
What is Beta-Hydroxybutyrate (BHB)?
When eating an ultra-low carbohydrate diet, the body switches from burning glucose to fat. As the liver breaks down fatty acids, it generates ketone bodies which serve as fuel for the brain, heart, and muscles in times when carbohydrates are in short supply.
In addition to eating low carb, the body also switches to running on ketones during periods of fasting, such as overnight while we sleep. Beta-hydroxybutyrate (BHB) is the most abundant of the three ketone bodies created by the liver, accounting 78% of the total ketones in the blood.[2]
Acetoacetate (AcAc) is second most prevalent ketone body, accounting for ~20% of total ketones in the blood. And last, but not least, is acetone, which accounts for a mere 2% of blood ketones. Interestingly, both BHB and acetone are derived from acetoacetate, but itโs BHB thatโs primarily used for energy production while AcAc is typically excreted via sweat and respiring (breathing).
THREE BENEFITS OF BHB
Supports Cognitive Function
While the brain only accounts for 2% of the bodyโs weight, it accounts for ~20% of the bodyโs energy needs on a daily basis. Typically the brain relies on glucose for fuel; however, during periods of low carbohydrate dieting, glucose is in short demand, which can lead to brain fog and difficulty concentrating. BHB supplies fast-acting fuel for the brain and is capable of supplying the brain with roughly 70% of its energy needs.[5] Furthermore, BHB also exerts broad neuroprotective benefits including a reduction in free radicals, decreased neuroinflammation, and improved cognition in patients with dementia
Aids Gene Expression
DNA is the biological โinstruction manualโ that dictates how we grow, function, and reproduce. If DNA expression becomes limited or compromised, your cellsโ ability to synthesize proteins is impaired leading to a host of health complications. BHB improves gene expression by inhibiting histone deacetylase (HDAC), an enzyme that cleaves the acetyl group from histone proteins on DNA rendering DNA less available to transcription factors.[3]
Inhibiting HDAC improves the bodyโs accessibility to genes (such as FOXO and MLT1) setting off a cascade of biological activity which has been noted to lead to improvements in metabolic health, longevity, and resiliency.[3]
Combats Oxidative Stress & Inflammation
In addition to their ability to support energy production and gene expression, BHB has also been noted in certain models to support the bodyโs resistance to oxidative stress through upregulation of FOXO.
FOXO proteins impact a wide range of mechanisms in the body including metabolism, apoptosis, and defense against oxidative stress. Together, these affect an organismโs longevity and lifespan. BHB also inhibits NLRP3, an inflammasome that stimulates release of inflammatory molecules including IL-1ฮฒ, IL-18, and TNF-ฮฑ. Preliminary studies note that BHB is capable of reducing levels of these inflammatory biomarkers.[4]
Exogenous Ketones
Until now, weโve been discussing ketones that are naturally produced by the body, otherwise known as endogenous ketone bodies. Ketones can also be supplemented in the form of BHB salts. BHB salts bind a molecule of BHB to a mineral such as sodium, calcium, or magnesium. When these are ingested, the body liberates the BHB to be used for energy while the minerals support a myriad of other functions in the body, such as hydration, muscle function, and blood clotting.
Now, youโre probably wondering, why would you need to supplement with BHB salts if youโre already following a ketogenic diet. Well, if a person is used to eating a very high carb diet and suddenly transitions to an ultra-low carb, ketogenic diet, it can take the body some time to get used to producing sufficient amounts of ketones to power it for its myriad of activities. While the body is โgetting its act togetherโ, flu-like symptoms can set in (lethargy, brain fog, cramping, etc). This condition in known as the keto flu.
Individuals transitioning to the keto lifestyle can supplement with exogenous ketones (in the form of BHB salts) to help ease the transition by supplying the body with readily accessible fuel. This may reduce fatigue and accelerate the bodyโs transition to burning fat for fuel.[6]
References:
1. Laffel, L. (1999). Ketone bodies: a review of physiology, pathophysiology and application of monitoring to diabetes. Diabetes/Metabolism Research and Reviews, 15(6), 412โ426.
2. Sena, S. F. (2010). Beta-hydroxybutyrateโฏ: New Test for Ketoacidosis. Department of Pathology and Laboratory Medicine.
3. Newman JC, Verdin E. Ketone bodies as signaling metabolites. Trends Endocrinol Metab. 2013;25(1):42โ52. doi:10.1016/j.tem.2013.09.002
4. Goldberg EL, Asher JL, Molony RD, et al. ฮฒ-Hydroxybutyrate Deactivates Neutrophil NLRP3 Inflammasome to Relieve Gout Flares. Cell Rep. 2017;18(9):2077โ2087. doi:10.1016/j.celrep.2017.02.004
5. White H, Venkatesh B. Clinical review: ketones and brain injury. Crit Care. 2011;15(2):219. Published 2011 Apr 6. doi:10.1186/cc10020
6. Cox, P. J., Kirk, T., Ashmore, T., Willerton, K., Evans, R., Smith, A., Clarke, K. (2016). Nutritional Ketosis Alters Fuel Preference and Thereby Endurance Performance in Athletes. Cell Metabolism, 24(2), 256โ268. https://doi.org/10.1016/j.cmet.2016.07.010







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