Keto supplements are taken to boost the effects of the high-fat, low-carb keto diet.
The keto diet (short for ketogenic diet) is the latest weight loss strategy to join the growing list of diets in the battle to shed unwanted pounds. What sets the keto plan apart from the many other popular low-carb diets — the paleo, South Beach and Atkins diets — is that it centers on a high-fat diet; meals are 70 or 80 percent fat; about 20 percent protein; and about 5 percent carbohydrate (1).
This reduction in carbs puts the body into ketosis — a metabolic state in which the body burns stored body fat instead of sugar as the main fuel.
Although ketosis has been achieved by following a keto diet, sticking to this type of diet can be difficult. That is where ketone supplements may possibly come into play.
Some suggest that ketone supplements — referred to as exogenous keto supplements because they come from a source outside the body — may be able to increase blood ketone levels, mimicking what happens in ketosis when following a keto diet.
Beyond helping people shed unwanted pounds, keto supplements are being studied for other benefits.
Some studies show their therapeutic potential in the management and prevention of metabolic diseases, neurodegenerative diseases and as an adjunct to cancer therapy (2).
Most of these studies, however, focus on the keto diet and not supplements. More studies on the efficacy of supplements are needed.
Experts warn that taking keto supplements are not a substitute for the keto diet. They are not a get-thin-quick solution. Instead, they should be viewed as supplements to the keto diet.
1 Keto supplements may decrease appetite. Keto diets have been experimentally and anecdotally linked to decreased appetite.
In one study, 15 people of normal weight who drank a beverage containing ketone esters noted decreased hunger, desire to eat and increased fullness after an overnight fast than those drinking a sugary beverage (3).
The mechanism whereby ketones decreased appetite is attributed to lower levels of the hunger hormone, ghrelin.
Researchers note that taking a ketone supplement to decrease appetite may only be beneficial during a fast. While supplements will still raise blood ketone levels after eating a meal containing carbs, the levels will not be as high as after a fast (such as after waking up in the morning).
2 Keto supplements help people with seizure disorders. The keto diet was originally designed to help children who suffer from seizure disorders — not to help people lose weight.
In fact, it has been used since 1920 for the treatment of epilepsy, especially in children with difficult to control seizures. Today, over 250 medical centers worldwide offer keto diets to children with epilepsy.
The results of one British clinical trial, showed that the keto diet significantly reduced the number of seizures in a proportion of children whose seizures did not respond well to anti-epileptic drugs.
After three months, 38 percent of children who started the diet had the number of their seizures reduced by over half, and were able to reduce their medication (4).
Although not all children had better seizure control, some had other benefits such as increased alertness, awareness and responsiveness.
Ketones and another chemical produced by the diet, called decanoic acid, are what researchers believe help minimize seizures.
While research has mostly focused on the effects of the keto diet in children with epilepsy, clinical evidence now demonstrates the effectiveness of the keto diet (or variations of the diet) in treating drug-resistant epilepsy in adults (5).
3 Keto supplements might help with type 2 diabetes. The keto diet benefits people with type 2 diabetes by lowering blood glucose levels and helping lose weight.
People with type 2 diabetes greatly benefit from managing their carb intake because carbs turn to sugar and, in large quantities, can cause blood sugar spikes. That is why the low-carb keto diet helps manage the disease.
According to a 2018 article published in the Expert Review of Endocrinology & Metabolism, the keto diet substantially reduces the glycemic response that results from dietary carbs as well as improves the underlying insulin resistance (6).
In a 2008 study, researchers compared the effect of a low-carb, keto diet versus a low-glycemic index diet on glycemic control in type 2 diabetes.
The keto diet led to greater improvements in glycemic control, and more frequent medication reduction/elimination than the low-glycemic index diet (7).
Future studies should be conducted on larger groups of patients to fully understand the mechanism of action as well as the possible long-term advantages and disadvantages of adopting such a diet regimen.
It is not yet known if taking ketone supplements mimics the same effects as the keto diet.
4 Keto supplements may improve endurance in athletes. In an April 2019 issue of the Journal of Physiology, researchers found that ketone ester supplements could help improve cycling performance and recovery.
Fit male volunteers participated in two daily training sessions (3 weeks, 6 days/week) while receiving either a ketone ester or a control drink following each session.
The participants who drank the ketone ester supplement after working out and before bed experienced a 15 percent boost in endurance compared to participants who did not drink the supplement (8).
Not all research has produced such positive results. According to some studies, athletes involved in high-intensity, short-duration sports might see drops in performance while on a keto diet.
Researchers recently tested the anaerobic exercise performance of 16 men and women following either a low-carb keto diet or a high-carb diet for four days.
The results of the study published in April 2019 in The Journal of Sports Medicine and Physical Fitness found that the keto diet reduced exercise performance in activities that were heavily dependent on anaerobic energy systems (9).
5 Keto supplements may improve symptoms of Parkinson’s disease. Parkinson’s disease is a progressive nervous system disorder that affects movement.
In a recent pilot study of 47 study participants with Parkinson’s, researchers set out to compare a low-fat, high-carb diet with the high-fat, low-carb keto diet.
After an eight-week period, researchers noted both diets resulted in improvements in movement symptoms (tremor and rigidity) and non-movement symptoms (cognitive changes, fatigue, pain, etc.)
However, the group following the keto diet experienced a greater improvement in non-motor symptoms, as compared to the low fat/high carb diet (41 percent versus 11 percent, respectively).
They also experienced less urinary problems, pain, fatigue, daytime sleepiness and cognitive impairment (10).
Although the trial only lasted two months, researchers are hopeful with the results.
6 Keto supplements may slow Amyotrophic Lateral Sclerosis (ALS). ALS is a progressive neurodegenerative disease that affects nerve cells in the brain and the spinal cord. The life expectancy of a person with ALS averages about two to five years from the time of diagnosis (11).
In a promising animal study, researchers from the Neuroinflammation Research Center at The Mount Sinai School of Medicine, found that the keto diet may help prevent ALS or delay the severity of symptoms.
Blood ketones in mice fed a keto diet were more than 3.5 times higher compared to controls. As a result, the keto-diet fed mice lost 50 percent of baseline motor performance 25 days later than the disease controls (12).
7 Keto supplements may be an effective adjunct to cancer therapy. Studies have shown that rapidly dividing cancer cells require higher levels of glucose than healthy cells. Armed with this information, researchers of one study set out to establish if inducing ketosis in two pediatric cancer patients would decrease glucose availability to certain tumors, thereby potentially impairing tumor metabolism.
The main outcomes showed that within 7 days of initiating the keto diet, blood glucose levels declined to low-normal levels and blood ketones were elevated twenty to thirty-fold.
Results of PET scans indicated a 21 percent average decrease in glucose uptake at the tumor site in both subjects (13).
It is believed that through glucose ‘starvation’ of tumor cells, the keto diet can contribute by restricting multiple cancer mechanisms, including proliferation, invasion and metastasis (14).
8 Keto supplements may help improve cardiovascular risk factors. There have been negative opinions regarding the possible harmful effects on triglycerides and cholesterol levels in those following the keto diet.
However, recent studies seem to demonstrate that the diet can actually lead to significant benefits in blood lipid profiles.
One of the biggest mistakes people make while on the keto diet is eating the wrong types of fats — saturated and trans fats (whole milk and full-fat dairy foods, fried foods, fatty beef, butter, cheese, etc.).
Instead, healthy fats — monounsaturated fat and polyunsaturated fats — should make up most of the fat intake. This includes salmon, vegetable oils, some nuts, seeds, etc.
While individuals can technically eat bacon and cheese, they do not have to eat them. There are healthier alternatives.
In one study, 12 men switched from their normal diet (17 percent protein, 47 percent carb and 32 percent fat) to a keto diet; eight control subjects consumed their regular diet for 6 weeks.
Total and LDL (“bad”) cholesterol were unaffected and HDL cholesterol (“good” cholesterol) tended to increase with the keto diet. There were also significant decreases in triglycerides.
There were no significant changes in blood lipids in the control group (15).
9 Keto supplements may improve mental health. Keto diets show promise for improving mood and may possibly benefit those diagnosed with mental health conditions such as depression.
Being in a state of ketosis has been shown to increase production of a common neurotransmitter in the brain called GABA. There is evidence that various anxiety disorders result from dysfunctional GABA activity (16).
In addition, it is believed that ketones increase the number of energy factories (mitochondria) in brain cells, which boost the energy levels in those cells. This is important, as impaired energy product is commonly seen in many mental disorders.
Large clinical studies investigating the effectiveness of a keto diet on mental health are lacking. Further studies and trials are needed.
There are two main forms of ketone supplements: ketone salts (made up of ketones bound to sodium) and ketone esters (linked to another compound called an ester and packaged in liquid form).
1 Keto supplements can affect the stomach. Nausea, diarrhea and stomach discomfort are more common with ketone salts.
2 Keto salts can cause high blood pressure. It is estimated that one serving of ketone salts contains 680 mg of sodium. Since manufacturers of ketone supplements recommend taking up to three servings per day, this intake of sodium can be dangerous, especially in people with high blood pressure.
Some ketone salt products contain nearly 70 percent of the recommended daily allowance of sodium in a single serving.
There could also be an issue with heart health and heart function.
Due to these health concerns — and the fact that there is such limited peer-reviewed research to support the use of these supplements — experts recommend trying the keto diet instead (with the guidance of a medical professional).
There have only been a few short-duration studies on exogenous keto supplements and their ability to increase blood ketone levels. Until more research is available, it is difficult to recommend optimal dosages at this time.
What are keto supplements? Known as exogenous ketone supplements, these supplements have been shown to increase blood ketone levels, mimicking what happens in ketosis when you follow a keto diet.
What do ketone supplements do? They are the supplemental variation of the ketones that you produce in your body during carb restriction. They basically help to increase blood ketone levels, which is beneficial for people who want to transition into ketosis quicker and burn fat.
What is in ketone supplements? They contain the beta-hydroxybutyrate ketone (which is the main energy source your body runs on during nutritional ketosis).
There are two forms of supplements: ketone salts (ketones bound to a salt, typically sodium, potassium, calcium or magnesium) and ketone esters (purest forms of ketones). Esters are harder to find and are frequently used in research.
What is the difference between endogenous ketones and exogenous ketone supplements? Endogenous ketones are made in the liver when the body transitions from burning glucose to burning fat through diet.
Exogenous supplements are made outside of the body and usually taken in the form of supplements.
Can exogenous ketones help you lose weight? Yes, but they are only one piece of a much larger puzzle in your journey to shed pounds.
Exogenous ketones do not trigger weight loss. However, they can temporarily increase your blood ketone levels and provide some physical and mental benefits for the short term — such as decreasing appetite.
They should be supplementary to a low-carb keto lifestyle that focuses on eating nutrient-dense foods, healthy fats, exercising, and managing stress levels and sleep quality.
How long does it take for keto supplements to work? The time it takes to enter ketosis while on the keto diet is 2 to 4 days if you eat 20–50 grams of carbs per day. However, some people may find it takes a week or longer to reach this state.
Supplements work much faster; ketone esters work quickly (in 10 to 15 minutes), while ketone salts can take about an hour.
However, the body is not producing its own ketones, so blood levels of ketones do not remain high many hours after ketone supplementation.
How safe is it to take ketone supplements? Researchers still do not have enough data to say. Although some studies show that those who drink a beverage containing ketone esters to decrease hunger is safe, the long-term effects are not yet known.
Are ketones and ketoacidosis the same thing? No. Both involve the production of ketones in the body. However, ketosis is generally safe, while ketoacidosis can be life-threatening.
Nutritional ketosis occurs when the body uses fat instead of glucose as fuel.
Ketoacidosis is a life-threatening condition where your body does not make enough insulin. It is a complication of type 1 diabetes and occurs as a result of dangerous levels of both glucose and ketones accumulating in the blood.
Do I have to follow the keto diet if I take ketone supplements? Yes. These supplements are meant to be used in conjunction with the keto diet. They are not a quick fix or replacement. Instead, they can provide some support to a healthy keto lifestyle.
What are raspberry ketones? They are the aromatic compounds found in raspberries that are thought to help for weight loss.
Although some studies show their potential weight-loss effects in animals, there is currently no evidence that raspberry ketone supplements can cause weight loss in humans.
The safety of raspberry ketone supplements is also not known. Typical diets only contain a few milligrams of raspberry ketones a day. By contrast, dietary supplements provide anywhere from 100 to 1,400 milligrams of raspberry ketones.
Will ketone supplements help combat “keto flu?” Keto flu is a term for a broad range of symptoms people experience two to seven days after starting the keto diet. Symptoms including nausea, vomiting, diarrhea, constipation, irritability, headache and weakness.
Researchers are not sure why some experience these symptoms, while others do not. Some possible reasons include: carb withdrawal, an immunologic reaction and a change in the gut microbiome.
There is limited research on the potential for supplements to reduce symptoms of keto flu. Instead, doctors recommend staying hydrated, consuming more healthy fats and getting enough electrolytes.
Those having a difficult time adapting to the keto diet may have to eliminate carbs gradually, rather than all at once.
Symptoms generally last about a week for most people.
What are ketone salts? They are a type of endogenous ketone supplement that are meant to increase the level of ketones in the blood, similarly to ketosis, so that the body burns stored fat instead of sugar for fuel.
There is a lack of information on the efficacy of ketone salts. Most of the scientific data on endogenous ketones refer to the benefits of ketone esters — ketones that are linked to another compound called an ester and packaged in liquid form.
There are only a small number of ketone esters available on the market.
How often should ketone supplements be taken? While manufacturers of ketone supplements recommend taking up to three servings per day, more clinical research is needed to establish how much should be taken.
What are BHB ketones? Beta-hydroxybutyrate (BHB) is one of three ketones the body produces during ketosis, the other two being acetoacetate and acetone. These ketone bodies replace glucose as fuel and provide your brain, heart and muscles with energy.
BHB is found in keto supplements. The other primary ketone body, acetoacetate, is not chemically stable as a supplement.
Do I need nutritional supplements while taking ketone supplements? One of the downsides of keto is that you could become deficient in some crucial nutrients that are typically found in foods that are banned or restricted under keto guidelines.
Bananas and beans, for example, are not keto-friendly because they contain too many carbs per serving. They are high in magnesium, however, so cutting them out of your diet takes away the benefits of this important mineral.
If your doctor advises you to take ketone supplements, he or she may recommend taking certain supplements to make up for the nutrients you might miss.
Where can I buy ketone supplements? They are available at health food and natural food stores, vitamin shops and other stores.
As with all supplements, seek the advice of a medical professional before purchasing them.
Exogenous ketone supplements are taken to boost the effects of the high-fat, low-carb keto diet.
Some suggest that ketone supplements may be able to increase blood ketone levels, mimicking what happens in ketosis when following a keto diet.
While there is some support that exogenous ketones do provide a mild boost in ketone levels, research has been limited. And of the studies available, researchers have focused on ketone esters, and not the widely available ketone salts. More research one ketone salts are needed.
Medical experts stress that ketone supplements are not a replacement for the keto diet. Instead, they should be viewed as supplements to the keto diet.
Beyond helping people lose weight, keto supplements are being researched for several other health benefits, such as the management and prevention of metabolic diseases, neurodegenerative diseases and as an adjunct to cancer therapy.
Side effects of taking ketone salts include nausea, diarrhea, stomach discomfort and raised blood pressure due to the high sodium content.