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 first part of this two-part series, found here, takes a look at what exogenous ketones are and how they work. If you haven’t had a chance to read that yet, it is highly recommended you do so before continuing on with this instalment.

It’s important to note that beta-hydroxybutyrate (BHB) is the most important ketone. Exogenous ketones supplements contain different amounts of BHB. Thus, “BHB” supplement (beta-hydroxybutyrate supplements) is another name for exogenous ketone supplement.

Read on as we review:

  1. The State of Exogenous Ketone Supplements
  2. The Patents Behind Ketone Supplements
  3. What to Look For in Exogenous Ketone Supplements
  4. Cost Comparison: Price per Ketone
  5. The Product Experience
  6. Exogenous Ketone Supplements Review
  7. The Future of Ketone Supplements
  8. Can Everyone Take Exogenous Ketone Supplements?
  9. Summary Takeaways

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.

Introduction of Ketone Supplements Timeline

Exogenous ketones have been in research & development since the early 2000s. However, they didn’t start making their way to the public until late 2014.

Ketoforce by Prototype Nutrition was the first to launch. Following this was Pruvit’s Keto OS (and Keto OS Charged, a caffeinated version).

Keto OS and Keto OS Charged are combination supplements. They combine MCT powder with BHB mineral salts. Whether or not this is more effective than pure BHB mineral salts is still up for debate. Data doesn’t show a large difference between the two[note]Kesl, S. L., Poff, A. M., Ward, N. P., Fiorelli, T. N., Ari, C., Van Putten, A. J., … & D’Agostino, D. P. (2016). Effects of exogenous ketone supplementation on blood ketone, glucose, triglyceride, and lipoprotein levels in Sprague–Dawley rats. Nutrition & metabolism, 13(1), 1.[/note]. You can refer to our previous exogenous ketone article for more on this).

KetoCaNa (also made by Prototype Nutrition) made it’s way to the market in 2015. It is a better tasting, powdered form of BHB salt. It uses calcium and sodium as mineral support.

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.

Products Often Mistaken for Being Ketone Supplements (That Aren’t..)

Pruvit released a dietary creamer called Keto Kreme. It consists of coconut oil and cinnamon extract. Be aware that Keto Kreme does not contain exogenous ketones like many people believe. It is an MCT Powder product similar to Quest Nutrition’s MCT Oil Powder.

Forever Green’s Ketopia Weight Management System includes KetonX and KetoPM. These are two patented products that claim to assist the body in reaching a state of ketosis quickly. However, neither contain exogenous ketones. In future, KetonX and KetoPM will have BHB salt patented by the USF.

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

KetoForce Average Blood Beta-Hydroxybutyrate Levels

Source: Data set taken from article published by Patrick Arnold on his Blog
Note: Blog currently has had some connection issues.

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.

Other Aspects to Consider…

Products contain added ingredients that provide side benefits. This is an area which you should consider based on your goals and budget. Current products on the market vary widely in the number and extent of extra ingredients used.

  • Other Ingredients: This category includes other ingredients aside from electrolytes and ketone bodies. Examples include: MCT powder and what it’s made from, caffeine, sweeteners, etc.

Of the current products, KetoCaNa and KetoForce are the simplest products. Kegenix ingredients is the most complex.

Exogenous Ketone Supplements Review

Source: Last updated February 2019. All data derived from product Nutrition Facts labels and standard calculations.
All prices are reflective of current US pricing and availability.
*Doesn’t account for MCT Powder active ingredient that also contributes to Ketone Power.
**Information currently not available – will be updated shortly.

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.

QUESTION(S): Do you take an exogenous ketone supplement? If so, what’s your goal and what results have you noticed? Let us know in the comments.

Damien Blenkinsopp MBA.

Damien is the founder of Ketosource and the host of the popular health tech/data podcast, The Quantified Body. He has an MBA from London Business School and both French (ESC) and UK 1st Class Hon. undergraduate degrees. His career has had a data-driven and analytical focus, spanning strategy consulting, market analyst and health tech/data. Damien has a passion for health, longevity and predictable results. The Quantified Body and Ketosource projects are both focused on leveraging data and analytical tools to help people get the results they want with confidence. Damien speaks 5 languages and has lived in 11 countries across 5 continents.