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Sodium 3-hydroxybutyrate is the monosodium salt of 3-hydroxybutyric acid, a naturally occurring ketone body and human metabolite. It serves as an alternative energy substrate for tissues, especially during periods of low glucose availability such as fasting or metabolic stress. Pharmacologically, it is used as a source of ketone bodies in certain inborn errors of metabolism (e.g., HMG-CoA lyase deficiency and multiple acyl-CoA dehydrogenase deficiency) to provide energy to the brain and heart when endogenous ketogenesis is impaired[7][10]. Mechanistically, it acts both as an energy substrate (bypassing defective metabolic pathways) and as a signaling molecule by activating hydroxycarboxylic acid receptor 2 (HCAR2) and free fatty acid receptor 3 (FFAR3), which are involved in anti-inflammatory effects, regulation of lipolysis, glucose homeostasis, and cellular redox balance[6]. It has also been investigated for potential benefits in neurological diseases such as epilepsy and leukodystrophy[7][8].
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