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Ketone monoester is a synthetic dietary supplement designed to rapidly elevate blood levels of the ketone body beta-hydroxybutyrate (βHB) without the need for carbohydrate restriction or increased fatty acid oxidation. The most studied form is R-1,3-butanediol acetoacetate diester, which undergoes hydrolysis in the gut to yield βHB and butanediol; the latter is further metabolized in the liver to βHB. This results in rapid and sustained ketosis within 30 minutes of ingestion. Ketone monoesters have been shown to lower blood glucose concentrations during oral glucose tolerance tests and post-exercise recovery, increase serum erythropoietin concentrations, and improve cognitive function through neurometabolic pathways involving elevated βHB[1][2][4][5]. They are generally recognized as safe by regulatory authorities such as the US FDA[5]. Mechanistically, their effects are attributed primarily to serving as an exogenous source of βHB—a metabolic substrate for brain and muscle—and potentially modulating signaling pathways related to metabolism and gene expression[6].
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