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Exogenous Ketones Helpful or Harmful to the Ketogenic Diet?

By Dr. Eric Berg DC
Views: 142

Our Educational Content is Not Meant or Intended for Medical Advice or Treatment

Why exogenous ketone supplements don’t live up to the hype

Having a hard time sticking to the ketogenetic diet? If you’re struggling with the low carb snacks, exogenous ketones may sound like an appealing alternative. As the keto diet becomes increasingly popular, we are seeing more and more ketone supplements. Exogenous ketone supplements are the latest craze.

Taking supplements are especially popular among those first starting the diet. Exogenous ketones are known for their ability to provide the benefits of the diet without the carb restrictions. But do they work?

Before exploring exogenous ketones and their effectiveness, it’s important to understand ketosis.


What Is Ketosis?

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Ketosis is a natural metabolic process in the body that occurs by burning fat. When the body can’t burn carbohydrates for energy, it burns fat instead. You can achieve ketosis through fasting or the ketogenic diet.

On a standard diet, your body uses glucose for energy. On a keto diet, you are restricting carbs. Since your body doesn’t have glucose for energy, the liver transforms the fat into ketones. Ketones are small fuel molecules made from fatty acids that act as an alternative fuel source.


The Benefits

Ketosis offers a variety of physical and mental health benefits. Entering a state of ketosis can be a powerful tool for weight loss. It’s scientifically proven to reduce hunger, boost energy and increase endurance. From a mental perspective, ketosis can also enhance cognitive function. Research shows its ability to boost memory and improve mental clarity.


Types of Ketones: Beta Hydroxybutyrate and Acetoacetate

There are two types of ketones: beta hydroxybutyrate (β-hydroxybutyrate or BHB) and acetoacetate (AcAc). Most exogenous ketones are beta hydroxybutyrate. This is due to the fact that the body transports more BHB compared to AcAc.

When ketones are formed naturally more BHB ketones are found in the blood. BHB is better for cell energy production, making it a better choice to include in product formulas.


How a Ketogenic Diet Improves Your Overall Health

Following a keto diet provides a variety of benefits. Studies confirm a diet low in carbs reduces the risk of chronic disease.

When your body is in nutritional ketosis, you are using fat and ketone bodies. You are not using glucose as your main source of energy.

The success of this diet is rooted in its ability to suppress hunger better than other diets. This is what makes weight loss feel effortless.

You know the feeling after eating sugary foods when you get a quick burst of energy followed by a crash? Eating a ketogenic diet balances your blood sugar levels, providing lasting stable energy.


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1. Energy boost and improved physical performance

Did you know that your ketone levels naturally rise during exercise? High blood ketone levels minimize the breakdown of lean muscle tissue. This enables athletes to work out for an extended period.

“Ketone bodies are oxidized as a fuel source during exercise, are markedly elevated during the post-exercise recovery period, and the ability to utilize ketone bodies is higher in exercise-trained skeletal muscle,” according to the National Institutes of Health. “The metabolic actions of ketone bodies can alter fuel selection through attenuating glucose utilization in peripheral tissues, anti-lipolytic effects on adipose tissue, and attenuation of proteolysis in skeletal muscle.”

During cardio a ketogenic diet can help increase fat oxidation without using glucose. This results in using less oxygen and burning more fat. This is why losing weight happens at a much faster rate on keto.


2. Reduced inflammation

One of the major benefits of a ketogenic diet is its anti-inflammatory effects. When the body burns ketones instead of glucose for energy, less free radicals are produced. This enables the body to heal and fight back illness faster.


3. More "good" cholesterol

Low carb diets include a lot of fat. This helps raise high-density lipoprotein (HDL), also known as “good” cholesterol.

When your good cholesterol levels are higher than your bad cholesterol levels, you are at a lower risk of developing heart disease.


4. Longer lasting weight loss

Studies show that a high-fat, low-carb diet is more effective than a low-fat, high-carb diet.

When you're in nutritional ketosis your body has a higher fat-burning rate. Not only does this help you lose weight, but also keep it off.

According to a two-month study published in the journal Nutrition and Metabolism, 12 obese participants who followed a ketogenic diet lost approximately 45 pounds each. Not only did they lose the weight, but also they were able to keep it off after consuming more calories in the months that followed. 

Researchers explained that participants were able to keep the weight off is because they were able to maintain their resting metabolic rate (RMR) and lean muscle mass.

This type of diet is especially effective when it comes to lowering abdominal fat. Abdominal fat is what causes most metabolism issues. 


5. Suppressed appetite

Cravings can feel nearly impossible to resist. This is the reason why most people call it quits in the early stages of dieting. 

It's important to understand that hunger pangs are often the result of unstable blood sugar levels. This imbalance tricks the brain into thinking you are hungry.

During ketosis, these levels are balanced, which naturally helps reduce those cravings. This is what will ultimately increase fat loss and make weight loss seem effortless.


6. Mental clarity

Our brains function at an optimal level while on ketones. This is why they are now being used to alleviate symptoms associated with neurological disorders such as Alzheimer’s and cognitive decline.


7. Can slow down the aging process

When it comes to aging, there are many factors to take into consideration. On a physical level, your telomeres shorten as you age. In addition, research indicates your mitochondrial health also plays a role.

Mitochondria affect all aspects of bodily function. Ranging from your energy and fat loss to your cellular health and inflammation, researchers have made the connection between mitochondria and the aging process.

Since fasting supports mitochondrial health, a keto-adapted lifestyle can provide anti-aging benefits.

Another way to increase your lifespan is to lower oxidative stress in the body. The key to lowering oxidative stress is to decrease your insulin levels. A ketogenic diet naturally lowers insulin levels and oxidative stress in the process.


8. Reduced risk of chronic disease

High blood sugar is associated with numerous health problems, including Type 2 Diabetesheart disease, cancer and neurological disease.

As indicated by the benefits listed above, the body functions at an optimal level on a ketogenic diet. Many chronic diseases are the result of inflammation and imbalanced sugar levels in the blood. Adopting keto-friendly eating habits naturally helps alleviate those symptoms.

The reason this diet is so successful is because of the fundamental physiological changes that occur in the body during ketosis. Unlike other diets that can work in the short-term, these changes provide healthy, long-term results.


Where Do Exogenous Ketones Come In?

When ketones are naturally produced inside the body, they are known as endogenous ketones. When ketones are taken from outside the body, they are known as exogenous ketones. 

If you eat something that is not included in the keto diet, exogenous ketones increase the number of ketone bodies. This elevates your ketone levels to help your body maintain ketosis. It’s advertised as a quick fix when you slip up and eat something that’s not keto-friendly.

Exogenous ketone supplements are created from the ketone beta-hydroxybutyrate, which your body naturally produces. While your body will be able to get back into ketosis on its own, exogenous ketones will speed up the process.


The Claimed Benefits

Many companies make consumers believe these products are just as effective as the ketogenic diet. However, there is limited research on the benefits of exogenous ketones. Here are the claimed benefits of these supplements:

  • Rapid weight loss
  • Appetite suppression
  • Energy boost
  • Mood enhancement
  • Better athletic performance
  • Reduced inflammation
  • Relieve symptoms of the Keto Flu - The Keto Flu is a condition characterized by flu-like symptoms that often occur at the start of a keto diet.

Now, let’s take a closer look.


Ketone Supplements: Ketone Salts and Ketone Esters

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There are two types of exogenous ketone supplements: ketone salts and ketone esters. Both types of ketone supplements raise ketone levels in the blood, which is what occurs during ketosis when you adhere to a ketogenic diet.

Ketone salts (BHB Salts) contain a ketone body paired with a mineral – sodium, potassium or magnesium. While there are a variety of ketone bodies, ketone salts use beta-hydroxybutyrate.


The Pros and Cons of Ketone Salts

As with any supplement, there are advantages and disadvantages.



  • Effectively raises ketone levels

According to research, participants who took 12 grams of ketone salts had 300% higher blood ketones.

However, having high blood ketones can come at a price. This explains why there are more disadvantages with these supplements compared to advantages.

  • Convenient

You won't have to put as much work in to bring your body into ketosis. The supplement works quickly to bring your body back into this state.



  • High intake of sodium 

When your salt intake is higher than the recommended daily amount, you are at a greater risk of developing health conditions such as stroke and cardiovascular disease.

  • Dehydration

The diuretic side effects of BHB Salts can cause dehydration. When you are urinating more often, it’s important to drink enough liquids to maintain a balanced level of electrolytes. 

  • Inhibits athletic performance

Research shows elevated blood ketones impact the body's use of glucose as fuel. Glucose is more effective for quick intense bursts of activity. Physical performance is negatively affected as a result.

"Often these supplements are marketed as a means of improving athletic performance but in this case, the research tells a very different story," says Jonathan Little, assistant professor in UBC Okanagan's School of Health and Exercise Sciences. "On top of that, the long-term impacts of artificially increasing blood ketone levels -- essentially tricking the body into thinking it is in a state of starvation -- is completely unknown."

This is why the natural approach is always the way to go. Your mind and body will thank you in the long run.

  • Not Approved by the FDA: In terms of food ingredients, these supplements are not “Generally Recognized as Safe” (GRAS) by the FDA.


The Pros and Cons of Ketone Esters

Ketone esters contain a ketone body paired with an alcohol molecule. In terms of ketones, they are more potent of the two supplements. 



  • No health risks associated with excessive salt intake
  • Higher blood ketone levels
  • FDA-approved



  • Unfavorable taste
  • Expensive
  • Gastrointestinal side effects


The Downside of Exogenous Ketones

While supplement companies state exogenous ketones offer numerous health benefits, there are many problems with these claims. In most cases, the opposite is true.


1. Slows Down Weight Loss

Exogenous ketones may help you get into ketosis, but they don’t help you lose weight. Despite being in ketosis for a few hours, it doesn’t help you lose weight. In fact, it can slow down the weight-loss process.

Why? Your body isn’t burning fat. Taking exogenous ketone supplements bypass your body’s ability to make your own ketones. When you take external ketones your body is going to be using those as fuel instead of your own ketones.

To put it simply, taking ketone supplements can inhibit body fat from being used as fuel.

Also, the calories can start to add up with these ketone supplements. One serving of ketone salts contains close to 100 calories. The effects only last several hours, which means multiple doses are required per day to keep your body in ketosis. 


2. Gastrointestinal issues

One of the most common side effects of exogenous ketones is nausea, diarrhea and stomachache. This is reported more often with ketone esters than ketone salts, since ketone esters are stronger.


3. Not Backed by Science

Due to false advertising, it seems as though there is a great deal of scientific evidence to support the effectiveness of ketone supplements. However, there is currently no peer-reviewed scientific research on ketone products.

In terms of the limited research that has been conducted, exogenous ketones fail to demonstrate any effect on physical performance.

According to one study, ketone salts increased fat oxidation, but negatively impacted high-intensity exercise performance in healthy adult males.


4. Limited information on product labels

There are several companies that do not provide a detailed description of their ingredients. Even if you know the ingredients, you don’t know the amount, so you may not be getting the amount of Beta-Hydroxybutyrate that you bargained for.


5. Expensive

Lastly, these ketone supplements are very expensive. Consumers can spend as much as $300 per month!

If you’re going to spend that much money on a product, it should be a worthwhile investment. Sadly, all evidence points to the contrary.


The Bottom Line

Exogenous ketone supplements defeat the purpose of changing your diet and lifestyle to become healthier. In terms of weight loss, you will be unsuccessful if your mentality is to eat whatever you want. Supplements will not solve all of your problems.

Put the effort in and follow the keto diet to see positive, long-lasting results. A ketogenic diet is not only beneficial for weight loss, but also for energy, mental performance, and enhancing the body’s natural ability to fight illness.

Keto is a game changer. It's more than a diet. It's a lifestyle. Once you go keto, you can't go back.



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