Are Ketones Worth It?

It’s Q&A Day at 10almonds!

Have a question or a request? We love to hear from you!

In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!

No question/request too big or small 😎

❝Are ketones useful to take, or just a waste of money?❞

Whether or not they’re useful to take as a supplement may depend on your goals (more on this shortly)!

As for financial considerations, that’s something that depends on knowledge of your budget, so we’ll stick to the science, and then hopefully you’ll be able to make an informed decision based on that.

First, for any unfamiliar, let’s quickly address:

What are ketones, anyway? Ketones are a normal biological fuel source your ever-industrious liver produces during fasting, exercise, low carbohydrate intake, or illness, primarily to supply energy—especially to your brain—when glucose availability drops.

Note: while normal ketone production is fine and healthy, dangerously high ketones in uncontrolled Type 1 Diabetes can cause ketoacidosis, a life-threatening condition because insufficient insulin allows ketones to rise unchecked and acidify your blood. Technically this can happen in other diabetes types too, but it’s much less likely when the body has at least some useable insulin. By “useable insulin”, here we mean insulin to which the body is not so insensitive as to ignore it; not in the “rudely shunning” social sense of “so insensitive as to ignore”, but rather in the “insulin insensitivity” sense, in which the body stops responding appropriately to insulin due to metabolic dysfunction (see: Improve Your Insulin Sensitivity). In T1D, on the other hand, the body is producing negligible amounts of insulin if any at all, due to the pancreas being at war with itself (T1D is first and foremost an autoimmune disorder of the pancreas). So that’s why ketone levels are such a big issue for people with T1D specifically, since those with T1D are invariably reliant on exogenous insulin (i.e. the kind that comes from a pharmacy rather than one’s pancreas).

On which note, if you do have diabetes of any type, then modulating ketone metabolism (where possible) can be beneficial, as a way of improving blood sugar control, including experimental drugs that shift muscles away from ketone use towards glucose use, but these therapies are still under development rather than established treatment.

For more on that, see: The multifaceted roles of ketones in physiology

There are some other uses that have been studied, with varying results, namely:

• Heart health: preclinical and early human studies suggest ketones may help support heart muscle function, including possible roles in coronary artery disease and some forms of heart failure, but long-term benefits, but the science for this is very early and unclear.
  • See for example: Ketone therapy prevents semaglutide-induced loss of cardiac mass ← yes, that’s very specific, but honestly, there are not a lot of papers to chose from
• Exercise performance: evidence for ketone supplements improving athletic performance is mixed at best, and the most conclusive evidence is actually for it impairing performance rather than enhancing it.
  • See for example: Ketone Diester Ingestion Impairs Time-Trial Performance in Professional Cyclists
  • And also: Exogenous Ketosis Impairs 30-min Time-Trial Performance Independent of Bicarbonate Supplementation
• Brain health & anti-inflammatory effect: despite widespread marketing, we were not able to find any compelling evidence that ketones meaningfully boost cognition, reduce inflammation, or broadly improve brain health in healthy people.
  • The best we could find was this review that suggested “modest” benefits: The Effect of Exogenous Ketone Bodies on Cognition in Patients with Mild Cognitive Impairment, Alzheimer’s Disease and in Healthy Adults: A Systematic Review and Meta-Analysis

Want to learn more?

For the benefits (and pitfalls) of raising endogenous ketones (rather than supplementing with exogenous ketones), see:

• How Beneficial Is MCT Oil, Really?
• Ketogenic Diet: Burning Fat Or Burning Out?
• Why Keto Fat Loss Doesn’t Work So Well For Women

Want to try some?

We don’t sell them, but here for your convenience is an example product on Amazon 😎

Take care!