D3-Hydroxybutyrate is mainly produced in the liver from oxidation of fatty acids and is transported to peripheral tissues for the production of energy. D3 Hydroxybutyrate forms about 80% of all ketone bodies that result from the oxidation of fatty acids in the liver. High levels of ketone bodies in blood causes ketosis. Normal ketosis is prevalent in conditions such as fasting, prolonged exercise or a high fat diet. Causes of pathologic ketosis include, multiple organ failure, diabetes, inborn errors of metabolism, growth hormone deficiency and alcohol abuse.

Biorex Diagnostics manufactures D3-Hydroxybutyrate reagents designed for CA 180/270/400 Furuno/Daytona systems.