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What Is A Beta Hydroxybutyrate Test?

Submitted on March 27, 2012

Beta hydroxybutyrate is a substance produced by the body and is classified as a ketone body. Ketone bodies are created from essential fatty acid metabolism in the liver. Usually, this should not happen unless there is some kind of deprivation or starving that the person is undergoing. This is because the primary fuel source in human beings is glucose and not fat. The body will only switch to this source if there is no glucose or if there is a disease like diabetes. In diabetes, insulin - the fuel switch - is either deficient or the body is resistant to it. Therefore, the body is in a continuous state of ketosis. This is dangerous over a substantial period of time because ketone bodies are acidic and will cause a form of acidosis called ketoacidosis.

Beta Hydroxybutyrate Levels

Before we talk about beta hydroxybutyrate levels, it is important to understand what exactly beta hydroxybutyrate is. Ketoacidosis is a condition where the body has insufficient insulin and is therefore not able to absorb blood sugar. The body has already produced ketones to help breakdown the fats to produce energy. A combination of high blood sugar and the accumulation of ketones in the blood is dangerous and can be life threatening. Beta hydroxybutyrate is one of the ketones that are produced in the body when the body loses its ability to absorb glucose properly. People who suffer from Type 1 diabetes suffer from insulin deficiency. Insulin deficiency can cause the production and growth of ketones. Doctors therefore measure the beta hydroxybutyrate levels to help manage conditions brought on by diabetes. Research has found that managing and controlling beta hydroxybutyrate levels helps to control diabetes and its related conditions. It also reduces the amount of time a person might need to stay in hospital and the time needed to manage the condition properly.

Normal and Abnormal Beta Hydroxybutyrate Levels

Keeping a constant check on the beta hydroxybutyrate levels helps doctors to treat patients of diabetes faster and more accurately. People who develop diabetes could be admitted to hospital with ketoacidosis. By checking the beta hydroxybutyrate levels; the doctors can monitor the condition. Treatment for abnormal beta hydroxybutyrate levels includes introducing artificial insulin into the body to prevent the condition from occurring. Testing to see if a person has normal beta hydroxybutyrate levels helps to check the effectiveness of insulin supplements as well. The normal beta hydroxybutyrate levels in serum are less than 3 mg/dl while the normal beta hydroxybutyrate levels in blood are between 0.21 to 2.8 mg/dl.

Anything above these levels is considered elevated or abnormal beta hydroxybutyrate levels. The other main reasons for high or abnormal beta hydroxybutyrate levels are starvation, continuous vomiting or any other digestive problem which results in the food not being properly absorbed into the body. During starvation, the body produces ketones to help with the breakdown of fat metabolism. Elevated beta hydroxybutyrate levels may also occur when an individual in on a diet that is low in carbohydrates. This is one of the causes of high beta hydroxybutyrate levels but is not harmful for the body.

The beta hydroxybutyrate range can be measured by simple blood test. Low beta hydroxybutyrate levels or abnormal beta hydroxybutyrate levels should be reported to the doctor immediately so that treatment can be started.


Checking for beta hydroxybutyrate level is done by performing a beta hydroxybutyrate test or more specifically, a beta hydroxybutyrate assay. This is a test that would be conducted on a blood sample. There are convenient kits that are available for this and can even be purchased on the internet. The test is conducted to find the levels of the ketone body, which, if elevated, indicates the possibility of ketoacidosis taking place. In most cases, when a patient is suspected of suffering from diabetic shock, the patient's breath is the most potent method of guessing if there is ketoacidosis. The patient's breath would smell like nail polish remover. This is because of the presence of acetone. The patient must then be prescribed the assay to distinguish between diabetic ketoacidosis or alcoholic ketoacidosis.

Procedure to Conduct The Test

Just like any other assay, a sample of the material to be tested is spread over a plate that is sensitive and contains a marking chemical or enzyme. A positive result would then produce an electrical signal. ELISA is a form of assay used to identify viruses or pathogens. It works by placing the material to be tested on a plate and then applying the antibody over the antigen. This should cause binding and then after a brief wash, an enzyme is used to create an electrical charge. This is then measured.


A test for any ketone body is nearly always done in a case of a medical emergency and therefore negates the possibility of any kind of preparation. It is however important that the doctor is informed whether the patient has consumed any alcohol.