Beta Hydroxy Butyrate (BHB) on Keto: Complete Guide

Last Updated March 4, 2019 By

Beta-hydroxybutyrate (or BHB) is one of 3 ketones created when you restrict your carbohydrates.

In fact, of the 3 ketones that result when fat is broken down and metabolized in the liver, BHB is the predominant ketone body.

This is because BHB can easily cross the blood-brain barrier.

When glucose is in short supply, the brain uses BHB for most of its energy needs. And depriving the body of glucose is the whole idea behind moving into the state of Nutritional Ketosis.

Ketosis is a natural state and defined as a blood level of Beta-hydroxybutyrate of 0.5 mM, or more.

Those who are first entering into Nutritional Ketosis do not always have blood levels that high, and of those who do, this level isn’t always consistent throughout the day.

BHB level in the blood will rise and fall, depending on how many ketones are made in the liver, their use by the brain, and how intensely you exercise.

Ketones do not normally rise above 0.5 mM unless you’re severely restricting carbohydrates, on a ketogenic diet, fasting, semi-fasting (also referred to as intermittent fasting), or taking BHB supplements.

Supplements can hasten the production of beta-hydroxybutyrate, but their ability to sustain ketosis is very limited.

You have to consistently take supplements in order to maintain the small rise in blood BHB that you get from taking them.

In this guide to beta-hydroxybutyrate ketones on keto, we’re going to take a look at why you need to know about BHB, their chemical structure, health benefits, side effects, and how to boost your levels — both naturally and artificially.

What are BHB?

Carbohydrates are broken down during digestion into glucose.

When carbohydrates are restricted in the diet, the lack of glucose causes the liver to drain its glycogen supply. Glycogen is the storage form of carbohydrates.

The liver can store about 80 carbohydrates worth of glycogen at any one time.

While the muscles also store glucose in the form of glycogen, about 200 to 300 carbohydrates worth, muscle glycogen has a different purpose than liver glycogen, so the muscles do not share their glycogen with the liver.

Liver glycogen is used to maintain your blood glucose level within a very tight margin.

The liver uses fat to fuel the conversion of glycogen into glucose. As glycogen gets used up, more fat is needed to create ketones.

There are 3 types of ketones, the by-product of fat breakdown in the liver:

  1. acetoacetate ketones (AcAc)
  2. beta-hydroxybutyrate ketones (BHB)
  3. acetone ketones

Ketones are produced by a process called ketogenesis.

Fatty acids are broken down to produce acetyl CoA, which then travels through a variety of chemical reactions and eventually results in acetoacetate ketones.

Acetoacetate is the first ketone the liver makes as it breaks down fat, but acetoacetate isn’t very stable, so once it enters the liver mitochondria, it is acted on by the B-hydroxybutyrate dehydrogenase enzyme and converted to beta-hydroxybutyrate, which is stable and usable by the brain.

Acetone ketones are not used for energy at all.

The small amount that results during fat breakdown are tossed off into the breath and urine, giving your breath and urine that distinctive smell that signals ketosis.

Chemical Structure of BHB

bhb structure

Beta-hydroxybutyrate does not have the chemical structure of a ketone.

A ketone has carbonyl carbons, which is carbon that is bonded to oxygen with a double bond. The double-bonded carbonyl carbons are then attached to two other carbon atoms.

That is the chemical structure of a ketone.

BHB are carbonyl carbons that are attached to only one other carbon atom, so even though one carbon is missing, BHB behaves similarly to a ketone.

The brain can use it just fine, so BHB is often spoken of as if it were a ketone, especially since it starts out as acetoacetate, is converted to BHB, and then converted back into acetoacetate once it crosses the blood-brain barrier and enters the mitochondria of cells, during the metabolic process.

Why You Should Know About BHB on Keto?

Maintaining Nutritional Ketosis (a blood ketone level of 0.5 mM to 4.0 mM) takes awareness, persistence, and dedication.

Knowing how ketosis is achieved, what beta-hydroxybutyrate ketones are, and how to manage them during the weight-loss phase, and beyond, will go a long way toward helping you reach your weight-loss and fitness goals.

Keto is founded on the idea that you need to stay within the optimal range of beta-hydroxybutyrate ketones to see effective weight-loss results, fat adaption, and heightened performance during maintenance.

You can’t do that if you don’t know what BHB is, nor how to measure them and increase them, when needed.

According to Dr. Phinney, fat adaption isn’t something that occurs overnight.

You have to get into the optimal zone for ketosis and stay there for several weeks before your body becomes efficient at burning fats for energy instead of glucose.

How to Measure Beta-Hydroxybutyrate Ketones?

Beta-hydroxybutyrate can be measured using a ketone blood meter.

A ketone blood meter looks like a blood glucose meter and works in a similar way:

  1. Prick your finger,
  2. Place a drop of blood on a ketone strip,
  3. and insert the strip into the meter.

These meters are not the same thing as blood glucose meters, but some blood glucose meters have dual capacity and can measure both glucose and beta-hydroxybutyrate ketones with a single finger prick.

While the distinctive smell of your breath and urine and drastic drop in hunger and cravings will tell you that you are in ketosis, using a ketone blood meter is the only way to know for sure if you are in the optimal zone for Nutritional Ketosis.

Keto Supplements that Contain BHB

The ketones that the liver makes are called endogenous ketones. Endogenous insinuates an internal process.

Exogenous ketones (external) are not produced by the body and must be taken as a supplement.

There are two types of BHB supplements:

  1. ketone salts
  2. ketone esters

Ketone salts are powdered supplements created in a lab by bonding a beta-hydroxybutyrate ketone to a molecule of sodium, calcium, or magnesium.

Many supplements contain all 3 mineral salts, which makes them great for improving your electrolyte balance, but a pretty expensive way of doing that.

The power is mixed together with a liquid and then you drink it, like a protein shake, In liquid form, these BHB ketones are going to get into the bloodstream rather quickly.

Ketone esters are BHB ketones bonded to esters and sold in the form of a liquid, but they are difficult to find.

They also taste horrible, and cost more than the ketone salts, so the salt form of supplement is far more popular within the low-carb community than the esters are.

The idea behind these BHB supplements is to raise your blood level of BHB, but since ketones can’t be stored in the body, ketones not used will back up in your bloodstream and, thereby, raise your ketone level into the optimal range for Nutritional Ketosis.

They are marketed as a quick way to do that.

These ketones perform in the body in the same way that endogenous ketones do. That much is true.

However, while the amount of ketones in your bloodstream can tell you if you are in the optimal zone for Nutritional Ketosis, or not, the body will use these foreign ketones first, before your own.

This means less fat breakdown, fewer of your own ketones made, and less weight loss.

In addition, the supplements do contain calories, so you might see yourself go into a lengthy stall if you don’t cut back on calories elsewhere or raise your activity to compensate, especially since most dieters have to drink several servings of the supplement per day to reach and maintain optimal ketosis.

Health Benefits of BHB

There are several health benefits of BHB:

Lessens Oxidative Stress – Free radicals form when the body burns glucose for fuel or oxidizes oxygen during normal body processes. These by-products of oxidation can damage your cells and DNA when they accumulate. When the body burns fats and BHB for fuel, rather than glucose, fewer free radicals are produced.

Anti-inflammatory – BHB blocks the inflammatory protein called NLRP3 Inflammasone, which causes inflammation. While inflammation is a natural part of the healing process, chronically high levels of inflammation can trigger insulin resistance, metabolic syndrome, Type 2 Diabetes, and Alzheimer’s Disease.

Anti-Aging – BHB fights against oxidative stress by activating the proteins that protect your cells from free radicals. BHB acts as an antioxidant to increase longevity by slowing down the aging process.

Improved Satiety – Protein and fat are what bring satiety, but the liver creates ketones from breaking down dietary fat, as well as body fat. One of the most common benefits of going into the state of ketosis is a drastic reduction in hunger. This occurs due to an increase in satiety.

Increased Endurance – Since the body can use ketones for energy, when exercise is intense, upping your activity level and increasing your intensity will often result in an increase in stamina and feelings of well-being.

Lower Ghrelin Hormone – The higher Ghrelin is, the hungrier you get, so low levels of Ghrelin mean a lot less hunger.

Fewer Cravings for Carbs – When satiety increases, there is less desire and temptation for sweets and starches. You’ll find much more strength to pass on the chocolate cake if you feel stuffed.

Improved Cognitive Performance – With BHB being a clean energy source, mental functions and performance can improve with higher levels of available BHB.

What are the Side Effects?

If you’re taking a BHB supplement to help you get into ketosis faster, you’ll still have to go through a period of adjustment.

While some supplements claim you can get into ketosis as fast as an hour, these supplements only raise your ketones by 0.3 to 1.0 mM, so during the first few days, many people experience:

  • Mood swings
  • Fatigue
  • Low energy
  • Brain fog
  • Raving hunger

While keeping your electrolytes up will ward off the keto flu, these above side effects occur when BHB is low, as the body becomes stressed when it first runs out of glucose and begins to move from a glucose metabolism to one that predominantly oxidizes fatty acids and ketones.

As the BHB level goes up, so do your feelings of well-being.

These side effects calm down and pretty much go away. However, there is a disadvantage to high BHB levels in the blood that we need to talk about next.

Disadvantage of High BHB Level

The main disadvantage to having too many BHB ketones in the blood is the reaction your body has to ketone levels that go higher than about 4.0 or 5.0 mM.

The body will secrete insulin to bring those high levels of ketones back down.

This is why ketoacidosis is not a problem for the average Keto dieter, unless you have Type 1 Diabetes. The body will stop ketone production if ketones go too high.

This will result in higher circulating insulin and can affect the way your body metabolizes body fat if you have Insulin Resistance.

Once the excess ketones are used by the brain or during activity, your insulin level will return to where it was before.

Best Way to Raise Your Beta-Hydroxybutyrate Ketones

Ketosis is driven by carbohydrate restriction. It is not driven by fat or protein consumption, while some people who are sensitive to protein will over-secrete insulin when consuming protein and will need to eat less.

This means that the best way to get your ketones up into the optimal ketosis zone is to lower your carbs and keep your consumption of low-carb products to a minimum, so the liver has a chance to empty out its glycogen stores and turn to more body fat to make BHB ketones.

If that doesn’t work, lower protein a little bit at a time and watch how your body responds.

The trick is to change only one variable at a time, so you’ll know which variable produced results.

Final Thoughts

Getting into the state of ketosis quickly and easily is the best way to ensure that you have plenty of beta-hydroxybutyrate ketones to fuel the brain and your daily activities.

While keto supplementation is available, they are not economical and don’t work for everyone.

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