Low carb diets are certainly having their moment in the media right now and if you’re following along you’ve likely come across the terms ketones or ketogenic diet at least a handful of times. There is a ton of misinformation and confusing marketing going on that leave people wondering what are ketones? What do ketones do? Where do ketones come from? How do you use ketones? Keep reading for everything you need to know about ketones.
Before we can get into the specifics of ketones, we first need to do a brief refresher of cellular metabolism. Cellular metabolism refers to the production of energy. The energy currency of the body is something called adenosine triphosphate or ATP and it is produced in our cells to give us energy and fuel all of our body’s processes. We can produce ATP by metabolizing either sugar (glucose) or fats. The body converts glucose to ATP through a process called glycolysis. Glucose produces quick, easy energy but only releases a small amount of ATP whereas burning fat is a slower, more difficult process but will generate significantly more ATP per gram of fat oxidized. The process of converting fats to ATP requires first beta oxidation followed by the citric acid (or Kreb’s) cycle in the mitochondria. Another important distinction between our two energy substrates is that we have a limited ability to store glucose (as liver and muscle glycogen) but an unlimited ability to store body fat.
What are ketones & where do they come from?
Ketones, or ketone bodies, are produced as byproducts when the body burns fat for fuel via beta oxidation. Since the body’s main fuel source is glucose, the burning of fat for fuel will only occur under low carbohydrate conditions. If carbohydrate intake is kept low and the stored glucose is used up, the body will burn fat via beta oxidation and use the ketones that are produced to create ATP in the citric acid cycle.
Conditions that would induce ketogenesis – or production of ketones – include restricting carbohydrate intake, fasting, intense workouts or a combination of the above. All of these situations will cause the body to burn through stored glucose (called glycogen) and once that storage is empty, the body will begin to tap into fat stores and start burning predominantly fat for energy production. Once the body is relying more on ketones for fuel than glucose, the state of ketosis is achieved.
Ketone symptoms and causes?
For some people, entering into ketosis – or using predominantly ketones for fuel can come with some unpleasant but temporary side effects often referred to as ‘the keto flu’. These may include:
- Bad breath
- Brain fog
- Mild flu-like symptoms
These symptoms can occur when the body is learning to transition to a different fuel source and should subside as the body adapts. Some individuals experience more pronounced symptoms than others and there is a significant genetic component that will influence how efficiently someone can produce ketones. For those that struggle to get into ketosis or those that simply want to ease the transition without the symptoms of the keto flu, considering supplementing with exogenous ketones may be helpful.
There is one other major side-effect related to ketones that gets mistakenly tied in with ketogenic diets and causes some confusion: ketoacidosis. This is a serious medical condition that can occur in both Type 1 and Type 2 diabetics when insulin is either unavailable or not functioning as it should. When this happens, the body is unable to use glucose as fuel and begins rapidly producing ketones in an attempt to compensate. Without proper insulin signaling, the body does not know when to shut off ketone production, allowing the ketones rise to an unhealthy level. When this occurs, it can cause a pH shift in the blood (hence the name ketoacidosis) that can be potentially fatal. The main symptoms of diabetic ketoacidosis are excessive thirst and urination, “fruity” or acetone-breath and disorientation/confusion. In diabetics this is an easily prevented condition if blood sugar and insulin levels are kept in check. For non-diabetic individuals ketoacidosis is extremely rare. It is related to insufficient insulin signaling, not ketogenic dieting or ketone supplements.
Types of Ketone Supplements
So far we’ve only discussed the body’s endogenous production of ketones, but what about ketone supplements? Exogenous ketones are ketones that are taken rather than produced by the body. Exogenous ketones can act as a fuel source for the body to burn for energy, can ease the transition into ketosis and can help prevent the symptoms associated with the keto flu.
The exogenous ketone supplements available on the market are called ketone salts that combine the ketone bodies acetoacetate and/or beta hydroxybutyrate with sodium, calcium or potassium. The current literature on ketone salt supplementation show that ingesting exogenous ketones causes a rise in blood ketone levels which can be a game changer for individuals trying to ease into ketosis without the keto flu, for those that want the benefits of ketones but have trouble sticking to a strict low carb diet, or for someone that wants and energy boost between meals or pre-workout.
Some of the most popular exogenous ketone supplements available are pruvit Keto-OS, Keto CaNa and Perfect Keto. As with all supplements, always check out the company and the ingredient list to be sure it is free of fillers, additives and includes high quality ingredients.
It is also worth mentioning that ketone salts alone will only raise blood ketone levels but do not show an ability to raise endogenous ketone production in the current literature. Finding a product that combines ketone salts with a ketogenic fat like MCT (medium chain triglycerides) or simply adding it in yourself will help to not only raise blood ketone levels but also increase endogenous production of ketones.
Using Ketones for Weight Loss
First let’s clear this up right away: despite some clever marketing, ketone supplements alone do not cause weight loss. Exogenous ketones simply provide a form of energy for the body to use and raise ketone levels in the blood. That said, when you are in ketosis that means you are burning fat for fuel and that fat can come from body stores or the diet. If you are eating in a way that ensures you are burning body fat for fuel and not just dietary fat, then weight loss will occur. Though not a miracle weight loss supplement, if used correctly ketones can be used to help you lose weight by a few different mechanisms.
Like we discussed previously, ketones are only produced when dietary carbohydrate is kept low enough to allow the body to tap into fat stores. Following a low carbohydrate diet is a fantastic way to reduce insulin levels and restore insulin sensitivity – two cornerstones of effective weight loss. Since exogenous ketones can help ease your transition into a low carb way of eating, they may improve compliance and reduce the side effects commonly experienced at the beginning of a ketogenic diet.
Burning glucose for fuel is quick and volatile whereas burning fat produces a slow, steady stream of energy to the body. For that reason, in addition to stabilizing blood sugar and insulin levels, burning ketones for fuel may help with appetite regulation as well. Also, high fat foods typically consumed on a ketogenic diet are highly satiating and may help prevent cravings and cut down on mindless, frequent grazing.
Taking exogenous ketones in combination of ketogenic fats like MCT’s (medium chain triglycerides) can help increase the body’s endogenous production of ketones. This results in the favorable side-effects of ketosis like mental clarity, reduced appetite and cravings, improved sleep and easier weight loss.
To summarize: ketones or ketone bodies can be made endogenously when we metabolize fat or taken exogenously in a supplement form. Ketones provide a steady form of energy for our cells and are naturally produced and used by various cells every day. The state of ketosis refers to relying predominantly on ketones for fuel and it can have many health benefits such as improved mental clarity, improved insulin sensitivity and glycemic control and weight loss. Getting into ketosis requires low glucose availability through low carb dieting, fasting, exercise or all of the above and can sometimes cause symptoms referred to as the “keto flu”. The use of exogenous ketones and MCT oil may help mitigate these symptoms and make the transition into ketosis easier. So, are ketones good for us? Absolutely! We make them every day.