High Ketones: What They Mean, Risks, and How to Manage Them
When your body starts breaking down fat for energy, it produces high ketones, chemicals made by the liver during fat metabolism that can build up in the blood. Also known as ketone bodies, they’re normal in small amounts during fasting or low-carb diets—but when they spike too high, they become a medical warning sign. This isn’t just about weight loss. For people with type 1 diabetes, or sometimes type 2, high ketones can lead to diabetic ketoacidosis, a life-threatening condition where blood becomes too acidic due to excess ketones and high blood sugar. It doesn’t happen overnight, but it can sneak up fast if you’re sick, skipping insulin, or dehydrated.
Not everyone with high ketones has diabetes. People on strict ketogenic diets may have elevated levels by design, but even then, knowing your numbers matters. A reading above 1.5 mmol/L on a blood ketone meter is considered moderate risk. Above 3.0 mmol/L? That’s a red flag. You can test at home with strips, just like checking blood sugar. But here’s the catch: urine strips are outdated and unreliable. Blood tests give you real-time data. If you’re diabetic and your ketones are high, don’t wait. Drink water, check your sugar, and call your doctor if it doesn’t drop after an hour or two. ketone testing, the process of measuring ketone levels in blood or urine to assess metabolic state isn’t optional for high-risk groups—it’s part of daily management.
What triggers this? Illness, missed insulin doses, extreme stress, or even a new medication can push ketones up. Some people don’t feel anything until they’re dizzy, nauseous, or breathing fast. Others get fruity-smelling breath or a dry mouth. These are clues. And if you’re on a low-carb diet and suddenly feel terrible, it might not be the keto flu—it could be something worse. The posts below cover how drugs like SGLT2 inhibitors (used for diabetes) can raise ketone risk, how to spot early signs before it turns critical, and what to do when your body starts burning fat too fast. You’ll find real advice on testing, prevention, and when to act—not guesses or fluff. This isn’t theory. It’s what keeps people out of the ER.
