From the Guidelines
BHB salts should be used with caution and only as a temporary aid to achieve ketosis, as the current evidence suggests that they may provide temporary benefits but do not replace the metabolic benefits of naturally produced ketones through diet or fasting. The use of BHB salts has gained popularity in recent years, particularly among individuals following a ketogenic diet, as they can help raise blood ketone levels and potentially provide energy during fasting periods or when transitioning to a ketogenic diet 1. Typical dosages of BHB salts range from 8-12g per day, often divided into 2-3 servings, and they usually come as a powder to be mixed with water or in capsule form.
When starting with BHB salts, it is recommended to begin with a lower dose, around 4-6g, to assess tolerance, as some people may experience digestive discomfort, including nausea and diarrhea. The benefits of BHB salts include potentially reducing "keto flu" symptoms, improving mental clarity, and enhancing athletic performance during low-carbohydrate states. However, it is essential to note that these supplements do not replace the metabolic benefits of naturally produced ketones through diet or fasting, and their effects are temporary, typically lasting 2-3 hours after consumption.
Key considerations when using BHB salts include:
- Starting with a low dose to assess tolerance
- Monitoring for potential side effects, such as digestive discomfort
- Using them as a temporary aid rather than a long-term solution
- Being aware that they can be expensive and should complement, not replace, dietary efforts to achieve nutritional ketosis
- Understanding that the current evidence on BHB salts is limited, and more research is needed to fully understand their effects on human health 1.
In the context of ketogenic diets, BHB salts may be useful for individuals who are struggling to achieve ketosis through dietary means alone, but they should be used under the guidance of a healthcare professional and in conjunction with a well-planned ketogenic diet. Ultimately, the decision to use BHB salts should be made on an individual basis, taking into account the potential benefits and risks, as well as the current state of the evidence 1.
From the Research
BHB Salts Overview
- BHB (Beta-Hydroxybutyrate) is a metabolite with intrinsic signaling activity that has gained attention as a potentially clinically useful supplement 2.
- There are available supplements for inducing ketosis: ketone salts, ketone esters, and medium-chain triglycerides, which all raise D-BHB in the blood and are safe and well-tolerated, but differ in safety profile, palatability, and price 2.
Safety and Tolerability of BHB Salts
- A study evaluated the safety and tolerability of orally administered free D-BHB in a sample of 24 healthy adults, and found that it was a safe and well-tolerated intervention for inducing sustained exogenous ketosis 2.
- The most frequently reported secondary effects were gastrointestinal discomfort, headache, and loss of appetite, but no correlation between weight-adjusted dose and frequency of secondary symptoms was observed 2.
BHB Salts and Disease Prevention
- BHB has been shown to have potential benefits in preventing and treating various diseases, including diabetic kidney disease, neurodegenerative disorders, cardiovascular diseases, cancers, and inflammation 3, 4.
- BHB serves as an "ancillary fuel" and induces anti-oxidative, anti-inflammatory, and cardio-protective features by binding to several target proteins 3.
- A review article discussed the applications of BHB supplementation in age-related diseases and explored its potential benefits and challenges 4.
Monitoring Ketosis with BHB Salts
- A study found that blood beta-hydroxybutyrate correlates better with seizure reduction due to ketogenic diet than do ketones in the urine 5.
- BHB has signaling functions and modulates nutrient utilization and energy expenditure, suggesting that it is not solely a metabolic intermediate, but also acts as a signal to regulate metabolism and maintain energy homeostasis during nutrient deprivation 6.