All of the data I’ll present below were from an experiment I did with the help of Dominic D’Agostino and Pat Jak (who did the indirect calorimetry) in the summer of 2013. (I wrote this up immediately, but I’ve only got around to blogging about it now.) Dom is, far and away, the most knowledgeable person on the topic of exogenous ketones. Others have been at it longer, but none have the vast experiences with all possible modalities (i.e., esters versus salts, BHB versus AcAc) and the concurrent understanding of how nutritional ketosis works. If people call me keto-man (some do, as silly as it sounds), they should call Dom keto-king.
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.
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.
I noticed for myself that it helps if I add some highly nutritional foods to my diet before I go into ketogenic diet. Adding minerals and vitamins will aid your body in this difficult process and on top of that if you have a deficiency of some sort you will be even more hungry and it will make your transition more difficult, so why make it harder on your self if you can just add some leafy greens to your diet.
Ketogenic diets have been successfully used to treat diseases that have an underlying metabolic component, effectively decreasing seizures in recalcitrant pediatric epilepsy (Kossoff et al., 2003), lowering blood glucose concentrations in type 2 diabetes mellitus (Feinman et al., 2015) and aiding weight-loss (Bueno et al., 2013). Emerging evidence supports several clinical uses of ketogenic diets, for example in neurodegenerative diseases (Vanitallie et al., 2005), specific genetic disorders of metabolism (Veech, 2004) and as an adjunct to cancer therapy (Nebeling et al., 1995). Ketone bodies themselves may underlie the efficacy of the ketogenic diet, either through their role as a respiratory fuel, by altering the use of carbohydrate, protein and lipids (Thompson and Wu, 1991; Cox et al., 2016), or through other extra- and intracellular signaling effects (Newman and Verdin, 2014). Furthermore, ketone metabolism may offer a strategy to improve endurance performance and recovery from exercise (Cox et al., 2016; Evans et al., 2017; Holdsworth et al., 2017; Vandoorne et al., 2017). However, achieving compliance to a ketogenic diet can be difficult for both patients and athletes and may have undesirable side effects, such as gastro-intestinal upset (Cai et al., 2017), dyslipidemia (Kwiterovich et al., 2003) or decreased exercise “efficiency” (Edwards et al., 2011; Burke et al., 2016). Hence, alternative methods to raise blood ketone concentrations have been sought to provide the benefits of a ketogenic diet with no other dietary changes.
There’s debate raging about which dietary tactic is the god particle for making you leaner, faster and healthier. How the ketogenic diet option squares off against the low carb route is vital for understanding the ways in which exogenous ketone supplements work. To get into ketosis the natural way, you need to keep your carb intake low enough for long enough for your body to begin using use fat as fuel. Your liver then converts a portion of that fat into energy molecules called ketones. These work together with glucose as a fuel source, but can actually kick in faster, allowing your body to operate more economically during lengthy, high-energy exercise efforts.
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 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.
I have, though, recently been diagnosed with ovarian cancer. After reading through your blog, I noticed there was a little about Ketogenetic diet and cancer. I purchased the MCT oil powder in hopes that will help me get into ketosis for the purpose of “starving” the cancer cells. Other then focus, I didn’t see any particular format for something like this. Here are my questions: How much of the powder should I take? And do you think the diet plus the MCT oil is a good idea for 1) aiding chemotherapy and 2) helping shrink the number of cancer cells?
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.

The way you make an exogenous BHB is by attaching it to some type of other compound (sodium, potassium, calcium, or magnesium) so that your body can process the molecule by cleaving the bond between the salt and the beta hydroxybutyrate. BHB + bound to a salt = BHB salts, which is what most people in the ketosis community call exogenous ketones. There are also things called esters, which are basically unbound BHB molecules. These are really disgusting and cause massive digestive issues, so I like to ignore them until we can produce them in a more appealing way.


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.
Yes. Both producing BHB in your liver as well as supplementing with beta hydroxybutyrate very safe. As we mentioned before, levels of 0.5 – 3.0 mmol measured in a blood test are completely normal. Some people get stressed out when they hear the term “diabetic ketoacidosis” or DKA, which is an entirely different metabolic scenario where your BHB levels skyrocket to 15-25 mmol blood readings.
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.
Is keto safe? Putting yourself through this type of therapy isn't always easy and the process can take some getting used to, in particular during the initial stages when people must go through a period of fasting in order to raise ketone bodies faster. Of course, by doing this, it can put your body through a bit of shock and may cause a person to experience some short-term side effects until their bodies begin to adapt to the lifestyle and any BHB supplement they may be taking.
Ketones are an alternate energy or fuel source for brain and body that our bodies have naturally produced and used for millennia. Ketones have recently leapt to the forefront of health and wellness conversations worldwide as the scientific body of research that seeks to understand their numerous unique properties and profound systemic effects has begun to grow (see below).
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.
Exogenous ketones supplements is also necessary if you’re wondering how to get into ketosis in 24 hours. Directly ingesting ketones via salts or esters will boost blood ketone levels in the system. These are generally made up of beta-hydroxybutyrate (BHB) which is processed by the body to metabolise into ketones for energy. Some benefits of taking such supplements include anti-inflammatory properties, cancer prevention, increased cognitive function, weight-loss, and athletic performance enhancement.

Hybrid strategy: A hybrid strategy is to follow a low-carb/high-fat ketogenic diet to induce nutritional ketosis and use ketone supplements strategically. Supplements like Ketone salts or MCT oil can help ease the transition into ketosis, they can be an effective tool when we are knocked out of nutritional ketosis and they can help push ketone levels higher in the body for added benefit.
Baseline measurements showed no significant changes in triglycerides or the lipoproteins (data not shown). Data represent triglyceride and lipoprotein concentrations measured after 4 weeks of daily exogenous ketone supplementation. No significant change in total cholesterol was observed at 4 weeks for any of the ketone treatment groups compared to control. (Fig. 1a). No significant difference was detected in triglycerides for any ketone supplement compared to control (Fig. 1b). MCT supplemented animals had a significant reduction in HDL blood levels compared to control (p < 0.001) (Fig. 1c). LDL levels in ketone-supplemented animals did not significantly differ from controls (Fig. 1d).
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.
Lastly, EK products in general ​are usually in the form of salts, which is why they are referred to as BHB Salts. The BHB ketones are bound to common salts such as sodium​, calcium, magnesium and potassium​ to improve absorption rate. These salts are also the core electrolytes your body needs to help you avoid feeling mentally drained and physically lousy during the keto-flu transition period.

In a keto-adapted individual where ketone metabolism is brisk with up to 100 grams or more being oxidized (i.e., ‘burned for energy’) daily, the small amount lost in breath and urine as acetone is minor. But because this breakdown occurs spontaneously without needing the help of enzymes, it also happens to AcAc in a stored beverage or food (even in an air-tight container), making the shelf-life of AcAc-containing products problematic. Thus all current ketone supplements consist of BOHB in some form rather than the naturally occurring mix of BOHB and AcAc produced by the liver.


A small side effect for some people is “ketosis breath”. Many people on a ketogenic diet have experienced this temporary phenomenon, and those taking exogenous ketones can experience it as well. The smell of your breath when you are early in the ketogenic diet can have a hint of acetone to it, and it might be mildly unpleasant, but it’s also harmless. Most gum is pretty low in carbohydrates and is a great option while your keto breath fades.

Effects of beta-hydroxybutyrate on cognition in memory-impaired adults. – Glucose is the brain’s principal energy substrate. In Alzheimer’s disease (AD), there appears to be a pathological decrease in the brain’s ability to use glucose. Neurobiological evidence suggests that ketone bodies are an effective alternative energy substrate for the brain. Elevation of plasma ketone body levels through an oral dose of medium chain triglycerides (MCTs) may improve cognitive functioning in older adults with memory disorders. On separate days, 20 subjects with AD or mild cognitive impairment consumed a drink containing emulsified MCTs or placebo. Significant increases in levels of the ketone body beta-hydroxybutyrate (beta-OHB) were observed 90 min after treatment (P=0.007) when cognitive tests were administered. beta-OHB elevations were moderated by apolipoprotein E (APOE) genotype (P=0.036). For 4+ subjects, beta-OHB levels continued to rise between the 90 and 120 min blood draws in the treatment condition, while the beta-OHB levels of 4- subjects held constant (P<0.009). On cognitive testing, MCT treatment facilitated performance on the Alzheimer’s Disease Assessment Scale-Cognitive Subscale (ADAS-cog) for 4- subjects, but not for 4+ subjects (P=0.04). Higher ketone values were associated with greater improvement in paragraph recall with MCT treatment relative to placebo across all subjects (P=0.02). Additional research is warranted to determine the therapeutic benefits of MCTs for patients with AD and how APOE-4 status may mediate beta-OHB efficacy. (http://www.ncbi.nlm.nih.gov/pubmed/15123336)
There’s also the issue of supplement safety in general. All supplements—whether you’re talking about vitamins, minerals, herbs, or other nutritional mixes—are only loosely regulated. “We know that there is contamination of supplements here in the U.S., often from products that are manufactured abroad,” Palumbo says. In that case, “the same concerns apply to this as for any other supplement.”
Second, there are inherent metabolic differences between boosting ketones via diet and boosting ketones via supplements. On a ketogenic diet, ketones go up because you’re converting body and dietary fat into ketone bodies. A rise in endogenous ketones means you’re burning fat and building the requisite machinery to metabolize the new energy source. On exogenous ketones, ketones go up because you ate some ketones; conversion of body and dietary fat into ketone bodies goes down if anything.
Hi, I still a little confused about when or how to take this. I am trying to get adapted and minimize the flu. Is it most beneficial before eating, after eating, with food or in place of food? I have been keto in the past but this time I am not switching over to fat burning mode even though my macros are good. ( I am thinking it is just too many calories and carbs at this point but I get hungry!) Help please.
The current recommendation for magnesium is 310-320 mg for adult women and 400-420 mg for adult men. Magnesium deficiencies are common; 2005-2006 data indicates that the majority of Americans’ dietary magnesium intake was less than the Estimated Average Requirement (EAR) for the respective age groups[25]. The EAR for a nutrient is about 20% LESS than the RDA. Current data on magnesium intake and deficiency in the US is not readily available, as magnesium testing is not part of routine electrolyte testing in hospitals and clinics[26].
“Consumption of KETO//OS before exercise can result in significant decreases in oxygen demand and increases in performance. We recommend 30 minutes before a workout. Note: Pre-workout use is recommended after building up to a full dose. The best way to maximize energy, appetite control and sustain energy is to take KETO//OS first thing in morning. To maximize benefits, build up to 1 serving 3 times daily – morning, afternoon and early evening. May be used with carbohydrate supplements if desired or by itself as a non-carb, highly efficient energy source.”
“Consumption of KETO//OS before exercise can result in significant decreases in oxygen demand and increases in performance. We recommend 30 minutes before a workout. Note: Pre-workout use is recommended after building up to a full dose. The best way to maximize energy, appetite control and sustain energy is to take KETO//OS first thing in morning. To maximize benefits, build up to 1 serving 3 times daily – morning, afternoon and early evening. May be used with carbohydrate supplements if desired or by itself as a non-carb, highly efficient energy source.”
Athletic performance benefits: The use of exogenous ketone supplements for bettering physical/athletic performance is promising for several reasons. Firstly, taking exogenous ketones (particularly BHB salts) induces acute nutritional ketosis for upwards of eight hours, mimicking fasting physiology (e.g. increases fat burning, insulin sensitivity, etc.).[3]
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).
That’s not all. Though Prüvit in particular has a legion of fans (the brand has nearly 35,000 Instagram followers and some 256,000 likes on Facebook) and a small team of affiliated medical experts, there’s no hard science on Prüvit or similar products. (Prevention reached out to several Prüvit experts and employees for interviews but did not receive a response.) The research page on the brand’s website does include links to legit scientific studies. But the studies are on the keto diet—not on Prüvit’s products. When it comes to research on the actual supplements, the brand’s website simply says “Human studies on finished products (underway) at various universities and research facilities.” In other words, there’s no scientific evidence available yet to show that they actually work.

Long-Term Effects of a Ketogenic Diet in Obese Patients – The present study shows the beneficial effects of a long-term ketogenic diet. It significantly reduced the body weight and body mass index of the patients. Furthermore, it decreased the level of triglycerides, LDL cholesterol and blood glucose, and increased the level of HDL cholesterol. Administering a ketogenic diet for a relatively longer period of time did not produce any significant side effects in the patients. Therefore, the present study confirms that it is safe to use a ketogenic diet for a longer period of time than previously demonstrated.(http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2716748/)


In terms of getting back into Ketosis, Keto//OS would most likely be a better choice (and a change back to a low-carb diet, of course) because it not only has MCTs, but also provides beta-hydroxybutyrate, which is the product that comes from your liver after it synthesizes acetoacetate. However, since this product also has caffeine (great for workouts), you might want to go with the decaf if you’re strictly looking for a ketosis jumpstart.
In addition, the body regulates ketone production via ketonuria (peeing out excess ketones) and ketone-induced insulin release, which shuts off hepatic ketogenesis (the liver making more ketones when you have enough).   The insulin from this process could be increasing glucose disposal which, when coupled with PDH activation, could drive glucose levels quite low.

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