When taken as a drink, the ester bonds are broken down to release butanediol (BDO) and D-BHB into the blood. BDO is easily metabolized by the liver to form D-BHB. Then, both molecules of D-BHB reach the blood, as the liver is unable to use ketones. Consumption of this ketone ester elevates blood ketone levels in humans safely, with few side effects.10 HVMN Ketone is WADA compliant and safe to use in all levels of sports. It is designated as a foodstuff and is FDA GRAS. Each lot is 3rd party certified and batch tested for banned substances. 
Nutritional ketosis induced with the KD has proven effective for the metabolic management of seizures and potentially other disorders [1–26]. Here we present evidence that chronic administration of ketone supplements can induce a state of nutritional ketosis without the need for dietary carbohydrate restriction and with little or no effect on lipid biomarkers. The notion that we can produce the therapeutic effects of the KD with exogenous ketone supplementation is supported by our previous study which demonstrated that acutely administered KE supplementation delays central nervous system (CNS) oxygen toxicity seizures without the need for dietary restriction [29]. We propose that exogenous ketone supplementation could provide an alternative method of attaining the therapeutic benefits of nutritional ketosis, and as a means to further augment the therapeutic potential of the KD.

There have been studies done on long term ketogenic diets. This 2004 paper inn Experimental & Clinical Cardiology titled ‘Long-term effects of a ketogenic diet in obese patients’ concluded that obese patients following a ketogenic diet for 24 ‘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.’


Ketone Bodies are then used by tissues as a source of energy3 through a pathway that leads to formation from β-hydroxybutyrate of two molecules of acetyl CoA, which are used finally in the Krebs cycle. It is interesting to note that the KBs are able to produce more energy compared with glucose because of the metabolic effects of ketosis—the high chemical potential of 3-β-hydroxybutyrate leads to an increase in the ΔG0 of ATP hydrolysis.3 

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.
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.
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.
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.

Over four visits, participants (n = 15) consumed 1.6 and 3.2 mmol.kg−1 of βHB as KE (141 mg/kg and 282 mg/kg of R-3-hydroxybutyl-R-1,3-hydroxybutyrate) or as KS (KetoForce, KetoSports, USA) sodium and potassium βHB, containing 1.6–3.2 g of each cation), plus 6 g of sweetener containing 19 kCal (4 g of carbohydrate) (Symrise, Holzminden, Germany), diluted to 300 ml using water. Drink blinding was not possible due to unmaskable differences in taste (bitter vs. salty).
Interest in the ketogenic diet is at an all-time high, and for good reason. It’s a great way to lose body fat, gain steady energy throughout the day, increase fat-burning capacity at rest and during exercise, reduce inflammation, and improve cognitive function. Keto also has a number of promising medical applications, including seizure control, enhanced efficacy of chemotherapy, and abatement of age-related cognitive impairment.
The concentrations of blood d-βHB after KE drinks were highly repeatable whether consumed whilst fasted or fed (Figures 4F,G). The d-βHB Cmax values ranged from 1.3 to 3.5 mM when fed and 2.3 to 4.7 mM when fasted. There was no significant effect of visit order on d-βHB kinetics, with the maximal difference in d-βHB Cmax reached by one individual being 1.2 mM when fed and 1.9 mM when fasted. Approximately 61% of the variation in the data was attributable to feeding (fed vs. fasted), <1% to visit order, 16% to inter-participant variability, and the residual 24% variability due to non-specific random effects.
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?
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.
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.
Administration of ketone supplementation significantly reduced blood glucose over the course of the study (Fig. 3a, b). MCT (5 g/kg) decreased blood glucose compared to control within 30 min which was sustained for 8 h at baseline and at week 1. MCT (10 g/kg) likewise decreased blood glucose within 30 min and lasted through the 12 h time point during weeks 2, 3, and 4. BMS + MCT (5 g/kg) lowered blood glucose compared to control from hours 1–8 only at week 1. BMS + MCT (10 g/kg) lowered blood glucose compared to control within 30 min and remained low through the 12 h time point at weeks 2, 3, and 4. Rats supplemented with BMS had lower blood glucose compared to control at 12 h in week 4 (10) (Fig. 3a). Administration of BD did not significantly change blood glucose levels at any time point during the 4-week study. KE (5 g/kg) significantly lowered blood glucose levels at 30 min for week 1, 2, 3, and 4 and was sustained through 1 h at weeks 2–4 and sustained to 4 h at week 3. (Fig. 3b).

The salts typically utilize sodium, potassium, calcium, or magnesium as the cation. Because these cations vary in molecular weight and valence (1+ or 2+), the amount of mineral delivered per gram of BOHB varies from 10% for the magnesium salt to 27% for potassium. Given that recommended daily intakes of these various minerals range from a few hundred milligrams up to 5 grams, whereas the daily ketone intake goal to mimic nutritional ketosis blood levels would need to be on the order of 50 grams, achieving this goal with ketone salts would severely challenge human dietary mineral tolerance.


Interestingly, the effects of exogenous ketones on blood substrate concentrations were preserved with the metabolic stimulus of a mixed meal. Following KE drinks, FFA and glucose fell and remained low in both fed and fasted subjects, despite higher insulin throughout the fed arm, suggesting that there was no synergistic effect of insulin and βHB to further lower blood glucose or FFA. In agreement with previous work, the threshold for the effects of βHB on glucose and lipids appears to be low (<1 mM), as there was no significant dose-response relationship between increasing blood βHB and the small changes in plasma FFA, TG or glucose across all of the study drinks (Mikkelsen et al., 2015).
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].
The protocols carried out in these studies were approved by the the South West Frenchay NHS REC (15/SW/0244) (Study 1) and London Queen's Square REC (14/LO/0288) (Study 2 and 3). The studies were carried out in accordance with the recommendations of the Declaration of Helsinki, apart from pre-registration in a database. All subjects gave written informed consent in accordance with the Declaration of Helsinki.
Exercise or performing an extensive workout during the day is a perfect way to burn all those glycogen reserves in your body. Performing a HIIT or High Intensity Interval Training is a perfect type of exercise to do this. So, the next morning when you are awake, get set on an intense exercise session (remember, in the morning, not the afternoon). This will keep the cortisol level lowered during the evening when you wish to have some rest.
Exogenous ketones (also known as ketone supplements) and well-formulated ketogenic diets share at least one thing in common. They both result in increased circulating concentrations of beta-hydroxybutyrate (BOHB), but ultimately are associated with very different patterns of ketosis, as well as differing metabolic and physiologic outcomes. In short, they should not be assumed to have equivalent effects simply because they achieve similar BOHB blood levels. Having said that, there are many reasons we should continue to study the various forms and potential applications of ketone supplements.
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.
If the goal is to deplete glucose levels so that we can start producing ketone bodies, then forcibly exerting physical energy through exercise is a great way to go about it. Keeping it relatively low intensity to begin with and working out in the morning is recommended as this helps to keep down your cortisol (stress hormone) levels. This only applies at the beginning of your keto adaptation process, as intense workouts such as HIIT once already keto-adapted will be completely fine.
and by the way! the product you’re marketing has way too much salt – it will negate the true, natural process of any keto diet. salt will make you retain water, which is exactly what you don’t want to do, if you ever really want to lose weight! and if higher than normal blood pressure is your goal, enjoy responsibly! in fact, if you lower your overall salt intake, you will shed much more water weight in the first weeks, as mentioned elsewhere.. one of the secret cheats to get you going. drinking plenty of water and frequent urination will keep you properly hydrated – just be aware when testing with urine strips, too much water will give you a lower reading. stay hydrated, stay healthy – have fun losing the weight!
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.
I heard a rep from Perfect Keto on a podcast and your Exogenous Ketones. I ordered and received it the other day. I see from this article that I should not do a full scoop at once, but break it up in a day. Good to know. I had about a half scoop before I worked out this morning and could tell I had more energy. Loved that. Just curious….any ideas how long it will take me to get back into ketosis and fat burning?? (I know it depends on what I eat, but a general idea that I promise not to hold you too! (I’m actually missing having ‘keto breath!)
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 came across a new company called KetoneAid that has begun producing small batches of ketone monoesters (KMEs). The main molecule in their product (D-β-hydroxybutyrate / D 1,3-butanediol) is based on a five-year, $10M study commissioned by the Defense Advanced Research Projects Agency (DARPA), looking to create the most powerful source of energy for special operations soldiers such as Navy SEALs, when undertaking very physically and cognitively challenging missions. In fact, the main researcher of the DARPA study is Dr. Richard Veech, the same person that authored the longevity study I just mentioned. Very cool.
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.
Also, it’s important to remember that just because something may be SAFE (and to reiterate, I’m not saying a long term ketogenic diet is safe), it doesn’t mean it’s good for you or beneficial. Running Marathons could be considered safe (especially if it’s on a closed race circuit), but does this mean it’s good for you? Or should you be out running marathons every day?

Beta hydroxybutyrate floats around in your blood, and importantly, can cross different barriers to be able to be turned into energy at all times. One of the most important areas where this happens is in the brain. The blood-brain barrier (BBB) is usually a very tightly regulated interface that doesn’t allow the transfer of many molecules, but since BHB is such a rock star and so hydrophilic, your brain knows to let it in so it can bring energy to the party at any time. This is one of the main reasons why increased levels of ketosis lead to improved mental clarity, focus and reduction in neurodegenerative diseases.
Perfect Keto MCT Oil Powder is number one on this list for a few different reasons. The company is founded by functional medicine clinician Dr. Anthony Gustin and each ingredient is used in specific amounts to provide maximum ketone benefits. They use zero binders and fillers often found in other MCT oil powders. It’s a premium product and they don’t make up for it by jacking up the price. However, number 3 on this list has a very similar product at a better value. That’s what keeps this from being a complete 5. However, it’s quality is one of the very best. This MCT Oil powder is one of the only MCT powders that uses ZERO additives and fillers.
In the second of these posts I discuss the Delta G implications of the body using ketones (specifically, beta-hydroxybutyrate, or BHB, and acetoacetate, or AcAc) for ATP generation, instead of glucose and free fatty acid (FFA). At the time I wrote that post I was particularly (read: personally) interested in the Delta G arbitrage. Stated simply, per unit of carbon, utilization of BHB offers more ATP for the same amount of oxygen consumption (as corollary, generation of the same amount of ATP requires less oxygen consumption, when compared to glucose or FFA).

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