The ketogenic diet has surged in popularity, prompting the emergence of keto-friendly supplements like keto powder drinks. These drinks often contain exogenous ketones, which are ketones sourced externally, as opposed to endogenous ketones, which are produced by the body. This article explores the potential benefits and side effects of keto powder drinks, providing a comprehensive overview for those considering incorporating them into their health regimen.
Understanding Ketosis and Ketones
The ketogenic diet, or keto diet, is high in fat and very low in carbohydrates. This diet encourages ketosis, in which the body burns fat instead of carbohydrates as its primary source of energy. Burning fat produces fatty acid byproducts called ketones. These are the substances that the body uses for energy when carbohydrates are in short supply.
During ketosis, three major ketone bodies are formed and utilized by the body for energy: acetone, acetoacetate, and β-hydroxybutyrate. All cells that contain mitochondria can meet their energy demands with ketone bodies, including the brain and muscle.
Endogenous vs. Exogenous Ketones
Ketones can be produced in the body (endogenous ketones) or come from an outside source (exogenous ketones). Exogenous ketones are synthetic or naturally-derived ketones in the form of supplements. These supplements can elevate the ketone levels in the blood, leading to a state of ketosis.
Why People Take Exogenous Ketones
People may choose to take exogenous supplements to help them achieve ketosis. The keto diet is highly restrictive, so people may have difficulty sticking to the diet and achieving ketosis as a result. Many health food stores sell exogenous ketones over the counter.
Read also: Easy Low-Carb Cheese Crackers
Types of Exogenous Ketone Supplements
There are two main categories of exogenous ketone supplements:
Ketone Salts
Supplement manufacturers make ketone salts by adding artificial ketones to electrolytes, such as magnesium, potassium, and sodium. These particular exogenous ketones can increase electrolyte levels. Higher levels can be harmful if a person has a medical condition, such as kidney disease, that affects their ability to regulate electrolytes. Ketone salts are made by adding artificial ketones to electrolytes, such as sodium, calcium, magnesium, and potassium.
Ketone Esters
Ketone esters are the purest form of ketones and therefore the most potent. Ketone esters are the more potent type of exogenous ketone. As a result, they may cause longer ketosis periods than other exogenous ketone supplements. They may also lead to fewer side effects, such as gastrointestinal discomfort, than ketone salts. There is also less risk of excess electrolytes. They work faster, as early as 10-15 minutes, as compared to the ketone salts, which take about an hour. Ketone esters also help maintain ketosis for a longer period of time.
Other Similar Supplements
Another item on the market is medium-chain triglyceride (MCT) oil, which is partially synthetic fat. The body rapidly absorbs MCTs. Following this absorption, the liver converts them into ketones. However, a person will not get into ketosis by taking MCTs alone. They will need to follow a ketogenic diet or take other exogenous ketone supplements to induce ketosis fully.
Potential Benefits of Exogenous Ketones
Researchers have carried out several studies on the potential benefits of taking exogenous ketones.
Read also: Keto Calorie Counting: A Detailed Guide
Exogenous Ketones for Ketosis
A 2019 review notes that exogenous ketones can effectively induce ketosis. A 2017 study investigated the effects of exogenous ketones on human metabolism. Researchers asked 15 healthy participants to consume drinks that contained either ketone esters or ketone salts. Both types induced a state of ketosis in the participants. However, this study involved only a small number of people. Further research is necessary to establish the accuracy of the findings.
Exogenous Ketones for Enhanced Athletic Performance
Authors of a 2022 review state that exogenous ketones appear to have an effect on the brain, heart, and skeletal muscle, which may have benefits to athletes. However, they concluded that the current evidence exogenous ketones are not a tool to improve athletic performance. A 2020 article states that, despite the biological rationale behind exogenous ketones and their beneficial effects on athletic performance, the current evidence available does not support this. Additionally, exogenous ketones may cause gastrointestinal symptoms. The authors state that more research is necessary to determine the long-term safety of ketone supplements. Due to the body’s increased need for glucose (blood sugar) during intense training, the glucose-sparing qualities of exogenous ketones may be helpful for athletes. Low levels of muscle glycogen (the storage form of glucose) have been shown to inhibit athletic performance. In fact, “hitting the wall” is a common term used to describe the fatigue and energy loss related to the depletion of muscle and liver glycogen reserves. Some studies have demonstrated that providing athletes with exogenous ketone supplements may improve athletic performance. One study of 39 high-performance athletes found that drinking 260 mg of ketone esters per pound of body weight (573 mg/kg) during exercise improved athletic performance. The athletes in the study who consumed the ketone drink traveled an average of 1/4 mile (400 meters) farther over a half hour than those who consumed a drink containing carbohydrates or fat. Exogenous ketones may also help you recover more quickly after intense workouts by promoting the replenishment of muscle glycogen. However, exogenous ketones may not be effective for athletes who participate in exercises that require short bursts of energy like sprinting. This is because these exercises are anaerobic (without oxygen) in nature. The body needs oxygen to break down ketones. Additionally, the exogenous ketone supplements currently available on the market contain ketone salts, which are less potent than the ketone esters used in current studies.
Exogenous Ketones for Psychiatric Disorders and Epilepsy
Some people follow a keto diet for reasons other than weight loss. For example, people with epilepsy have used the ketogenic diet for many years to help reduce the number and severity of seizures. Doctors also have tested whether the diet could help minimize the symptoms of psychiatric disorders, such as schizophrenia and bipolar disorder. Experts believe that these disorders may be partly due to changes in metabolism that affect the brain. Examples include:
- changes in the release of brain chemicals called neurotransmitters
- increased inflammation
- abnormal glucose metabolism in the brain
Some experts theorize that the metabolism-altering effects of exogenous ketones may help treat these disorders. However, few studies have investigated this idea. A 2019 review of the available research suggests that exogenous ketones affect levels of certain neurotransmitters within the brain, therefore reducing some of the signs of psychiatric conditions. The review authors conclude that using exogenous ketone supplements to help the body enter ketosis may be an effective treatment for certain mental health conditions.
Appetite Suppression and Weight Loss
The ability of the ketogenic diet to reduce appetite and help with weight loss has been demonstrated in many studies. The elevation of ketones in the blood associated with the ketogenic diet has been linked to a reduction in appetite. Supplementing with exogenous ketones may be an effective way to reduce appetite, as well. Ketones can suppress appetite by impacting the hypothalamus, a part of the brain that regulates food intake and energy balance. One study of 15 people found that those who consumed 0.86 calories of ketone esters per pound (1.9 calories/kg) of body weight had significantly less hunger and desire to eat, compared to those who consumed a carbohydrate drink. What’s more, hormones that increase appetite like ghrelin and insulin were significantly lower in the group that consumed the ketone ester drink. Exogenous ketones cause weight loss indirectly by lowering your appetite. The same thing happens when you’re in nutritional ketosis.
Read also: Magnesium Supplements for Keto
Potential for Preventing Mental Decline
Ketones have been shown to be an effective alternative fuel source for the brain in times of low glucose availability. There is also evidence that ketone bodies help reduce neurological damage by blocking inflammasomes, a group of protein complexes that cause inflammation in the body. Supplementing with exogenous ketones has helped improve mental function in many studies, particularly in people with Alzheimer’s disease. Brain glucose uptake is impaired in people with Alzheimer’s disease or mild cognitive impairment. Thus, it has been suggested that the gradual depletion of brain glucose can contribute to the progression of Alzheimer’s disease. One study followed 20 adults with Alzheimer’s disease or mild cognitive impairment. Increasing their blood levels of beta-hydroxybutyrate by supplementing with MCT oil - a type of saturated fat that promotes ketone production - led to a greater improvement in cognitive performance, compared to a placebo. Several studies on rats and mice with Alzheimer’s disease have found that supplementing with ketone esters led to improvements in memory and learning, plus helped reduce anxiety-related behavior. Exogenous ketones have also been found to help reduce neurological damage related to epilepsy and Parkinson’s disease.
Reaching Ketosis More Quickly
Reaching a state of ketosis has been associated with weight loss, better appetite control and protection from chronic diseases like diabetes. However, achieving ketosis by following a ketogenic diet or fasting can be difficult for many people. Exogenous ketone supplements can help you get there more quickly. Prüvit Keto OS supplements contain both beta-hydroxybutyrate and MCT powder. Supplementing with both beta-hydroxybutyrate and MCTs has been shown to effectively raise levels of ketones in the blood without the need for dietary change. However, it’s important to note that ketone salts, which are the kind of ketones found in Keto OS, are much less effective at raising ketone levels than ketone esters. In several studies, supplementing with ketone salts resulted in beta-hydroxybutyrate levels of less than 1 mmol/L, while taking ketone esters raised blood beta-hydroxybutyrate concentrations to 3 to 5 mmol/L. Those beginning a ketogenic diet sometimes find exogenous ketones to be helpful not only in raising ketone levels but also in reducing symptoms of “keto flu.” These include nausea and fatigue, which sometimes occur in the first weeks of the diet as the body adjusts.
Potential Risks and Side Effects
A person needs to speak with a doctor before taking supplements.
Digestive Issues
Taking ketone supplements can cause stomach upset in some people. This side effect can limit the number of supplements that a person can take. One of the most common side effects of these supplements is stomach upset, including diarrhea, pain and gas. Studies suggest that higher and repeated doses of ketone salts and ketone esters can lead to gastrointestinal intolerance.
Electrolyte Imbalances
Taking ketone salts also increases the risk of electrolyte imbalances. Electrolytes are vital for the conduction of electrical signals in the muscles and neurons. For example, they help the heart maintain a regular rhythm. Electrolyte imbalance: Electrolytes are vital for your muscles to function properly and for your heart to maintain a normal rhythm. Since ketone salts contain the minerals sodium, potassium, magnesium, and calcium - consuming large amounts may put you at risk for an electrolyte imbalance.
Hypoglycemia
Some doctors are concerned that the ketogenic diet decreases blood sugar levels, potentially leading to hypoglycemia, which can make a person feel weak and lethargic. Ketogenic diets can cause blood sugar levels to go too low. This is dangerous if you have diabetes and take medications that lower blood glucose levels.
Bad Breath
When following a ketogenic diet, elevated ketone levels in the body can cause bad breath. This can also happen when taking supplements.
Expense
Prüvit recommends two servings of Keto OS per day for “optimal performance.” Following this recommendation, two weeks’ worth of Prüvit Keto OS will cost around $182.
Unpleasant Taste
Though ketone salts are much more tolerable to drink than ketone esters, the main complaint of Keto OS consumers is that the supplement has an unpleasant taste.
Lack of Regulation and Insufficient Evidence
The Food and Drug Administration (FDA) do not regulate the exogenous ketone supplement market. Therefore, neither they nor other regulatory agencies test or evaluate ketone supplements for safety, purity, or effectiveness. The FDA does not regulate ketone supplements for their purity, safety, and effectiveness. Because of this, it’s best to talk to your doctor about your options. Furthermore, many studies use an off-the-shelf consumer product containing exogenous ketones but do not independently analyze the product to confirm its composition and purity.
Considerations and Recommendations
If a person is considering taking exogenous ketones, they need to talk with a doctor first. Considering the lack of a comprehensive, multi-faceted overview of the ketogenic diet (KD) in relation to health issues, we compiled the evidence related to the use of the ketogenic diet in relation to its impact on the microbiome, the epigenome, diabetes, weight loss, cardiovascular health, and cancer. The potential positive impacts of a KD on each of these areas warrant further analysis, improved studies, and well-designed randomized controlled trials to further illuminate the therapeutic possibilities provided by this dietary intervention.
While ketone supplements can help with weight loss, they need to be accompanied by following a keto diet. The bottom line is that instead of spending your money on ketone supplements, it’s better, and likely safer, to put that towards buying healthy, whole foods to include in your diet.
The Role of Ketone Drinks in a Keto Lifestyle
One important reason people decide to drink ketones when they’re just starting a keto diet is to reduce keto flu symptoms, such as headaches, brain fog, fatigue, and body aches. It’s normal for you to experience strong carbohydrate cravings when you’re transitioning from a high-carb to a low-carb diet and this is when a ketone drink can be beneficial. Whether you’re an athlete or exercise frequently on keto, an exogenous ketone supplement can provide you with additional support so you can push through a workout. As an added benefit, it may even help improve your recovery post-workout. Some people choose to eat more carbs on certain occasions or during the weekend. This can kick them out of ketosis. Exogenous ketones can help you transition into ketosis again.
Strategic Use and Safety
Ketone drinks are generally safe, although you need to take them strategically. Use them in addition to a properly formulated and healthy ketogenic diet instead of a standalone supplement. While this is rare, do keep in mind that combining a ketogenic diet, prolonged fasting, and taking exogenous ketones increases the likelihood of ketoacidosis.