Ketones

  • When there isn’t a sufficient level of available glucose — which is what the body uses for its main source of fuel — and glycogen levels are depleted, blood sugar and insulin are lowered and the body looks for an alternative source of fuel: in this case, fat.
  • This process can happen when a person fasting, after prolonged exercise, during starvation, or when eating a low-carb, ketogenic diet.
  • And when the body begins breaking down fats for energy like this, a process known as beta-oxidation, ketones are formed for use as fuel for the body and brain. This is known as ketosis.
  • People following a ketogenic diet specifically reduce their carbohydrate intake for this reason: to create ketones for energy.

Best Ketone Supplements

#1 Real Supplements Rated Best in 2020
Keto Plus™ Exogenous Ketones (goBHB™) - 30 Servings | Formulated for Ketosis, Energy and Focus | Keto Certified, Vegan Friendly (Raspberry Lemonade)
  • ►►Exogenous Ketones (BetaHydroxybutyrate) + Amino Acids, Chromium Picolinate & Prebiotic Fiber.
  • ►►Sustained energy for your workout, school work, or as an afternoon pick-me-up.*
  • ►►Refreshing Raspberry-Lemonade Flavor. Mixes easily in water.
  • ►►Benefits of a Keto diet without the carb restriction or fasting.*
  • ►►90-day Money Back Guarantee (^See details below).
Sale#2 Real Supplements Rated Best in 2020
Keto Science Real Ketones Powder Dietary Supplement, Sugar-Free Lemon Drink Mix, Supports Carb-Fighting Diet and Weight Loss, 5.3 oz. (15 Servings)
  • SUPPORTS WEIGHT LOSS: Ketones promote increased metabolism, weight loss and enhanced brain function
  • FOR A KETOGENIC LIFESTYLE: Promote ketosis and improve ketogenic performance for an active, on-the-go lifestyle
  • EASY TO MAKE: Just mix with water, shake, and enjoy the metabolism-boosting benefits
  • PROVEN FORMULA FOR RESULTS: Formulated with patented and proven GoBHB ketones that your body can put to work quickly
  • KETO & PALEO: Ketogenic and Paleo-friendly lemon flavored drink mix that’s sugar free
#3 Real Supplements Rated Best in 2020
Exogenous Ketones Powder and BHB (Lemon) - Ketone Drink for Ketosis & Boosts Energy –– Keto Drink Mix - Fast Acting Ketosis Packets - Ketones Supplement for Ketosis (20 Keto Packets) by MCM Nutrition
  • BHB RESTORES YOUR ENERGY, PUSHES PEAK PERFORMANCE & IMPROVES RECOVERY: Beta-Hydroxybutyrate (BHB) is your brain’s main energy source for ketosis! By fusing BHB & exogenous ketones, you unleash a ketosis supplement that renews your energy levels, enriches mental clarity & enhances recovery post-workout!
  • ACHIEVE KETOSIS IN 30-MINUTES… MAXIMIZE YOUR KETOGENIC DIET: Take control of your keto-journey, whether you’re keto or just intermittent fasting this lemon-flavored mix will deliver ketosis in minutes! Best of all, it makes tracking your calories & managing your macros EASIER so you can stay in your Ketogenic state!
  • PEACE OF MIND FOR HIGH-CARB DAYS… REWARDS YOUR FITNESS GOALS: Finally, high-carb days don’t have to kick you out of ketosis! MCM Nutrition’s keto drink packets gives you access to instant ketones so you maintain ketosis! You’ll wonder how you ever managed without it!
  • FIGHTS BRAIN FOG & SUPPORTS BLOOD SUGAR: It’s no secret brain-fog weighs you down when getting back into ketosis! Skip the side-effects & unlock a ketosis drink packet containing the essential nutrients to achieve QUICK ketosis! Ketones also work to balance your blood sugar, leaving you with consistent energy levels!
  • 20 SERVINGS OF HIGH-QUALITY LEMON KETONES: Keto supplements are nothing short of an investment into your own body and we understand that! That’s why we allow you to put our ketones to the test… so you have nothing to lose!
Sale#4 Real Supplements Rated Best in 2020
Pruvit Keto//OS NAT – Raspberry Lemonade Charged (5 Single Serve Packets)
  • Facilitates quick absorption of ketones which allows a state of ketosis to be reached faster than ever for unrivaled results.
  • facilitates quick absorption of ketones which allows a state of ketosis to be reached faster than ever for unrivaled results.
  • facilitates quick absorption of ketones which allows a state of ketosis to be reached faster than ever for unrivaled results.
  • facilitates quick absorption of ketones which allows a state of ketosis to be reached faster than ever for unrivaled results.
#5 Real Supplements Rated Best in 2020
Exogenous Ketone Supplement, Key Keto: Patented BHB Salts (Beta-Hydroxybutyrate) - Formulated for Ketosis, to Burn Fat, Increase Energy and Focus, Supports a Keto Diet. Strawberry Lemonade (208g)
  • Instant Ketosis (15 Servings) - It can take days to get into ketosis after a day of eating high carb, and weeks to keto-adapt. During that time, you can deal with fatigue, brain fog, lethargy, and weakness since you're not making enough ketones on your own yet. Cut that time down to minutes with Key Keto. Skip feeling like a zombie and enjoy the energy that comes with active ketones in your blood.
  • Lasting Energy - Exogenous ketones can dramatically increase your energy at any time of the day with no jitters, heart pounding, or nausea. Key Keto can get you going physically and mentally, and can help you power through even the toughest workout or the longest meeting.
  • Quality - KEY KETO contains the highest quality BHB salts (beta-hydroxybutyrate). Each serving comes with 11.1 grams of high-quality Patented BHB and each jar contains 340 grams of product, which gives you 20 full servings or 40 half scoop-servings of the best tasting Keto drink on the market. It's the perfect keto preworkout drink!
  • Simplicity - KEY KETO is easy to measure for each dose you take. Whether you need a half scoop for a little energy before work, or a full scoop before a workout or to get you back into ketosis after a carb refeed, our precise powder scoop has you covered. It's a perfect keto base to mix with water or your favorite drink, Key Keto powder dissolves perfectly in liquids with no grit, no chalk, and no aftertaste.
  • Made in the USA - KEY KETO's high quality, lab tested, precisely measured keto supplement is sourced and manufactured in the USA at an NSF & GMP certified facility. With Key Keto, you are promoting US businesses and supporting the innovation that fuels elite athletes, weekend warriors, and health-conscious people like you.
#6 Real Supplements Rated Best in 2020
5X Potent Apple Cider Vinegar Capsules Plus Keto Bhb Salts - Keto Diet Pills with Mct Oil, Fat Burner and Weight Loss Supplement Detox Formula for Women and Men
  • Experience a 1500mg proprietary formula sourced naturally from Apple Cider Vinegar with the Mother to support body detox, appetite suppression, weight management, metabolism, and energy
  • Ketogenic blend of Apple Cider Vinegar with the Mother, Bhb salt (Beta Hydroxybutyrate), and Mct oil (medium chain triglyceride) help trigger ketosis to convert from burning glucose to ketone for improved weight management
  • Bhb ketones ensure you longer lasting energy and stamina as well as mental performance that is usually experienced with a keto diet
  • Manufactured in the United States and rigorously tested by third party laboratories to ensure safety, consistency, and quality
  • Formulated with high quality ingredients that are gluten free, nonGMO, and vegetarian
#8 Real Supplements Rated Best in 2020
#9 Real Supplements Rated Best in 2020
BHB Keto Pills - Keto BHB Capsules for Weight Loss - Keto Fit Pills Made in USA - BHB Exogenous Ketones Supplement for Ketogenic Diet - Keto Advanced Weight Loss 3000 mg - Keto Fast Diet Pills
  • Keto Advanced Weight Loss - Cuteford Keto BHB pills are formulated to naturally increase strength and stamina without grueling and having to sacrifice your daily routine. Its unique formula offers 100% bioavailability to reach ketosis phase faster. As a result, our keto fat burner pills with 800 mg of pure BHB will effectively support weight loss.
  • Enhanced Ketosis & BHB Boost - By activating and speeding up the state of ketosis, Cuteford BHB keto capsules turn fat into energy, boosting athletic performance and improving mental clarity. A full month supply of the keto burn pills will help you maintain proper digestion and support metabolism during a low-carb diet. Try a clean and stable form of energy!
  • Keto Pills for Appetite Suppression - Cuteford ketosis pills are aimed to support a keto diet for beginners without a feeling burnt out throughout the day. Our BHB keto diet pills will help your system manage cravings for sugar and gradually reduce the symptoms as hunger and fatigue.
  • Pure Keto Quality - Cuteford keto supplements for ketosis are proudly made in USA following the highest world quality requirements. With a powerful blend of calcium, sodium, and magnesium beta-hydroxybutyrate each keto pill is 100% natural and safe to use: free of GMOs, gluten, sugar, soy derivatives, and artificial flavors.
  • 100% Guaranteed Results - At Cuteford, our motto is energizing people to enjoy life to the fullest. Our keto BHB pills will provide you only with a positive experience! 100% risk-free! Do you need any assistance? Not satisfied with the product for any reason? Contact our online customer support service, and we'll make things right!
#10 Real Supplements Rated Best in 2020
KetoneAid KE4 World's Strongest Ketone Ester Drink, 30g Exogenous D BHB. Not a Salt. Sugar Free, Caffeine Free. (3 Count)
  • WORLD'S STRONGEST EXOGENOUS KETONE DRINK. With 30 grams of D-Beta Hydroxybutyrate (D-BHB) per serving, that makes Ketone Aid's KE4 Ketone Ester the most concentrated product on the market. However most find benefit with only 10ml, which is 1/6th of a bottle/serving. One can test the effectiveness of a BHB drink using a blood ketone meter. With 10ml, most experience a 1.0mm jump blood ketone levels
  • NOT A KETONE SALT. Most of the Exogenous Ketone Drinks on the market are referred to ask "Ketone Salts". Not sure if it is a salt? Look at the supplement facts and you will see 1-4 grams of total salt per serving (Including Sodium, Potassium, Calcium and Magnesium). You would have to drink 10-20 servings of ketone salts to match 1 serving of Ke4, however doing so would require a salt load of 20+ grams of salt
  • NON-RACEMIC 100% BIOAVAILABLE. Most of the Exogenous BHB Ketone Supplements are racemic. Racemic means that it contains both the bioavailable (the body can use it), "D" (or R) form and also the form that the body can't use, called the "L" (or S) form. This essentially doubles the salt load even further and if a product has 11.7g of BHB and it is racemic, it is effectively only 5.85g of the D form of BHB. Furthermore salt will limit the uptake of BHB, further reducing effectiveness.
  • NATURALLY DERIVED. Many incorrectly think the ketone salts are natural and the ester is synthetic. That is incorrect. Most, if not all, ketone bhb drinks are not naturally derived, in part because they are racemic. KE4 is naturally derived and undergoes a fermentation type process.
  • THE ONLY KETONE ESTER that is Made in the USA, used in a placebo controlled Clinical Trial* and about $1 per gram.
#11 Real Supplements Rated Best in 2020
Exogenous Ketones Powder, BHB Beta-Hydroxybutyrate Salts Supplement, Best Fuel for Energy Boost, Mental Performance, Mix in Shakes, Milk, Smoothie Drinks for Ketosis – Vanilla
  • New Advanced Formula: We reinvented our original Ketone Base formula to make it better tasting and less bitter. Same high-quality ingredients, but with no sugar or fillers.
  • Sweet, Not Bitter: We use monk fruit for the perfect sweetness and eliminated the usual bitterness of BHB. Enjoy our delicious Chocolate flavored Exogenous Ketones mixed into drinks and smoothies.
  • Kick Into Ketosis: Exogenous ketones supplement may help you get into a ketogenic state quicker. The beta-hydroxybutyrate (BHB) formula helps support raised blood ketone levels & weight loss efforts.
  • Mix On The Go: Powdered base dissolves easily into water, coconut milk, coffee, and shakes. It’s made with only clean ingredients, nothing artificial, and has added electrolytes for pure hydration.
  • Body Fuel: Supplementing with ketones may help improve athletic endurance, mental performance, and energy levels. Sustained ketosis has been shown to support healthy weight management.
#13 Real Supplements Rated Best in 2020
Perfect Keto Test Strips - Best for Testing Ketones in Urine on Low Carb Ketogenic Diet, Ketosis Home Urinalysis Tester Kit, 100 CT
  • ✅ Measure Ketones: Perfect Keto Test Strips are used for measuring whether you’re in ketosis based on ketones in your urine. It’s easier to use than a glucose blood meter or breath analyzer monitor.
  • ✅ Reliable: Count on this doctor developed, high-quality testing kit to give you results with precision. Unlike other products, these are convenient and easy to use at home, at work, or during travel.
  • ✅ Quick Results: Just pee on a strip, or in a cup and dip the strip. Tap off excess urine, then wait 40-60 seconds. Compare the dipstick’s color to our chart to determine if you’re in ketosis.
  • ✅ Bulk Kit: 100 precision keto tester strips per bottle. If you test and monitor once per day, you can do urinalysis testing for 3 months plus with this one package. They’re best for women or men.
  • ✅ New to Keto? Sticks are great to see your progress on getting your body into ketosis. They can also measure ketones for those on low carb diets such as Atkins
#14 Real Supplements Rated Best in 2020
Keto BHB Exogenous Ketones Pills (2720mg | 120 Capsules) Keto Pills w. goBHB® Salts, Natural Caffeine & L-Carnitine - Keto BHB Capsules Beta Hydroxybutyrate for Ketosis Keto Vitamins Keto Salts
  • Powerful Exogenous Keto supplement. Made with 2100 MG of BHB Keto Salts — beta hydroxybutyrate —Natural caffeine, and L-Carnitine Tartrate, it makes the perfect keto weight management pills for assisting ketosis, and maintaining energy on a low-carb diet. Zeal Naturals Exogenous Ketone Supplement is the most powerful keto weight management supplement you'll find.
  • Sustain and support the body with energy. This keto base bhb ketones supplement with BHB salt will not only help you enter ketosis, it has the necessary components to help you sustain powerful energy and avoid "keto-flu" on the keto fast. Enhanced with green coffee bean for clean steady energy and L-Carnitine for essential amino acids your body needs, it will help you stay alert, focused, and energetic all day.
  • These keto diet pills will help you metabolize fat while maintaining muscle by helping you enter ketosis quickly, increasing protein synthesis, and decreasing your appetite for carbs. The best bhb exogenous ketones pills & keto pills for the keto diet.
  • Maintain Focus. Increase mental alertness by increasing brain ketone levels and normalizing blood sugar levels with this keto exogenous supplement. Made for athletes, professionals, and anyone wanting to have energy and focus all day to crush their goals.
  • Keto exogenous ketones and diet keto pills for huge keto boost. If you're looking for ketogenic supplements, keto capsules for weight management, and exogenous ketones bhb salts, look no further.
#15 Real Supplements Rated Best in 2020
Ketones, The Fourth Fuel: Warburg to Krebs to Veech, the 250 Year Journey to Find the Fountain of Youth
  • Christofferson, Travis (Author)
  • English (Publication Language)
  • 223 Pages - 08/13/2020 (Publication Date) - Independently published (Publisher)
#16 Real Supplements Rated Best in 2020
#17 Real Supplements Rated Best in 2020
KETO-MOJO Test Strip Combo Pack for Use ONLY with The New GK+ Meter | 60 Blood Glucose + 60 Blood Ketone (120ct)
  • FOR USE ONLY with the KETO-MOJO GK+ meter model and NOT with previous Keto-Mojo meter models.
  • ACCURACY & PRECISION for ketogenic and glucose testing. These test strips are the most advanced in the industry and require NO CODING. Super-sip patented technology quickly fills the blood channel avoiding inconsistent or inaccurate results.
  • LONG LASTING STRIPS: Individually foil wrapped strips ensure greater sterility and longevity.
  • RECOMMENDED BY EXPERTS: Leading keto experts, healthcare professionals and researchers trust and recommend KETO-MOJO for accurate testing of ketosis and glucose monitoring.
  • EXCELLENT CUSTOMER SUPPORT: Our knowledgeable and friendly US-based support team all live the keto life and are eager to help you resolve any issue. Contact them via our company website.
#18 Real Supplements Rated Best in 2020
NatureWise Raspberry Ketones Plus | Advanced Weight Loss & Appetite Suppressant with Powerful Antioxidant Blend Boosts Energy & Metabolism | Vegan & Gluten-Free [2 Month Supply - 120 Veggie Capsules]
  • NATURAL METABOLISM BOOST: NatureWise Raspberry Ketones Plus+ combines pure raspberry ketones with a blend of powerful plant extracts like acai, African mango seed, green tea, and cayenne to naturally increase fat burning and detoxing for a healthier and more efficient metabolism.*
  • SUPPORTS HEALTHY WEIGHT LOSS: Raspberry Ketones and African Mango Seed are thought to support weight loss by influencing hormones that regulate sugar and fat metabolism, while Green Tea and Cayenne are natural thermogenics that raise metabolic rate to burn more calories.*
  • ANTIOXIDANT POWER: High antioxidant content in Green Tea and Acai helps the liver to detox fat-soluble toxins that can interfere with healthy liver metabolism, which affects your body’s ability to lose weight and stay healthy.*
  • POTENT, PREMIUM INGREDIENTS: Our formula delivers 400 mg of raspberry ketones per serving together with a blend of high quality plant extracts standardized for consistent purity and potency.
  • 2 MONTH SUPPLY: Includes 120 vegetarian capsules designed to help naturally boost your metabolism and curb cravings to support your weight loss program.
#19 Real Supplements Rated Best in 2020
Keppi Exogenous Ketones Chocolate BHB Powder Supplement: BHB Chocolate Ketones Formulated to Increase Energy, Burn Fat, Maintain Ketosis and Mental Focus
  • Keppi exogenous ketones - the best keto bhb supplement: Say goodbye to a carb rich diet that leaves you craving more food. With the ketogenic diet, you can fuel your body by drawing on naturally stored fats for more stable energy. Many keto enthusiasts love the mental focus, get-it-done productivity and improved energy levels that come with ketosis. Our Chocolate exogenous ketones drink is packed with BHB Salts for a great keto supplement to help you hit peak performance.*
  • Chocolate ketones supplement to kickstart ketosis: Whether you are new to the ketogenic diet, or coming off a carb cycle, our keto salts boost ketone levels instantly. Designed for the keto diet, our beta hydroxybutyrate BHB ketone supplement supports raised blood ketone levels, improving aerobic endurance, brain function, and energy levels so you can crush the day, whatever comes at you! Ketosis has also been shown to support healthy weight management.*
  • Tasty chocolate keto powder: Our all-natural exogenous chocolate ketones powder dissolves instantly into water, smoothies or your coffee. Keppi keto exogenous ketone salts are packed with sodium, potassium and magnesium BHB salts and contain 15 servings. Our ketone powder also helps get you into ketosis and avoid symptoms of the Keto Flu or carb cycling such as fatigue, bloating and headaches. Give yourself a keto boost with Keppi Keto BHB powder.
  • No added extras. just pure keto bhb salts: While some competitors pack their bhb exogenous ketones drinks with all sorts of nasty fillers, Keppi only uses natural ingredients. Our tasty and effective exogenous ketones have no sugar, carbs, fat, fillers, binders, or gums - just pure BHB ketones that get you into ketosis fast and maintain your ketogenic state during the day. Our lab uses top quality manufacturing processes and is GMP certified and proudly American!
  • Keppi, your trusted keto diet partner: We have been in the health and wellness space for more than half our lives and use our ketogenic supplements on a daily basis. Pair our exogenous ketones booster with our other keto supplements like MCT Oil and Collagen Peptides for better focus, more energy and a fitter, healthier you. We stand by all our products, so if you're not completely satisfied with our keto supplements, send us a note and we'll do our utmost ensure you're a happy customer.
#20 Real Supplements Rated Best in 2020
Exogenous Ketone Supplement, Key Keto: Patented BHB Salts (Beta-Hydroxybutyrate) - Formulated for Ketosis, to Burn Fat, Increase Energy and Focus, Supports a Keto Diet. Lemon Lime Sherbet 15 Servings
  • Instant Ketosis (15 Servings) - It can take days to get into ketosis after a day of eating high carb, and weeks to keto-adapt. During that time, you can deal with fatigue, brain fog, lethargy, and weakness since you're not making enough ketones on your own yet. Cut that time down to minutes with Key Keto. Skip feeling like a zombie and enjoy the energy that comes with active ketones in your blood.
  • Lasting Energy - Exogenous ketones can dramatically increase your energy at any time of the day with no jitters, heart pounding, or nausea. Key Keto can get you going physically and mentally, and can help you power through even the toughest workout or the longest meeting.
  • Quality - KEY KETO contains the highest quality BHB salts (beta-hydroxybutyrate). Each serving comes with 11.1 grams of high-quality Patented BHB and each jar contains 340 grams of product, which gives you 15 full servings or 30 half scoop-servings of the best tasting Keto drink on the market. It's the perfect keto preworkout drink!
  • Simplicity - Key Keto is easy to measure for each dose you take. Whether you need a half scoop for a little energy before work, or a full scoop before a workout or to get you back into ketosis after a carb refeed, our precise powder scoop has you covered. It's a perfect keto base to mix with water or your favorite drink, Key Keto powder dissolves perfectly in liquids with no grit, no chalk, and no aftertaste.
  • Made in the USA - Key Keto's high quality, lab tested, precisely measured keto supplement is sourced and manufactured in the USA at an NSF & GMP certified facility. With Key Keto, you are promoting US businesses and supporting the innovation that fuels elite athletes, weekend warriors, and health-conscious people like you.

Ketone Facts and Benefits

Ketones, also known as “ketone bodies,” are byproducts of the body breaking down fat for energy that occurs when carbohydrate intake is low.

Here’s how it works:

  • When there isn’t a sufficient level of available glucose — which is what the body uses for its main source of fuel — and glycogen levels are depleted, blood sugar and insulin are lowered and the body looks for an alternative source of fuel: in this case, fat.
  • This process can happen when a person fasting, after prolonged exercise, during starvation, or when eating a low-carb, ketogenic diet.
  • And when the body begins breaking down fats for energy like this, a process known as beta-oxidation, ketones are formed for use as fuel for the body and brain. This is known as ketosis.
  • People following a ketogenic diet specifically reduce their carbohydrate intake for this reason: to create ketones for energy.

Exogenous ketones have become a popular nutritional supplement since their introduction in 2014.

Like with any new supplement, though, there tends to be a lot of misinformation that you have to sift your way through to find the reliable data. So, this article does the hard work for you and gets right to what the true benefits and drawbacks of exogenous ketones are.

We also cover what forms of ketones to consider, how they function in the body, and their role in future research.

What Are Ketones?

Ketones are fuel for the energy-generating mitochondria within the cells of our bodies. They are an alternative fuel source to glucose.1

Ketones are simple compounds because of their small molecular structure and weight. Specifically, they are organic (carbon-based) compounds that contain a central carbon atom double-bonded to an oxygen atom and two carbon-containing substituents, denoted by “R” .

Generic Ketone Structure

In humans, there are 3 different ketones produced by the mitochondria of the liver. These are also often referred to as ketone bodies 2.
The three ketones are:

  1. Acetone
    Acetoaceate ( also know as Acetoacetic Acid)
  2. Beta-Hydroxybutyric Acid (also known Beta Hydroxybuyrate or BHB). Other chemical names include 3-hydroxybutyric acid or 3-hydroxybutyrate.
  3. BHB is not technically a ketone since it contains a reactive OH-group in place of where a double-bonded oxygen normally would be as you can see in the diagram below. Yet, BHB still functions like a ketone in the body and converts into energy much like acetoacetate and acetone.

Exogenous Ketone Bodies Explained

Exogenous ketone bodies are just ketone bodies that are ingested through a nutritional supplement. Ketone bodies produced in the liver are more properly referred to as endogenous ketone bodies.

Exogenous = Originates from a source external from the body.
Endogenous = Originates from a source internal to the body.
Most supplements rely on BHB as the source of their exogenous ketone bodies. BHB is converted to acetoacetic acid with a small quantity converted to acetone through a acetoacetate decarboxylase waste pathway. Some of the acetoacetic acid will enter the energy pathway using beta-ketothialase, which converts acetoacetic acid to two Acetyl-CoA molecules.

Important note: Research is in its early stages and we need more data to understand the long-term effects of combining high blood ketone levels with high or moderate carbohydrate based diets.

We don’t yet fully understand what the long term effects of combining a non ketogenic diet with exogenous ketone supplements are. Research is in its early stages and more data is needed.

A common question is why BHB is the go-to ketone body for exogenous ketone supplements. The likely reason is a combination of its efficient conversion into energy and its ease of formulation. In other words, that it is easier to formulate BHB into a nutritional supplement. And the body efficiently converts BHB to acetoacetic acid, which effectively raises blood ketone levels.

 

Ketone Salts vs. Ketone Esters

Exogenous ketones of beta-hydroxybutyrate are available in two forms:

  1. Ketone Salts: Naturally-derived compounds that simply mix sodium (and/or potassium, or calcium) with BHB to improve absorption. Commercially available supplements are all made from ketone salts currently (includes KetoForce, KetoCaNa and Keto OS). These are also sometimes called “Ketone Mineral Salts” of “BHB Mineral Salts”.
  2. Ketone Esters: Synthetically-made compounds that link an alcohol to a ketone body, which is metabolised in the liver to a ketone. Ketone esters are used primarily in research for testing their efficacy in elevating ketone body levels. Yet, the first commercial Ketone ester drink will be available in 2018 by HVMN. Research esters are reportedly very unpleasant tasting which HVMN hopes to change.

Structure of a BHB Ester

The Ketone esters raise blood levels of beta-hydroxybutyrate to higher levels than the Ketone salts. There is also strong evidence that ketone esters are more effective than ketone salts as far as their physiological benefits go. It is not clear why this happens, but could be because of a difference in the absorption rate in the GI tract.

However, esters tend to be a little tougher to tolerate (due to gut distress after ingestion) and don’t have the most pleasant taste (as mentioned earlier).

Why use Exogenous Ketones?

Exogenous ketone supplements may provide a multitude of benefits. These include athletic performance enhancement, more efficient weight loss, cancer prevention, cognitive improvement and anti-inflammatory properties.

Weight Loss Goals

  • Appetite suppression: Appetite was measured in 10 males and 5 females after consuming a ketone ester (KE) or a dextrose (DEXT) drink . Desire to eat and perception of hunger dropped after both drinks, but the KE was 50% more effective for 1.5-4hrs. Insulin levels rose for both drinks but were 3x less with the KE drink after 30mins (Fig 2). The hunger hormone, ghrelin, was significantly lower between 2 to 4 hours after drinking the KE. In conclusion Ketone esters delay the onset of hunger and lower the desire to eat.
  • The fate of excess ketones: In the event someone has an excessive amount of ketones in the blood, the body (specifically the kidneys) will work as quickly as possible to filter out ketones via urine rather than converting them to adipose tissue.9 This is not to say that you can’t gain fat if you consume an exorbitant amount of exogenous ketones, but that they are less prone to be converted to fat than other nutrients.
  • More tolerable than MCT oil: MCT oil has been known to cause gastrointestinal distress in users, especially when taken in higher amounts. Exogenous ketones in the form of ketone salts, in comparison, are well-tolerated. Thus they enable one to avoid adverse GI events while providing the body with similar types of benefits. Figure 2 shows Ketone esters can be effective at reducing appetite. A combination of MCT oil and exogenous ketones may aid weight loss and allow a lower loading of ketone supplements, without the GI distress seen with MCT oil.

Performance Goals

  • Athletic enhancement: The improvement of energetic efficiency and fuel sparing mechanisms. Exogenous ketone supplementation could enhance both of these components of athletic performance. There is a promising outlook in this area for a variety of reasons:
    • Exogenous ketones induce acute ketosis, lasting for several hours. This is without needing to have depleted muscle glycogen stores. (Low muscle glycogen is well known to impair sustained physical performance).10.
    • The ‘carb-sparing’ effect from BHB suppresses the break down of muscle glycogen. This leads to lower lactate levels. When increasing exercise intensity, fat oxidation (burning) reaches a limit. At that point the muscle burns carbohydrates as fuel. But when consuming Ketone esters, the body does not make this switch. This suggests Ketones are being used instead. 11
    • Exogenous ketones cause the body to rely less on fat as fuel. Fat takes longer to metabolise for energy than muscle glycogen. This is why fatty acids are not the preferred fuel under heavy exercise. This could be useful for keto-adapted athletes performing high-intensity cardiovascular or strength training.12 This is particularly useful for the Keto-adapted athlete who wants to undergo high-intensity cardiovascular or strength training.
    • Ketone esters increase free carnitine whilst exercising (which seems to improve physical performance).
    • Exogenous ketones reduce the use of Branched-chain amino acids (BCAAs) as fuel (deamination). Consumption of a ketone ester drink reduced the rise in muscle BCAAs by 50% during exercise. 6
  • Improved cognition: Elevated plasma ketone concentrations divert the brain to utilize ketone bodies for synthesis of phospholipids, which drives growth and myelination. Normally, glucose would be the preferred substrate, which is much less efficient.14 BHB seems to act as a signal for neuronal pathways. These enhance synaptic plasticity, cognition and neuronal stress resistance. 15 In rat studies, ingestion of a ketone ester for 5 days improved their spatial learning and memory. 16.

 

Health & Longevity

  • Anti-carcinogenic properties: Data seems to suggest that exogenous ketones are an effective anti-carcinogen. The reason behind this is that cancer cells are unable to use ketone bodies effectively, unlike most healthy tissues in the body. In fact, dietary ketone supplementation has been shown to increase survival rates of mice with systematic cancer by as much as 70%.17
  • Neuroprotection: As humans age, the brain becomes more susceptible to neurodegeneration and subsequent conditions such as Alzheimer’s and Parkinson’s disease. Exogenous ketone supplementation appears to ameliorate the typical decline in cognitive function that comes with aging. The likely mechanism for this neuroprotective property is that ketone bodies reduce the inflammation and hyperexcitability that is normally exhibited as glucose metabolism declines in the brain.18, 19
  • Anti-Inflammatory properties: There is evidence that ketone bodies play a crucial role in reducing inflammation by inhibiting a specific class of proteins called inflammasones.20
  • Gene regulation profile change. There is evidence that gene sets can be up regulated or down regulated. Still early days but an example of this is a change in mitochondrial 3-hydroxy-3-methylglutaryl-CoA synthase (mHS) in rats on a ketogenic diet.

 

Mechanisms: How Exogenous Ketones Work

Exogenous ketones have a variety of physiological effects shortly after ingestion:

  • For starters, ingesting ketones (especially ketone esters) is an efficient way to elevate BHB in the blood by upwards of 2 mMol for nearly 8 hours (see Ref. 2). Ketone salts don’t appear to elevate BHB in the blood as efficiently (or significantly) as ketone esters do, though.
  • Exogenous ketone supplementation causes blood glucose to decrease significantly, likely due to the acute increase in insulin sensitivity. Therefore, exogenous ketones may present a potential therapy for type-2 diabetics via regulation of blood glucose.
  • Exogenous ketones also improve oxygen utilization, especially in the central nervous system (CNS).21 This effect decreases the likelihood of oxygen reaching potentially toxic levels in the CNS, which in turn has a number of other positive health ramifications (such as those discussed in the previous section).

Possible Downsides to Ketone Supplementation

As with almost any nutritional supplement, side effects and downsides are possible after consuming exogenous ketones. That being said, they tend to be rather benign and will most likely improve as exogenous ketone supplementation becomes more prominent. The most common side effects to be aware of when using exogenous ketones include:

Electrolyte Imbalance – The physiological reasoning behind electrolytes becoming depleted during a state of ketosis is due to lack of water retention and frequent urination. When supplementing with exogenous ketones, the acute state of ketosis will likely increase the frequency of urination, but it won’t deplete glycogen stores. Therefore, it may be useful to drink an electrolyte solution if you are urinating a lot after taking exogenous ketones, but it’s dependent upon how you feel.

Halitosis (bad breath) – If you’re on a ketogenic diet you are probably aware that as the body starts to metabolize fat, ketones can cause poor breath. There is very little one can do about this, it’s just the nature of the beast. Unfortunately, this can also arise when using exogenous ketones, but it’s not as lasting as when on a ketogenic diet. Chewing gum or mints is about the best option if it becomes a noticeable issue. This maybe caused by over consumption of the ketone supplement, tailoring the quantity consumed may prevent excess BHB being converted to acetone, which is likely excreted by the lungs.

Possible GI distress (flatulence) at exceptionally high doses – In the studies referenced in this article, exogenous ketones taken in large doses occasionally resulted in GI distress, especially flatulence. However, the cause of this is hypothesized to be due to the fact that ketones were mixed in a milky fluid that wasn’t very palatable. If you’re taking a nominal dose of exogenous ketones the likelihood of GI distress is rather low. Moreover, if some GI distress is prevalent, it should improve as you become accustomed to taking ketones.

Hypoglycemia: why not to be concerned – Taking exogenous ketones can drive blood glucose levels quite low, but you are not likely to feel the typical symptoms of hypoglycemia. This is because when ketone levels are high enough, they dominate as fuel in the brain; hence, you will feel just fine despite having low blood glucose. A highly-cited study by George Cahill, found elevated ketone levels could protect fasted participants when they were administered insulin to induce hypoglycemia.

 

Future Applications & Research

Most current research on exogenous ketones focuses on the health and longevity applications of their use.

Another area that is targeted, is the psychological benefits of exogenous ketones, especially with how they can help protect brain tissue from degradation. As mentioned earlier, this has implications for the prevention of conditions like Alzheimer’s disease, Parkinson’s disease, and epileptic seizures.

Hopefully, in the not-too-distant future research will also focus more on the athletic performance benefits of exogenous ketones, specifically with regards to resistance training and cardiovascular exercise. The data on each of these applications is very limited at this time.

Takeaways

Exogenous ketones are becoming a popular topic of research. Importantly, research aims to validate their various uses (physical performance, weight loss, neuroprotective effects etc.). While there is good research on many of these, more data is needed to provide conclusive evidence.

Exogenous ketones, especially Ketone esters, achieve ketosis without following a ketogenic diet. But they must be consumed regularly to maintain ketosis. If Ketones are readily available then they may be used preferential over carbohydrates and fats when exercising. Even in highly glycolytic (carbohydrate) activities, such as sprinting.

Exogenous ketones certainly appear to have strong health and longevity properties at this point, especially for reducing the risk of cancer and possibly preventing/reversing type-2 diabetes.

 


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