The aim of this study is to examine the interrelationships and importance of biochemical and endocrine blood parameters in the assessment of beta-hydroxybutyrate (BHB) values in healthy and ketotic cows using multiparameter statistics. The experiment included 45 Holstein Friesian cows (22 healthy and 23 with ketosis). The criterion used for detecting ketosis was the value of BHB ˃1.2 mmol/L. Based on laboratory indicators, cows were precisely classified into two large clusters: a cluster of healthy cows and a cluster of cows suffering from ketosis with minimal mixing of individual cows between clusters. Metabolic parameters were divided into two large clusters: parameters whose values increased in ketosis and decreased in healthy animals and parameters whose values decreased in ketosis and increased in healthy individuals. In ketotic cows there was a higher expression of non-esterified fatty acids, total bilirubin, aspartate aminotransferase, insulin and growth hormone, and a lower expression of glucose, albumin, triglycerides, cholesterol and total lipids compared to the healthy group. In 3 cows with ketosis, greater metabolic similarity with healthy cows was found, because of the absence of pronounced changes in the concentration of hormones and glucose. Thyroxine and triiodothyronine showed either increased or decreased expression in ketotic cows. In cows with lower values of these hormones, there were more pronounced metabolic changes characteristic of ketosis. For the development of metabolic adaptations to ketosis, in addition to hyperketonemia, there must be endocrine changes and changes in glycemia.