Some think so because higher ketone levels imply increased fuel for the brain and heart (that prefer ketones), and increased protection against inflammation and oxidation. But are the health benefits coming from the ketones themselves, or are they coming from the state you have to put your body in to actually produce them? And if you're kicking yourself out of ketosis by ingesting ketones would you still get the same benefits?
Let’s take a look at some of the facts and misconceptions about three of the minerals used to make ketone mineral salts: sodium, calcium, and magnesium. Potassium is very hygroscopic, meaning that it absorbs water very easily. Therefore, it is only feasible that it can be utilized in liquid formulations.  Thus, one should be cautious if companies say they have potassium BHB salt powder in their product. I’d be very surprised if that’s actually the case.

Given that blood βHB after identical ketone drinks can be affected by factors such as food or exercise (Cox et al., 2016), the accuracy of tools for non-invasive monitoring of ketosis should be investigated. Breath acetone and urinary ketone measurements provide methods to approximate blood ketosis without repeated blood sampling (Martin and Wick, 1943; Taboulet et al., 2007). However, breath acetone did not change as rapidly as blood βHB following KE and KS drinks. Acetone is a fat-soluble molecule, so may have been sequestered into lipids before being slowly released, resulting in the differences observed here. Similarly, significant differences in blood d-βHB between study conditions were not reflected in the urinary d-βHB elimination. As the amount of d-βHB excreted in the urine (≈0.1–0.5 g) represented ~1.5% of the total consumed (≈23.7 g), it appears that the major fate of exogenous d-βHB was oxidation in peripheral tissues. These results suggest that neither breath acetone nor urinary ketone measurements accurately reflect the rapid changes in blood ketone concentrations after ketone drinks, and that blood measurement should be the preferred method to quantitatively describe ketosis. That said, it should be noted that although commercial handheld monitors are the most practical and widely available tool for measuring blood ketones, they can overestimate blood D-βHB compared to laboratory measures (Guimont et al., 2015) and these monitors do not measure L-βHB and so may not provide accurate total blood ketone concentrations, especially if a racemic ketone salt has been consumed.
Ketosis is a unique metabolic state where your body burns fat instead of glucose for fuel. Glucose is a simple sugar molecule derived from carbohydrates. Your body prefers using glucose to using fat and protein to make energy. This is because glucose it is easy to burn as it doesn't require much energy. On the other hand, your body uses fat and protein to build and repair tissue and make hormones.
It's also a smart idea to start slowly with this supplement. We can thank Dave Asprey for the term “disaster pants” which has been used by those who try MCT oil at too high a dose when they first start using it. There is a chance that you can experience the same unpleasant gastrointestinal effect with exogenous ketones if you start with too high a dose, or if you maintain a higher carbohydrate diet while using this supplement. Used in appropriate doses, it gets absorbed through your stomach into your liver, then sent out to the rest of your body.

Considering both the broad therapeutic potential and limitations of the KD, an oral exogenous ketone supplement capable of inducing sustained therapeutic ketosis without the need for dietary restriction would serve as a practical alternative. Several natural and synthetic ketone supplements capable of inducing nutritional ketosis have been identified. Desrochers et al. elevated ketone bodies in the blood of pigs (>0.5 mM) using exogenous ketone supplements: (R, S)-1,3 butanediol and (R, S)-1,3 butanediol-acetoacetate monoesters and diester [48]. In 2012, Clarke et al. demonstrated the safety and efficacy of chronic oral administration of a ketone monoester of R-βHB in rats and humans [49, 50]. Subjects maintained elevated blood ketones without dietary restriction and experienced little to no adverse side effects, demonstrating the potential to circumvent the restrictive diet typically needed to achieve therapeutic ketosis. We hypothesized that exogenous ketone supplements could produce sustained hyperketonemia (>0.5 mM) without dietary restriction and without negatively influencing metabolic biomarkers, such as blood glucose, total cholesterol, HDL, LDL, and triglycerides. Thus, we measured these biomarkers during a 28-day administration of the following ketone supplements in rats: naturally-derived ketogenic supplements included medium chain triglyceride oil (MCT), sodium/potassium -βHB mineral salt (BMS), and sodium/potassium -βHB mineral salt + medium chain triglyceride oil 1:1 mixture (BMS + MCT) and synthetically produced ketogenic supplements included 1, 3-butanediol (BD), 1, 3-butanediol acetoacetate diester/ ketone ester (KE).


Another important difference between endogenous and exogenous BOHB is that most synthetic BOHB used in dietary supplements is a mixture of the two ‘D’ and ‘L’ isomers, whereas endogenously produced BOHB consists of just the D-isomer. Metabolically, the two isomers are very different, and current published information indicates that most of the energy and signaling benefits of BOHB derive from the D-form. This is potentially problematic because the L-isomers are not metabolized via the same chemical pathways as the D-forms (Lincoln 1987, Stubbs 2017), and it remains unclear whether humans can convert the L-form to the D-form.
KE consumption decreased FFA from 0.6 to 0.2 mM, TG from 1.0 to 0.8 mM, and glucose from 5.5 to 4.7 mM by the end of the study (4 h). The effect was not altered by a meal (Figures 5A–C). Dextrose drinks also lowered FFA from 0.6 to 0.2 mM and TG from 1.0 to 0.7 mM (Figures 5A, B). This was likely mediated by the transient increase in glucose, which rose from 4.6 to 6.5 mM following the dextrose drink (Figure ​(Figure5C).5C). The anti-lypoytic effect of dextrose drinks was shorter than that of KE drinks as d-βHB concentrations were elevated for longer after KE drinks than glucose after dextrose drinks. Insulin increased to ~ 35 mU.ml−1 after both the meal and the dextrose drink, but also increased to 13 ± 2 mU.ml−1 when KE was consumed whilst fasted owing to the 15 g of glucose in the flavored drink used as a diluent (Figure ​(Figure5D5D).
In a nutshell… WOW! The chart above shows each of the games/categories I played, showing my prior 5-day averages compared to the day I took the ketone esters. Compared to my baselines, my scores increased across the board, with the biggest improvements in spatial orientation (+32.2%), working memory (+23.7%), quantitative reasoning (21.5%), task switching (+14.9%), and information processing (+14.9%). Below are more detailed comparisons:

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.


Zhou Nutrition’s MCT Powder is another great quality MCT powder to try out. Taking a note from Perfect Keto, Zhou uses only Acacia Fiber during its manufacturing process and avoids all use of the common additives and fillers you see in most MCT powders. Zhou’s MCT Powder is made with the patented “goMCT” MCTs. While you don’t get the delicious flavors Perfect Keto have perfected, Zhou’s MCT Powder is a proven product pushing a 4 digit tally in positive reviews. Hundreds have attested to its true lack of flavor and positive ketone results.
The product does not work. I have taken one scoop daily and for last two days two scoops (once in the morning and once in the night). I also do intermittent fast i.e. no food from 8 pm - next day 2 pm other than this powder in the morning. My food is 1500 calories with 60% fat, 30% protein and 5% carbs. I used to achieve ketosis naturally prior to using the powder. But now, there is no ketosis. This product does not work. I am wondering how on earth did they pick up so many reviews, unless it is faked marketing.
And now, you can take ketone supplements (salts and esters), known as exogenous ketones, without actually restricting anything. According to those promoting this nasty-tasting supplement, that means you can have a brain and body fuelled by ketones, along with all of the supposed health benefits that come with running on fat. Well, don't fall for it.

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.


One monk, for example, set out to do a 40 day fast with medical supervision while maintaining his daily activities in the monastery. After 36 days, the medical professionals had to step in due to “profound weakness” and low blood pressure when standing. Although the monk fasted for 15 days longer than Ghandi, the medical professionals were able to stop the fast in time so that he could recover.
If you stop eating carbs, your body first uses up glucose reserves stored in the liver and muscles. After it burns all that's left of glucose, it has no other options but to start burning fat. It can burn either your body's fat stores or the fat you eat. However, not all cells in your body can use fat to make energy and this is where ketones come into play.
You may wonder why we are emphasizing on using these specific oils. Well, this is because the extra virgin oil is an unprocessed form, and contains lauric acid that is antimicrobial in nature and is good for brain health. (This is the same lauric acid that is naturally found in breast milk as well.) Its antibacterial property also indirectly supports the growth of Candida that keep your gut healthy.
Fortunately a new way to test ketosis has been developed - and that is by measuring acetone levels in the breath. This is rather new technology but based on the reports I have seen it does look reasonably reliable. The testing process is simple, you use a device like that made by Ketonix, you breathe into it, wait a minute or so and it will give you a color indicating the state of ketosis you are in. However, there are numerous downsides:
Hi. Thanks for the informative article! I have fallen down the exogenous ketone rabbit hole for the last 2 days trying to figure everything out. I am currently on a nutritional ketonic diet but after 8 months, I am finding it difficult to stay on it 100%. I would like to remain on a low-carb diet, but also have a little more flexibility in my food choices. If you take the expense out of the equation, which product would you recommend for someone who wants to use ketosis as a method of weight loss? Thank you so much.

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Once you hit the bed, the adrenal glands will be off and the body will enter the anabolic stage. This will allow your body to repair itself. If you stay up late for long periods of time your body will enter the hypercatabolic state. In this state, the levels of cortisol in your body increase significantly. This also increases the insulin resistance of the body which would again increase the blood sugar levels.
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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).


Some think so because higher ketone levels imply increased fuel for the brain and heart (that prefer ketones), and increased protection against inflammation and oxidation. But are the health benefits coming from the ketones themselves, or are they coming from the state you have to put your body in to actually produce them? And if you're kicking yourself out of ketosis by ingesting ketones would you still get the same benefits?
Ketones are naturally slightly acidic, so the combination of BHB with sodium acts as a bit of a buffer to this acidity. Ketones will also naturally act as a diuretic, so you lose salt, potassium calcium and magnesium, and it is generally encouraged to increase sodium intake with ketones. The addition of sodium to the product will replenish this salt loss.
The culprit is often restaurant meals or other meals where the nutrition facts are not available with the food itself. Such “ignorance is bliss” situations allow us to avoid dealing with daunting numbers. Many people don’t hesitate to stop and enjoy a meal at a restaurant, but they freak out when they actually see the numbers on a label.  By now, we all know that opting for fatty meat with a side of veggies cooked in butter isn’t that bad after all.  It turns out that what you thought to be the safe, “healthy,” doctor-approved choice might not always be what you think it is.
Task switching is the process of adapting to changing circumstances (switching from one goal to another). Two cards are shown one above the other, and a combination of letter and a number (i.e., “A4”) will appear on one of the two cards. If it appears on top, the task is to indicate whether the number is an even number, and if on the bottom the task is to indicate whether the letter is a vowel.
Considering both the broad therapeutic potential and limitations of the KD, an oral exogenous ketone supplement capable of inducing sustained therapeutic ketosis without the need for dietary restriction would serve as a practical alternative. Several natural and synthetic ketone supplements capable of inducing nutritional ketosis have been identified. Desrochers et al. elevated ketone bodies in the blood of pigs (>0.5 mM) using exogenous ketone supplements: (R, S)-1,3 butanediol and (R, S)-1,3 butanediol-acetoacetate monoesters and diester [48]. In 2012, Clarke et al. demonstrated the safety and efficacy of chronic oral administration of a ketone monoester of R-βHB in rats and humans [49, 50]. Subjects maintained elevated blood ketones without dietary restriction and experienced little to no adverse side effects, demonstrating the potential to circumvent the restrictive diet typically needed to achieve therapeutic ketosis. We hypothesized that exogenous ketone supplements could produce sustained hyperketonemia (>0.5 mM) without dietary restriction and without negatively influencing metabolic biomarkers, such as blood glucose, total cholesterol, HDL, LDL, and triglycerides. Thus, we measured these biomarkers during a 28-day administration of the following ketone supplements in rats: naturally-derived ketogenic supplements included medium chain triglyceride oil (MCT), sodium/potassium -βHB mineral salt (BMS), and sodium/potassium -βHB mineral salt + medium chain triglyceride oil 1:1 mixture (BMS + MCT) and synthetically produced ketogenic supplements included 1, 3-butanediol (BD), 1, 3-butanediol acetoacetate diester/ ketone ester (KE).

The famous keto-breath is powerful enough to throw shade on your increasingly ripped rig. The mouth-based ketones are released when your body scalds fat are responsible for the pong. Going into ketosis by changing your diet means your body doesn’t have carbs as a fuel source, so you’re using fats and proteins for energy, which fuels the potency of the fireworks seeping from your grill. The same can happen when taking supplements, but not by the same degree – proving that changing your diet it obviously a more potent fat burning tool. A lot of people also report gastric distress, so you could offend those you’re co-habituating with. What’s more, they can have a slight diuretic effect, which can deplete your magnesium, potassium and sodium stores, so make sure your levels are topped up when you’re out for a extra long exercise stint. Research in Nutrition and Metabolism on animals, found there were no negative side effects, but whether this extends to humans is still up for discussion. Fortunately, you’re more likely benefit from the upsides such as improved endurance, appetite suppression and fat burning.


Two ground-breaking studies have recently been published on the effects of intermittent fasting on males. One group of researchers studied the effects that 16 hours of intermittent fasting had on males that lift weights. They found that muscle mass stayed the same, fat mass decreased significantly, and the males who fasted for 16 hours a day burned more fat for fuel compared to the control group that only fasted for 12 hours.
We are told by our parents, doctors, and the media that milk builds strong bones and that we should take calcium supplements to help protect against osteoporosis. Indeed, calcium deficiency can lead to a plethora of health problems[12]. However, those of us who take calcium supplements or consume calcium-fortified foods and beverages may, in fact, be consuming above the Recommended Dietary Allowance (RDA) of calcium.
I’m often asked if it’s necessary to buy and use keto products like urine sticks. They’re small test strips that you dip in urine to see if your body is producing ketones (and therefore indicate if you’ve entered ketosis.) There's very little information on how to know that you are in ketosis other than using these ketones supplements because they are as accurate as can be in determining your current state. Outside of that, you can only guess if you are in it or not by your body's performance.
I don’t recommend that you go straight for a 1-2 day fast, but begin by restricting yourself to certain eating windows. Typically people restrict themselves to the hours of 5pm – 11pm. People often refer to their fasting windows by numbers: 19/5 or 21/3, for example, means 19 hours of fasting and 5 hours eating or 21 hours fasting and 3 hours eating, respectively.
As seen in this exercise, glucose tends to fall quite precipitously following exogenous ketone ingestions. Without exception, every time I ingested these compounds (which I’ve probably done a total of 25 to 30 times), my glucose would fall, sometimes as low as 3 mM (just below 60 mg/dL). Despite this, I never felt symptomatic from hypoglycemia. Richard Veech (NIH) one of the pioneers of exogenous ketones, has suggested this phenomenon is the result of the ketones activating pyruvate dehydogenase (PDH), which enhances insulin-mediated glucose uptake. (At some point I will also write a post on Alzheimer’s disease, which almost always involves sluggish PDH activity —in animal models acute bolus of insulin transiently improves symptoms and administration of exogenous ketones does the same, even without glucose.)

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