A Guide to Beta-Hydroxybutyrate (BHB)

Your body has a compensation mechanism to adapt to changes that affect its normal functioning. For example, in heart failure that causes reduced cardiac output, the body compensates by activating the Renin-Angiotensin-Aldosterone System (RAAS). The RAAS increases salt and water retention by releasing aldosterone, which in turn increases the cardiac output.

When glucose levels in your body are low, the low energy levels trigger a compensation mechanism. When you have low energy levels, you always feel tired, and your brain has trouble focusing. Not eating meals with enough carbohydrates can lead to low energy levels. Therefore, always make sure that you eat a balanced diet. When your body has low energy, it utilizes fats as a compensation mechanism.

One of the primary ketones that your body uses is beta-hydroxybutyrate, also known as BHB.

What is Beta-hydroxybutyrate (BHB)?

Beta-hydroxybutyrate is a major ketone naturally produced in the liver from the breakdown of fats when your glucose levels are low, due to a diet containing low carbohydrates.


It boosts your energy levels to help your brain and muscles function correctly. It is also released when you are exercising or fasting. Normally, the levels of BHB are within steady levels, whether you are fasting or not. However, the levels of the ketone increase after you go for approximately two to three days without food. Conditions like diabetes also result in high levels of the ketone due to deficiency of insulin.

Though your body can produce the chemical nature, you can also take it exogenously through BHB keto supplements. Some people can induce the state of ketosis by having a keto diet.

A keto diet is a diet containing low carbohydrates and high levels of fat. When on a keto diet, your body enters into a metabolic state called ketosis, in which your body produces high amounts of ketones, beta-hydroxybutyrate included.

How does it work?

Beta-hydroxybutyrate acts indirectly on the tissues affected by low sugar levels, such as the brain and muscles.

It travels through the bloodstream to the cells in the muscles and brain. It then undergoes different conversion stages once inside the cell. It is first converted to acetoacetate by a dehydrogenase enzyme and then to acetyl CoA. Once it reaches the stage of acetyl CoA, it enters the Kreb’s cycle.

The Kreb’s cycle, also known as the citric acid cycle, is a chemical process that involves oxidation of acetyl CoA to release energy.

9 Health Benefits of Beta-hydroxybutyrate

There are several benefits that the ketone offer to your body when you take it as a supplement or through a keto diet.

heatlh benefits of bhb

It is said to have many positive health effects, such as contributing to metabolic rates, weight loss, and more, which are still under study.

The known benefits of the Beta-hydroxybutyrate include:

1. It acts as fuel

The main function that the ketone plays in the body is the production of fuel when you are fasting, exercising, or eating a low carbohydrate diet.

Every tissue in your body is capable of breaking down the ketone to release energy. The tissues do this through oxidation of acetyl CoA. The ketone is useful in the proper functioning of the brain and muscle cells.

2. It causes the expression of genes

Expression of genes is essential for all body functions such as reproduction, growth, and prevention of diseases. The BHB  ketone makes all this possible by inhibiting an enzyme known as histone deacetylase (HDAC). Since the expression of genes occurs within your DNA, any chemical or enzyme that affects the normal function of DNA also affects gene expression.

The HDAC enzyme hinders DNA transcription by cleaving DNA histone proteins. When the ketone inhibits the enzyme, it promotes DNA transcription and, therefore, gene expression.

3. It improves cognitive function

The brain utilizes most of the energy in your body. This is because the brain regulates all body functions. Activities that need a lot of concentration, such as taking a test and studying, make the energy burn a higher amount of glucose for energy. Therefore, when your blood glucose levels lower, you have difficulties concentrating and completing basic tasks.

4. It has anti-inflammatory effects

Beta-hydroxybutyrate also inhibits a stimulator of inflammation known as NLRP3. The inflammasome causes the release of inflammatory agents such as IL-18 and TNF-alpha. By blocking the activity of NLRP3, the ketone reduces signs of inflammation, such as swelling, redness, and pain.

5. It reduces oxidative stress

The oxidation of the Beta-hydroxybutyrate to release fuel also results in the release of fewer oxygen-reactive species (ROS). ROS is important in aiding the immune system to fight off diseases. However, high levels of ROS are dangerous because they can cause oxidative damage and lead to the development of chronic diseases such as diabetes, heart disease, and arthritis. By releasing low levels of ROS, the ketone causes your immune system to function as required. It also reduces aging by delaying the occurrence of wrinkles due to the reduction of oxidative stress.

6. It increases athletic performance

The ketone makes athletes run faster and for longer periods due to the high levels of energy.

7. It increases levels of high-density lipoproteins (HDL)

HDLs are also known as cardioprotective lipoproteins. This is because they reduce the risk of heart diseases such as heart attack and stroke. Its ability to cause weight loss has been related to the lowering of HDLs.

8. It is a potential anti-seizure

According to animal studies, the ketone, as well as other ketones like acetoacetate, is effective in preventing seizures. It reduces the severity and frequency at which the seizures occur. It is capable of doing this because it can cross the blood-brain barrier to block the firing of neurons.

9. It regulates insulin and glucose

It regulates the levels of insulin and glucose, which prevents the development of obesity and type 2 diabetes.

What can Beta-hydroxybutyrate help with?

Beta-hydroxybutyrate supplements can help in preventing the keto flu when starting the keto diet.

The keto flu is a common side effect that usually occurs when you are transitioning from your normal diet to the keto diet. It is called the keto flu because you will present with flu-like symptoms such as a running nose and sneezing.

Also, BHB can assist with weight loss for people who have been trying to lose weight. This is because it is associated with reduced appetite and also reduces your cholesterol levels. It can also help people trying to achieve faster ketosis since the keto diet takes a while before you can notice any changes.

Who should take beta-hydroxybutyrate (BHB)?

Not everybody is eligible to take the beta-hydroxybutyrate supplements. The BHB supplement comes in the two forms; BHB salts and BHB esters. The main salts are sodium and calcium salts, while the main ester is the monoester form. When you take beta-hydroxybutyrate, the body cleaves the salt or ester to release the free ketone.

Some people need exogenous ketone more than others because of the benefits that it provides. These people include:

Alzheimer’s disease patients

Alzheimer’s is a disease that affects normal cognitive function by mainly impairing your memory. Since the supplements boost cognitive function, they can help relieve symptoms of Alzheimer’s in the patients.

People with dry eyes

The supplement can be given in the form of eye drops to prevent dry eyes. Dry eyes can lead to complications like corneal ulcers and visual difficulties if left untreated.


The supplements give you more energy to run faster.

Patients with Parkinson’s disease

Parkinson’s disease is associated with a poor cognitive function that can affect your walking and balance. Since the supplements aid in cognitive function, they can improve such symptoms.

Anyone with difficulties of memory loss

Men and women in their menopause usually suffer from memory loss and lack of concentration due to low levels of the hormones testosterone and estrogen, respectively.

Epileptic patients

Since studies show the effectiveness of the supplements in reducing seizures, epileptic patients can also use it.

Psychiatric patients

Patients who suffer from psychiatric disorders such as anxiety and bipolar can also benefit from beta-hydroxybutyrate. Though the exact mechanism of this is unknown, researchers have associated its benefit to the metabolic effects that the BHB supplement causes.

Precautions involved in taking Beta-hydroxybutyrate?

The salt supplements of the ketone are in powder form while the BHB esters in liquid form. If you are taking the salt, mix it with water or a beverage, and drink the mixture about half an hour before eating. The dosage will depend on the dosage prescribed by your physician.

When taking beta-hydroxybutyrate, make sure that:

  • You take them by mouth for only five days a week.
  • You eat a healthy diet to manage your levels of insulin and carbohydrates.
  • Do regular blood glucose tests, at least four to six times every day. The frequency should increase if you have symptoms of high blood sugar.

Avoid these supplements if:

  • You are pregnant.
  • You do have diabetes because it can cause ketoacidosis, which is fatal.
  • You do have hypertension.

Beta-hydroxybutyrate Possible Side Effects

The use of these BHB supplements is generally safe.

Side effects are caused by the presence of high levels of the ketone in your blood that make your blood too acidic. Common side effects of taking beta-hydroxybutyrate supplements that are experienced by almost everyone using it include constipation, stomach upset and pain, and diarrhea.

However, these side effects are likely at doses higher than normal. Other side effects you may experience include:


It is a condition in which blood sugar levels are low. This will happen because the beta-hydroxybutyrate reduces the activity of insulin, a hormone that lowers blood sugar levels, and glucose.

Electrolyte imbalance

Imbalance of electrolytes is mainly seen with salt supplements. The imbalance can have consequences like irregular heartbeats.

High blood pressure

This side effect is particular if you are using supplements containing sodium salt.


Dehydration mainly occurs with the use of sodium salt supplements. It can lead to dry eyes, dry mouth, and headaches.


Though rare in normal healthy individuals, supplements of the ketone can cause ketoacidosis. This is mainly seen in diabetic individuals.

Loss of appetite

This was associated with a reduction in the levels of ghrelin, a hormone that promotes appetite.