Friday, January 29, 2016

Exogenous ketones, how the hell did I get here, and who are these people?

This article is about seven months in the making.  So if I don't bore you, which I do my best not to (like writing 6,000 word articles on something as trivial as butt wink), then I hope you'll hang in there long enough to get through this one.  As it took me months of arguing, seeing both anecdotal results and reading a metric ass load of studies, and hearing about a hundred overwhelming testimonials to finally sit down and write this.

Rewind about seven months ago to one day in the gym.  I was just about to finish up my training session when this woman I sorta-kinda knew approached me.

Mind out of the gutter guys...not in that way.

She asked me what I thought of ketogenic diets.

"Not really a big fan.  Good for fat loss, but outside of that I'm not a fan."

"What if I told you I was involved with a company making exogenous ketones?"

"Ok, and?" I shrugged.

"Do you know much about ketones?"  she asked, in a rather smart ass way.

"Yes I know about ketones."

"Well" she smirked "this is a supplement you can take, pee on a stick and it shows you are using ketones for energy."

"Ok." I said, in about the most lukewarm manner you could reply to someone with.

"You don't find that fascinating?"

"Oh yes, peeing my pants over here."

I can't remember if that's what I said, but it was something to that effect.  Either way, I wasn't impressed nor enthralled by her information.  Who the fuck cares about ketones?

A few weeks later a friend of mine she was working with that was preparing for a men's bikini competition asked me the same series of questions.  Once again, my response was a lukewarm "I don't give a shit" kind of one.

"Dude, they are awesome." he said.

"How so?" I asked.

"Just the focus and energy you get from them.  I'm pretty depleted from dieting, and when I take them I have plenty of energy to train, feel really focused...not like a preworkout but just, really focused."

I looked down at my temperature gauge again to check the reading.

"Lukewarm" it read.

I yawned.

Still, somehow he convinced me to at least come have a sit down with the two of them later in the week to learn about this product.  I relented to be a decent friend and agreed to the meeting.  I also am a social creature by nature, and I never bypass and opportunity make someone exceptionally uncomfortable if I have the chance to do so.

Once there, I believe I remember being about as repulsive as possible in order to turn her off in regards to my interest in said product.

Then I basically ignored the information about the product and talked about banging hookers in the Caribbean, or something like that, in order to make her think I was a total pig and not worth working with.

Let me be clear, I've never ever ever banged a hooker in the Caribbean.  Only in Vegas.

I'm joking.  Yes, I'm f'ing joking.  My point was, at that time, to come across as an asshole (you know this isn't hard for me) in order to make her leave me alone.

What I did not know was that she was quite used to dealing with a variety of people....including assholes...and that my 11 scale asshole meter didn't have as much of an effect on her as I wanted it to.  In other words, she kept bothering me to at least try this stupid product out or read about it.

You have no idea how annoying she was.  I'm not being facetious here.   Remember being a kid, and your sibling would keep touching you or hitting you, and mom or pops would tell them to stop "touching you"?  Then they would get as close to you as possible, without actually touching you.

That annoying.

I have no idea how this happened but she managed to get me on a call with another guy in the company and we chatted about this thing, and then he mentioned a name to me that changed everything.

"Patrick Arnold is involved...."

At that point, they had my full attention.

You see, Patrick is a god damn genius.  And he's not going to be involved with anything that isn't legit as fuck.

Now I was listening.

The major component to this product was BHB, beta-hydroxybutyrate, with some MCT oil added in to slow down the digestion rate as they had found in testing, without something to slow the digestive rate, well, people's stomachs didn't feel so great.  We will just leave it at that.

Just to science-wiki you real quickly.......

In humans, beta-hydroxybutyrate is synthesized in the liver from acetoacetate, the first ketone produced in the fasting state. The biosynthesis is catalyzed by the enzyme beta-hydroxybutyrate dehydrogenase.

Although not a ketone itself, the concentration of beta-hydroxybutyrate, like that of other ketone bodies, is raised in ketosis. This elevated beta-hydroxybutyrate level seen in ketosis is naturally expected due to the fact that, as mentioned above, it is formed from acetoacetate. The compound can be used as an energy source by the brain when blood glucose is low.[1] Diabetic patients can have their ketone levels tested via urine or blood to indicate diabetic ketoacidosis. In alcoholic ketoacidosis, this ketone body is produced in greatest concentration. Both types of ketoacidosis result in an increase beta-hydroxybutyrate to oxaloacetate ratio, resulting in TCA cycle stalling and shifting of glucose towards ketone body production.

I also learned on the call that Toney Freeman was involved and was raving about the product as well.  Basically saying all the same stuff my friend was.  The focus, the added energy, appetite suppression, a more balanced mood, and just a more overall feeling of "well being."

My initial thoughts were actually, that if this was an energy source that could be used then competitors in depletion stages might see a benefit from it.  The last few weeks before a bodybuilding competition, most people are zombies from the severe starvation, and the excessive training load.  If it didn't have any kind of negative impact on their conditioning, it was at least worth looking into.

Seeing as how I really wanted to prove this annoying chick wrong, I decided I'd buy some, and send samples out to people I knew who were in such a state.  I was certain I would be able to report back to her that she was full of horse manure, and this will make her leave me alone.

So I bought some of this stuff, sent it off to several competitors I knew, and I awaited their responses about how this stuff did nothing.

I couldn't wait to rub this chick's nose in it.  To let her know how wrong she was.  I couldn't wait to copy and paste the responses back to her and let her know she could go sell this crap to some other gullible schmuck.  I've been around this field for over two decades.  And anyone that has followed me for anything length of time, knows what a skeptic I am about supplements.  In fact, despite the fact that I am sponsored by True Nutrition, the only supplement I have raved about with them is Muscle Intrusion.  Not that I don't love their products, because I do.  The only reason went on with them to be sponsored is because I believe that TN actually produces products of the highest quality in everything they do.  Let me also add, that in no way, do these two companies compete with each other.  

So I waited.  And then I got my responses back.

First IFBB pro physique competitor hit me back.

"Paul...what the fuck is this shit?  It's amazing!"

Me - "I knew it was garbag.....wait, what?"

"I have barely been able to move to get cardio and training done.  I took a pack this morning and within 30 minutes or so I was energized and motivated and knocked out my cardio with no problem."

Me - "But wait, no.  No.  Wait.  No.  But..."

Her - "Where do I get more of it?"

Me - "......................................"

The other person I sent it to, had actually been going hypoglycemic during her training.  She had actually come to me for help because she was so frustrated that she couldn't make it through a single leg day without going hypo, and having to cut her workouts short.

She confided in me that she had worked every type of pre and peri nutrition protocol you could think of.  And nothing helped.

So just on a hunch, I sent her some packs of this stuff.

A few days later, her response was the same as the other chicks.

"Paul...what the fuck is this shit?!?!?  It's amazing!"

ME - "....................................ok"

Her - "I took a pack about 30 or 45 minutes before training.  Did legs.  Didn't go hypo.  Do you know how long it's been since that happened?  I haven't been able to make it through a leg workout in forever without that happening."

Me - "Well, try it again.  Could just be by chance."

But without fail, she would take the ketone product, go train, and never go hypo.

I was getting desperate.  I had no bad news to report back.  I had nothing to rub this chicks nose in.  I was desperate.  So I sent it to a buddy who is an IFBB pro to try, and he said he saw no difference.

Finally!  Redemption.

"But" he said.  "I'm eating like, 800 grams of carbs a day.  So it's kinda hard to tell."


Reluctantly, I reported back to her on my very small bit of anecdotal evidence that it did look like it really was pretty legit.  At least for someone in depletion stages of a contest diet, or someone whose blood sugar was dropping during training.  I mean, that's not covering a huge demographic, but still.  It did do "something."

She asked me if I would be interested in reading about some studies in relation to it.  I wasn't.  But I told her I would, because believe it or not, I actually try to be good to people and respect the things they are passionate about.  Especially if I think they are genuinely decent people.   The product did look interesting.  So I started researching BHB more, and what it might actually be good for in regards to athletes.

My initial findings led me to inflammation.  And to put it mildly, I was quite overwhelmed.  And by overwhelmed I mean, there's a metric assload of studies that show over and over and over and over and over again that BHB reduces chronic inflammation, and has a very positive effect on restoring healthy levels of inflammation to the body.

I'm not writing another article about inflammation, and I'm going to make you not be lazy so this is what I'm going to do here.  I'm going to link a bunch of studies that show that BHB has a tremendous impact on reducing chronic inflammation in the body.  Now why is this important?  Because chronic inflammation is related to just about every nasty ass disease or something that causes a severe reduction in health in some way, shape, or form.

Here, you know what, I will be nice enough to provide the studies and some high level overviews....

The ketone metabolite β-hydroxybutyrate blocks NLRP3 inflammasome-mediated inflammatory disease.

BHB reduces NLRP3 inflammasome-mediated interleukin (IL)-1β and IL-18 production in human monocytes. In vivo, BHB or a ketogenic diet attenuates caspase-1 activation and IL-1β secretion in mouse models of NLRP3-mediated diseases such as Muckle-Wells syndrome, familial cold autoinflammatory syndrome and urate crystal-induced peritonitis. Our findings suggest that the anti-inflammatory effects of caloric restriction or ketogenic diets may be linked to BHB-mediated inhibition of the NLRP3 inflammasome.

In their study, published in the Feb. 16 online issue of Nature Medicine, the researchers described how the compound β-hydroxybutyrate (BHB) directly inhibits NLRP3, which is part of a complex set of proteins called the inflammasome. The inflammasome drives the inflammatory response in several disorders including autoimmune diseases, type 2 diabetes, Alzheimer’s disease, atherosclerosis, and autoinflammatory disorders.

“These findings are important because endogenous metabolites like BHB that block the NLRP3 inflammasome could be relevant against many inflammatory diseases, including those where there are mutations in the NLRP3 genes,” said Vishwa Deep Dixit, professor in the Section of Comparative Medicine at Yale School of Medicine.

How awesome is that one bit above?  Someone actually named their kid, Vishwa Deep Dixit!  If that's not a porn name in the making I don't know what is.  

Ok fine, back to inflammation......

Basically, BHB works to block inflammasomes, therefore reducing chronic levels of inflammation in the body.  And once again, inflammation is related to well everything from diabeetus, to heart disease, migraines, chronic fatigue, immune system problems, and well, just about every negative aspect of your overall health.  

Hey it's all there in science.  I wanted to be wrong.  I really did.  But the more I dug, the more interested I became.  

I ended up researching a lot about the positive effects of BHB on inflammation and eventually was part of a panel that would speak about the positive effects of keto-os along with two doctors, and my friend Brandon Lilly, who got on board with this as well.  

Fact was, because I had only researched the inflammation side of things, the two doctors blew me away at all the research related to the positive effects keto-os has on everything from epigenetics to balancing out neurotransmitters (GABA, serotonin, dopamine) to increased levels of ATP.  Which was another part that really piqued my interest.  If you know anything about increasing strength, then you know that increasing ATP is a big friend of yours.

If you eat a calorie-restricted diet for several days, you will increase the breakdown of your fat stores. However, many of your tissues cannot convert these fatty acid products directly into ATP, or cellular energy. In addition, glucose is in limited supply and must be reserved for red blood cells -- which can only use glucose for energy -- and brain tissues, which prefer to use glucose. Therefore, your liver converts many of these fatty acids into ketone bodies, which circulate in the blood and provide a fuel source for your muscles, kidneys and brain.
Synthesis and Breakdown of Ketone Bodies

Low fuel levels in your body, such as during an overnight fast or while you are dieting, cause hormones to increase the breakdown of fatty acids from your stored fat tissue. These fatty acids travel to the liver, where enzymes break the fatty acids into ketone bodies. The ketone bodies are released into the bloodstream, where they travel to tissues that have the enzymes to metabolize ketone bodies, such as your muscle, brain, kidney and in
testinal cells. The breakdown product of ketone bodies goes through a series of steps to form ATP.

The interesting part I ended up finding about here was that, the breakdowns of ketones to ATP is actually a far cleaner process than the breakdown of glucose to ATP.  

We're about to get super fucking sciencey so hang on here.  I'm make it a bit easier after this link, but the reason I'm using all of this research is to be thorough.

Oh and by the way, this article was about researching brain tumors....but we're stealing the ATP portion for strength athletes.  That makes me feel horrible inside in some sort of way, but I think science can indeed make us feel yucky inside at times........

Ketone bodies are more energetically efficient than either pyruvate or fatty acids because they are more reduced (greater hydrogen/carbon ratio) than pyruvate and do not uncouple the mitochondrial proton gradient as occurs with fatty acid metabolism [14]. In contrast to glucose, ketone bodies by-pass cytoplasmic glycolysis and directly enter the mitochondria where they are oxidized to acetyl-CoA [44,49]. The amount of acetyl-CoA formed from ketone body metabolism is also greater than that formed from glucose metabolism [50]. This increases TCA cycle metabolites (from citrate to α-ketoglutarate) while reducing the mitochondrial NAD couple, [NAD+]/[NADH], and increasing the mitochondrial Q couple [Q]/[QH2] [14,50]. The difference between these couples increases the redox span between the NADH dehydrogenase complex (site I), and the CoQH2-cytochrome C reductase (site III) thus enhancing the mitochondrial proton gradient [14]. This enhances the energy available from the hydrolysis of ATP, ΔG'ATP, the cell's key energy reserve generated through the mitochondrial Fl ATPase [14,16]. Remarkably, the ketone body-induced increase in the ΔG'ATP is also accomplished using less oxygen [48,50]. These and other findings led Veech to designate ketone bodies as a "super fuel" [14].

In addition to increasing ATP production while reducing oxygen consumption, ketone body metabolism can also reduce production of damaging free radicals [14,16,48]. The semiquinone of Q, the half reduced form, spontaneously reacts with oxygen and is the major source of mitochondrial free radical generation [14,51]. Oxidation of the Q couple reduces the amount of the semiquinone form thus decreasing superoxide production [14].

Annnnd to add..........

These data indicate that the infusion of beta-hydroxybutyrate may alter the balance from ATP degradation toward ATP resynthesis in muscle and liver by providing an immediate source of fuel and reducing equivalents under under specific metabolic conditions. This activity in combination with other metabolic interventions may have therapeutic value by restoring ATP pools in ATP-depleted tissues.

So basically, just as far as I've gotten - 

Keto-OS is completely f'n legit in regards to - 

1.  Increasing ATP, or at minimum reduces the degradation of ATP.  This means more contractile power for training, through a process that does it in a far cleaner state than the oxidation of glucose does.

2.  Has an exceptionally positive effect on neurotransmitters.  In essence, I use it now as a pre-workout and I can't lie.  It's amazing.  It's sort of hard to explain.  If you've ever had a workout where you just felt awesome, and totally focused, and had a steady stream of energy, it's like that.  I DO still use Intrusion with my training for this reason.  And because it takes about 30-45 minutes for them to kick in, I sort of stack these two.  I use the keto-os about 30-45 before training, then about halfway through training I start drinking the Intrusion from True Nutrtion.  From what I can tell and have learned from the doctors and scientists involved in this, the ketones have a muscle glycogen sparing effect.  Which is why the one girl I had using them stopped going hypo.  

3.  Reduces chronic inflammation and fatigue - This has been a major reason why I have been able to train longer, harder, more often, and not feel as run down.  It used to be that on leg days, about two or three hours post leg training I was just done for the day.  Now, I take half a pack about two or three hours post workout, and I feel fine.  No more feeling like I'm going to pass out, and am worthless for the day.

In fact, I have a great anecdotal story to provide about this as well.  

When we did the conference, I told Brandon before we left "I could use the strongest cup of coffee in the world right now.  I'm dead."  At the conference they were actually serving the keto-os.  So I drank two, and within 30 minutes, I was wide awake, and my fatigue was gone.  Brandon absolutely can verify he felt the same way.  

Since then I've talked to Charles Poliquin about it, and he had already been involved with a guy who was doing research on this very product a few years before.  Unfortunately, the dude passed away and the research died with him.  So he was pretty excited to learn about this, and wanted in on it as well.  So he and I will be doing some work together in regards to promoting the product, and researching all the ways it can benefit people from training, to neurological issues, to health and even concussions.

So the product itself has a myriad of positive effects on people.  I just returned from a huge conference in Vegas, and the number of testimonials about what this product had done for people mirrored the other ones I had heard before.

1.  Sense of well being
2.  More energy
3.  Improved mood
4.  Decreased pain
5.  Improved sleep

There were literally people who had been able to come off of anti-depressants, and even seen huge pain reduction in things like rheumatoid arthritis.  

Oh and lastly, no, you don't have to be on a ketogenic diet in order to use it at all!  You just get the benefits of BHB without having to actually go on an awful ketogenic diet.  I'm going to catch hell for that last sentence because the ketogenic diet is absolutely the crowd this product attracts.  But I eat like, almost 400 grams of carbs a day and still get great results from using it.  

So there you go. 

I've tried to be as open and honest as I can be about this whole thing.  This was a big deal for me because anyone who has followed me knows that I am no fraud, scammer, or snake oil salesman.  I took over six months to try and prove that this product was bunk and at every turn I was proven wrong either through anecdotal evidence, or the science behind it.  So I finally had to admit defeat. 

How I generally use it is like this.  

30-45 minutes before training - 

2-3 hours after training to reduce fatigue from training, or on non-training days to reduce "workout hangover".

Honestly, from those perspectives alone, it's been money and has made a huge difference in how I feel.  I actually kept this info out of my body recomp post a while back because I still wasn't totally convinced (yes I'm hard headed) of how legit it was.  But this is what would happen.

I'd use it for 4 weeks or so.  Run out.  Not pay attention.  Then, because my training frequency and volume was so high, I'd notice I wasn't recovering from training as well as before.  Then I would order some more, add it back in, and sure enough, my recovery ability would increase.

I wanted to be irritated because my initial response was that this product was junk.  But there's just too much science and anecdotal evidence behind it to label it that.  

You don't have to believe a word I say.  In fact, I implore you not to.

Go out and learn, read, and research yourself.  I urge everyone to question anything and everything in regards to training and diet BUT only if you're willing to experiment yourself.  No one ever learned if something worked for them by just arguing about it on the internet.  And I have no interest in arguing about this.  I've seen it work for others, and it works for me.  The science is there, the results and testimonials are there.

And that's the bottom line.  

I was wrong.  And admit defeat.

If you're interesting in grabbing some, here's a link to do so (below).


  1. Great explanation:) Thanks for writing.
    Dr. Heather

  2. Well said Paul! You rock! Thank you for writing this.

  3. Thank you Paul! You rock! Well said.

  4. Paul, I met you at the Overland Park Hilton gathering in November with Brandon Lilly...I was so impressed with your discoveries and matched my own. Thank you for looking 'under-the-hood' with this and writing such a concise summary.
    Frank Priebe

  5. Congrats, I never thought I'd see another supplement company make Biotest look like a bargin...but you did it, Pruvit. You did it. $144 for 30 servings...then the site says build up to 1 serving 3 times daily to maximize results. Riiiight.

    Paul, I've been reading your blog for years. If you say the stuff works then I have to believe it does. That said, at almost $5 a serving, I'm only buying it if it doubles my test levels , makes my boners last forever, and grows my hair back. It do that?

    1. I don't use that much. If you noted in the article, I use half a pack before training then half a pack later. That's 1 pack a day. I haven't found the need to increase the amount. So that's $144 a month. A whopping $5 a day. I'm pretty sure everyone wastes $5 a day on something.

    2. I will also say this - generally people who bitch about cost aren't that serious to begin with. Ever. People who don't want to pay a few hundred bucks for a seminar? Not fucking serious. People who don't want to pay money for legit supplements or high quality food? Not serious.

      Taking care of yourself is NOT a cheap lifestyle. People want things to be cheap then bitch that it is not of high quality. Generally higher quality products cost more because well.....they are of higher quality or meet certain standards for quality. TN's stuff is more expensive than most. Why? Because it consistently tests out as of the highest quality. People would rather pay $19 for some bullshit 2 pound tub of sugar than spend the extra $50 on something that actually has the ingredients in it.

      There's nothing I hate more than whiners about these things. About the only cheap supplement you can get that really works is creatine.

    3. Come on now, so if you're poor you can't be healthy?

    4. I never said that. I said if you're into THIS lifestyle it is NOT a cheap one. Supplements of high quality are expensive. They are expensive because of the degree of cost that goes into manufacturing them.

      But the same applies to seminars. People are cheap fucks and don't want to pay a few hundred dollars for a weekend where they would learn a tremendous amount that would help them improve. Instead, they would rather go around asking 1,000 people on the net, who don't have experience, how to improve. Rather than spend the money.

      I have no pity for them or anyone who bitches about the cost of something. Great coaches cost a lot to hire or to teach. Great products cost a lot because it's expensive to manufacture them.

      You can be poor and be healthy. You probably can't be poor and hire great coaches, purchase super high quality food, and super high quality supplements.

      Stop complaining and just don't buy it if that's the case. There's nothing worse than someone whining about something they aren't even going to participate in.

  6. You say you didn't mention it in your body recomp post. Looking back, do you believe it had a significant impact on your body recomp process? If so, would you attribute that to better ability to recover and handle a more training volume, or something else?


    1. I didn't mention it because I was still testing it. It absolutely made a difference in recovery.

  7. Paul,
    I'm just beginning the big 15 from 5/3/1 boring but big. Just curious if in an ideal scenario without family and work obligations you'd recommend first thing in the morning cardio and evening lifting or vice versa? Really enjoying reading strength,life,legacy. Thanks and keep up the good work.

    1. So confused right now. You're doing 5/3/1?

    2. Sorry,I've started the big 15. I've just finished 2 years of 5/3/1. Curious your thoughts on cardio or lifting first thing in the morning. Thanks

    3. Perfectly acceptable. I prefer intervals right now simply because it takes less time.

  8. I have a pack of this I was given a couple months back and because of how skeptical I am and how gullible the person who gave it to me is I have refused to use it.

    I may need to try it now... Dammit.

  9. This product advertises it gets you into a state of ketosis, how is that possible through ingestion? Ingesting ketones into your body won't put your body into ketosis, of course if you test the urine it will have trace of ketones... because you ingested them. It seems like false advertising.

    1. That's not what it does. Take some more time to read it.

    2. They raise ketone levels in your body and they recommend following a low carb high fat diet or ketogenic diet to maintain the ketone levels in your body that will keep you in ketosis. Exogenous ketones just kick-start the adaptation phase.

    3. This is not true at all. The recent study done with exogenous ketones WHILE taking carbohydrates show the body using exogenous ketones in a ketogenic type environment while carbs are still being consumed. so no that's incorrect.

  10. I have read this post a few times and am intrigued. However, I have one question...and if it is answered already I apologize for missing it.

    If ketones are being used for fuel as opposed to glucose and/or fat, how will this assist in weight loss?

    Part of me assumes that the length of time it spends in the body as an energy source is brief, but then that would negate the other benefits that are listed besides energy for a work-out.

  11. Have you tried more than 1 scoop at a time? Or is there no benefit to that?

  12. Would there be any benefit in taking more than 1 serving at a time?

  13. Would there be any benefit in taking more than 1 serving at a time?

  14. Paul, do you know how much caffeine is in a serving? I got the non-caffeinated version for starters because I figure I can add as much caffeine as I want, and I don't like not knowing how much there is. It's not anywhere on the website as far as I can tell.

  15. Hi Paul Carter old post hope you dont mind but do you think this would work for an aspiring crossfitters trying to add volume to their workout?

  16. Great article. Since writing it, have you worked together with Charles Poliquin to do any further research?

  17. Great article. Since writing it have you done further research with Charles Poliquin on the product?

  18. Hi Paul
    Great article! My original reasons for searching this topic was for my own contest fat loss. I'm pleasantly surprised about the inflammation aspects! My 75 yr old father was just diagnosed with RA. Hopefully I can get him to try this.
    What are your views on using this while on a keto diet and will it inhibit optimum fat loss. Especially in the early stages while body fat percentages are still in the teens. I appreciate all you research! Thanks in advance.