Laboratory Medicine

Test catalogue

β-Hydroxybutyrate \| BHB \| Ketones \| Beta-Hydroxy Butyric Acid
Test Name β-Hydroxybutyrate \| BHB \| Ketones \| Beta-Hydroxy Butyric Acid Clinical Utility Monitoring therapy for diabetic ketoacidosis Investigating the differential diagnosis of any patient presenting to the emergency room with hypoglycemia, acidosis, suspected alcohol ingestion, or an unexplained increase in the anion gap. Beta-hydroxybutyrate (BHB) is considered the best marker of ketosis in diabetic ketoacidosis (DKA). As a result, most laboratories have replaced traditional serum ketone testing with direct measurement of BHB.
Specimen Type / Requirements Container Type Preferred: Lt Green (PST) Acceptable: Gold (SST) Preferred Testing Volume = 1mL Minimum Testing Volume = 0.5mL
Specimen Handling Collection Instructions: Collect sample in gold top (SST) tube. Write your initials, date and time of collection on the collection label. Laboratory Staff Instructions: Centrifuge and sperate from cells as soon and possible. Rejection Criteria: Grossly hemolyzed, lipemic, Unlabeled or Not Sufficient Quantity Samples will be rejected. Avoid repeat freeze/Thaw cycles. Transportation: Send sample to core lab as soon as possible.
Stability

β-Hydroxybutyrate | BHB | Ketones | Beta-Hydroxy Butyric Acid

Test Name

β-Hydroxybutyrate | BHB | Ketones | Beta-Hydroxy Butyric Acid

Clinical Utility

Monitoring therapy for diabetic ketoacidosis Investigating the differential diagnosis of any patient presenting to the emergency room with hypoglycemia, acidosis, suspected alcohol ingestion, or an unexplained increase in the anion gap.

Beta-hydroxybutyrate (BHB) is considered the best marker of ketosis in diabetic ketoacidosis (DKA). As a result, most laboratories have replaced traditional serum ketone testing with direct measurement of BHB.

Specimen Type / Requirements

Container Type

Preferred: Lt Green (PST)

Acceptable: Gold (SST)

Preferred Testing Volume = 1mL

Minimum Testing Volume = 0.5mL

Specimen Handling

Collection Instructions: Collect sample in gold top (SST) tube. Write your initials, date and time of collection on the collection label.

Laboratory Staff Instructions: Centrifuge and sperate from cells as soon and possible.

Rejection Criteria: Grossly hemolyzed, lipemic, Unlabeled or Not Sufficient Quantity Samples will be rejected. Avoid repeat freeze/Thaw cycles.

Transportation: Send sample to core lab as soon as possible.

Stability

Ambient (15 to 30°C)	Refrigerated (2 to 8°C)	Frozen -20°C or lower
- -	7 days	7 days

Turnaround Time (TAT)

STAT: 1hr | Routine: 4hrs

Test Utilization

Reference Value

Age	Value
0 - 18 Y	0.00 – 0.29
> 18 Y	0.00 - 0.42

> 2.0 mmol/L is suggestive of ketoacidosis

Epic Code

LAB2336

Methodology

Enzymatic

Testing Location

SMH-Biochemistry

Other Information

Last Updated: Oct 06, 2026