Hyperketonemia

Hyperketonemia is a metabolic condition characterized by elevated levels of ketone bodies in the bloodstream. Ketone bodies are produced when the body breaks down fat for energy, typically in the absence of sufficient carbohydrates. While ketosis is a normal physiological process that occurs during fasting, prolonged exercise, or adherence to a very low-carbohydrate diet, hyperketonemia specifically refers to abnormally high ketone levels that may indicate an underlying metabolic imbalance.

The primary causes of hyperketonemia include severe fasting or starvation, prolonged low-carbohydrate diets, uncontrolled diabetes mellitus (particularly type 1 diabetes), and certain metabolic disorders such as fatty acid oxidation defects. In diabetic ketoacidosis (DKA), a life-threatening complication of uncontrolled diabetes, hyperketonemia occurs alongside hyperglycemia (high blood sugar) and metabolic acidosis, leading to systemic symptoms like nausea, vomiting, abdominal pain, and confusion.

Diagnosis of hyperketonemia typically involves blood or urine tests to measure ketone levels. In clinical settings, blood ketone levels above 0.6 mmol/L are often considered elevated, though thresholds may vary depending on context. Treatment depends on the underlying cause; for example, diabetic ketoacidosis requires immediate medical intervention, including insulin therapy, fluid replacement, and electrolyte correction. In non-diabetic cases, reintroduction of carbohydrates or addressing metabolic disorders may restore ketone balance.

While mild ketosis is generally safe and may have therapeutic benefits in certain conditions, such as epilepsy or obesity management, hyperketonemia can pose serious health risks if left untreated. Symptoms may range from mild fatigue to severe systemic complications, emphasizing the importance of monitoring and medical evaluation when elevated ketone levels are suspected.