Organic Acids, Plasma

3-Oh-Butyric Acid

Optimal Result: 0 - 30 umol/L.

Other names: 3-Hydroxybutyric Acid / 3-Oh-Butyric Acid / 3-Hydroxybutyric / ß-Hydroxybutyrate / beta-hydroxybutyrate

3-Oh-Butyric Acid is a by-product of ketosis. Like the other ketone bodies (acetoacetate and acetone), levels of 3-hydroxybutyrate in blood and urine are raised in ketosis.

What is ketosis and when does it occur?

Ketosis occurs when cells do not get a steady supply of sugar from dietary carbohydrates, so they burn fat instead. If you eat a low carbohydrate diet or if your insulin is not working, then you can have metabolic ketosis. It is not necessarily a serious matter, but your doctor may need to find out just what the cause is. If your insulin is not working well enough, its action may be improved by increasing your intake of chromium, vanadium and lipoic acid.

3-hydroxybutyrate is synthesized in the liver from acetyl-CoA and can be used as an energy source by the brain when blood glucose is low. Blood levels of 3-hydroxybutyric acid levels may be monitored in diabetic patients to look for diabetic ketoacidosis.

Ketones, such as 3-hydroxybutyric and acetoacetic acids, are the end-products of rapid or excessive fatty acid breakdown.


- Ketone bodies: a review of physiology, pathophysiology and application of monitoring to diabetes. [L]

- Medical aspects of ketone body metabolism. [L]

- Role of beta-hydroxybutyric acid in diabetic ketoacidosis: A review [L]

- Beta-Hydroxybutyrate, [L]

- Diabetic Ketoacidosis [L]

- Essential roles of four-carbon backbone chemicals in the control of metabolism [L]

What does it mean if your 3-Oh-Butyric Acid result is too high?

Higher beta-hydroxybutyrate levels can be seen in different conditions linked to metabolic substrate use disorders, insulin deficiency, and altered redox status including the following: 

- Diabetic ketoacidosis: Ketone body production is stimulated by dehydration and insulin deficiency. 

- Alcoholic ketoacidosis: Ketone body production is stimulated by altered redox status within the liver mitochondria.

- High fat diet

- Steroid or growth hormone deficiency

- Salicylate poisoning

- Fasting and starvation: beta-hydroxybutyrate levels are increased after approximately 3 days, rising to a plateau after 4 weeks of food deprivation.

- Lactation: Ketone body production is stimulated by the high-fat content of milk.

- Ketogenic diets: These diets are popular for the control of refractory seizures and body weight in obese individuals.

- Glycogen-storage diseases and other metabolic disorders

Potential Intervention:

Identify & correct specific underlying imbalance. See above for possible causes.

Consider supplementing with chromium, vanadium, and lipoic acid. Talk to your doctor before starting any supplement regimen or lifestyle change.

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