I’m getting an increasing number of questions about exogenous ketones. Are they good? Do they work for performance? Is there a dose-response curve? If I’m fasting, can I consume them without “breaking” the fast? Am I in ketosis if my liver isn’t producing ketones, but my BOHB is 1.5 mmol/L after ingesting ketones? Can they “ramp-up” ketogenesis? Are they a “smart drug?” What happens if someone has high levels of both glucose and ketones? Are some products better than others? Salts vs esters? BHB vs AcAc? Can taking exogenous ketones reduce endogenous production on a ketogenic diet? What’s the difference between racemic mixtures, D-form, and L-form? What’s your experience with MCTs and C8?
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”).
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).
Ketones are produced by the body as a indicator of the body starting to use fat for fuel. Your body then uses those ketones as brain fuel (mostly) , but if you were to have a carb meal it would kick your body out of ketosis (fat burning state) because the carbs are a more easily usable source of energy. So why would you want to add a outside source of energy such as ketones not naturally produced by the body its self? It would kick you out of the fat burning state just like the carbohydrate meal because your body rather spare it’s own energy source as much as possible and also since the outside source ketones are not naturally produce by the body your body does not go into fat burning state because it doesn’t have to go through the natural process to produce its own ketones meaning the body is in its fat burning state since ketones are a by product of fat being used as fuel. Your body has to go through the natural process by itself. Outside ketones are treated as a alternative fuel source so your body has no reason to use fat as its fuel source. Just like carbs. Don’t fall for the scam do your homework it’s science backed up by facts. https://www.t-nation.com/diet-fat-loss/avoid-this-ketogenic-rip-off
Ketone supplements: are they a groundbreaking boost to a low-carb diet, or should you be wary of the broad claims that companies make about their benefits? In this article you’ll learn all about exogenous ketone supplements and, what’s more, you’ll read about the experiment we ran on the supplements at our head office in Stockholm. How did ketone supplements perform when we put them to the test? Do they work? Read on to find out our verdict!

In Summary, I think it’s important to do your own research and draw your own conclusion about the long term risks of ketosis. For some people, a ketogenic diet may be a necessity given their health situation. For those of us who do not suffer from such health conditions I would present the question ‘why do you want to follow a strict ketogenic diet for an extended period’, and then follow this up with ‘are the potential risks and sacrifices worth the benefits?’
There are three types of ketones produced when you’re on ketogenic diet: acetoacetate, beta-hydroxybutyrate (BHB), and acetone. The kinds that you’ll find in your supplements are BHB because your body can readily use and absorb them. This means that not all ketones are created equal and there are several different types, each with unique properties that are worth considering when shopping.
Hello, I’ve tried several different Exogenous Ketone supplements and I believe Perfect Keto may be the best I’ve tried. Thus far I’ve had Keto//OS from Pruvitt, Kegenix, KetoForce, KetoCaNa and Ketond. Out of all these brands both Perfect Keto and Ketond have been the products that hack me into Ketosis quick and for longer periods of time. Perfect Keto is less expensive that Ketones from Pruvitt mainly because Pruvitt and their Network Marketing is all about making money. The flavors of Perfect Keto are much better than Pruvitt.
If you have been reading the science behind the ketogenic diet, you know there can be a lot of benefits associated with choosing this way of eating. There is usually a transition period from when someone chooses to go on a ketogenic diet and implements the changes to their menu to when they actually get into ketosis and are able to produce and burn ketones for fuel.

Do I still follow a ketogenic diet? Not anymore. I was strict keto for 12 weeks – enough time to experiment and learn about it. I did enjoy parts (lots of fat!) but I don’t see it as a sustainable way of eating, nor did I benefit from it health or sports performance wise (more on this in an upcoming article). But, I was following a strict keto diet – sans carbs. I think if I were to follow a ketogenic diet AND incorporate a regular carb refeed then the results may be different.


The other potentially important distinction between nutritional ketosis and chemically-induced ketosis is the potential metabolic role played by liver AcAc production and redox status. Although the ratio of BOHB to AcAc in venous blood is typically 80% to 20%, classic studies by Cahill (1975) have observed important hepatic vein and peripheral arterio-venous gradients for this ratio in keto-adapted patients. What these observations imply is that the liver produces a higher proportion of AcAc than is found in the peripheral blood, and that this is due to uptake of AcAc in peripheral cells (principally muscle) with re-release as BOHB. In the process, the reduction of AcAc to BOHB produces NAD+, which is beneficial to mitochondrial redox state and mitochondrial function (Verdin 2015, Newman 2017).

In general, too much caffeine on a regular basis can prevent you from going into ketosis. But since we are trying to get into ketosis in 24 hours I believe it will help you for one day by curbing your hunger and getting through the fast easier. In case, you do not like coffee, you can opt for caffeine drinks or you can opt for other beverages which consist of caffeine in smaller quantities.
At day 29 of the study, animals were euthanized and brain, lungs, liver, kidneys, spleen and heart were harvested and weighed. Organ weights were normalized to body weight. Ketone supplementation did not significantly change brain, lung, kidney, or heart weights compared to controls (Fig. 5a, b, d, f). MCT supplemented animals had significantly larger livers compared to their body weight (p < 0.05) (Fig. 5c). Ketone supplements BMS + MCT, MCT and BD caused a significant reduction in spleen size (BMS + MCT p < 0.05, MCT p < 0.001, BD p < 0.05) (Fig. 5e). Rats administered KE gained significantly less weight over the entire study compared to controls. BMS + MCT, BMS, and BD supplemented rats gained significantly less weight than controls during weeks 2 – 4, and MCT animals gained less weight than controls at weeks 3 – 4 (Fig. 6). Increased gastric motility (increased bowel evacuation and changes to fecal consistency) was visually observed in rats supplemented with 10 g/kg MCT, most notably at the 8 and 12-h time points. All animals remained in healthy weight range for their age even though the rate of weight gain changed with ketone supplementation [53–54]. Food intake was not measured in this study. However, there was not a significant change in basal blood glucose or basal blood ketone levels over the 4 week study in any of the rats supplemented with ketones (Fig. 7).
Your body uses the energy source that is the easiest to use, in our case this is glucose. Glucose is just a type of sugar. As our body cannot store glucose as such it stores the extra glucose in form of glycogen that is stored in our liver and muscles. To initiate production of ketones in your body as fast as possible you must deplete your body of glycogen reserves. The best way to do this is a simple 24 hours fast. This will deplete your glycogen stores as fast as possible. If you don’t over eat for dinner or you even skip it all together you will already wake up in state of mild ketosis the next morning due to the overnight fast. Here are also described some signs that you are in Ketosis already.
The metabolic phenotype of endogenous ketosis is characterized by lowered blood glucose and elevated FFA concentrations, whereas both blood glucose and FFA are lowered in exogenous ketosis. During endogenous ketosis, low insulin and elevated cortisol increase adipose tissue lipolysis, with hepatic FFA supply being a key determinant of ketogenesis. Ketone bodies exert negative feedback on their own production by reducing hepatic FFA supply through βHB-mediated agonism of the PUMA-G receptor in adipose tissue, which suppresses lipolysis (Taggart et al., 2005). Exogenous ketones from either intravenous infusions (Balasse and Ooms, 1968; Mikkelsen et al., 2015) or ketone drinks, as studied here, inhibit adipose tissue lipolysis by the same mechanism, making the co-existence of low FFA and high βHB unique to exogenous ketosis.

This is delicious! I'm not sure what people are talking about when they say it tastes bad. I put a half scoop only (because its soooo expensive) in my iced coffee with have cream every morning and it tastes better than it ever did without. I'm not sure its really working and it does upset my stomach. I will have to get some strips to check ketosis and will come back to update. I think I'll probably still only give three stars though because it is WAY WAY WAY OVERPRICED! I can't believe how small the container was when it arrived for almost $60!! Even if it works, and it does taste delicious, I can't justify this kind of price point. This is such a bad business model. You probably get people to buy this once, maybe twice at this price, whereas if you made it more affordable, like double the product (an actual month's supply) you'd have customer's for life! Drop the price and I will buy again for sure!
First, there’s something unnatural about having elevated levels of ketones and glucose together. It’s really hard to make that happen using traditional whole foods. The closest natural approximation you could get to it would be the traditional coconut-rich diets of the Kitava people in the South Pacific, where the medium chain triglycerides (MCT) in the coconut fat increased ketone production alongside the carbs in the fruit and tubers they ate. They had excellent metabolic health, but they weren’t anywhere close to a ketogenic diet. Coconut fat isn’t as ketogenic as purified MCT oil, let alone exogenous ketones.
Are you ready for a very basic metabolism overview? Most modern humans break down carbohydrates into glucose and this then breaks down further and enters mitochondria to produce ATP, which is the energy system of your cells. In other words, you use carbs for energy. When you are on a ketogenic diet, you are breaking down fats into things called ketone bodies, and this is how you provide your body with energy, instead of via carbohydrates. So, you’re either using carbohydrates for fuel or fat for fuel. 
This research is a good reminder to discuss with your doctor before taking any supplements. Given the widespread use of calcium supplements, more research is required before any final conclusions can be drawn. Several ketone companies have tried to avoid the large sodium loads but instead relied on a bump in the calcium content from the BHB ketone salts, seemingly without consideration for the aforementioned results. Calcium BHB will likely absorb slower compared to sodium BHB due to digestion and absorption kinetics.  For those looking to optimize brain uptake of ketones, this probably isn’t the best strategy (as uptake is directly proportional to the levels in the blood).   Be cautious of supplements running from the sodium and chasing the calcium BHB instead, and make sure you factor that into your overall daily needs.
Before that though, I do want to touch on MCT oil and it’s impact on ketone levels. MCT – or Medium Chain Triglyceride – are fatty acids that bypass the liver – and become quick energy for the brain and muscles. As they are a fat based energy source (and not a carbohydrate) they are quickly converted into ketones. This means MCT oil is a great way to boost ketone levels in the body.

Of course, there may be some people who choose to take these supplements because they genuinely do feel they benefit from them. This is of course your choice and this article in no way aims to shame or criticize anybody. However, I do think that, for most people, eating a low-carb diet based on real foods is a lot more likely to be associated with the benefits that the supplements claim to provide than the supplements themselves.


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.
Ketones naturally exist in the body, being created during the process of fat metabolism and are therefore safe to consume even during pregnancy or breastfeeding. Supplements such as Ketologie’s PROBHB are simply providing ketones from an external (exogenous means literally ‘outside of the body’) source. However, if you suffer from any medical conditions and/or are on medications, it is always advisable to consult your health care provider prior to starting any new nutritional or dietary supplement.  
Ketone Esters: These are not normally found in the body, but exogenous ketone esters convert into BHB once it is in the body. They are also synthetically (lab) made compounds that link an alcohol to a ketone body, which can then be metabolized by the liver into a ketone. They are like ketone salts on steroids as they have 5-10 time more BHB per serving/maximum daily intake than ketone salts. To date, pure ketone esters have been very expensive to produce and have only been available to researchers, elite athletes (Tour de France cyclists), and the US Department of Defense (people have spent more than $20,000 to have an independent lab produce a single serving!).
Hi Mark, sorry this is off topic but not sure where to send a question for a future Ask Mark. I’m about to go into my yearly physical and I am wondering if there is any specific bloodwork that you like to do for your annual check up. I’m 47 year’s old and the than the basic blood work like lipid panel, etc..I’m going to ask my doctor to test my testosterone, HbA1C, fasting insulin, and Vitamin D levels. I’m also going to ask my doctor to do a stool test to check for parasites or other infections I may have picked up from open water swimming for triathlons. Can you recommend any other blood work that might be useful? Thanks!

This may have been mentioned, I haven’t checked all comments, but glutamine causes gluconeogenesis so that may explain why it affects Ketosis. Whenever I took a glutamine powder supplement for gut healing, I noticed I would “feel” less Ketogenic and I knew it was affecting me adversely. Glycine (which is also in bone broth) also has this effect I believe. Apparently some amino acids are just more easily converted to glucose.
If you’ve done any reading about ketosis, you no doubt read at some point that ketosis is a “natural” state. You may have read on a bit more and learned what is meant by that statement or you may have simply skipped ahead to the keto success stories and decided to give it a try. But we’d like to direct your attention back to that little tidbit of information about keto being “natural” for a moment.
This is delicious! I'm not sure what people are talking about when they say it tastes bad. I put a half scoop only (because its soooo expensive) in my iced coffee with have cream every morning and it tastes better than it ever did without. I'm not sure its really working and it does upset my stomach. I will have to get some strips to check ketosis and will come back to update. I think I'll probably still only give three stars though because it is WAY WAY WAY OVERPRICED! I can't believe how small the container was when it arrived for almost $60!! Even if it works, and it does taste delicious, I can't justify this kind of price point. This is such a bad business model. You probably get people to buy this once, maybe twice at this price, whereas if you made it more affordable, like double the product (an actual month's supply) you'd have customer's for life! Drop the price and I will buy again for sure!
The liver is always producing ketones to some small degree and they are always present in the bloodstream. Under normal dietary conditions, ketone concentrations are simply too low to be of any significant benefit. A ketogenic diet and exogenous ketone supplements will increase the amount of ketone in your body. The idea that  ketones are “toxic” is ridiculous. Ketones are a normal physiological substance that play many important roles in the human body.
We will go deep in the science behind this fascinating diet and then review some of the best exogenous ketone supplements out there in the market. Because without the knowledge and the right information about exogenous ketones that you can properly follow, you might never reach your goals and you may as well keep eating that mashed potato for dinner and club sandwich for lunch.
Great question. So if you are already in nutritional ketosis from your diet, exogenous ketones would still help raise ketone (energy) levels when you want that (maybe for focus at work or energy at the gym. They also help get you back into ketosis after cheat meals and skip the “keto flu” which is the period when your body is using up stored glycogen.
For the ketone esters, on the other hand, repeated doses of 20-30 grams in any one day may be possible. Thus these products may be able to maintain a modest level of ketonemia without dietary carbohydrate restriction. Thus some of the cardiac and brain fueling benefits may follow, not to mention the epigenetic effects limiting oxidative stress and inflammation. But given the recent observation that administered ketone esters markedly reduce circulating free fatty acids (Myette-Cote 2018) — possibly due to an insulin-tropic effect or direct suppression of lipolysis (Taggart 2005) — their sustained use in people with underlying insulin resistance may compromise their long-term benefits by promoting weight gain unless combined with carbohydrate restriction.
Will taking exogenous slow down my fat loss? Since now before digging into my body for energy/ketones, I will first use up the exogenous ketones I ingest. Also do exogenous ketones somehow help get even more keto adapted, keeping in mind I have been on a strict keto diet without a problem and don’t mind it at all. Outside of performance improvements, do you think exogenous ketones is for someone like me who is primarily looking for fat loss.
It’s hard to say. Achieving a natural state of ketosis (as in, by eating a ketogenic diet) is thought to be beneficial in the short-term. But experts don’t know the long-term effects, Palumbo says. And some suspect that it could lead to problems like kidney damage or an increased risk for heart disease (and day-to-day keto diet side effects are, at this point, well-documented). Assuming that ketone supplements do work identically to natural ketones, taking them long-term could have similar health effects.

So if you really want to jump start ketosis, do what the prehistoric humans did; don’t eat for 3 to 5 days. Keep the water bottle and multivitamins close and go on a strict fast. It might seem extreme and to a degree it is, but starving yourself will put you into ketosis. No ifs, ands, or buts about it. And it will cause you to lapse into a ketogenic state faster than if you tried to do so by manipulating the foods you eat (replacing carbs with fats). Once starvation has caused your body to transition to a ketogenic state, you can begin to introduce your low carb, high fat keto-friendly foods.

If you have been reading the science behind the ketogenic diet, you know there can be a lot of benefits associated with choosing this way of eating. There is usually a transition period from when someone chooses to go on a ketogenic diet and implements the changes to their menu to when they actually get into ketosis and are able to produce and burn ketones for fuel.

Before that though, I do want to touch on MCT oil and it’s impact on ketone levels. MCT – or Medium Chain Triglyceride – are fatty acids that bypass the liver – and become quick energy for the brain and muscles. As they are a fat based energy source (and not a carbohydrate) they are quickly converted into ketones. This means MCT oil is a great way to boost ketone levels in the body.


Each serving of Core BHB™ contains a clinically effective dose (12 grams) of pure goBHB™ exogenous ketones. This ensures you’re getting the purest and most efficacious BHB salts available. Research and scientific findings continue to demonstrate the promising benefits of exogenous ketones, especially when used with a calorie-controlled diet and healthy exercise regimen.
If you are new to ketosis and don’t know much about it, it is a metabolic state, where your body preferentially uses ketones (instead of glucose) for energy. This can lead to a host of different health benefits. If you’d like to learn more about ketosis, what ketones are, and how to benefit from these, feel free to read through our guides: What is Ketosis? What is the Ketogenic Diet? What Are Ketones?
Exogenous ketones are not a magical fat-loss supplement, and to suggest otherwise is both factually incorrect and deliberately misleading. In fact, consuming ketones to excess can hinder rather than help fat loss! Aggressive marketing of exogenous BHB’s has helped to create a myth being believed now by millions – that simply drinking ketones each day will somehow magically melt away the pounds. The metabolic fact that unscrupulous marketers do not point out is that dietary fat (plate fat; or fat/ketones you ingest) will be burned before stored fat (body fat). So, whilst exogenous ketones can help you to mitigate hunger (and therefore help you achieve a caloric deficit) – and although they also have many other benefits (detailed below); they are not a magic wand that you can wave to achieve weight or fat loss and should not be marketed as such.
I wrote this post at about the same time Germany won the World Cup in Rio de Janeiro in 2014. There’s been a lot of moving and shaking in the world of exogenous ketones since then, not to mention soccer. Looking back on my post, I still consider it relevant in terms of what exogenous ketones possibly can (and cannot) do for performance. In this case, to see if exogenous ketone esters provide me a “boost” by allowing me to do the same amount of work while expending less energy (and work at a relatively lower VO2) compared to no supplementation.

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