BETA-HYDROXYBUTYRATE (BHB)

OTHER NAME(S):

Beta-Hydroxybutyric Acid, BHB, Calcium-D,L-3-Hydroxybutyrate, D-3-Hydroxybutyrate, D-Beta-Hydroxybutyrate, D-Beta-Hydroxybutyric Acid, Glyceryl-Tris-3-Hydroxybutyrate, L-Beta-Hydroxybutyrate, L-Beta-Hydroxybutyric Acid, Sodium-D, L-3-Hydroxybutyrate, 1,3-Butanediol Acetoacetate Diester, 3-Hydroxybutanoic Acid, 3-Hydroxybutyl-3-Hydroxybutyrate Monoester, 3-Hydroxybutyrate, 3-Hydroxybutyric Acid.

Overview

Overview Information

Beta-hydroxybutyrate is a chemical that is made by the body to provide energy in times when not enough carbohydrates or sugars have been eaten. Beta-hydroxybutyrate can also be made in the lab and taken as a supplement.

Beta-hydroxybutyrate is placed in the eye for dry eye and taken by mouth for athletic performance, migraine, Alzheimer disease, memory loss with age, Parkinson disease, and many other conditions, but there is no good scientific evidence to support these uses.

How does it work?

Beta-hydroxybutyrate is a chemical that is used as energy by some cells of the body when sugar levels are low. Beta-hydroxybutyrate seems to help nerves and the brain to work better. Beta-hydroxybutyrate might be used as energy by muscles in the body to improve exercise ability.
Uses

Uses & Effectiveness?

Insufficient Evidence for

  • Athletic performance. Early research on the use of beta-hydroxybutyrate for athletic performance is mixed. One small study shows that taking a chemical called 3-hydroxybutyl-3-hydroxybutyrate, which turns into beta-hydroxybutyrate in the body, might help athletes to run faster. But other studies show that taking beta-hydroxybutyrate before cycling doesn't decrease fatigue or improve power while cycling.
  • Dry eye. Applying eye drops containing beta-hydroxybutyrate doesn't seem to improve eye symptoms in patients with dry eyes.
  • Obesity. Early research suggests that beta-hydroxybutyrate might help to preserve muscle mass and reduce feelings of hunger in obese people who are on a very low-calorie diet or a starvation diet.
  • Alzheimer disease.
  • Decline in memory and thinking skills that occurs normally with age.
  • Migraine.
  • Parkinson disease.
  • Other uses.
More evidence is needed to rate the effectiveness of beta-hydroxybutyrate for these uses.

Side Effects

Side Effects & Safety

When taken by mouth: A chemical that turns into beta-hydroxybutyrate in the body, called 3-hydroxybutyl-3-hydoxybutyrate, is POSSIBLY SAFE when taken daily for up to 5 days. Some people might have stomach upset, diarrhea, constipation, and stomach pain. These side effects are more likely to happen when very high doses are used.

When applied into the eye: Beta-hydroxybutyrate is POSSIBLY SAFE. An eye drop containing 1% beta-hydroxybutyrate has been used without side effects for up to 4 weeks.

Special Precautions & Warnings:

Pregnancy and breast-feeding: There isn't enough reliable information to know if beta-hydroxybutyrate is safe to use when pregnant or breast-feeding. Stay on the safe side and avoid use.

Interactions

Interactions?

We currently have no information for BETA-HYDROXYBUTYRATE (BHB) Interactions.

Dosing

Dosing

The appropriate dose of beta-hydroxybutyrate depends on several factors such as the user's age, health, and several other conditions. At this time there is not enough scientific information to determine an appropriate range of doses for beta-hydroxybutyrate. Keep in mind that natural products are not always necessarily safe and dosages can be important. Be sure to follow relevant directions on product labels and consult your pharmacist or physician or other healthcare professional before using.

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View References

REFERENCES:

  • Achanta LB, Rae CD. ß-Hydroxybutyrate in the brain: One molecule, multiple mechanisms. Neurochem Res. 2017;42(1):35-49. View abstract.
  • Beylot M, Chassard D, Chambrier C, et al. Metabolic effects of a D-beta-hydroxybutyrate infusion in septic patients: inhibition of lipolysis and glucose production but not leucine oxidation. Crit Care Med. 1994;22(7):1091-8. View abstract.
  • Clarke K, Tchabanenko K, Pawlosky R, et al. Kinetics, safety and tolerability of (R)-3-hydroxybutyl (R)-3-hydroxybutyrate in healthy adult subjects. Regul Toxicol Pharmacol. 2012;63(3):401-8. View abstract.
  • Cox PJ, Kirk T, Ashmore T, et al. Nutritional ketosis alters fuel preference and thereby endurance performance in athletes. Cell Metab. 2016;24(2):256-68. View abstract.
  • Evans M, Cogan KE, Egan B. Metabolism of ketone bodies during exercise and training: physiological basis for exogenous supplementation. J Physiol. 2017;595(9):2857-2871. View abstract.
  • Evans M, Patchett E, Nally R, Kearns R, Larney M, Egan B. Effect of acute ingestion of β-hydroxybutyrate salts on the response to graded exercise in trained cyclists. Eur J Sport Sci. 2018;18(3):376-86. View abstract.
  • Gautschi M, Weisstanner C, Slotboom J, Nava E, Zürcher T, Nuoffer JM. Highly efficient ketone body treatment in multiple acyl-CoA dehydrogenase deficiency-related leukodystrophy. Pediatr Res. 2015;77(1-1):91-8. View abstract.
  • Gross EC, Sandor P, Fischer D. Preliminary data on exogenous ketone bodies in migraine prevention. Cephalalgia 2017; 37(1S) 52-171.
  • Hashim SA, VanItallie TB. Ketone body therapy: from the ketogenic diet to the oral administration of ketone ester. J Lipid Res. 2014;55(9):1818-26. View abstract.
  • Hiraide A, Katayama M, Sugimoto H, Yoshioka T, Sugimoto T. Effect of 3-hydroxybutyrate on posttraumatic metabolism in man. Surgery. 1991;109(2):176-81. View abstract.
  • Holdsworth DA, Cox PJ, Kirk T, Stradling H, Impey SG, Clarke K. A ketone ester drink increases postexercise muscle glycogen synthesis in humans. Med Sci Sports Exerc. 2017;49(9):1789-1795. View abstract.
  • Kawakita T, Uchino M, Fukagawa K, et al. Randomized, multicenter, double-blind study of the safety and efficacy of 1%D-3-hydroxybutyrate eye drops for dry eye disease. Sci Rep. 2016;6:20855. View abstract.
  • Kemper MF, Srivastava S, Todd King M, Clarke K, Veech RL, Pawlosky RJ. An ester of ß-hydroxybutyrate regulates cholesterol biosynthesis in rats and a cholesterol biomarker in humans. Lipids. 2015;50(12):1185-93. View abstract.
  • McNally MA, Hartman AL. Ketone bodies in epilepsy. J Neurochem. 2012;121(1):28-35. View abstract.
  • Newman JC, Verdin E. ß-Hydroxybutyrate: A signaling metabolite. Annu Rev Nutr. 2017;37:51-76. View abstract.
  • Newport MT, VanItallie TB, Kashiwaya Y, King MT, Veech RL. A new way to produce hyperketonemia: use of ketone ester in a case of Alzheimer's disease. Alzheimers Dement. 2015;11(1):99-103. View abstract.
  • Pawan GL, Semple SJ. Effect of 3-hydroxybutyrate in obese subjects on very-low-energy diets and during therapeutic starvation. Lancet. 1983;1(8314-5):15-7. View abstract.
  • Plecko B, Stoeckler-Ipsiroglu S, Schober E, et al. Oral beta-hydroxybutyrate supplementation in two patients with hyperinsulinemic hypoglycemia: monitoring of beta-hydroxybutyrate levels in blood and cerebrospinal fluid, and in the brain by in vivo magnetic resonance spectroscopy. Pediatr Res. 2002;52(2):301-6. View abstract.
  • Reger MA, Henderson ST, Hale C, et al. Effects of beta-hydroxybutyrate on cognition in memory-impaired adults. Neurobiol Aging. 2004;25(3):311-4. View abstract.
  • Simeone TA, Simeone KA, Stafstrom CE, Rho JM. Do ketone bodies mediate the anti-seizure effects of the ketogenic diet? Neuropharmacology. 2018;133:233-241. View abstract.
  • Thomsen HH, Rittig N, Johannsen M, et al. Effects of 3-hydroxybutyrate and free fatty acids on muscle protein kinetics and signaling during LPS-induced inflammation in humans: anticatabolic impact of ketone bodies. Am J Clin Nutr. 2018;108(4):857-67. View abstract.
  • Toksoy HB, Tanzer FN, Atalay A. Serum carnitine, beta-hydroxybutyrate and ammonia levels during valproic acid therapy. Turk J Pediatr. 1995;37(1):25-9. View abstract.
  • Valayannopoulos V, Bajolle F, Arnoux JB, et al. Successful treatment of severe cardiomyopathy in glycogen storage disease type III With D,L-3-hydroxybutyrate, ketogenic and high-protein diet. Pediatr Res. 2011;70(6):638-41. View abstrtact.
  • Van Hove JL, Grünewald S, Jaeken J, et al. D,L-3-hydroxybutyrate treatment of multiple acyl-CoA dehydrogenase deficiency (MADD). Lancet. 2003;361(9367):1433-5. View abstract.
  • Van Rijt WJ, Heiner-Fokkema MR, du Marchie Sarvaas GJ, et al. Favorable outcome after physiologic dose of sodium-D,L-3-hydroxybutyrate in severe MADD. Pediatrics. 2014;134(4):e1224-8. View abstract.
  • Waldman HS, Basham SA, Price FG, et al. Exogenous ketone salts do not improve cognitive responses after a high-intensity exercise protocol in healthy college-aged males. Appl Physiol Nutr Metab. 2018;43(7):711-7. View abstract.
  • Woods WG, Pawan GL, Semple SJ, Ralphs DN. Effect of intravenous 3-hydroxybutyrate on postoperative nitrogen balance. Hum Nutr Clin Nutr. 1983;37(5):391-4. View abstract.
  • Woolf EC, Syed N, Scheck AC. Tumor metabolism, the ketogenic diet and ß-hydroxybutyrate: novel approaches to adjuvant brain tumor therapy. Front Mol Neurosci. 2016;9:122. View abstract.

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