What Is the Relationship between Ketosis and Urine?

Generally, ketosis and urine have an important connection, as ketone bodies are expressed in the urine when patients enter this metabolic state. It can be the result of starvation, fasting, or poorly controlled diabetes and may also be deliberately induced in a ketogenic diet. One way to determine if a patient has ketosis is to test the urine to check for signs of ketone bodies. Some patients do this at home with test kits because they are advised to do so by health providers, or they want to monitor their metabolisms.

In ketosis, the body starts burning fat for energy because it isn’t getting it from other sources. Ketone bodies are a byproduct. To eliminate them, the body pushes them out through the kidneys along with other byproducts of metabolism. Patients can also exhale them, developing fruity or alcoholic breath caused by the buildup of ketone bodies. The connection between ketosis and urine can be important for patients to know about because changes in the urine or breath may be a sign of a problem.

Changes to the urine can make it appear darker and may give it a strong smell. If the urine is tested, it will reveal varying levels of ketone bodies, and in some tests it is also possible to measure glucose concentrations. Home test kits for checking the ketosis and urine connection often consist of sticks or strips passed under the urine stream or dipped in test samples. They change color to reflect the number of ketones present. In the laboratory, the known link between ketosis and urine can be exploited to test samples with chemicals that will react with ketone bodies to change urine color and allow the lab to diagnosis ketosis.

Accidental ketosis can be dangerous, as it may reveal that a patient’s diabetes is not controlled or that the patient’s diet is not sufficient. People who starving can develop other complications as the metabolism struggles to meet energy needs and starts consuming any available source of energy. In ketogenic diets, the goal is to introduce controlled ketosis to promote weight loss or control a seizure disorder. People can use the association between ketosis and urine to monitor themselves and determine when they’re entered ketosis.

Science on ketogenic diets is mixed. Some studies support their use for seizure disorders, where they are sometimes effective in cases of refractory epilepsy that resists other means of treatment. For weight loss, such diets can promote early high weight loss by helping the body shed water, but may not be beneficial in the long term. They can also be hard to maintain; they may also be less effective than more subtle, and slow-acting, lifestyle changes.