Exogenous Ketone Supplements: Review of Current Products and Future Developments

Exogenous ketone supplements hold promise for those looking to lose weight, improve their health and longevity, and enhance cognition. In this article, we dive into the history of exogenous ketone supplementation. We will look at the different forms of exogenous ketones available and what to look out for when choosing a supplement.

The State of Exogenous Ketone Supplements

Exogenous ketones are new on the scene. There are a few companies manufacturing them for dietary use. The exogenous ketone products currently available on the market are BHB mineral salts. These combine BHB with sodium and potassium to improve absorption. The term “BHB mineral salts” is the same as beta-hydroxybutyrate salts and ketone salts.

However, there are also combined BHB supplements that include MCT (or other) oils. These exogenous ketone products come in either liquid or powder form.

The Patents Behind Ketone Supplements

There are several companies that own patents behind exogenous ketones. These patents cover both BHB salts and esters. Currently, all products on the market stem from one patent. This patent is at the University of South Florida (USF). Companies either make use of the patent directly or license it from USF.

Existing patents include:

• University of South Florida. The inventors are Patrick Arnold (KetoTech and KetoSports products), Dominic D’Agostino and Shannon Kesl. The main patent is this one.
• Richard Veech, M.D. who has developed the ketone ester (rather than ketone salts). These are now commercially available.
• TΔS® (T Delta S) a UK based company has developed the ketone ester product, ΔG® (DeltaG) at the University of Oxford, UK. It is available exclusively through HVMN in the US.

What to Look Out for in Exogenous Ketone Supplements

Depending on your goals you may favour one supplement over another. However, there are a number of factors you should consider to help you decide which product is the best for you.

We explore these in this section. Later in the article, we will compare the currently available products against these criteria.

How Strong is the Blood Ketone Impact?

Ultimately, one of the most objective parameters you can look at is the impact of the products on your blood ketones. Depending on a product’s make up (type, purity, ingredients) a ketone salt may have a different impact on blood ketone levels.
We define this as…

• Power: The products impact on BHB levels in the blood. The stronger the product, the better it is at putting the body into ketosis. Therefore the longer the effect lasts.

There is very little publicly available data on human consumption of the different ketone salts. The published studies are on mice. Unfortunately, in human based studies the specific product used is not revealed.

Some limited data is available through self-experiments published on blogs. They state the ketone salt used. However, the information available is only for the KetoSports products, specifically KetoForce.

KetoForce Average Blood Beta-Hydroxybutyrate Levels Over Time

Although, not confirmed, it may be that the ketone salt used in Peter Attia’s self-experiment published here is the BHB salt KetoForce (to confirm). The serving taken in the experiment is lower than the typical serving size used for KetoForce (15.6g instead of 19g). Attia’s data shows a bump of 1.9 mmol/L (2.6 mmol vs. 0.7 mmol) at the 60 minute post ingestion mark. He compared the BHB salt to his baseline ketosis levels.

(Note: Since we can’t provide data for the different products yet, the next article in this series, will focus on this topic. It will provide the results of our own self-experiments with different ketone salt products)

How Many Ketones for the Price?

BHB is the main active ingredient in ketone products. It’s impact on per gram dose should be similar across ketone salt products. It makes sense to standardize how you look at the cost of the supplement based on how many grams of BHB it contains. This allows you to compare products with different serving sizes. You can also take into account the products BHB density and weighting of additional ingredients.

This brings us to the next criteria to look at…

• Price per BHB gram: The cost for each active gram of BHB contained in the product. To do this, divide total grams of BHB in a serving by the cost per serving.

Most of the products provide this information directly. If not, it is easily calculated based on the nutrition facts labels. We’ve provided this cost comparison in our review.

However, it may be too simple to look at the products this way. Other ingredients may provide further benefits.

Some supplements contain a mixture of BHB, and another ingredient, MCT Powder (e.g. Keto OS). So just looking at the BHB doesn’t do a supplement justice – even when we’re only interested in the products Ketone Power. The MCT powder provides an extra bump in ketones. This is something we’ll look at in another article on MCT Powders.

The Product Experience

A variety of factors affect how you experience the product, and how easily you can fit it into your life. Many questions we receive at Ketosource relate to the items below. So we know these are important.

• Taste: The palatability of the product. Exogenous ketones naturally have an unpleasant taste. Manufacturers try to compensate this with the mix of extra ingredients. Some products fair better than others in this area.
• Form (Convenience): Whether the product comes in liquid or powder form. Generally, powder products are easier to transport. This is important to keep in mind if you need something on-the-go.
• GI Tolerance: A major limiting factor for ketone supplements has been gut tolerance in response to consumption. MCT oil has a relatively low gut tolerance. The highest tolerable dose in a case study was 4 tablespoons in one intake[note]Azzam R, Azar N. (2013). Marked Seizure Reduction after MCT Supplementation Case Reports in Neurological Medicine)[/note]). Therefore, it is important to consider this, especially for those with more sensitive guts.
• Electrolyte Balancing: Exogenous ketones may throw electrolyte balance out of whack. Therefore, added electrolytes are something to consider when purchasing a ketone supplement. This topic deserves deeper discussion, as a variety of ideas have surfaced which differ. The electrolyte balance of a supplement can become a key determining factor in how you should use the supplement. We’ll discuss this in a future article to give it the attention it deserves.

Exogenous Ketone Supplements Review

The Future of Ketone Supplements

Many new ketone salt products have reached the market in the past two years. These products focus on improving gut tolerability. We will test the products and update the article.

The outlook for the other, more powerful form of exogenous ketone, the ester, is still highly volatile and subject to change.

Research has used ketone esters for some time. However, their use in the general population has been extremely limited.

Anecdotal evidence suggests that ketone esters are extremely hard to palate. However, the two ketone ester products currently on the market are masking the ester taste with lemon and berry flavours. Unfortunately, they are extremely costly to manufacture at this point. This is the barrier that needs to be overcome in order to make them as widely available as the ketone salts.

For a more in-depth comparison of ketone esters and ketone salts refer to the previous exogenous ketone article.

Consideration: Is it OK for Everyone to Take Ketone Supplements?

Some people should take caution before supplementing with ketones. This is because there are potential downsides. Those with gastrointestinal issues may experience symptoms such as diarrhea and upset stomach.

Type-1 and type-2 Diabetics should consult a physician before using exogenous ketones. Ketones can significantly alter blood sugar levels. However, exogenous ketones may prove to be therapeutic for type-2 diabetics. This is an ongoing area of research that could change treatment for these people.

Summary Takeaways

It is early days with respect to ketone supplements. The patents that have not yet resulted in commercial products will soon bring more products to market.

Nonetheless, we’re already seeing a variety of ketone supplement options based on the University of South Florida patent.

Which product you decide to use will depend on your personal goals. Budget, fat loss, athletic performance, health and longevity will all impact your decision. In future articles, we will look at how to use these products to achieve different goals.