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.

Top Ketone Supplements

SaleBest Seller No. 2
Keto Matrix Keto Supplement - Exogenous Ketones - Keto BHB Salts + MCT Oil Powder - Beta Hydroxybutyrate + C8 & C10 - Formulated by Dr. John Limansky MD, The Keto Dr
73 Reviews
Keto Matrix Keto Supplement - Exogenous Ketones - Keto BHB Salts + MCT Oil Powder - Beta Hydroxybutyrate + C8 & C10 - Formulated by Dr. John Limansky MD, The Keto Dr
  • BHB + MCT POWDER ULTIMATE KETO SUPPLEMENT - Keto Matrix harnesses goBHB & goMCT MCT powder, the patented beta-hydroxybutryrate (exogenous ketone) and MCT oil powder to deliver two of the best supplements for promoting ketosis in one great tasting powder.
  • FORMULATED BY THE KETO DOCTOR - Keto Matrix was formulated from the ground up by Dr. John Limansky MD, one of the foremost authorities on the Keto diet. Dr. Limansky consults on the Keto diet for beginners through performance athletes and developed this supplement to help anyone achieve and maintain ketosis.
  • FULL TRANSPARENCY - Unlike other ketogenic supplements, Keto Matrix doesn't hide behind proprietary blends and publishes the exact amounts of Beta-Hydroxybutyrate and MCT oil powder in every serving. Have confidence that you're getting the perfect levels of goBHB & goMCT in every serving.
  • BENEFITS - Whether you're looking to burn fat, increase energy levels, reduce cravings, boost exercise performance or improve cognitive function without the jittery effect of coffee, Keto Matrix is the perfect formula to achieve your goal.
  • SATISFACTION GUARANTEED - As with all Biohack MD products, we offer a 60-day unconditional money back guarantee. Whether you're just starting out with the keto diet, or have plenty of experience, add exogenous ketones and mct oil powder to your diet with Keto Matrix.
Best Seller No. 3
KetoBM Ketone Blood Meter Kit - Complete Monitoring System for Ketogenic Diet and Ketosis Testing (Vial Strips)
  • COMPLETE KIT: Includes everything needed for at home testing: meter, 10 ketone strips, lancing device and 10 lancets
  • EASY TO USE: Made for home use with no calibration or control solution required.
  • ACCURATE: State-of-the-art monitoring system provides accurate and reliable results.
  • SAFE: KetoBM products are FDA registered and exceed all US safety standards.
  • RISK FREE: We stand by all of our products and offer an unconditional 30 day money back guarantee and 2 year free replacement or repair.
Best Seller No. 4
Ketond Advanced Ketone Supplement - 30 'On the Go' Packs - Exogenous Ketone Supplement 11.7g of BHB Salts to Lose Weight, Increase Energy & Focus (Fruit Punch, Pina Colada, Peach)
16 Reviews
Ketond Advanced Ketone Supplement - 30 'On the Go' Packs - Exogenous Ketone Supplement 11.7g of BHB Salts to Lose Weight, Increase Energy & Focus (Fruit Punch, Pina Colada, Peach)
  • Made in the USA. Enjoy Ketond's summer flavor variety pack! 30 Individually packaged servings: 10 each of Fruit Punch, Pina Colada and Peach. Each serving contains 11.7 grams of goBHB.
  • Ketond is 100% transparent with all of the ingredients used and nothing is hidden in a "Proprietary Blend"
  • Ketond powered by goBHB (beta-hydroxybutyrate) delivers the purest dosage of this carbohydrate-free high performance fuel.
  • Ketond is for anyone looking to manage their weight, maximize cognition, or simply feel more energetic in a low carbohydrate environment. Just mix in water and you have a delicious, refreshing beverage that helps you feel better, think more clearly, and perform at higher levels.
  • Ketond is NOT part of some multi-level, direct pyramid style of marketing program. This means we are able to offer our product at a FRACTION of the cost of the other guys. Go ahead and research for yourself. Multilevel companies are great for the guys in the Pyramid but not so great if you are looking for a great supplement sold at a great price.
SaleBest Seller No. 5
Dr. Boz Max Strength Ketones-In-A-Capsule Exogenous Ketones Supplement -Best Keto pill for Weight Loss - Weight Loss Supplements to Burn Fat Fast - Boost Energy -84 Count
  • EXOGENOUS KETONES - THE BHB BOOST Dr Boz Max Strength BHB packs Ketones-In-A-Capsule. Nothing else. Just ketones. No Caffeine. No sweeteners. Just KETONES. These powerful BHB particles boost your blood ketones within minutes. Last for up to 3 hours. Supplementing with DR.BOZ Keto BHB will turn up your energy! Ketones fuel your body. Why doesn't everyone burn ketones for energy? Because it's hard to start that "fire." Light your fire with DR.BOZ Keto BHB. Burn Stored Fat As Fuel. This means: Bu
Best Seller No. 7
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 Hydxoxybutyrate (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.
SaleBest Seller No. 8
100% Pure Raspberry Ketones Extract NEW Extra Strength Appetite Suppressant, Energy Booster, All Natural, 60 Vegetarian Capsules
121 Reviews
100% Pure Raspberry Ketones Extract NEW Extra Strength Appetite Suppressant, Energy Booster, All Natural, 60 Vegetarian Capsules
  • MAXIMUM STRENGTH- 100% Pure Raspberry Ketone Capsules -Our product is packed with 1000mg of pure raspberry ketones per daily intake (2 capsules), which is a highly potent concentration. Do not fall for other products that offer an impure formula with a lower concentration.
  • EFFECTIVE & SAFE WEIGHT LOSS - Raspberry ketone is an all-natural chemical from red raspberries, which will help speed up your metabolism as well as suppress your appetite. Our ketones naturally contain antioxidants that will help you improve mood, energy, and a wide-range of positive benefits.
  • NATURAL FORMULATION: No unnecessary fillers, binders, or potentially harmful preservatives or GMOs means no unwanted side effects for you! We go the extra mile to ensure our supplements have passed extensive quality control testing before being bottled and sold. aSquared Nutrition's Raspberry Ketone formula is Gluten Free & Vegetarian safe, and is made in an FDA registered & GMP certified manufacturing facility in the USA.
  • Research suggests that Raspberry Ketones can act as a fat burner for men and women by increasing adiponectin, a protein hormone that regulates the metabolism of sugars and fats in the body.
  • All Tigereye Nutraceuticals health and weight loss supplements are 100% pure with no artificial fillers or binders, and rigorously tested by third party laboratories to ensure their potency and safety.
Best Seller No. 9
HVMN Ketone - Ketone Ester Elite Endurance Nutrition Drink, Pocket-Sized, Exogenous BHB, Salt-Free Sugar-Free Performance Energy, 3 Count Servings
32 Reviews
HVMN Ketone - Ketone Ester Elite Endurance Nutrition Drink, Pocket-Sized, Exogenous BHB, Salt-Free Sugar-Free Performance Energy, 3 Count Servings
  • HVMN Ketone is the most effective exogenous ketone drink - a sports drink to improve performance, recovery, and cognitive ability
  • Scientifically proven to raise blood BHB levels more effectively than ketone salts
  • 1 bottle = 1 serving
  • Salt-free, stimulant-free, and sugar-free
  • The world's best athletes rely on HVMN Ketone: Tour de France cyclists, NFL teams, the US Military, top contenders in MMA and boxing and now, a world-record breaking cyclist.
SaleBest Seller No. 10
Keto Science Real Ketones Caps Dietary Supplement, Supports Carb-Fighting Diet, Weight Loss and Increased Metabolism, Keto & Paleo Friendly, 14 servings,60 Count (Packaging May Vary)
  • Ketones promote increased metabolism, weight loss, and brain function
  • Carb control made simple with convenient, easy to swallow capsules
  • Formulated with patented and proven GoBHB ketones that your body can put to work immediately
  • Ketogenic & Paleo-friendly supplement capsule
  • Includes 60 convenient, easy-to-swallow capsules
SaleBest Seller No. 11
KETO-MOJO Blood Ketone and Glucose Testing Meter Kit, Monitor your ketogenic diet, 1 Lancet Device, 10 Lancets, 10 Ketone Test Strips, Carrying Case. Does NOT include Glucose Strips
973 Reviews
KETO-MOJO Blood Ketone and Glucose Testing Meter Kit, Monitor your ketogenic diet, 1 Lancet Device, 10 Lancets, 10 Ketone Test Strips, Carrying Case. Does NOT include Glucose Strips
  • ACCURATE RESULTS: Blood testing is the most accurate way to test for ketone and glucose levels. The Keto-Mojo Testing Kit exceeds strict FDA and International standards ensuring you get the best measurement results possible.
  • EASY TO USE: The KETO-MOJO Meter Kit is very easy to use with its easy to follow instruction videos found online as well as comprehensive Help section as well. If that isn't enough, you can reach out to their amazing customer support team for help.
  • Tested and Recommended by leading Keto Experts such as Dominic D'Agostino; Dr. Nasha Winters, ND, FABNO, L.Ac, Dipl.OM; Professor Thomas Syfried; Mariam Kalamian, EdM, MS, CNS; The Diet Doctor, Andreas Eenfeldt, MD; and others.
  • COMPLETE HOME KIT PACKAGE: The KETO-MOJO Monitoring System includes everything you need to do a blood test in the comfort of your own home. INCLUDES: , (1) Keto-Mojo Testing Meter, (1) Lancing Device + (10) Lancets, (10) Blood Ketone Testing Strips, (1) Carrying Case, (2) AAA Batteries,, (3) Manuals. Does NOT include Glucose Strips.
  • GET FAST RESULTS IN SECONDS: The KETO-MOJO Testing Strips are innovatively designed to give you results in SECONDS. Glucose -Blood Sugar Test Strip- results in only 5 seconds and Ketone results in 10. Less delay and waiting time, it's ideal for busy and active individuals who want results fast.
Best Seller No. 12
Real Ketones Prime D+ BHB (Beta-Hydroxybuterate) and MCT Exogenous Ketone Powder Supports Ketogenic Diet, Energy Boost, Mental Clarity (28 Serving, Lemon Twist)
  • BHB + MCT EXOGENOUS KETONES FOR EVERYBODY: Real Ketones Prime D+ exogenous ketones fuels quick, sustained ketosis, which allows your body to burn fat rather than glucose for its primary fuel. Our multi-patented formulation of BHB+MCT ketones helps your body produce its own ketones and ignite its own fat-burning ability. Prime D+ will enhance brain function, improve sleep, and increase energy without the jitters or the crash, giving you natural energy your body prefers to perform your best.
  • PRODUCE YOUR OWN KETONES NATURALLY WITH BHB+ MCT: Prime D+'s BHB+MCT patented formulation mimics the body's natural ketogenic process with exogenous ketones that turn on your body's own fat burning ability within an hour, helping to elevate and sustain ketone levels. All other ketone supplements are limited to delivering BHB ketones, which will indeed spike your ketone levels, but will not deliver consistent ketosis by helping your body make its own ketones.
  • ALLOWS FOR FLEXIBLE KETO DIET: Prime D+'s exogenous ketone formula makes staying in ketosis much easier with your keto diet. By providing your body ketones, you have more flexibility when eating carbs because PRIME D+'s BHB + MCT ketone combo bridges the gap to keep you in ketosis. While a few extra carbs in just a plain keto diet will throw you out of ketosis, PRIME makes keto dieting much easier, cheat day friendly, more carb flexible and worry free.
  • BEST TASTING KETO SUPPLEMENT & QUALITY INGREDIENTS GUARANTEED: Prime D+ tastes great and is formulated with key nutritional ingredients not found in other ketone supplements. Our pure exogenous ketones combine 4 balanced electrolytes calcium, magnesium, potassium, sodium with Prime D+ Energy blend and a proprietary Bio-Enzymatic blend to ensure the most balanced ketosis experience & performance potential. Prime D+ is allergen free, and is 100% non-GMO.
  • FREE REAL KETONES APP INCLUDED WITH PURCHASE: Now you can get complete keto diet and lifestyle guidance with any Real Ketones purchase. Daily tips and guidance: Keto tips, grocery lists, recipes and more. One-on-one support: Always here to answer questions. Weight and progress tracking: Track your fitness journey. Food and activity planning: Stay on track with your diet and exercise program.
Best Seller No. 13
Ketond Advanced Ketone Supplement - 15 'On the Go' Packs - Exogenous Ketone Supplement 11.7g of BHB (Beta-Hydroxybutyrate) Salts to Lose Weight, Increase Energy (Grape, Tigers Blood, Citrus Mango)
15 Reviews
Ketond Advanced Ketone Supplement - 15 'On the Go' Packs - Exogenous Ketone Supplement 11.7g of BHB (Beta-Hydroxybutyrate) Salts to Lose Weight, Increase Energy (Grape, Tigers Blood, Citrus Mango)
  • Enjoy Ketond's fruit variety pack! 15 Individually packaged servings: 5 each of Grape, Tigers Blood and Citrus Mango. Each serving contains 11.7 grams of goBHBTM.
  • Ketond is 100% transparent with all of the ingredients used and nothing is hidden in a "Proprietary Blend"
  • Ketond powered by goBHBTM (beta-hydroxybutyrate) delivers the purest dosage of this carbohydrate-free high performance fuel.
  • Ketond is for anyone looking to manage their weight, maximize cognition, or simply feel more energetic in a low carbohydrate environment. Just mix in water and you have a delicious, refreshing beverage that helps you feel better, think more clearly, and perform at higher levels.
  • Ketond is NOT part of some multi-level, direct pyramid style of marketing program. This means we are able to offer our product at a FRACTION of the cost of the other guys. Go ahead and research for yourself. Multilevel companies are great for the guys in the Pyramid but not so great if you are looking for a great supplement sold at a great price.
SaleBest Seller No. 14
MuscleTech 100% Keto Plus, Exogenous Ketones & Aminos, Sour Peach Candy, 35 Servings
2 Reviews
MuscleTech 100% Keto Plus, Exogenous Ketones & Aminos, Sour Peach Candy, 35 Servings
  • 12g BHB SALTS - The exogenous beta-hydroxybutyrate in 100% Keto Plus is a combination of Calcium BHB, Magnesium BHB and Sodium BHB that delivers exogenous ketone bodies.
  • 3g AMINOS - Supplies a 3g blend of L-phenylalanine, L-alanine and L-arginine per 2 scoops.
  • SUPPORTS KETONE PRODUCTION - Studies indicate that the core ingredients in 100% Keto Plus help support the body's natural ketone production in response to exercise.
  • ZERO GRAMS OF SUGAR - 100% Keto Plus will not affect your ketogenic macros.
  • STIMULANT FREE - Non stim formula
SaleBest Seller No. 15
Ketone Meter, Digital Ketone Breath Analyzer, Portable Ketone Monitor, Ketosis Testing Kit with 5 Mouthpieces for Dietitian Testing
  • In order to get accurate ketone readings, please exhaust the residuals completelywith the ketone breath analyzer before your first use by running the keto breath tester 3 times without blowing, because each ketone breath analyzer was tested during the production before shipping to warehouse, there maybe residuals; if you want to test another person consequently after your testing, please also kindly exhaust your previous residuals
  • Breath Ketone Breath Meter save you from finger pricks, and the device can be used repeatedly by replacing the mouthpiece;Keto Breath Testing is a far more accurate method than urine strips testing, also more convenient because you only need to breathe with the digital ketone meter
  • The ketone meter result will be slightly different from the blood testing because of using different ketone testing methods
  • Ketone breath Analyzer with 3 LED indications: Green Light (Ketosis Reading Successfully), Amber Light (Low Battery), Red Light (Ketosis Reading Unsuccessfully), batteries are not included
  • Portable ketone meter designed to carry around anywhere & make sure you are in ketosis at all times; Ketone breath tester is guaranteed with 12 months, if you are not satisfied for any reason, we offer money back for 30 days after purchase, or we will replace the defective product at no charge
Best Seller No. 16
Exogenous Ketones Supplement -Best Keto Drink for Weight Loss Powder Energy -Focus- Ketosis for Beginners- Diet Works Fast Women & Men- Dr Approved -Dr Boz Max Strength Keto BHB - Raspberry Lemonade
9 Reviews
Exogenous Ketones Supplement -Best Keto Drink for Weight Loss Powder Energy -Focus- Ketosis for Beginners- Diet Works Fast Women & Men- Dr Approved -Dr Boz Max Strength Keto BHB - Raspberry Lemonade
  • Supplement with DR.BOZ Keto BHB turns up your energy! Ketones fuel your body. Why doesn't everyone burn ketones for energy? Because it's hard to start that "fire." Light your fire with DR.BOZ Keto BHB.
  • Burn Stored Fat As Fuel. This means: Burn KETONES. Losing weight is easy once you burn ketones for fuel. Let us help you start that fire with DR.BOZ Keto BHB.
  • Clear Brain Fog, Boost Mental Clarity.
  • DID YOU FALL OFF THE KETO-BANDWAGON? Hop back on with DR.BOZ Keto BHB.
  • It takes days to switch your body from burning glucose to ketones. Keto-adaptation happens after weeks of circulating ketones. Transitioning to keto-life is awesome once you get past the fatigue, brain fog, flu-symptoms, and weakness. Speed this transition up and cut down on those symptoms. Cut that time down to minutes with DR.BOZ Keto BHB. Skip feeling like a zombie and enjoy the energy that comes with active ketones in your blood.
Best Seller No. 17
Perfect Keto Ketone Testing Strips: Test Ketosis Levels on Low Carb Ketogenic Diet, 100 Urinalysis Tester Strips Best for Accurate Meter Measurement of Urine Ketones Tests: by Perfect Keto
  • Perfect for measuring state of ketosis in the ketogenic diet using a simple ketone strip. This ketones test is easier to use than other keto kits like a keto blood meter or breath analyzer ketone monitor.
  • Lab grade doctor developed highest quality keto strips. Convienent and easy to use for on-the-go ketosis testing.
  • Quick easy and reliable urinalysis testing for ketosis after you have had a keto snack or other keto products. Easy for on-the-go testing analysis after keto diet supplements or low carb food.
  • 100 strips per bottle with accurate results and measurement of ketone levels without the mess of having to use a keto blood testing kit.
  • Not just for the keto diet. These ketosis strips can also be used to measure ketones for those on the Atkins diet or Low Carb diet. Takes only 40 seconds to measure your ketosis levels.
Best Seller No. 18
Smackfat Ketone Strips - Perfect for Ketogenic Diet and Diabetics - Precise Ketone Measurement and Supports Ketone Adaptation, 100 Strips
5,343 Reviews
Smackfat Ketone Strips - Perfect for Ketogenic Diet and Diabetics - Precise Ketone Measurement and Supports Ketone Adaptation, 100 Strips
  • Focused Ketogenic Diet Strips - Meant to accurately read ketones. Also benefits the Atkins Diet and Paleo Diet. Add this to your Ketogenic Diet Plan for best results.
  • Precise Accuracy - Urinalysis test is easy to use, just dip and read. Sensitivity is positioned for ketogenic benefits.
  • 100 Ketone Test Strips - More than enough to help stay on top of your daily ketone measurement if you choose to test frequently. Add this to your Ketogenic Diet Supplies with confidence.
  • Motivational Support - Smackfat provides video demonstration as well as informative education geared towards ketone strips use and the ketosis diet.
  • Lifetime Product Warranty - You are backed by our lifetime product replacement guarantee that assures you will have the best customer experience
Best Seller No. 19
The Complete Book of Ketones: A Practical Guide to Ketogenic Diets and Ketone Supplements
1 Reviews
The Complete Book of Ketones: A Practical Guide to Ketogenic Diets and Ketone Supplements
  • Dr. Mary Newport
  • Publisher: Basic Health Publications, Inc.
  • Paperback: 432 pages
Best Seller No. 20
Keto Diet Pills Appetite Suppressant Supplement - Exogenous Ketones Ketogenic Diet Pills - Boosts Metabolism and Supplies Energy- 60 Capsules
  • SUSTAIN POWERFUL ENERGY: This keto dietary supplement will not only help you enter ketosis, it has the necessary components to help you sustain powerful energy and avoid common symptoms on the keto fast. Keto Lifestyler will help you stay alert, focused, and energetic all day.
  • BEST WEIGHT LOSS SUPPLEMENT: Put the power of exogenous ketones to work inside your body and watch the results. Simply put, BHB salts (beta hydroxybutyrate) are formulated in a way that allows your body to use fat instead of carbs for energy, the whole goal behind keto weight loss! If you put the effort in, it will work for you!
  • KICKSTART YOUR KETO DIET : Start your weight loss keto diet on the right foot with these easy to swallow keto diet pills, simply take the recommended dosage each day for optimum weight loss results, perfect for men and women and no need to drink horrible tasting keto powders
  • KETOSLIM FOCUS DIET : Ketosis supplements are not only made to help with weight loss, but they have also been known to have nootropic benefits to this carb blocker supplement. Taking this supplement has shown the best premium weight loss results. This fat burn burn pill is designed to work for men and women. Keto Lifestyler supports a boost in your metabolism to help you reach your ideal shape and weight
  • ENHANCE FOCUS & ENERGY : For best results, never go into your keto diet alone. Boost your mental and physical energy levels with 2 easy to swallow vegetable capsules. Eliminate brain fog, improve focus, combat the afternoon crash, and power through the most difficult part of your days with Keto Lifestyler.

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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