Summary
HVMN research lead Dr. Latt Mansor, who holds a PhD in physiology from Oxford, joins Dr. Anthony Gustin to discuss the latest science on exogenous ketones. They trace the evolution from BHB ketone salts to ketone esters to HVMN's current R1,3-butanediol product (Ketone IQ), covering the pros, cons, and ideal blood ketone ranges for each. The conversation covers HVMN's $6 million Department of Defense contract studying cognitive performance in hypoxia, where exogenous ketones significantly preserved cognition and improved oxygen saturation. They also discuss emerging research into exogenous ketones for Alzheimer's, traumatic brain injury, diabetes management, and the nuances of dual-fuel metabolism when combining carbohydrates with ketones.
Key Points
- R1,3-butanediol (Ketone IQ) provides a slow steady rise in blood BHB to 2-2.5 mmol/L that stays above 1 mmol/L for about six hours at rest
- The Goldilocks zone for performance benefits is 1.5-2.5 mmol/L blood BHB; going above 5 mmol/L causes adverse effects
- HVMN's $6 million DOD contract showed exogenous ketones significantly preserved cognition and improved oxygen saturation in hypoxia
- Ketone esters spike BHB to 3-5 mmol/L within 30 minutes but cause blood pH drops and increased perceived exertion
- Ketone salts are limited by salt load: high doses cause GI distress before reaching therapeutic ketone levels
- Recovery studies show ketones taken post-workout activate mTOR pathway and increase leucine uptake, improving muscle protein resynthesis
- Peter Haspel's group demonstrated 15% improved work output after three weeks using ketones as a post-workout recovery strategy
- Exogenous ketones acutely suppress lipolysis but over the long run support overall fat burning, especially when combined with fasting
Key Moments
DOD hypoxia research: ketones preserve cognition and improve oxygen saturation
Phase one military research showed significant cognitive decline in hypoxia, but exogenous ketones preserved cognition and unexpectedly improved oxygen saturation, leading to a $6 million Phase 2 contract.
"with the presence of ketones, we saw an improvement in oxygen saturation significantly in the ketone group."
Ketone IQ vs esters vs salts: the Goldilocks zone for blood BHB
Dr. Mansor explains the optimal blood BHB range of 1.5-2 mmol/L for performance and 1.0 mmol/L for therapeutic use, and why ketone salts cannot reliably reach these levels due to salt load limitations.
"the general consensus is to reach at least 1.5 to 2 millimolar, if not higher, to get the benefit of performance. And then for therapeutic users, it's 1.0 millimolar."
R1,3-butanediol pharmacokinetics: slow rise, six-hour duration
Unlike ketone esters which spike BHB rapidly, Ketone IQ produces a gradual rise peaking around 2-3 mmol/L at two to three hours and stays above 1 mmol/L for about six hours at rest.
"it has a slow, steady rise. You can probably And it will slowly rise up to like two, three and peak around two, three hours. And it will stay if you're at rest. What we've seen internally for our internal study is that if you're at rest, it will stay above one millimolar for about six hours"
Emerging therapeutic applications: Alzheimer's, TBI, and diabetes
NIH is investigating ketone esters for Alzheimer's, the University of British Columbia has published studies on exogenous ketones in healthy, obese, and diabetic populations, and HVMN has submitted a grant for TBI research.
"NIH is looking at using ketonester for Alzheimer's. British University of British Columbia, they published three papers so far on healthy, obese, and diabetic individuals using exogenous ketones"
