌where ‌your‌ ‌body‌ ‌burns‌ ‌fat‌ ‌for‌ ‌fuel.‌ ‌However,‌ ‌it‌ ‌can‌ ‌be‌ ‌challenging‌ ‌to‌ ‌determine‌ ‌whether‌ ‌your‌ ‌diet‌ ‌needs‌ ‌to be adjusted to reach and maintain ketosis.‌ ‌‌Because of that, Vivo ‌strips‌‌ ‌can‌ ‌be‌ ‌used‌‌ to‌ ‌measure‌ ‌your‌ ‌ketosis‌ ‌level.‌ Thanks to Vivoo strip tests, you can learn about your body’s ketone level in just 2 minutes. Because of this, Vivoo is a great help for you; both with following your diet and determining your goals in the future. ‌Using‌ ‌Vivoo‌ ‌is‌ ‌a‌ ‌fast,‌ ‌cheap,‌ ‌and‌ ‌convenient‌ ‌method‌‌ compared‌ ‌to‌ ‌blood-testing‌.‌ ‌Vivoo‌ ‌gives‌ ‌you‌‌ personalized‌ ‌advice‌ ‌to‌ ‌get‌ ‌into‌ ‌ketosis‌ ‌and‌ ‌maintain‌ ‌it‌ ‌according‌ ‌to‌ ‌your‌ ‌urine‌ ‌ketone‌‌ levels.‌

‌If‌ ‌you‌ ‌want‌ ‌to‌ ‌check‌ ‌your‌ ‌day-to-day‌ ‌urine‌ ‌ketone ‌levels,‌ ‌the‌ ‌‌best‌ ‌times‌ ‌are‌ ‌in‌‌ ‌the‌ ‌early‌ ‌morning before breakfast or‌ ‌the‌ ‌late‌ ‌evening‌ ‌after‌ ‌dinner.‌  Although there isn’t clear information about how often the ketone level should be measured, it is important for individuals who have just started the ketogenic diet to measure their ketone levels frequently during the first two weeks. This way, it’s easier to see whether the diet works or not and whether there is an excess of ketones. 

Whether you follow the keto diet or not, it is still crucial that you regularly measure your ketone levels. Follow-up can be done every week using Vivoo strip tests.  During‌ ‌the‌ ‌first‌ ‌few‌ ‌weeks‌ ‌of‌ ‌going‌ ‌keto, Vivoo’s‌ ‌urinalysis‌‌ is‌ ‌an excellent‌ ‌tool‌ ‌to‌ ‌measure‌ ‌whether‌ ‌you‌ ‌are‌ ‌in‌ ‌ketosis‌.  Thanks to the Vivoo application, you can indicate that you are currently on a ketogenic diet and receive nutritional advice based on your results. This is a beneficial option for people at the beginning of their diet and for people who need additional dietary advice.

You do not need to be on a ketogenic diet to use the Vivoo strip tests.  It’s already determined that there is a benefit in monitoring your ketone level anytime. Our Vivoo strip test result can provide a lot of information. If you want to get information about the ketone level in your body and still have a look at the recommendations, Vivoo strip tests will assist you in doing that.




I’m Not On A Ketogenic Diet So Why Are There Ketones In My Urine?

The presence of ketones in the urine is a common complication of diabetes. If you’re sure that you don’t have diabetes, it’s the body’s normal adaptation to starvation. However, in an individual with diabetes, this situation is dangerous and life-threatening.

What Are Ketones?

Ketones are acids that the body makes when it burns its own fat. They’re made when glucose, the primary energy source, is short in supply. This occurs overnight or during dieting or fasting.

The liver converts fatty acids into ketones, which are then released into the bloodstream for use as energy. In people with diabetes, high levels of ketones in the blood can result from taking too little insulin, and this can lead to a particularly dangerous condition known as ketoacidosis.

Ketoacidosis is very risky for someone with Type 1 diabetes because they can develop dangerous levels of ketones. Ketoacidosis can also occur in someone with Type 2 diabetes if there is a major increase in insulin resistance, such as from an infection or treatment with steroids, or a reduction in insulin release from the pancreas.

Ketones can be tested by blood or urine. You can quickly check the ketone levels in your urine with Vivoo strip.

Related: Vivoo Ketone Box

What Causes Ketones in Urine Without Ketosis?

Ketones in the urine can be caused by several factors. These may include:

1) Diet

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Dietary Preferences: People who are not on a ketogenic diet but prefer high fat and low carbohydrate foods may have ketones in their urine.

Fasting: In a person without diabetes, ketone production is the body’s normal adaptation to starvation. Starvation starts when you haven’t eaten for a prolonged period of time, for example 14-20 hours. This can occur at night or when fasting.

Eating disorders: Anorexia nervosa and bulimia nervosa can also cause ketones to appear in the urine. In these individuals, starvation is one of the causes of severe ketoacidosis, even when the patient denies diet restriction. 

2) High Amounts of Exercise

Workout group class at the gym

Post-exercise ketosis was first described by Forssner. When someone overtrains, the need for respiratory fuel increases, and blood-glycerol and plasma-free fatty acid (FFA) levels rise. The increased concentration of FFA and the depletion of glycogen cause an increased rate of ketone body formation in the liver. During exercise, the extra ketone bodies serve as fuel for respiration and don’t accumulate. After exercise, the raised concentration of FFA results in post-exercise ketosis. 

3) Excessive Alcohol Consumption

Glasses of rose wine. Visit Kaboompics for more free images.

Drinking too much alcohol is another reason for ketones in the urine. Alcoholic ketoacidosis can develop when you drink excessive amounts of alcohol for a long period of time. The overconsumption of alcohol often causes an inadequate intake of nutrients as meals may be eaten irregularly. People who drink too much may also vomit, further depleting the body of nourishment. Not eating enough or vomiting can lead to periods of starvation, which can then lead to alcoholic ketoacidosis. 

4) Other Factors

Other causes of ketones in urine are:

  • illness or infection
  • pregnancy
  • fever
  • medications, such as corticosteroids and diuretics
  • prolonged vomiting and diarrhea
  • eclampsia


Ketones in urine can be caused by many factors. If you have ketones in your urine, the first place to look is at your diet. What you eat and drink is very important. You may be able to remedy the situation by making dietary changes, or there may be a more serious cause. See your doctor immediately if you think you might have ketonuria.

Lifestyle Suggestions

Suggestions for ketones in urine:

  • Monitor your blood glucose levels.
  • Test your ketones regularly.
  • Reduce your alcohol consumption.
  • Follow a healthy diet plan.

Related: The Top 3 Ways That You Can Improve Your Health Using the Vivoo App


Vivoo Ketone Box

Vivoo’s Ketone box gives insights about the presence of ketones in the urine. Normally, no ketones are expected in the urine. However, if‌ ‌you‌ ‌are‌ ‌following‌ ‌a‌ ‌‌ketogenic‌ ‌diet,‌ ‌‌this‌ ‌box‌ ‌can help you to ‌track ‌your‌ ‌ketosis ‌state.‌ ‌

What‌ ‌are ‌Ketones?‌

The human body primarily uses glucose for energy. When‌ ‌your‌ ‌cells‌ ‌don’t‌ ‌get‌ ‌the‌ ‌glucose‌ ‌they‌ ‌need‌,‌ or‌ the body doesn’t have enough insulin to use glucose, your‌ ‌body‌ ‌begins‌ ‌to‌ ‌burn‌ ‌fat‌ ‌instead. ‌This, in turn, produces‌ ‌ketones.‌ Ketones‌ ‌are‌ ‌chemicals‌ ‌that‌ ‌the‌ ‌body‌ ‌creates‌ ‌when‌ ‌it‌ ‌breaks‌ ‌down‌ ‌fat‌ ‌to‌ ‌use‌ ‌for‌ ‌energy.‌ This means you make ketones when you don’t have enough stored glucose (or sugar) to turn into energy.  

Vivoo‌ Energy ‌Box ‌- Ketone Tracker

The breakdown of fat for energy and producing ketones is a normal process for everyone. Normally, the body produces only small quantities of ketones. But starvation, a ketogenic diet, or some chronic conditions like diabetes may result in increased ketones forming in the blood and eventually spilling into the urine.

What Does My Result Mean?

Ketones‌ ‌which‌ ‌are‌ ‌not‌ ‌used‌ ‌for‌ ‌energy‌ ‌spill‌ ‌into‌ ‌the‌ ‌urine.‌ ‌Starvation,‌ ‌low-carbohydrate‌ ‌diets,‌ ‌certain‌ ‌diseases,‌ ‌and‌ ‌problems‌ ‌in‌ ‌carbohydrate‌ ‌metabolism‌ ‌may‌ ‌cause‌ ‌ketone‌ ‌production.‌ Ketone‌ ‌bodies‌ come‌ ‌in‌ ‌two‌ ‌main‌ ‌forms:‌ ‌BHB‌ ‌and‌ ‌AcAc.‌ ‌BHB‌ ‌is‌ ‌the‌ ‌dominant‌ ‌ketone‌ ‌and‌ ‌increases‌ ‌relative‌ ‌to‌ ‌AcAc‌ ‌during‌ ‌ketosis.‌ ‌Vivoo‌ ‌test‌ ‌strips‌ ‌measure‌ ‌the‌ ‌urine’s‌ acetoacetate ‌(AcAc)‌ ‌level.‌ ‌When‌ ‌you‌ ‌start‌ ‌to‌ ‌produce‌ ketones, ‌you‌ ‌may‌ ‌feel‌ ‌weak‌ ‌and‌ ‌fatigued.‌ 

Vivoo‌ Energy ‌Box ‌- Ketone Tracker

‌For‌ ‌a‌ person‌ ‌without‌ ‌diabetes,‌ ‌ketone‌ ‌production‌ ‌doesn’t‌ ‌become‌ ‌an‌ ‌issue.‌ ‌However, ‌when‌ ‌you‌ ‌have‌ ‌diabetes,‌ ‌things‌ ‌can‌ ‌run‌ ‌out‌ ‌of‌ ‌control‌ ‌and‌ ‌too‌ ‌many‌ ‌ketones‌ ‌can‌ ‌build‌ ‌up‌ ‌in‌ your‌ ‌blood.‌‌ ‌‌High‌ ‌levels‌ ‌of‌  ketones increase‌ ‌acidity‌ ‌and‌ ‌may‌ ‌be‌ ‌dangerous‌ ‌for‌ ‌the‌‌ body.‌ ‌‌That’s why urine‌ ‌ketone‌ ‌testing‌ ‌can‌ ‌be‌ ‌advantageous‌ ‌for‌ ‌early-diagnosis‌ ‌in‌ ‌diabetes.‌

How Does Vivoo Measure Ketosis?

The‌ ‌ketogenic,‌ ‌or‌ ‌keto ‌diet‌ ‌is‌ ‌a‌ ‌low-carb,‌ ‌high-fat‌‌, and‌ ‌moderate-protein‌ ‌diet.‌ ‌A ‌common‌ ‌goal‌ ‌of‌ ‌people‌ ‌on‌ ‌the‌ ‌keto‌ ‌diet‌ ‌is‌ ‌to‌ ‌achieve‌ ‌ketosis,‌ ‌which is a‌ ‌natural‌ ‌state‌ ‌where ‌your‌ ‌body‌ ‌burns‌ ‌fat‌ ‌for‌ ‌fuel.‌ ‌However,‌ ‌it‌ ‌can‌ ‌be‌ ‌difficult‌ ‌to‌ ‌determine‌ ‌whether‌ ‌your‌ ‌diet‌ ‌needs‌ ‌adjusting‌ ‌to‌ ‌reach‌ ‌and‌ ‌maintain‌ ‌ketosis.‌ ‌‌Because of that, Vivoo ‌strips‌‌ ‌can‌ ‌be‌ ‌used‌‌ to‌ ‌measure‌ ‌your‌ ‌ketosis‌ ‌level.‌ ‌Using‌ ‌Vivoo‌ ‌is‌ ‌a‌ ‌fast,‌ ‌cheap,‌ ‌and‌ ‌convenient‌ ‌method‌‌ compared‌ ‌to‌ ‌blood-testing‌ ‌when‌ ‌following‌ ‌a‌ ‌ketogenic‌ ‌diet.‌ ‌Vivoo‌ ‌gives‌ ‌you‌‌ personalized‌ ‌advice‌ ‌to‌ ‌get‌ ‌into‌ ‌ketosis‌ ‌and‌ ‌maintain‌ ‌it‌ ‌according‌ ‌to‌ ‌your‌ ‌urine‌ ‌ketone‌‌ levels.‌

Vivoo‌ Energy ‌Box ‌- Ketone Tracker

If‌ ‌you‌ ‌want‌ ‌to‌ ‌check‌ ‌your‌ ‌day-to-day‌ ‌urine‌ ‌ketone ‌levels,‌ ‌the‌ ‌‌best‌ ‌times‌ ‌are‌ ‌in‌‌ ‌the‌ ‌early‌ ‌morning or‌ ‌the‌ ‌late‌ ‌evening‌ ‌after‌ ‌dinner.‌ ‌Vivoo’s‌ ‌urinalysis‌‌ is‌ ‌a‌ ‌good‌ ‌tool‌ ‌to‌ ‌measure‌ ‌whether‌ ‌you‌ ‌are‌ ‌in‌ ‌ketosis‌ ‌during‌ ‌the‌ ‌first‌ ‌few‌ ‌weeks‌ ‌of‌ ‌going‌ ‌keto.‌ ‌During‌ ‌this‌ ‌time,‌ ‌your‌ ‌body‌ ‌can’t‌ ‌use‌ ketones ‌efficiently‌ ‌for‌ ‌energy.‌ ‌Therefore, ‌‌your‌ ‌body‌ ‌passes‌ ‌them‌ ‌out‌ ‌through‌ ‌the‌ ‌urine.‌ ‌But‌ ‌as‌ ‌you‌ ‌get‌ ‌deeper‌ ‌into‌ ‌ketosis,‌‌ your‌ ‌body‌ ‌adapts‌ ‌to‌ ‌using‌ ‌them‌ ‌for‌ ‌fuel‌ ‌and‌ ‌becomes‌ ‌more‌ ‌optimized‌ ‌in‌ ‌producing ‌‌them. ‌This leaves ‌fewer‌ ‌ketones‌ ‌to‌ ‌be‌ ‌excreted‌ ‌in‌ ‌the‌ ‌urine.‌ ‌As‌ ‌a‌ ‌result,‌ ‌if‌ ‌you’ve‌ ‌been‌ ‌in‌‌ a‌ ‌keto-adapted‌ ‌state‌ ‌for‌ ‌many‌ ‌months,‌ ‌you‌ ‌may‌ ‌get‌ ‌a‌ ‌negative‌ ‌or‌ ‌trace‌ ‌ketone‌ result‌‌ in‌ ‌your‌ ‌urinalysis.‌‌‌