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Beta-Hydroxybutyrate (BHB) in Serum/Plasma

Published: August 9, 2026Updated: August 16, 2026

This test measures the concentration of beta-hydroxybutyrate, a key ketone body produced when your body breaks down fat for energy, often seen in conditions like diabetic ketoacidosis or fasting states.

Quick summary

["Ketone monitoring helps track metabolic health and manage conditions requiring fat metabolism."]

Medically reviewed by WellAlly Editorial TeamLast reviewed August 16, 2026Editorial policy

Key facts at a glance

LOINC
2513-0
Short code
Ketones SerPl Ql
Synonyms
Ketones SerPl Ql
Category
chemistry
Sample
serum
Container
Red-top tube (SST)
Units
N/A
Fasting
false
Population
adult
Sex
all
Age range
18–65 years
Specimen volume
5 mL
Stability
Room temperature: 4h, Refrigerated: 24h, Frozen: 7d
Hemolysis max
500
Lipemia max
1000
Icterus max
500
TAT
4–24 hours
Order
routine

Why Is This Test Done?

Your doctor may order this test to check for elevated ketone levels, which can indicate metabolic stress. It’s commonly used in diabetes management to prevent dangerous ketone buildup (ketoacidosis) or to assess nutritional status in fasting or low-carb diets.

Common Reasons for Testing

Tests for BHB are often performed in patients with diabetes (especially type 1) to monitor blood sugar control, in individuals experiencing unexplained vomiting or dehydration, or in those following strict dietary changes (e.g., ketogenic diets).

What to Expect Before the Test

No special preparation is usually needed, but your doctor may advise fasting for 8–12 hours before the draw if this is part of a broader metabolic evaluation.

What the Results Mean

Results are interpreted based on clinical context. High levels may signal ketosis (e.g., from fasting or diet) or metabolic disorders, while very low levels could indicate inadequate fat metabolism or underlying health issues.

Clinical interpretation

How abnormal results are interpreted and what conditions they suggest.

Clinical Significance

Short name

BHB Level

Frequently asked questions

What causes elevated BHB levels?
Elevated BHB can result from fasting, low-carb or ketogenic diets, uncontrolled diabetes, or conditions like starvation or severe illness. It’s also a marker of ketosis, which some use for weight loss or epilepsy management.
What does a normal BHB level indicate?
Normal levels vary by context—e.g., fasting may show modest increases—but consistent low levels might warrant further evaluation for metabolic or nutritional concerns.
Can diet alone affect BHB test results?
Yes, dietary changes (e.g., cutting carbs) can temporarily raise BHB. Always discuss results with your doctor, as they’ll consider your full medical picture.
  1. 1
    MedlinePlus — Laboratory TestsSource
  2. 2
    Lab Tests OnlineSource
  3. 3
    Mayo Clinic — Tests & ProceduresSource

Click any link to access the full source. PubMed Central (PMC) links provide free full-text access.

This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment.

Medical Disclaimer

This content is for general informational and educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the guidance of a qualified healthcare provider with any questions you have about a medical condition, and never disregard professional medical advice or delay seeking it because of something you read here.

If you think you may have a medical emergency, call your local emergency number or go to the nearest emergency department immediately.

Medically reviewed by WellAlly Editorial Team Last reviewed August 16, 2026. · Read our editorial policy