Keto Supplementation: Does Exogenous Keto Really Work?

The ketogenic diet is a high-fat, very low-carb diet that encourages a metabolic state called ketosis, in which the body burns fat instead of carbohydrates as its primary source of energy. The process of burning fat results in the production of ketones, which are used for energy when carbohydrates are in short supply.

Exogenous ketones are supplements that can help a person achieve ketosis while being slightly less strict regarding what they eat. However, the Food and Drug Administration (FDA) does not regulate the exogenous ketone supplement market, so these supplements are not tested or evaluated for safety, purity, or effectiveness.

Exogenous ketones can be found in the form of ketone esters and ketone salts. Ketone esters are the most potent type of exogenous ketone and may cause longer ketosis periods than other supplements. Ketone salts are available in a variety of forms, including drinks, pills, and powders, and can increase electrolyte levels.

Some studies have shown that exogenous ketones can improve athletic performance and reduce appetite, but more research is needed to confirm these findings. Additionally, there are potential downsides to exogenous ketones, such as high cost and unpleasant taste. Overall, while exogenous ketones may be a helpful tool for achieving ketosis, more research is needed to fully understand their effectiveness and potential side effects.

Exogenous ketones may help with weight loss

The ketogenic or keto diet is a very low-carb, high-fat diet. The diet puts your body into ketosis, a nutritional state characterised by raised blood ketones and weight loss. However, it can be hard to follow consistently. Ketone supplements can help your body stay in ketosis.

Ketone supplements have been shown to decrease appetite, which may help with weight loss. In one study, participants drinking a beverage containing ketone esters experienced 50% less hunger after an overnight fast than those drinking a sugary beverage. However, ketone supplements may not affect appetite as much in people who have already eaten a meal.

There is also some evidence that exogenous ketones can be helpful for people already following the keto diet. However, it is not a get-thin-fast solution.

The bottom line is that there is some evidence that exogenous ketones may help with weight loss, but more research is needed.

Exogenous ketones may improve athletic performance

Exogenous ketones are a readily oxidisable fuel for working skeletal muscle. They can be used by athletes to enter a metabolic state that would not normally occur naturally: the state of having full glycogen stores and elevated ketone levels.

Exogenous ketones can improve athletic performance in several ways. Firstly, they can lower blood lactic acid levels. Lactic acid build-up occurs when the body burns carbohydrates at a high rate without enough oxygen. By lowering lactic acid levels, exogenous ketones can reduce muscle soreness and weakness, thereby improving performance.

Secondly, exogenous ketones can lower glycogen use. During exercise, the muscle breaks down stored carbohydrates (glycogen) to provide fuel for the working muscle. When an athlete consumes an exogenous ketone supplement before working out, their muscle uses ketones as fuel before needing to use glycogen. This means that glycogen is preserved, which can be beneficial for endurance performance.

Thirdly, exogenous ketones can decrease muscle protein breakdown. Exercise triggers the breakdown of some muscle proteins to fuel metabolic processes inside the cell. However, taking an exogenous ketone supplement before exercise can decrease this breakdown, helping to protect the muscle during exercise.

Additionally, exogenous ketones can increase the activation of protein synthesis, which can promote muscle mass gain. After exercise, complex signalling pathways are activated to trigger the synthesis of muscle protein. A key regulator of this process is the enzyme mTOR. When athletes mix exogenous ketones with a protein and carbohydrate recovery drink, mTOR is more strongly activated, potentially leading to increased muscle mass.

Finally, exogenous ketones could help accelerate glycogen resynthesis after exercise. An experiment showed that when athletes were given a ketone drink after depletive exercise, their muscle glycogen levels were 50% higher. However, it is important to note that another study found that adding a ketone ester to a protein and carbohydrate recovery drink did not enhance the normal rate of glycogen resynthesis.

While exogenous ketones may offer these potential benefits, it is important to note that they are not a replacement for a well-balanced diet and proper training. Additionally, the long-term effects of exogenous ketones are still unknown, and they may not be suitable for all athletes or sports. Furthermore, the regulatory agencies do not test or evaluate ketone supplements for safety, purity, or effectiveness. Therefore, athletes should consult with a coach, trainer, or doctor before taking any supplements.

Exogenous ketones may help with psychiatric disorders and epilepsy

Exogenous ketone supplements may help with psychiatric disorders and epilepsy.

Exogenous ketone supplements, such as ketone esters and ketone salts can generate rapid and sustained nutritional ketosis and metabolic changes, which may have potential therapeutic effects on central nervous system disorders, including psychiatric diseases.

Ketone supplements have been shown to decrease anxiety-related behaviour in rats and mice. In one study, sub-chronic oral administration of exogenous ketone supplements, such as ketone ester, ketone salt and a combination of the two, evoked an anxiolytic effect in normal rats.

Ketone supplements have also been shown to decrease absence epileptic activity in Wistar Albino Glaxo/Rijswijk rats. In one study, rats were fed with a ketone ester/ketone salt supplemented food for 10 days, which decreased the spike-wave discharge number.

Exogenous ketones may help with Alzheimer's and Dementia

Exogenous ketones are supplements that can help a person achieve ketosis while being slightly less strict regarding what they eat. The ketogenic diet is a very low-carb, high-fat diet that encourages a metabolic state called ketosis, in which the body burns fat instead of carbohydrates as its primary source of energy. The process of burning fat results in the production of fatty acid byproducts called ketones.

Two preliminary studies have shown that increasing the uptake of ketones in the brain can have a positive impact on cognitive health. One study involving 15 people diagnosed with mild Alzheimer's disease placed them on a ketogenic diet and gave them a triglyceride supplement for three months. All 10 participants who stuck to the diet showed a significant improvement on the Alzheimer's Disease Assessment Scale-Cog. Another study involving 50 participants taking a triglyceride supplement twice a day for six months showed a direct correlation between ketone levels and cognitive function.

The ketogenic diet has limitations that can complicate its clinical application. It can be restrictive, and side effects such as headaches, gastrointestinal distress, and kidney stones are possible. However, the current state of the evidence suggests that the ketogenic diet can be safe and feasible, and multiple biomarkers of cardiometabolic health can even improve.

Exogenous ketone supplements are generally considered to be a safe and effective way to increase ketone body concentrations, but the long-term effects are unknown.

Exogenous ketones may improve cardiovascular health

Exogenous ketones are supplements that can help people achieve ketosis, a metabolic state in which the body burns fat instead of carbohydrates as its primary source of energy. Ketosis can be challenging to maintain, and exogenous ketones can help people stay in this state even after consuming non-keto-friendly meals. While the research on the effectiveness of exogenous ketones is still ongoing, there is evidence to suggest that they may have benefits for cardiovascular health.

Exogenous ketones have been found to lower blood glucose levels and improve cognitive function, making them potentially useful in treating type 2 diabetes and neurological diseases. Additionally, they have been shown to reduce inflammation and improve cardiac metabolism in rodent models of heart failure, with supporting human studies also emerging.

One of the key mechanisms by which exogenous ketones may improve cardiovascular health is by providing an alternative fuel source for the heart and improving cardiac energy production. In healthy adults, infusion of beta-hydroxybutyrate (BHB), a type of exogenous ketone, has been shown to reduce myocardial glucose uptake without changing free fatty acid utilization. This suggests that the heart can utilize BHB as an energy source, particularly in situations where glucose availability is limited.

Furthermore, exogenous ketones have been found to decrease endogenous glucose production and reduce the availability of non-esterified fatty acids (NEFAs), which can lead to improved insulin sensitivity and enhanced glucose clearance by the body. This can be especially beneficial for individuals with insulin resistance or type 2 diabetes.

In addition, exogenous ketones can increase plasma glucagon concentrations and decrease glucagon-like peptide 1 (GLP-1) levels, which may have implications for glucose regulation and insulin secretion. However, more research is needed to fully understand the role of these hormonal changes in the context of exogenous ketone supplementation.

While the exact mechanisms are still being elucidated, the available evidence suggests that exogenous ketones may improve cardiovascular health by modulating metabolic processes, reducing inflammation, and providing an alternative fuel source for the heart, especially in conditions where energy demand is high or glucose availability is limited. However, further long-term studies in humans are needed to confirm these potential benefits and fully understand the underlying physiological processes.

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