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Do Keto Supplements Help Increase Ketosis and Aid the Ketogenic Diet?

Do Keto Supplements Help Increase Ketosis and Aid the Ketogenic Diet?

A detailed look into keto BHB pills, the fastest way to reach ketosis, keto pills and weight loss, the best keto supplements and frequently asked questions.

exogenous ketone supplements and pills

Exogenous Ketone supplements and pills are claimed to put your body into ketosis without having to follow a ketogenic diet. (Image via Shutterstock)

The ketogenic (also known as “keto diet“) diet has been a hot topic of conversation over the last couple of years, and it has been studied and used as a therapeutic approach since the 1920s.

The traditional ketogenic diet limits carbohydrate intake to roughly 5% of your daily calorie intake, increases fat intake to around 75% of your total calories, leaving protein at about 20% of your total intake.

There is evidence to support that this diet can lead to an improvement in some metabolic pathways and aid in beneficial health effects.

One of the most popular health outcomes that has put this diet in the spotlight is the evidence supporting weight loss and increased fat loss[1].

While the keto diet may provide benefits, it can also be very difficult to follow. Research studies have investigated the use of exogenous ketones (ketone supplements and pills) as a way of raising blood ketone levels and inducing ketosis in a quicker manner versus having to follow a ketogenic diet.

 

What Is Ketosis?

When following a standard higher-carbohydrate diet, your body’s cells typically rely on glucose for fuel. The glucose comes from starchy foods like bread, pasta and some vegetables, as well as sugar.

When these foods are restricted, like with a ketogenic diet, your body is then forced to find alternative fuel sources to keep running, such as fat.

When fat is used as the alternative fuel source and broken down in excess, ketone bodies are produced, and this metabolic shift puts your body into a state of ketosis.

The two main ketone bodies produced during ketosis are acetoacetate and beta-hydroxybutyrate (also known as βHB, BHB or β-OHB). A third, less abundance, ketone body is acetone[2][3]. These ketone bodies can replace glucose as fuel and provide your brain, heart and muscles with energy, and it is also thought that the ketone bodies themselves may be responsible for the weight loss associated with a ketogenic diet[2][4].

 

Keto βHb Pills: What Are They?

Keto pills, or keto supplements, are being used to aid weight loss in an easier manner and within a quicker timespan, via ketosis within the body.

These supplements are referred to as exogenous ketones since they are from a source outside the body. When the body produces ketones, they are referred to as endogenous ketones[1][2][5].

The two main ketone bodies that are naturally produced in the body during ketosis are acetoacetate and beta-hydroxybutyrate (βHB)[2][3].

Exogenous ketone supplements contain only βHB since acetoacetate is not chemically stable as a supplement[2].

There are two main forms of ketone supplements (exogenous ketones):

  • Ketone Salts:
    • The ketones are bound to a salt, typically sodium, potassium, calcium or magnesium and are most often found in powder form and mixed with liquid[2].
  • Ketone Esters:
    • The ketones are linked to another compound, called an ester, and packaged in liquid form. These are primarily used in research and are not as readily available for purchase as ketone salts[2][6].

Some of these pills or supplements may also contain fish oil, creatinine, vitamin D or other nutrients as well, but it is best to find the supplements with the least number of additives.
 

Fastest Way to Get into Ketosis and Supplements to Increase Ketosis

Most people naturally experience a mild state of ketosis during periods of fasting or strenuous exercise, however achieving ketosis can take anywhere from 24 hours to 3.5 days after initiation of a ketogenic diet[5].

Exogenous ketone supplements provide βHB directly to the body and can help you reach ketosis in a quicker manner.

Additional supplements and methods include:

  • The Use of Medium-Chain Triglycerides (MCTs)

    • You can find MCT oil commercially or increase the amount of coconut oil in your diet as coconut oil contains MCTs. Medium-chain triglycerides can help you add more fat to your diet and stay in ketosis as these fats are digested more rapidly than traditional fats. It is best to slowly increase MCTs in the diet as these fats can also have digestive side effects such as stomach cramping or diarrhea.
  • Following a Standard Ketogenic Diet/ Minimizing your Carbohydrate Intake

    • This means a diet that is 5% carbohydrates, 75% fat and 20% protein.
  • Include Physical Activity

    • When you exercise, you deplete your body of its glycogen stores and if carbohydrate intake is minimized then glycogen stores remain low. In response, your liver increases its production of ketones.
  • Using exogenous ketones as they can increase blood ketone levels and help you achieve ketosis more rapidly.

    • These include ketone salts/βHB pills. Follow the instructions on the label and do not exceed more than the daily recommended amount.
  • Using Keto Protein Powders

    • These are formulated to have a low carbohydrate content. However, be aware of serving size as carbohydrates can still add up.
  • Supplementing with Digestive Enzymes, specifically Lipase.

    • Some people may experience digestive issues due to the high-fat content of the keto diet. Supplementing with lipase can help better break down these fats.

 

Do Keto Pills Really Work?

Keto pills are designed to help your body get to a state of ketosis quickly, and several studies have proven that ability, but overall human studies are limited when looking at weight loss.

Keto supplements themselves have not been shown to directly increase weight loss, but rather they may do so indirectly.

Research has found that exogenous ketones may aid weight loss by reducing hunger, causing you to naturally eat fewer calories[1][2] [7][9].

These supplements help your body reach ketosis, but it is still up to you to make the lifestyle changes necessary to remain in that metabolic state for sustainable periods of time so that you can lose the weight.

It is important to note that ketone supplements may not affect appetite as much in people who have had a keto meal beforehand as studies have observed higher blood ketone levels in those who did not eat a meal before taking a ketone supplement compared to those who did[8][10].

Therefore, these supplements may only be beneficial during a fast, including a simple overnight fast.

Exogenous ketones, or keto pills, increase serum β-hydroxybutyrate (βHB), however, they are not ketogenic, and studies have shown that they may, in fact, inhibit endogenous ketone production, and therefore do not encourage the creation of ketone bodies in the liver.

Exogenous ketones mimic the effects, many of which are positive, of nutritional ketosis, rather than inducing it[5].

Preliminary research also suggests that increased βHB levels and faster time to ketosis might improve the acceptability of the ketogenic diet and improve compliance rates, but more research is required.

People may also experience less of the unpleasant side effects that can come from transitioning from a standard, higher-carb diet to a ketogenic one, however there is limited research[2][5].

These symptoms, commonly known as ‘keto-flu’, include:

  • Constipation
  • Headache
  • Bad breath
  • Muscle cramps
  • Diarrhea

 

Best Keto Supplements/Keto Pills for Weight Loss

There are several Keto supplements available on the market, however Research Verified Keto, Keto Diet Shop, Keto Slim RX, Keto Slim, and Teal Farms Keto are some of the top reviewed products with the necessary ingredients to produce ketosis.

When looking for a top product, it is important that the product contains:

  • An adequate amount of βHB (there are several brands out there that do not provide an amount that would aid ketosis, or they do not disclose the amount)
  • A salt that binds with the βHB, such as calcium, magnesium, potassium and sodium. Having all three of these in the supplement ranks it even higher
  • Products that have the least/do not have additives, fillers, binders or preservatives as these ingredients are unnecessary
  • An inspection from a third-party

Some of the drawbacks and concerns to these supplements include:

  • Price – The higher quality products are going to be pricier.
  • Taste – It can be difficult to mask the taste from the βHB.
  • Potential side effects listed in the FAQs section below.

 

FAQs

Q. Do keto diet pills have side effects?

In general, exogenous ketone supplements are generally considered to be a safe and effective way to increase ketone body concentrations, but it is the long-term effects that are unknown[2][11].

Adverse effects have been found when ingesting ketone body salts and/or esters, however the reported side effects are more common with ketone salts than ketone esters.

Some of these effects include:

Another study[16] found that if following the recommended daily serving sizes, the recommended daily allowances of minerals found in most supplements were up to five times higher than necessary, potentially causing metabolic alkalosis, a condition in which the pH of the tissue is elevated beyond the normal range[2][15][17].

Q. Does a ketogenic diet cause fat loss?

The ketogenic diet, or keto diet, has been shown to offer several impressive health benefits, including weight loss. Research also indicates that the diet can help aid fat loss, however long-term studies to support the effectiveness are lacking.

There appears to be a reduction in the formation of fat (lipogenesis) and an increase in the breakdown of fats (lipolysis); and there is a greater metabolic efficiency in consuming fats[18][22].

Q. What about carb blockers? What are they and can they help me with the keto diet?

Carb blockers, also known as starch blockers, block your body from digesting and absorbing complex carbohydrates by inhibiting the digestive enzyme alpha-amylase. These carb blockers can also be referred to as amylase inhibitors. Amylase is what helps break down the complex carbohydrates that you consume into simple sugars so that your body can absorb them.

The carb blocker prevents the amylase from attaching to these starches and breaking them down. This allows the complex carbs to make their way through your body without raising your blood sugar and contributing calories[23].

Simple carbohydrates are the ones found in fruit, milk and processed foods such as candy and soda while complex carbohydrates are typically foods with higher nutritional value, a higher fiber content and have a slower rate of digestion.

Examples of complex carbohydrates include whole grains, quinoa, beans and legumes, and starchy vegetables.

It is important to note; that carb blockers only work with complex carbs and not simple carbs.

Most carb blockers are made from a bean derivative, the most common being the white kidney bean extract known as Phaseolus vulgaris.

White kidney bean extract is the only substance that has evidence and studies to back up its claims of blocking your body from producing the enzyme needed to digest starches[23][25].

These supplements have been proven useful in many cases and can be an asset to the keto diet (but are not a critical part of the diet).

Carb blockers are generally considered safe to consume, but they may still have adverse effects, the most common including gastrointestinal issues such as abdominal bloating, stomach cramps and diarrhea[23][24].

Before taking carb blockers, make sure to check with your doctor and pharmacist as there are medications and conditions where contraindications can occur.

 

Conclusion

The keto diet may provide benefits, such as weight loss and fat loss, but it can also be very difficult to follow.

More people have turned to exogenous ketone supplements as a way of raising blood ketone levels and inducing ketosis in a quicker manner versus having to follow a strict ketogenic diet.

Preliminary research has shown benefits with these weight loss supplements, however, more research is needed.

Feedback:

References

1. Preiato, D. Does the ketogenic diet work for weight loss? Healthline https://www.healthline.com/nutrition/does-keto-work#supplements. Published November 12, 2019. Accessed January 27, 2020.
2. Van De Walle G. Do exogenous ketone supplements work for weight loss? Healthline https://www.healthline.com/nutrition/exogenous-ketones. Published October 23, 2018. Accessed January 27, 2020.
3. McPherson PA, McEneny J. The biochemistry of ketogenesis and its role in weight management, neurological disease and oxidative stress. J Physiol Biochem. 2012;68(1):141-51. doi:10.1007/s13105-011-0112-4.
4. Newman JC, Verdin E. Ketone bodies as signaling metabolites. Trends in Endocrinol Metab. 2014;25(1):42-52. doi:10.1016/j.tem.2013.09.002.
5. Harvey CJdC, Schofield GM, Williden M. The use of nutritional supplements to induce ketosis and reduce symptoms associated with keto-induction: a narrative review. PeerJ. 2018;6:e44. doi:10.7717/peerj.4488.
6. Scott JM, Deuster PA. Ketones and human performance. J Spec Oper Med. 2017;17(2):112-116. https://www.ncbi.nlm.nih.gov/pubmed/289599043.
7. Poff A, Koutnik A, Moss S, Mandala S, D’Agostino D. Exploring the viability of exogenous ketones as weight loss supplements. Curr Dev Nutr. 2019;3(1):21. doi:10.1093/cdn/nzz041.P21-017-19.
8. Stubbs BJ, Cox PJ, Evans RD, Cyrank M, Clarke K, de Wet H. A ketone ester drink lowers human ghrelin and appetite. Obesity (Silver Spring). 2018;26(2):269-273. doi:10.1002/oby.22051.
9. Stubbs BJ, Cox PJ, Evans RD, Santer P, Miller JJ, Faull OK, Magor-Elliott S, Hiyama S, Stirling M, Clarke K. On the metabolism of exogenous ketones in humans. Front Physiol. 2017;8:848. doi:10.3389/fphys.2017.00848.
10. Pinckaers PJ, Churchward-Venne TA, Bailey D, van Loon LJ. Ketone bodies and exercise performance: the next magic bullet or merely hype? Sports Med. 2017;47(3):383-391. doi:10.1007/s40279-016-0577-y.
11. Hashim SA, VanItallie TB. Ketone body therapy: from the ketogenic diet to the oral administration of ketone ester. J Lipid Res. 2014;55(9):1818-1826. doi:10.1194/jlr.R046599.
12. Clarke K, Tchabanenko K, Pawlosky R, Carter E, King MT, Musa-Veloso K, Ho M, Roberts A, Robertson J, Vanltallie TB, Veech RL. Kinetics, safety and tolerability of (R)-3-hydroxybutyl (R)-3-hydroxybutyrate in healthy adult subjects. Regul Toxicol Pharmacol. 2012;63(3):1-25. doi:10.1016/j.yrtph.2012.04.008.
13. Leckey JJ, Ross ML, Quod M, Hawley JA, Burke LM. Ketone diester ingestion impairs time-trial performance in professional cyclists. Front Physiol. 2017;8:806. doi:10.3389/pfhys.2017.00806.
14. Evans M, Egan B. Intermittent running and cognitive performance after ketone ester ingestion. Med Sci Sports Exerc. 2018;50(11):2330-2338. doi:10.1249/MSS.0000000000001700.
15. Da Costa D, Bangalee V, Subban K, Naidoo R. Ketone body supplement label claims: what supplement has been supplemented? SA J Sports Med. 2019;31(1):1-2. doi:10.17159/2078-516X/2019/v3lila6369.
16. Fischer T, Och U, et al. Effect of a sodium and calcium DL-ß-Hydroxybutyrate salt in healthy adults. J Nutr Metab. 2018;2018:9812806. doi:10.1155/2018/9812806.
17. Cox PJ, Kirk T, Ashmore T, Willerton K, Evans R, Smith A, Murray AJ, Stubbs B, West J, McLure SW, King MT, Dodd MS, Holloway C, Neubauer S, Drawer S, Veech RL, Griffin JL, Clarke K. Nutritional ketosis alters fuel preference and thereby endurance performance in athletes. Cell Metab. 2016;24(2):256-268. doi:10.1016/j.cmet.2016.07.010.
18. Paoli A, Rubini A, Volek JS, Grimaldi KA. Beyond weight loss: a review of the therapeutic uses of very-low-carbohydrate (ketogenic) diets. EJCN. 2013;67:789-796.
19. Veldhorst MA, Westerterp-Plantenga MS, Westerterp KR. Gluconeogenesis and energy expenditure after a high-protein, carbohydrate-free diet. Am J Clin Nutr. 2009;90:519–526.
20. Cahill Jr GF. Fuel metabolism in starvation. Annu Rev Nutr. 2006;26:1–22.
21. Paoli A, Grimaldi K, Bianco A, Lodi A, Cenci L, Parmagnani A. Medium term effects of a ketogenic diet and a mediterranean diet on resting energy expenditure and respiratory ratio. BMC Proceedings. 2012;6(Suppl 3):P37.
22. Paoli A, Cenci L, Fancelli M, Parmagnani A, Fratter A, Cucchi A et al. Ketogenic diet and phytoextracts comparison of the efficacy of mediterranean, zone and tisanoreica diet on some health risk factors. Agro Food Ind Hi-Tech. 2010;21:24.
23. Mac L. Carb blocker 101: what you need to know. Perfect Keto. https://perfectketo.com/carb-blocker/. Published July 23, 2019. Accessed February 7, 2020.
24. Barrett ML, Udani JK. A proprietary alpha-amylase inhibitor from white bean (Phaseolus vulgaris): a review of clinical studies on weight loss and glycemic control. Nutr J. 2011;10:24. doi:10.1186/1475-2891-10-24.
25. Celleno L, Tolaini MV, D’Amore A, Perricone NV, Preuss HG. A dietary supplement containing standardized Phaseolus vulgaris extract influences body composition of overweight men and women. Int J Med Sci. 2007;4(1):45-52. doi:10.7150/ijms.4.45.
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Meghan Rittmaster, MS, RDN, LD

Meghan is a registered dietitian nutritionist in private practice in Minneapolis, Minnesota. Her areas of expertise include functional ...

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