Beta Hydroxybutyrate
Label Mnemonic: BHY
Epic code: LAB570
Order form: Laboratory Requisition
Collection Medium:
Plasma Separator Tube 4.5 mL
Alternate Collection Media:
Call laboratory for additional acceptable specimen collection containers.
3 mL whole blood from light green top tube or 1 light green top Microtainer® for pediatric patients.
Testing Schedule:
24 hrs/day, 7 days a week, including holidays.
Turn Around Time:
1 hour (upon receipt in laboratory)
Reference Range:
0.0-0.3 mEq/l
Ketosis is a common feature in acutely ill patients. In subjects suffering from starvation, acute alcohol abuse, or diabetes mellitus, ketosis can result in severe life-threatening metabolic acidosis. The presence and degree of ketosis can be determined by measuring blood levels of β-hydroxybutyrate.

Ordinarily, β-hydroxybutyrate is the ketoacid present in the greatest amount in serum. It accounts for approximately 75% of the ketone bodies which also include acetoacetate and acetone. During periods of ketosis, β-hydroxybutyrate increases even more than the other two keto acids (acetoacetate and acetone), and has been shown to be a good index of ketoacidosis, including the detection of subclinical ketosis.

In diabetics, the measurement of β-hydroxybutyrate as well as blood glucose can help to assess the severity of diabetic coma and help exclude hyperosmolar non-ketotic diabetic coma.

The β-hydroxybutyrate assay is specific for β-hydroxybutyrate and shows no cross-reactivity with acetoacetate or acetone.
Sample Processing:
Centrifuge at a speed and time necessary to get barrier separation of plasma/serum and cells within 1 hour of collection. Send specimen in original tube. Do Not transfer to another tube.
Each sample must be labeled with at least TWO full patient identifiers (First/Last Name & DOB are sufficient for non-UIHC affiliated clients) to avoid sample rejection/delays.
Sample Storage:
All sample storage requirements are intended for delivery to UIHC within 24 hours of collection for testing. If samples won't arrive in this time period, please call the UIHC Core Lab for alternative storage/shipping instructions (319-356-3527).
Transport Instructions:
Place labeled specimen into zip-lock type biohazard bag; seal bag.
Place completed requisition into outside pocket of bag.
Transport in cooler with refrigerated coolant packs.
CPT Code:
See also:
Urinalysis, Urine