Drinks and powders that raise the body's fasting fuel in the blood within minutes, without changing what is eaten. A dose blunts the blood sugar rise after carbohydrate, dampens hunger for hours, and helps failing hearts pump. Costs are short-term: stomach upset, faster heart rate, mild blood acidity. Nothing yet links them to outcomes that matter over years. (Full Review)
| Marker | Target | Why |
|---|---|---|
| Blood beta-hydroxybutyrate | 1.0–3.0 mmol/L at peak, 30–90 min post-dose | Confirms the product works and the dose is right |
| Fasting glucose | 75–90 mg/dL | Tracks the metabolic effect being sought |
| HbA1c | 4.8–5.4% | Detects whether acute glucose effects accumulate |
| Fasting insulin | 2–5 µIU/mL | Ketones lower glucose without raising insulin; a rise suggests something else |
| Serum sodium | 137–142 mmol/L | Ketone salts add sodium; esters transiently increase urinary sodium loss |
| Serum potassium | 4.0–4.5 mmol/L | Exogenous ketosis reduces urinary potassium loss, which can stack with drugs |
| Serum bicarbonate | 24–28 mmol/L | Large ester doses lower bicarbonate and blood pH |
| Creatinine and eGFR | eGFR above 90 mL/min/1.73 m² | Ketone esters acutely change filtration rate |
| ALT | Below 25 U/L (men), below 20 U/L (women) | Rodent data flag hepatic fat and inflammation with esters and diols |
| Resting heart rate | Individual baseline, no sustained rise above 5 bpm | The most consistent cardiovascular signal from ketone dosing |
| Heart-rate variability | No established target; track change from personal baseline | Acute dosing lowers the "rest and digest" measures dose-dependently |
| Blood pressure | Below 120/80 mmHg | Salts add sodium; no group-level change was found but individuals vary |
| ApoB | Below 80 mg/dL | Captures whether acute lipid shifts persist |
Cadence: Baseline, 4 weeks, 12 weeks, then every 6 months; morning heart rate, heart-rate variability and blood pressure tracked at home; sodium and blood pressure at every checkpoint on salts.