Ketones are produced when the human body uses fat reserves instead of glucose to produce the necessary energy to function. But why may you find ketones in urine during pregnancy?
The presence of ketones in the urine is termed ketonuria (1). The hormonal changes of pregnancy may affect the body’s resistance to insulin, affecting glucose metabolism (2). This change prevents the cells from using the glucose in blood sugar to produce energy. It leads to the cells using stored fat to produce energy, resulting in ketone production.
Read this post as we explain the causes, treatment, prevention, and implications of ketonuria during pregnancy.
Why Do Ketones Occur In Urine During Pregnancy?
Ketones may develop in the urine due to various reasons. Although ketones appear in trace amounts throughout the pregnancy, excess ketones in urine for a considerable time could be an indication of gestational diabetes. If diagnosed early, the condition can be managed to ensure that you and your baby are both healthy.
Are Ketones In Urine Normal During Pregnancy?
Studies suggest that ketonuria is a common finding during pregnancy, possibly due to fasting or starvation, or vomiting over a long period (3). It is also reported that the appearance of ketones in urine was found throughout the pregnancy. So, if you find traces of ketones on and off during pregnancy, then it might not be linked to gestational diabetes.
However, this study also states that gestational diabetes is a possibility for a woman who showed clinical indications of pre-diabetes, or is showing signs of gestational diabetes. (1).
Your doctor is the best person to understand and interpret whether the ketones in your urine are indicating an adverse maternal condition, because, if the level of ketones goes up, then it may lead to diabetic ketoacidosis (DKA), a complication in diabetic pregnancies, which can cause fetal loss (3), (4).
Ketones can develop in the urine due to many reasons. Find out what they are next.
What Causes Ketones In Urine During Pregnancy?
During pregnancy, ketones can develop in urine if you (5):
- Did not eat properly on the previous day
- Missed your bedtime snack
- Are on a low-carbohydrate diet
- Are fasting during pregnancy
- Have extreme morning sickness and diarrhea that leaves you dehydrated
- Have any illness or infection
- Did strenuous exercise on the previous day
- Have gestational diabetes
It is important to know if the ketones in the urine pose any harm to the fetus. The section below talks about it.
Can Ketones Harm Your Baby?
Yes, they can, but only when your test results show abnormal ranges consistently. Studies show that ketones can easily cross the placenta and affect the fetal central nervous system. It showed embryo growth abnormalities, reduced volume, and distortion of the internal organs.
The studies have also shown a reduction of the cerebral cortex volume, corpus callosum, hippocampus, larynx, lateral brain ventricles, and thymus. However, the studies on the influence that ketones have on fetal development are limited (5).
In any case, you can test for ketones in urine at home and track the ketone level on an everyday basis.
Lab Test To Detect Ketones In Urine During Pregnancy
As high levels of ketones in urine might indicate an underlying clinical cause, you doctor might recommend a clinical diagnosis if they notice some of the below symptoms.
- High blood glucose levels
- Unusual thirst
- Frequent vaginal, and bladder infections.
Lab tests for ketones in urine include urine-based dipstick test and blood tests (6).
How To Test For Ketones In Urine At Home?
You can also monitor the ketones in your urine using the dipstick test available at various pharmacies. Use it on the first urine of the day for the most accurate result. Ideally, the reading should be negative to trace (5).
You can take the test at home using the kit. First, take the urine sample in a clean container and dip the strip into the sample. Take it out and leave it aside for a few minutes. When the color of the strip pad changes, compare it to the color chart mentioned on the kit bottle (5). If the ketone level in the urine is moderate or large, then, seek your doctor’s advice.
The ketone urine test is used to detect an already existing condition of ketonuria. Your doctor might prescribe blood monitoring to determine if you are having gestational diabetes (6). If your doctor finds out that you have gestational diabetes, then they would recommend diet and lifestyle changes to keep the blood glucose levels normal throughout the pregnancy.
The section below throws light on some preventive measures to control the ketone levels in urine during pregnancy.
How To Treat Ketonuria?
Based on the test results of the diagnostic tests, your doctor might prescribe the following treatment options.
- If you are showing trace amounts of ketones and if they are due to vomiting or changes in diet, then it would resolve on its own.
- But if your blood glucose levels indicate gestational diabetes, then your doctor might prescribe insulin, or dietary changes.
- If the ketonuria is due to infection, then your doctor might prescribe medications, which are safe during pregnancy, to treat the infections.
How Can You Prevent Ketones In Urine?
Here are a few simple steps to keep your ketones at a healthy level (5):
- Never skip meals
- Eat three snacks and three meals every day
- Include protein in your diet
- Do not cut down on carbohydrates during pregnancy
- exercise and stay active to reduce the risk of gestational diabetes
1. What is the normal range of ketones in urine during pregnancy?
If the concentration of ketone bodies is less than 0.5 mm (millimolar), it is considered to be a normal level during pregnancy. An excess level may arise due to different factors such as exercising for too long, improper diet, or a ketogenic diet (7).
2. Why do I have ketones in my urine if I am not diabetic?
Diabetes is one of the risk factors for ketones in the urine. Even non-diabetic people may develop ketones in urine if their body utilizes fats instead of glucose to keep functioning. Other reasons for non-diabetic people to have ketones in urine can be chronic vomiting, extreme workouts, eating disorders, or a low-carb diet (8).
3. Can not eating cause ketones in urine?
Yes. Starving or not eating for long durations is believed to be one of the causes of ketones in the urine.
Although ketones are present in minute amounts during pregnancy, excessive ketones in urine during pregnancy over an extended period could indicate gestational diabetes. While ketones in trace amounts can be corrected with diet and lifestyle changes, higher ketone levels in the urine necessitate immediate medical treatment. Early treatment will also reduce yours and your baby’s chances of experiencing any pregnancy issues. Avoiding skipping meals, having frequent meals in intervals and protein-rich foods, exercising, and being physically active could also help to prevent excess ketones when pregnant.
- Ketones in the urine can be detected throughout the pregnancy.
- Gestational diabetes, a low-carb diet, or fasting may cause ketones in urine during pregnancy.
- A urine-based dipstick test and some blood tests can identify a high ketone level in a pregnant woman’s urine.
- The treatment for ketonuria during pregnancy varies depending on the cause.
- If you have trace quantities of ketones in your system, a slight change in your diet and lifestyle can help.
MomJunction's articles are written after analyzing the research works of expert authors and institutions. Our references consist of resources established by authorities in their respective fields. You can learn more about the authenticity of the information we present in our editorial policy.
1. Helen L Robinson, et al.; Prevalence of maternal urinary ketones in pregnancy in overweight and obese women; The Royal Society of Medicine Journals
2. Symptoms & Causes of Gestational Diabetes; National Institute of Diabetes and Digestive and Kidney Diseases
3. Ketones in Urine; Medline Plus; US National Library of Medicine
4. Learning about ketones; Allina Health’s Patient Education Department (2014)
5. Agata Bronisz, et al.; Pregnancy Ketonemia and Development of the Fetal Central Nervous System; NCBI (2018)
6. Urine-based Ketone Testing in Pregnancy Complicated by Diabetes; Health Technology Inquiry Service
7. Meichen Qian et al.; Effect of Elevated Ketone Body on Maternal and Infant Outcome of Pregnant Women with Abnormal Glucose Metabolism During Pregnancy; Diabetes Metab Syndr Obes
8. Ketone bodies (urine); University of Rochester Medical Center
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Shreeja holds a postgraduate degree in Chemistry and diploma in Drug Regulatory Affairs from the University of Mumbai. Before joining MomJunction, she worked as a research analyst with a leading multinational pharmaceutical company. Her interest in the field of medical research has developed her passion for writing research-based articles. As a writer, she aims at providing informative articles on health... more
Dr. Karishma Bhatia did her MS in Obstetrics and Gynaecology from Maulana Azad Medical College (MAMC) and currently practices in Rohini, North Delhi. She also completed DNB, MNAMS and Fellowship training in Gynaecological Laparoscopy (Kiel, Germany) and Reproductive Medicine. She is a lifetime member of AOGD, FOGSI, ESAG.
If your cells don't get enough glucose, your body burns fat for energy instead. This produces ketones, which show up in your urine. During pregnancy, it could indicate gestational diabetes, poor diet or needing to eat more calories.How do you get rid of ketones during pregnancy? ›
When ketones occur because of vomiting, starving or fasting, changing your diet and eating properly helps settle the condition. “You should keep yourself hydrated, even if you don't feel like consuming fluids.” “Your doctor may also advise medications for vomiting.”Why does pregnancy cause ketones in urine? ›
Ketones in your urine may be a sign that you and your baby are not getting enough energy fuel in your diet. Ketones and your baby. Some studies have shown that excess ketones in a pregnant woman's urine may affect developing brain cells and lead to babies with a lower IQ and future learning disabilities.Should I be worried about ketones in urine while pregnant? ›
Urinary ketones are common in pregnancy. This study shows that 22% of women have urinary ketones at either 16 or 28 weeks gestation and 8% have ketones at 36 weeks gestation. In some previous studies, maternal ketonuria has been associated with adverse fetal outcomes.How do you prevent ketones? ›
Also try these steps to bring down your ketone levels: Drink extra water to flush them out of your body. Test your blood sugar every 3 to 4 hours. Don't exercise if you have high blood sugar and high ketones.Does drinking water reduce ketones? ›
Drinking more water
Many people suggest that drinking more water may help reduce a person's keto breath. This is because the body expels more ketones in urine rather than as a breath. By drinking water, people will produce more urine, which will help expel many of the ketones from the body.
Ketones are most common in people who do not consume enough carbohydrates. The human body uses simple carbohydrates from starchy foods, honey, and certain fruits to produce glucose (blood sugar). Glucose serves as the body's main source of energy.How do you get rid of ketones? ›
It is recommended that you drink 8 ounces of water or carb/caffeine free beverage every 30-60 minutes to help flush out the ketones. Again, ketones are a sign that your body needs more insulin. Some people might already have an insulin dosing plan in place related to ketones.How do you treat ketones? ›
- Intravenous (IV) fluid replacement. One DKA symptom is increased urination, which can result in fluid loss. ...
- Electrolyte replacement. When a person has DKA, their electrolyte levels tend to be low. ...
People without diabetes can also have ketones in the urine if their body is using fat for fuel instead of glucose. This can happen with chronic vomiting, extreme exercise, low-carbohydrate diets, or eating disorders.
You have ketones in your urine and can't reach your doctor for advice. You have many signs and symptoms of diabetic ketoacidosis — excessive thirst, frequent urination, nausea and vomiting, stomach pain, weakness or fatigue, shortness of breath, fruity-scented breath, and confusion.Can dehydration cause ketones in urine? ›
Ketone testing can be done anytime using a urine test strip or a blood sugar meter that tests for ketones.. If ketone levels are very high or if the person is dehydrated, ketones may begin to build up in the blood.Can stress cause ketones in urine? ›
Results: Our main finding was that social stress markedly increased concentrations of serum β-hydroxybutyrate by 454% in normal weight men. The increase in ketone bodies during stress in normal weight subjects was associated with an increase in ACTH, norepinephrine and epinephrine concentrations.Can a UTI cause ketones in urine? ›
Additionally, there may be signs of illnesses such as sepsis, pneumonia, and urinary tract infections that can lead to high ketone levels.When is the best time to check ketones in urine? ›
Conclusions. These results indicate that ketonuria in subjects with stable ketosis is highest and can be most reliably detected in the early morning and post-dinner urine. Recommendations can be given regarding precise time of the day for measuring ketone bodies in urine in future studies with KDs.Does lemon water stop ketosis? ›
The participants maintained ketosis — a common indicator of a fasting state — while consuming these beverages ( 3 ). That said, if you add calorie-containing ingredients like sugar to lemon water, it will kick you out of your fast.When should you go to the hospital for ketones? ›
Elevated ketones are a sign of DKA, which is a medical emergency and needs to be treated immediately. Go to the emergency room or call 911 right away if you can't get in touch with your doctor and are experiencing any of the following: Your blood sugar stays at 300 mg/dL or above. Your breath smells fruity.How long does it take for ketones to come down? ›
The time it takes to enter ketosis varies from person to person ( 6 , 7 ). In general, it can take 2–4 days if you eat 20–50 grams of carbs per day. However, some people may find it takes a week or longer to reach this state ( 6 , 7 , 8 ).What happens if you have ketones in your urine? ›
Having some ketones in your urine is normal. But high ketone levels in urine may be a sign that your body is too acidic. This condition is called ketoacidosis. The most common type of ketoacidosis is a complication of diabetes called diabetic ketoacidosis (DKA).What happens if ketones are high? ›
When ketones build up in the blood, they make it more acidic. They are a warning sign that your diabetes is out of control or that you are getting sick. High levels of ketones can poison the body. When levels get too high, you can develop DKA.
Not eating enough food can also sometimes trigger diabetic ketoacidosis. The symptoms of diabetic ketoacidosis include: high blood glucose levels. rising levels of ketones in the urine.What are normal pregnancy ketones? ›
The normal ketone bodies levels are <0.5 mM and levels >1.0 mM is defined as hyperketonemia, and level >3.0 mM indicate ketoacidosis. Certain physiological conditions, such as prolonged exercise, improper diet during pregnancy, or ketogenic diet, result in a mild or moderate increase in ketone body levels in the body.Do ketones hurt your kidneys? ›
Very high levels of ketones make your blood more acidic and overburden your kidneys. "Medical News Today" reports that one of the side effects of a ketogenic diet is the formation of kidney stones.What does it mean when you have ketones in your urine? ›
Having some ketones in your urine is normal. But high ketone levels in urine may be a sign that your body is too acidic. This condition is called ketoacidosis. The most common type of ketoacidosis is a complication of diabetes called diabetic ketoacidosis (DKA).Does dehydration cause ketones in urine? ›
If ketone levels are very high or if the person is dehydrated, ketones may begin to build up in the blood. High blood levels of ketones may cause fruity-smelling breath, loss of appetite, nausea or vomiting, and fast, deep breathing.Can you be in ketosis while pregnant? ›
Experts stress that the keto diet is simply not safe for pregnant women, in part since the basic premise of this diet — teaching the body to use ketones instead of glucose — doesn't work for growing babies. Glucose from carbohydrates is a primary energy source for baby's growth and development.What are the symptoms of ketones? ›
You have ketones in your urine and can't reach your doctor for advice. You have many signs and symptoms of diabetic ketoacidosis — excessive thirst, frequent urination, nausea and vomiting, stomach pain, weakness or fatigue, shortness of breath, fruity-scented breath, and confusion.Can stress cause ketones in urine? ›
Results: Our main finding was that social stress markedly increased concentrations of serum β-hydroxybutyrate by 454% in normal weight men. The increase in ketone bodies during stress in normal weight subjects was associated with an increase in ACTH, norepinephrine and epinephrine concentrations.What are normal pregnancy ketones? ›
The normal ketone bodies levels are <0.5 mM and levels >1.0 mM is defined as hyperketonemia, and level >3.0 mM indicate ketoacidosis. Certain physiological conditions, such as prolonged exercise, improper diet during pregnancy, or ketogenic diet, result in a mild or moderate increase in ketone body levels in the body.What infections cause ketones in urine? ›
Additionally, there may be signs of illnesses such as sepsis, pneumonia, and urinary tract infections that can lead to high ketone levels.
Pregnant women on ketogenic diets may face greater risks for birth defects and gestational diabetes, according to a narrative review published in Frontiers in Nutrition.What diet is best for pregnancy? ›
To maintain a healthy pregnancy, approximately 300 extra calories are needed each day. These calories should come from a balanced diet of protein, fruits, vegetables and whole grains. Sweets and fats should be kept to a minimum.How can gestational diabetes be prevented? ›
Before you get pregnant, you may be able to prevent gestational diabetes by losing weight if you're overweight and getting regular physical activity. Don't try to lose weight if you're already pregnant. You'll need to gain some weight—but not too quickly—for your baby to be healthy.