Thursday, July 17, 2025

and, in fact, i'm realizing that the internet is confused about blood and urine ketone levels.

many, many relatively reliable websites define ketonuria using blood concentrations. that is, they say that urine ketones over 3.5 is a medical emergency, but the ranges they are reporting seem to be the same as blood, which seems suspect.

i had to dig down the results a little, but i think this is a better definiton:

We categorized ketosis according to blood β-OHB levels as absent (<0.6 mmol/l), mild (0.6–1.5 mmol/l), moderate (1.6–3 mmol/l) or marked (>3 mmol/l). Ketonuria was semi-quantified as mild, moderate or marked for urine ketone levels of 1–4 mmol/l, 5–14 mmol/l and ≥15 mmol/l, respectively. The presence of ketoacidosis was assessed using both definitions suggested by the American Diabetes Association (ADA) and the Joint British Diabetes Society (JBDS) [15, 16].

at 3.9, that would put me in the mild category, and not be that concerning at all.

but if the blood results were 3.9, i'd be dead.

there's a reason i couldn't make sense of it - it was wrong.