Formulation:

Exogenous ketone supplements are typically taken as a liquid and contain beta-hydroxybutyrate (a.k.a. 3-hydroxybutyrate), which is often attached to an ester — a ketone ester — or a salt — a ketone salt. Some manufacturers produce ketone supplements in powder or tablet form; however, most research studies have used liquid forms.

Range of dosages studied:

Ketone esters: 115 to 1,500 milligrams per kilogram of body weight or a total of 12 to 25 grams.

Ketone salts: 140 to 468 milligrams per kilogram of body weight or a total of 6 to 36 grams.

Effective Dosages:

Cognitive function

Adults: The effective dosage for improving cognitive function in people under conditions of metabolic stress (e.g., fasting, hypoxia, or exercise) is a single dose of ketone ester (375 to 750 milligrams per kilogram of body weight or a total of 25 grams) taken by mouth 20 to 30 minutes before testing.^[1][2][3][4] Benefits have also been found with daily use of a ketone salt (12 grams twice a day) or a ketone ester (12 grams three times a day) taken by mouth for 2 to 6 weeks.^[5][6]

Special considerations: In studies that show a benefit, ketone supplements are typically taken without food. However, the effects in humans vary considerably, and not all the trials find a benefit.^[7][8][9] Furthermore, due to a lack of dose-response studies and meta-analyses, the precise effective dose and most effective type of ketone are uncertain. Additionally, further research is needed to understand the therapeutic efficacy of ketones in people with mild cognitive impairment or Alzheimer's disease.

Glycemic control

Adults: The effective dosage for improving glycemic control (lowering blood glucose) is a single dose of ketone ester (250 to 1,500 milligrams per kilogram of body weight or a total of 12 to 25 grams) or a ketone salt (140 to 468 milligrams per kilogram of body weight or a total of 6 to 36 grams) taken by mouth before a meal.^[10][11] Benefits have also been found with daily use (12 to 25 grams of a ketone ester or 12 grams of a ketone salt) taken by mouth one to three times per day for 2 to 6 weeks.^[10][11]

Special considerations: Some trials have found similar effects in people with type 2 diabetes,^[12][13] but outcomes are mixed,^[14][15] and more research is needed. Meta-regression analyses are also needed to determine the optimal dose and ketone type. Ketone supplements are not typically taken with food in the studies that have tested their effects.

Heart failure

Adults: The effective dosage for improving cardiac function (increases left ventricular ejection fraction, cardiac output, and stroke volume) is a single dose of ketone ester (115 to 500 milligrams per kilogram of body weight or a total of 25 grams) taken by mouth before the test.^[16][17][18] Benefits have also been found with daily use of a ketone ester (25 grams four times a day) taken by mouth for 2 weeks.^[16][17]

Special considerations: Ketone supplements are not typically taken with food in the studies that have tested their effects. However, due to the scarcity of studies, future research is needed to clarify the optimal dose and type of ketone for improving cardiac function.

Other Considerations: