While exogenous ketones (EK) are a newer supplement, having entered the market for consumers in just the past few years, scientists have been synthesizing ketone bodies in a lab since the 1960’s. They were useful for scientists studying their use for specific disease conditions, most notably childhood seizure disorders, though they were prohibitively expensive for consumers (1, 2).

While ketone salts are widely available, unfortunately in the near-term ketone esters are in short supply and the only people who will be able to afford taking them several times per day will be elite athletes, the military, corporate CEO-types, and professional poker players. Even with economies of scale and ramping up production, the cost of raw materials to produce pure ketone esters will keep their price tag prohibitively high for most people, but could realistically get down to a few dollars per gram.
Exogenous ketones are created in a lab to accelerate both physical and mental performance. These ketone drinks were actually used in pro cycling races back in 2015, trading at prices that would make using your kidney as a bartering tool seem like a cut price deal. Fortunately, they’ve now come down in cost and are used often in between meals as a way of blackmailing your body into getting into ketosis way faster.
After a few days of fasting, or of drastically reduced carbohydrate consumption (below 50 g/day), glucose reserves become insufficient both for normal fat oxidation via the supply of oxaloacetate in the Krebs cycle (which gave origin to the phrase ‘fat burns in the flame of carbohydrate') and for the supply of glucose to the central nervous system (CNS).4
Increased calcium levels in the bloodstream may contribute to the hardening of arteries (atherosclerosis), which in turn can lead to a heart attack.  Calcium from supplements enters the bloodstream in one bolus, whereas we usually tend to get calcium from foods in small doses from the breakdown process. This might explain why calcium from food doesn’t create the same risk that is introduced by calcium supplements. At first glance, it seems to be the case that high calcium intake –at least from supplements–may not be ideal.
What is the reason for needing to keep our stress levels down? Well the body reacts to stress, whether physical or emotional, by dumping glycogen and potentially glucose in your bloodstream, thus elevating insulin levels. This in turn blocks our bodies from entering ketosis. To keep your mental and emotional stress to a minimum, it may be wise to meditate, sleep, relax, or do something that is fun and care-free.
Let me introduce myself. My name is Mark Sisson. I’m 63 years young. I live and work in Malibu, California. In a past life I was a professional marathoner and triathlete. Now my life goal is to help 100 million people get healthy. I started this blog in 2006 to empower people to take full responsibility for their own health and enjoyment of life by investigating, discussing, and critically rethinking everything we’ve assumed to be true about health and wellness...

The best time to start a one day fast is in the evening (neither morning nor the night) – preferably, around 6 pm. It won’t make you lose your vital energy during the daytime workouts, nor does it let you sleep with undigested foodstuff in your stomach. Taking late meals and sleeping with undigested food doesn’t allow your body to rest. So the natural healing mechanism of your body fails during the sleep time as the entire resources are busy digesting your food.


Many of us avoid foods like processed meats and cheeses or salted nuts because of their high sodium content. However, processed carbohydrate sources can have equal or higher amounts of sodium per serving. An ounce of salted pretzels[3] has over four times as much sodium as an ounce of salted peanuts[4]. Just because we can’t taste the sodium doesn’t mean it isn’t in there. Flavors from other ingredients like sugar and spices can make it difficult to identify salt as a dominant flavor.

Many of us avoid foods like processed meats and cheeses or salted nuts because of their high sodium content. However, processed carbohydrate sources can have equal or higher amounts of sodium per serving. An ounce of salted pretzels[3] has over four times as much sodium as an ounce of salted peanuts[4]. Just because we can’t taste the sodium doesn’t mean it isn’t in there. Flavors from other ingredients like sugar and spices can make it difficult to identify salt as a dominant flavor.
Supplemental BHB’s are ideal for people new to the ketogenic way of eating. The changes that happen in your brain and body when adapting to a VLC diet are both immediate and profound. For example, our kidney’s start processing minerals salts much more efficiently. Ironically, after years of being advised to decrease our intake of salt (sodium), it turns out that for people transitioning away from the Standard American Diet (SAD diet) towards a lower carb or ketogenic diet there is actually a need to increase dietary mineral salts such as potassium, sodium, magnesium and calcium. During the process of becoming keto-adapted, it is very important to increase your intake of these essential minerals, in order to prevent the onset of unpleasant symptoms (known as “keto flu”).
There are many top-rated exogenous ketone supplements, which is a great resource to help get your body to adapt faster and produce at a high-performance level, but you need to be careful how they can effect you and your energy levels and your general mood each day, so it’s important to check with your local physician and be safe about it. Remember that when you switch over to this diet, you must maintain high sodium levels during the process. It is recommended to add more 'keto salt' to your daily intake, starting off gradually and increasing it to as much as 500g a day. You need to add salt and electrolytes to your routine, because a person can lose levels through their urine, which causes your body to become more dehydrated and can leave you feeling a little sick and weak if you don't have the balance properly set up. Most exogenous ketone supplements we found have quite a bit of sodium in their ingredients, which helps you reach the level of salt intake you need each day. It is important to understand how this whole process works before even thinking about tackling it yourself. This is why you should consult with a professional to seek out advice and address any concerns that you may have before getting started.

However, we will not be commenting on ketone esters since there are big differences between them and ketone salts, and the ketone salts are the ones that have been heavily commercialized and marketed to the public over recent years. Ketone esters may be more difficult to market due to their having an unpleasant taste. We may look more deeply into the esters in the future.
Slowly ramp up your ketone intake. Be patient! 🙂 For many of us, our bodies aren’t used to running on ketones, so you can expect an adjustment period. Try ¼ scoop first. Transitioning to ketosis removes water from our bodies, so getting lots of water will help with any dehydration and stomach issues. Ramp up from there, trying ½ scoop the second week or when you feel it’s appropriate, and then try a whole scoop 1-2 weeks in. You can use it for extra energy or to help get into ketosis if you aren’t there already. Most people use it 0-3 times per day.
Even though endurance athletes can train in a carb depleted state, they will generally consume carbohydrates in the lead up to a race (the athlete is seeking to increase the ability to run off fats by training in a carb depleted state, then benefiting from both fats AND carbs come race day). Likewise, with the brain, even though the brain can function off ketones, does it mean it’s the best state for brain function?
How BHB turns into energy is a fairly simple process. As we’ve mentioned, beta hydroxybutryate eventually leads to energy production after you consume it or after your body breaks stored body fat down. It does this by going into the cell, entering the mitochondria (energy factories) at which stage it cleaves the carboxyl acid group and becomes acetoacetate (another “ketone body”). Acetoacetate turns into acetoacetyl-CoA, which then is cleaved to acetone (another “ketone body”) and acetyl-CoA. Acetyl-CoA is the whole reason we want BHB in the first place. This jumps into what is called the Kreb’s cycle (don’t you remember any of your biochemistry classes?) and is churned into ATP — the energy currency of your cells!
Despite the recent growth of the ketone salt market, there is very little published work analyzing the effects of these products on any biomarkers or performance measurements in humans. Several studies have been carried out in rats,6,7 with blood BHB levels being relatively low (<0.5 mM) post-consumption of salt drinks. In humans, ketone salts provided peak D-BHB levels of 1 mM, whereas the same amount of BHB in a ketone ester (BD-BHB) raised blood BHB to 2.8 mM.5
Currently, we lack enough evidence to change the recommendations for calcium intake. The Tolerable Upper Intake Level (UL) for adults 19-50 years old is 2500 mg. This is well over the RDA of 1000 mg for the same age group. Calcium supplements commonly contain 600-1200 mg. When assessing your own calcium intake, keep in mind that calcium from food sources and calcium from supplements may have different outcomes.
Getting into a state of ketosis normally involves eating a ketogenic diet consisting of around 80 percent fat, 15 percent protein, and 5 percent carbs. Over time, the body transitions from burning carbs for fuel to burning ketones—an alternative fuel source that the liver makes by breaking down fat, explains keto diet expert Amy Davis, RD, LDN. Since advocates say that ketosis can help you lose weight fast, think more clearly, and feel more energized, it’s tempting to try.
I (Kim) researched the topic and planned and ran the experiment under the guidance and supervision of Dr. Andreas Eenfeldt, who touched base with me every step of the way to check the experiment design and execution for scientific rigor (to the greatest degree possible) and who has edited this writeup for quality and trustworthiness reasons. I also consulted with other keto experts and researchers to gather feedback both on the experiment design and the results data. They are referenced in the text when this was the case.
So by taking in the perfect keto base, which are the exogenous ketones (BHB). This will easily put my body into ketosis rather than having to do the ketosis diet? I cant make up my mind on whether to buy the ketone powder and/or the MCT oil powder. What is the benefit of the MCT oil powder? When i read about it on the perfectketo website, it sounds like it does the same job as the perfect keto base. I’m also curious about the bone broths others sell for ketose related stuff. Is it very benedficial even when it has about 600mg of sodium in it?

Hi! My question is, how low must my current daily carb count be in order to benefit from taking your exogenous ketones? I am a 33 year old female, keeping total carbs at 100-125 grams per day. My priority is fat loss, and I do HIIT training 4-5 days a week. I’ll soon be adding in heavier strength training. I don’t function well eating less than 100 total carbs a day. Could this even benefit me? And if it will benefit me, would the befits outweigh the sodium content? I keep my sodium at 2,000 mg a day, as I’m trying to avoid water weight.
Patrick Arnold is an organic chemist who is notorious for being the creator of several performance-enhancing steroids. He is arguably one of the strongest influencers on the advancement of sports supplementation. Currently he is focused on developing products under the KetoSports brand, which includes two exogenous ketone products – KetoForce and KetoCaNa.
Over five visits, participants (n = 16) consumed either 4.4 mmol.kg−1 of βHB (2.2 mmol.kg−1 or 395 mg/kg of KE; 1 mole of KE delivered 2 moles of d-βHB equivalents): twice whilst fasted, and twice following a standardized meal, or an isocaloric dextrose drink without a meal. To improve palatability, drinks were diluted to 500 ml with a commercially available, citrus flavored drink containing 65 kCal (5 g of carbohydrate) (Glaceau, UK). The dextrose drink was taste-matched using a bitterness additive (Symrise, Holzminden, Germany). The standard meal consisted of porridge oats (54 g), semi-skimmed milk (360 ml) and banana (120 g), giving 600 kCal per person, with a macronutrient ratio of Carbohydrate: Protein: Fat of 2:1:1.

Currently, we lack enough evidence to change the recommendations for calcium intake. The Tolerable Upper Intake Level (UL) for adults 19-50 years old is 2500 mg. This is well over the RDA of 1000 mg for the same age group. Calcium supplements commonly contain 600-1200 mg. When assessing your own calcium intake, keep in mind that calcium from food sources and calcium from supplements may have different outcomes.


The problem? Exogenous ketone supplements work by flooding your bloodstream with ketones. But unless you’re also eating a ketogenic diet (and producing a steady stream of ketones naturally), those supplemental ketones won’t stick around forever. “The benefit of exogenous ketones is limited due to their excretion through the urine,” explains Madge Barnes, MD, family medicine specialist with Texas Health Family Care. In other words? They’ll only work for a few hours until you pee them out. As a result, you need to keep on supplementing—which can get expensive. Twenty single-serving packets of Prüvit’s Keto//OS MAX Pure Therapeutic Ketones, for example, cost $130. (The company doesn’t specify how often you should take them.)
You must realise that our bodies are lazy and switching to a new energy source means hard work, that means that your body will not do this easily and you basically have to force it. One way to speed up this process is to put your body into fight or flight mode. My preferred  controlled exercise to do this is to have a high intensity workout followed immediately by a  cold shower.  I am describing it in the article to go slowly, but in this case it will actually be beneficial if you can force your self to go straight into a cold shower and try to stay there at least 2 minutes. One of the benefits of this that your body will produce the hormone noradrenaline. Obviously this is something for people in perfect health. Please advice your doctor before you want to take cold showers.
Your body is trained to use glucose as its main energy source, but when you decrease your consumption of carbs, your body turns to another source of energy that is naturally produced by our own bodies--fat. Therefore, a great way to lose weight faster is to consume low-carb fruits, vegetables and other food that are specially designed for a low-carb diet.
Importantly, at Diet Doctor we do not think you need to spend any extra money at all in order to revolutionize your health. You can achieve radiant health just by enjoying authentic food that is naturally low in carbohydrates, getting plenty of sleep and some exercise (going for a walk is free) and reducing stress. A lot of you who answered the survey made exactly these points in your explanations of reasons for not taking the supplements. I whole-heartedly agree.

You may find a tiny amount here and there is ok (i.e., 2g of sugar with a meal full of fat may be ok).  But if you are starting out I would recommend cutting all sugar from your diet, and most importantly avoiding any sugar consumption on an empty stomach. For best results track your ketone levels before and after meals to see the impact the food has on your ketone levels.
Serial drinks or a continuous NG infusion of KE effectively kept blood ketone concentrations >1 mM for 9 h (Figure ​(Figure6).6). With drinks every 3 h, blood d-βHB rose and then fell, but had not returned to baseline (~ 0.1 mM) when the next drink was consumed. There was no significant difference in d-βHB Cmax between drinks 2 and 3 (3.4 ± 0.2 mM vs. 3.8 ± 0.2 mM p = 0.3), as the rate of d-βHB appearance fell slightly with successive drinks (0.07 ± 0.01 mmol.min−1 and 0.06 ± 0.01 mmol.min−1 p = 0.6). d-βHB elimination was the same after each bolus (142 ± 37 mmol.min, 127 ± 45 mmol.min; and 122 ± 54 mmol.min). When KE was given via a nasogastric tube, the initial bolus raised blood d-βHB to 2.9 ± 0.5 mM after 1 h, thereafter continuous infusion maintained blood d-βHB between 2–3 mM. Total d-βHB appearance in the blood was identical for both methods of administration (Serial drinks AUC: 1,394 ± 64 mmol.min; NG infusion AUC: 1,305 ± 143 mmol.min. p = 0.6).
Before the Nobel Prize was awarded to Yoshinori Ohsumi, other researchers were making groundbreaking discoveries about autophagy. In 2009, an article was published in Cell Metabolism entitled Autophagy Is Required to Maintain Muscle Mass. In this article, researchers described how deactivating an important autophagy gene resulted in a profound loss in muscle mass and strength.
Hi! I have what might be a silly question about using these supplements. What happens if you are taking them and your diet goes off the rails, like you take the Keto//OS and then eat a bunch of pizza or chocolate. Does your body just immediately revert back to using the carbs for energy instead of the ketones? Or, if it doesn’t, would that mean your body would just store those carbs as fat? I realize that ideally you wouldn’t eat the pizza, but sometimes I do and I worry about what exactly I’m doing to my body if I’ve also taken ketones.
Exogenous ketones have a wide range of benefits that can enhance your fat-burning lifestyle. I personally use them daily as a strategy to heighten my mental performance and give my workouts an extra boost. For these purposes, I have also found it logical to combine exogenous ketones with other known health and performance boosting agents such as branched-chain amino acids and medicinal mushrooms.
One other thing I must point out is also that we are talking about being in ketosis and not being fully keto adapted. You enter ketosis when your body starts producing ketones above a specified level, being fully keto adapted means that your body is full adapted to  use fat as your primary energy source and that the production of certain enzymes in your body is fully adapted. This doesn’t happen in one day and it takes about 1 month on average to be fully keto adapted. But we are not looking for this as we just want to end the most unpleasant period and to start losing weight.
It’s not clear that the Weir coefficients used to estimate EE are relevant for someone in ketosis, let alone someone ingesting exogenous BHB. (The Weir formula states that EE is approximated by 3.94 * VO2 + 1.11 * VCO2, where VO2 and VCO2 are measured in L/min; 3.94 and 1.11 are the Weir coefficients, and they are derived by tabulating the stoichiometry of lipid synthesis and oxidation of fat and glucose and calculating the amount of oxygen consumed and carbon dioxide generated.) While this doesn’t impact the main observation—less oxygen was consumed with higher ketones—it does impact the estimation of EE and substrate use.

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