We all have heard about ketogenic diets or the commonly used term keto diets for weight loss. The state of ketosis produces ketone bodies that work towards achieving fat-burning goals. Beta-hydroxybutyrate (BHB) is one such ketone body. So, the question comes is there a way to achieve ketosis by taking BHB directly in place of keto diets as keto pills, also referred to as keto BHB pills? Wouldn’t it be much quicker and easier to achieve ketosis? So, if you are looking for a shortcut to ketosis along with feeling more energy and reduced food cravings then are keto BHB pills an option for you?
What is Keto BHB?
Keto BHB or Beta-hydroxybutyrate is one of the ketone bodies produced in mammals that is abundantly present (1). Check out the information for Keto BHB pills below. But first, let us see what are ketone bodies and what is their role?
What are Ketone Bodies? What is beta-hydroxybutyrate?
Ketone bodies are small molecules that are synthesized mainly in the liver from fats. When we restrict carbohydrates as in the keto diet, the ketone bodies are used as an alternative energy source. The body first uses stored glucose from the liver, once fully depleted, the body begins to use fat as an energy source.Â
Ketone bodies produced in the liver from the fats then circulate through the bloodstream to provide energy to the tissues during fasting or prolonged exercise or whenever energy is required in a carbohydrate-restricted state or when glucose is not available.
Humans make 3 types of ketone bodies:
- Acetoacetate (AcAc),
- 3- beta-hydroxybutyrate (3HB or BHB), and
- Acetone
Out of the 3 ketone bodies, BHB is the most abundant (about 80% of the total circulating ketones) and acetoacetate (around 20%), and acetone is the least abundant (about 1%) in human circulation.Â
Ketosis and weight loss? Can we take keto BHB pills?Â
Ketosis through a ketogenic diet has been popularly used for weight loss. There is, however, a difference between a low-carb diet (50-150g carbs/day) and a low-carb ketogenic diet (LCKD) (<50g carb/day) as one can enter ketosis only through the latter (2, 3). So, while a standard American diet has a composition – of carbs, 55%, fat 30%, protein 15%, the standard ketogenic diet has fats 75%, proteins 20%, and carbs 5% (3). The low carb <50g/day lowers blood glucose resulting in the production of ketone bodies and thus the body utilizes fats as the primary fuel. Achieving a goal of carb<50g/day though is a bit challenging to achieve.
It has been reported that ketone body Beta-hydroxybutyrate (BHB), keto BHB when taken as a keto pill (also called keto bhb pill), can help achieve weight loss by a similar mechanism to a ketogenic diet. However, whether the keto bhb pills are able to induce ketosis is controversial. In the keto diet, we restrict carbs and deplete the stores of glucose. Excess glucose gets deposited in the liver and muscle as glycogen and further excess stores it as fat. In the absence of glucose and glycogen, the body will use fat as an alternative source of energy. Ketone bodies suppress appetite and help in weight loss in a calorie-restricted state.Â
Keto BHB Pills/ Supplement Beta-Hydroxybutyrate – Is it D-BHB or L-BHB?
Among different isoforms of beta-hydroxybutyrate, Dextro (D)-BHB is directly absorbed into the circulation, and some get converted to AcAc by the liver. Levo (L)-BHB, however, is not metabolized and is slowly excreted in urine (4). Thus, any BHB used now as Keto BHB pills/supplements is D-BHB though earlier racemic has also been used.Â
A recent study comparing the effects of D-BHB, D+L BHB, and medium chained triglycerides (MCT) reported that D-BHB, despite being low caloric, increased blood ketones above 1mmol, which was 1.7-fold greater than D+L BHB or MCT (4).
Health Benefits of Keto BHBÂ pills
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Keto BHB Pills are an excellent energy source
Keto BHB pills provide fuel to the brain, heart, skeletal muscle, and other tissues (when carbs are not eaten) by breaking down ketones. Burning ketones for energy as compared to carbs has the advantage of also lowering the levels of reactive oxygen species or free radicals in the body.
Keto BHB helps burn fat
Keto BHB has been proven to burn fat. BHB keto pills have been claimed to burn fat instead of carbs, help suppress appetite, and improve satiety which aids in weight loss. The advantage of using keto BHB pills as compared to the keto diet for weight loss is that you burn fat while maintaining muscle.
BHB is Brain Healthy
Keto BHB (and other ketone bodies) can easily travel to the brain. The brain does not store glucose, so it requires a continuous supply of glucose. Keto BHB thus supplies energy to the brain in absence of glucose. However, even if glucose is available, the brain utilizes ketones preferentially.
In the brain, BHB has been shown to enhance the production of neuron-healthy chemicals such as BDNF (brain-derived neurotrophic factor) in the mouse brain which helps improve cognitive function and reduce depression. It is notable that BDNF is also increased by exercising. BHB also reduces inflammation in the brain through its action of inhibiting the NLRP3 inflammasome.
Keto BHB Pills Help Improving Cognition in Alzheimer’s disease
Keto BHB has also been shown to ameliorate cognitive functions in animal models of Alzheimer’s disease. Studies have also shown that ketones improve cognitive functions in patients suffering from Alzheimer’s disease.
BHB helps prevent seizures in Epilepsy
The ketogenic diet has been used in the treatment of Epilepsy for decades. Keto BHB has beneficial roles in epileptic seizures by a similar mechanism as the ketogenic diet by increasing the synthesis of the chemical neurotransmitter GABA.
Keto BHB Pills prevent aging and help in longevity
Keto BHB pills have been hypothesized to regulate aging and longevity by inhibiting histone deacetylase enzymes thereby increasing histone acetylation and causing changes in gene expression which causes increased lifespan in C. elegans.Â
It is notable that fasting also increases histone acetylation. However, no such studies of keto BHB or BHB keto pills on aging and longevity have been confirmed in humans.
Keto BHB for Dry Eyes
BHB has shown benefits in the treatment of dry eye diseases and is available as ophthalmic drops.
How to Increase BHB Levels Naturally?
Several lifestyle interventions can help increase your beta-hydroxybutyrate levels without the need for keto BHB pills.
- Fasting/ Intermittent fasting can induce ketosis and ketone body production after 12-14 hours which further increases with the duration of fasting.
- Post-Exercise Ketosis can occur after rigorous prolonged exercise increasing ketone bodies
- Ketogenic diet restricting carbs can induce a state of ketosis thereby increasing BHB levels
What are the side effects of Keto BHB pills?
The side effects of exogenous Keto BHB pills are –
- Increase urinary frequency which may result in electrolyte imbalance
- Ketones can cause Halitosis (bad breath)
- Hypoglycemia
- Stomach upset, diarrhea, and constipation at higher doses (5).
- When comparing ketone esters with salts, ketone salts are better tolerated with little gastrointestinal distress
- Since keto BHB supplements are mostly available as salts, their regular use may increase blood pressure.
Though BHB is considered to be safe, there are more studies required to confirm the same and one must consult a physician before starting a Keto BHB supplement.
Ketones vs Ketoacidosis and why diabetics must be cautious while on keto bhb pills?Â
Excessive ketone bodies can produce a pathological and toxic condition called ketoacidosis. Though it is a rare condition in normal individuals, it can occur in diabetic individuals. It generally occurs in people with type 1 diabetes because they do not produce insulin. Insulin is a hormone that prevents the overproduction of ketones. Thus, the overproduction of ketones causes blood to become acidic.Â
Some of the symptoms that diabetics must watch for include – extreme thirst or dry mouth, frequent urination, high blood glucose, and high urine ketone levels. Diabetics thus need to test for blood BHB and blood glucose to avoid this fatal condition. Other conditions such as alcoholism, starvation, and an overactive thyroid can also sometimes lead to ketoacidosis. However, it is rare in healthy individuals following a low-carb diet.
How do you know if you are in a state of ketosis when on keto bhb pills?
Physiological ketosis is achieved when blood ketone levels are above 0.5mmol. Serum levels of BHB can rise to 1-2mmol after 2 days of fasting or 90 min intense exercise and 6-8 mmol after prolonged starvation. A ketogenic diet devoid of carbs can consistently increase the levels to 2mmol (1).Â
One can achieve two types of ketosis:
Endogenous ketosis
This is achieved when the body produces ketone bodies after fasting, exercising, or following a ketogenic diet.
Exogenous ketosisÂ
Exogenous ketosis occurs when you take supplements like ketone esters or salts to form ketone bodiesÂ
How to check if your body is in ketosis after a low-carb keto diet or on keto bhb pills?
Even after following a restricted carb diet, one cannot be sure if the restriction is enough to induce ketone bodies. For checking if ketone bodies are being formed, it is possible to measure the level of BHB by the following methods:
Blood BHB levels
Blood BHB levels can be measured using commercial blood ketone meters. Blood BHB levels for inducing ketosis should be over 0.5 mmol (3). We just need to insert a keto strip in the blood ketone meter just like a glucose meter. There are also glucose meters available that can be used to measure both glucose and ketones.
Urine Ketone Strips
Urine keto strips are available to measure ketone bodies. But the urinary measurements are not as accurate as measuring blood levels. Urine keto strips can measure acetoacetate which is the ketone body excreted in the urine.
Breath Analyzer
A breath analyzer can measure acetone in the breath. It is a simple and low-cost method but like urine keto strips, this method is also not accurate.
Measuring BHB can ensure dietary adherence if you plan to induce BHB through a keto diet.Â
What are Keto BHB pills/ supplements? Can you take ketones exogenously?
Maintaining a restricted low-carb, high-fat diet has its own challenges. Apart from the limited food options to choose from, extreme carbohydrate restrictions can lead to fatigue, low mood, irritability, constipation, headaches, and brain fog. Further, one has to also give consideration to preventing nutritional deficiencies due to a lack of whole grains. A keto dietitian may help create a diet to ensure there are no deficiencies. Â However, there are options to use exogenous ketones as Keto pills.
The only ketone that can be administered exogenously is keto BHB. BHB supplements in the form of powder, keto pills, or keto drinks can make achieving ketosis faster and easier and synergize with the keto diet and boost ketosis easily.
Ketone SaltsÂ
Ketone salts are generally the Beta-hydroxybutyric acid bonded to sodium, potassium, magnesium, and/or calcium. This is to nullify the acidic nature of BHB alone (6). Ketone salts consisting of BHB, and above minerals not only produce ketosis but also have additional benefits of supplementing with these minerals such as sodium, potassium, magnesium, and calcium (7).
Ketone salts have several other advantages. Ketone salts help in muscle anabolism increasing protein synthesis in skeletal muscles and preventing protein catabolism. This mainly happens when ketone salts are administered in a calorie-deficient state. People who follow the keto diet for weight loss have thus the advantage of preserving lean body mass when ketone salts are added (7). However, excessive sodium may be a disadvantage in long-term use.
Ketone EstersÂ
So, exogenous ketones, especially ketone esters when consumed regularly, achieve ketosis even without following a keto diet. However, as there is limited literature and studies conducted on ketone esters, ketone salts are more popularly used. Ketone salts also taste better compared to ketone esters which are bitter in taste.
MCT Oil for elevating BHB
In addition to a carb-restricted diet, consuming MCT oil can also help achieve ketosis. Medium-chained triglyceride (MCT) oil, derived from coconut oil and palm kernel oil, is popularly used for inducing ketosis. It contains mainly caprylic acid (C8 – 65-75%) and capric acid (C10, 25-35%), both get converted into ketone bodies though caprylic acid is highly ketogenic. However, unlike BHB ketone salts and esters, it requires conversion to BHB.
One of the adverse effects of MCT oil is gastrointestinal distress and high caloric load (4). It was reported that combining exogenous ketones (Keto BHB pills) with MCT oil helped in weight loss without any problem of GI effects with MCT alone (5). So, MCT oil with Keto BHB is an option for ketosis and weight loss.
Some Popular BHB Supplements as Keto Pills
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Premium Keto BHB Diet Pills By Purely Optimal –
These are available as 60 capsules in 1 bottle of keto BHB supplement to be taken as 2 capsules per serving containing calcium beta hydroxybutyrate, magnesium beta hydroxybutyrate, and sodium beta hydroxybutyrate. Other ingredients are gelatin, rice flour, magnesium stearate, and silicon dioxide. These are claimed to get you into rapid ketosis to lose extra pounds and achieve your dream body. However, the company claims in their instructions that combining with a low-carb diet can help achieve the desired results quickly. The pills also help to reduce food cravings.
KetoLogic Keto Meal Replacement Shake Powder
KetoLogic recommends replacing one of the meals with Keto Shake powder daily to boost ketosis and fight fat. It has only 4g net carbs, 15g fat, and 8g protein, carefully formulated macros for anyone following a keto diet. It also contains whey protein, MCT, and 24 vitamins and minerals; all rapidly absorbed and converted to ketones to fuel your body and give a natural energy boost. It is sugar-free, gluten-free and claimed to support weight loss.Â
Keto BHB Exogenous Ketone Pills with BHB salts, natural caffeine, and L- carnitine by Zeal Naturals
This Keto BHB supplement has calcium, sodium, and magnesium beta hydroxybutyrate as keto salts with natural caffeine from green coffee and L-carnitine tartrate with calcium, magnesium, and sodium. All combined to form a Keto weight management pill which claims to help sustain the body with powerful energy and avoid keto flu on the keto diet. Green coffee bean boosts energy and L-carnitine supports exercise performance and recovery. These keto pills help metabolize fat while maintaining muscle by helping you achieve fast ketosis and reducing appetite. The keto pills are claimed to promote mental alertness and support weight loss.
KetoneAid KE4 Pro Ketone Ester Drink
This contains 2.5 grams of D-Beta Hydroxybutyrate (D-BHB) Ketone Ester per serving.Â
KE4 is not a keto salt, is naturally derived, is 100% bioavailable, and is the only Ketone Ester that’s published by FDA GRAS. It contains no caffeine and no sugar. The company claims that it is not required to follow a Ketogenic diet with this supplement. It is claimed to boost energy and increase athletic performance, mental clarity, metabolic health and deep sleep.Â
Does that mean you do not need to follow a ketogenic diet while on keto BHB pills?
Will keto BHB in absence of a ketogenic diet be effective for weight loss or maintaining ketosis is a complicated question to answer? AÂ better option is to cut carbs for a few days to enter ketosis and start Keto BHB pills/supplements a few weeks later can not only help achieve ketosis quickly but also help sustain ketosis for a longer period of time by increasing blood ketones levels.
References
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6640868/
- https://pubmed.ncbi.nlm.nih.gov/17684196/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8153354/pdf/nutrients-13-01654.pdf
- https://www.frontiersin.org/articles/10.3389/fnut.2020.00013/full
- https://ketosource.co/exogenous-ketones-how-they-work/
- https://www.frontiersin.org/articles/10.3389/fnut.2021.618520/full
- https://en.wikipedia.org/wiki/Beta-Hydroxybutyric_acid
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