“Ketonemia” is a term that describes an unusually high amount of ketone bodies in the blood. This is due to a process called ketosis, during which the body burns fat for energy instead of glucose.

A high amount of ketones in the blood may be due to a person eating a ketogenic (keto) diet, meaning they eat very little carbohydrates. This forces the body to use fat as an energy source.

Ketosis can also occur when there is insufficient insulin in the body, such as if the body has issues producing insulin. Ketonemia can occur in people with diabetes.

In very high amounts, ketones can cause the blood to become acidic, causing various symptoms. This is known as ketoacidosis.

This article defines ketonemia, including treatment, diagnosis, and how it differs from ketonuria.

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“Ketonemia” is a term that describes the quantity of ketones in the blood. It can occur as a result of a metabolic process called ketosis. During ketosis, the body uses fat as its main energy source.

Ketosis can lead to a high volume of ketones.

Typically, the body uses glucose as its main energy source. Glucose comes from eating carbohydrates.

When there is not enough glucose for the body to use for energy, it begins to use fat instead. When the body burns fat for energy, the liver produces ketones.

Ketonemia is not a condition but rather a finding or observation. When these ketones circulate in the blood in higher concentrations than usual, doctors refer to this as ketonemia.

According to the National Health Service in the United Kingdom, the typical blood ketone range is under 0.6 millimoles per liter (mmol/L).

Ketonemia vs. ketonuria

“Ketonuria” refers to high levels of ketone bodies in the urine. When there is a higher-than-normal level of ketones in the blood, they are excreted in the urine. A doctor can use urine and blood tests to detect whether a person is in ketosis.

Other than having a higher-than-usual amount of ketones in the blood, there may be no other specific symptoms associated with ketonemia.

However, ketonemia is one sign that a person may be experiencing ketoacidosis.

Ketoacidosis symptoms

Ketoacidosis is generally associated with a very high level of ketones in the blood and urine. It may occur due to complications of diabetes, alcohol misuse, or starvation.

Diabetic ketoacidosis (DKA) is the most common type of ketoacidosis.

Symptoms of ketoacidosis range from mild to severe and may include:

Most people recover from ketoacidosis, but it can be fatal in some cases.

According to a 2016 study, DKA generally has a 2–10% death rate. Researchers note this percentage may vary based on how early DKA is detected and the resources available to treat it.

There are several reasons a person may experience an increase of ketones in their blood.

Common causes include:

Ketogenic (keto) diet

Some people follow a keto diet to lose weight or gain other potential health benefits. The keto diet requires a person to eat very little carbohydrates and moderate protein intake.

The ultimate aim of this diet is to induce a state called nutritional ketosis. It accelerates ketone production, and the body begins to break down fat and ketone bodies for energy rather than relying on glucose.

While this does cause ketonemia, it is generally considered safe because the ketone increase is moderate.


People with diabetes, including type 1, type 2, or other types, such as gestational diabetes, may have high amounts of glucose and low amounts of insulin in their blood. Sometimes, this can cause ketonemia because the body needs insulin to convert glucose into energy.

Still, if the level of ketone bodies becomes too high, it can lead to DKA.

Alcohol misuse

People with alcohol use disorder may develop ketonemia. It often happens after an episode of heavy alcohol use. As a result of this episode, a person cannot eat to take in glucose for the body to produce energy.

A combination of the effects of heavy alcohol use, such as nausea, vomiting, and low blood sugar, can be the underlying reason for ketonemia.


Mild starvation ketosis can occur after fasting for 12–14 hours or longer.

Fasting for a long time can cause the body to burn fat stores for energy and increase the production of ketones.

A doctor can assess whether a person has ketonemia by taking a blood sample and measuring the amount of ketones.

People with diabetes may need to test their ketones regularly if they have high blood sugar or are feeling particularly unwell.

People wanting to measure their blood ketone levels at home can use a blood ketone meter. It works similarly to a blood glucose test and involves sticking a finger with a needle and placing a drop of blood on the strip.

Ketonemia and ketosis do not require treatment because the levels of ketones in the blood are not typically dangerous. Many people choose to put their bodies in a state of ketosis as part of their health goals.

However, if these levels become dangerously high and the person begins to experience ketoacidosis, they need urgent treatment.

Depending on the type of ketoacidosis, the treatment can vary:


Treatment for DKA may include:

  • intravenous (IV) insulin to correct high blood sugar
  • electrolyte supplements
  • IV fluids

Healthcare professionals will closely monitor the person to ensure glucose and electrolyte levels are within the adequate range.

Alcoholic ketoacidosis (AKA) and starvation ketoacidosis

Treatments for AKA and starvation ketoacidosis are similar and may include:

  • IV saline
  • IV glucose
  • oral or IV thiamine
  • electrolyte supplements

“Ketonemia” refers to high levels of ketone bodies in the blood due to a metabolic state called ketosis. It is unlikely harmful and may be due to a person eating a keto diet.

However, when ketone levels become too high, called ketoacidosis, it can cause severe symptoms that are potentially life threatening. Diabetic ketoacidosis is the most common form of ketoacidosis.

A doctor can easily detect ketonemia with a blood test. People can also test their blood for ketone levels at home with a blood ketone meter.

Ketoacidosis is a serious condition. It requires immediate treatment to stabilize the person and replace essential fluids and electrolytes.