What are Exogenous Ketones?

Originally posted on HVMN and authored by Brady Holmer on July 27th, 2019

The ketogenic diet is more lifestyle than diet. It’s gaining popularity among those who wish to improve their metabolic health, lose weight, or boost their productivity. The many purported benefits of the diet are due, in part, to the properties of ketones, which are produced by the liver in someone on the low-carb diet, or someone in a fasted state.

Table of Contents

Endogenous vs. Exogenous Ketosis

General Health Benefits of Ketosis

Exogenous Ketones: Another Avenue to Ketosis

Benefits of Exogenous Ketones

Ketone Salts

The Science on Ketone Salts for Health

The Science on Ketone Salts for Performance

Advantages and Disadvantages of Ketone Salts

Ketone Esters: Acetoacetate Diester

The Science on AcAc Diester for Health

The Science on AcAc Diester for Performance

Advantages and Disadvantages of AcAc Diester

Ketone Esters: BHB Monoester (HVMN Ketone)

The Science on BHB Monoester

Advantages and Disadvantages of BHB Monoester

Ketone Oils and Powders

The Science on MCTs

Advantages and Disadvantages of MCTs

How do MCTs Differ from Exogenous Ketones?

When and How to Use Exogenous Ketones

Final Thoughts on Exogenous Ketones

But, keto isn’t for everyone. Some may find it restrictive, and others, like athletes, may find that this way of eating does not lend itself to optimal performance (depending on their specific needs). Fortunately, there is another way to benefit from ketones without going on a keto diet or fasting. 

Exogenous ketone supplements are another way to get into ketosis.

Endogenous vs. Exogenous Ketosis

Being in a state of ketosis means that you have elevated levels of ketones in your blood, usually measured at > 0.5mM. That’s simply the line you must cross to enter ketosis; but there are two distinct ways of arriving there. 

Traditionally, this happens as a result of eating a very low carbohydrate-ketogenic diet (called nutritional ketosis) or practicing caloric restriction or intermittent, prolonged fasting. In these situations, carbohydrate depletion and a reduction in insulin causes free fatty acids (FFAs) to be released from fat stores in the body through a process called lipolysis. Then, these FFAs are transported to the liver, where they’re used to produce ketone bodies. This is known as endogenous ketosis—meaning ketones are being produced by the body. 

Someone who is producing their own ketones is in a ketogenic state.

There are three ketones: beta-hydroxybutyrate (BHB), acetoacetate(AcAc), and acetone. However, we don’t produce an equal amount of each.  

Normally, the ratio of circulating BHB to Acetoacetate is about 1:1. However, in ketosis (whether due to fasting or a ketogenic diet), this ratio can rise up to 6:1. In ketosis, you’ll have higher levels of circulating BHB compared to AcAc.1 Acetoacetate is the first ketone produced and from this. BHB and then acetone are also produced. While BHB is highly active and stable, acetone can essentially be thought of as a waste product of metabolism—most of it gets excreted in the breath, although a small amount may be metabolized.

The other avenue by which we can enter ketosis is known as exogenous ketosis. Exogenous means that ketones are coming from an outside source—either directly through exogenous ketone supplementation or indirectly through another supplement that can serve as a ketogenic precursor (like an MCT oil). We will discuss these later on.

General Health Benefits of Ketosis

What’s the big deal about being in ketosis? In order to enter ketosis, the BHB ketone body must be present in your blood at >0.5mM—this is true regardless of whether ketosis is achieved endogenously or exogenously (through supplements). 

Ketosis achieved through dietary or fasting-related routes has a variety of health benefits. Some of these are distinct to endogenous ketosis, and some benefits are provided by ketones regardless of the source.

For one, using ketones as an energy source, as opposed to carbohydrates, actually produces more ATP molecules per unit of oxygen consumed.2 The ketogenic diet is one way to create a body that burns a “cleaner” fuel that results in less oxidative stress. When looking specifically at the benefits of the ketogenic diet, appetite suppression and satiety,3 enhanced memory,4 lower levels of inflammation,5 weight loss, increased fat burning, and protection from cardiovascular diseases and diabetes6 are all cited. 

Similar metabolic benefits have been shown to occur with intermittent/prolonged fasting—which is another way to achieve ketosis.

Exogenous Ketones: Another Avenue to Ketosis

As you already know, instead of becoming ketogenic (producing our own ketones from body fat stores), we can consume ketones and ketogenic precursors exogenously. If your blood ketones are above 0.5mM, you’re in ketosis—regardless of how you got there. 

For the most part, exogenous ketones come in the form of BHB or acetoacetate. The ketogenic precursors include types of fats known as medium-chain triglycerides (MCTs) which are also present in food sources like coconut oil, another exogenous “ketone supplement.” We have “ketone supplement” in quotes because these products don’t actually contain ketones—they’re simply the fats that are readily converted into ketones in someone following a low-carb high-fat diet.

Exogenous ketones provide a way to achieve ketosis even in the absence of a ketogenic diet, carbohydrate restriction, or fasting. While the route to ketosis differs, the signaling effects of exogenous vs. endogenous ketones are virtually the same—BHB and AcAc from the liver are no different structurally than BHB or AcAc taken as a supplement. It’s just simple biochemistry!

Since exogenous ketones don’t require modified dietary practices, they can be used by anyone who wants to get the benefits of ketosis without the time it takes to get there through diet alone (sometimes it can take weeks). Athletes and mathletes alike can use ketone supplements to get themselves into a ketotic state. These supplements rapidly elevate blood ketones and with consistent supplementation, can keep blood ketone levels elevated for a prolonged period of time. For example, H.V.M.N. Ketone Ester drink keeps blood ketones elevated between 4 - 6 hours. 

It is important to differentiate ketosis from ketogenesis here. Those who elevate blood ketones through supplements aren’t ketogenic, but they are in ketosis.

For those who are eating a ketogenic diet or practicing fasting, exogenous ketones can be used to deepen ketosis, helping to achieve higher levels of blood ketones than might be possible through dietary restriction. Essentially, you’d be superimposing exogenous ketones onto the endogenous ketones you’re already producing.

Benefits of Exogenous Ketones

Using supplements vs. a ketogenic diet or fasting does have some benefits. While the metabolic health boost might not be the same (for instance, exogenous ketones aren’t ideal for weight loss), exogenous ketones have several other assets, depending on your personal needs. 

Quicker ketosis is one of them. 

Many ketone supplements, like H.V.M.N. Ketone Ester, can elevate blood ketone levels within 30 minutes of ingestion.7,8 For this reason, they can be used like many other performance aids (i.e. caffeine) in a short period of time. They don’t require a change in diet or prolonged fasting. This could be ideal for those who might not find either of these lifestyle practices ideal or enticing. Intermittent fasting is a hot topic, sure, but it’s not for everyone.

Exogenous ketones are also a great way to aid the transition into a ketogenic diet. 

For example, if you’re practicing a carbohydrate periodization or carb cycling routine, exogenous ketones can quickly get you back into ketosis. New to the keto diet? Exogenous ketones could help prevent the keto flu—the period when the brain has no glucose for energy, but the liver hasn’t yet fully started to produce a steady supply of ketones.9

For already-keto folks, exogenous ketones can be one way to deepen ketosis. Using these supplements while on a fast can also raise ketone levels above what your body is naturally producing. 

Finally, while they don’t directly aid in weight or fat loss, exogenous ketones have an appetite suppressant effect.

This property just might help you adhere to a dietary regimen or prevent the munchies that could derail your strict eating habits. H.V.M.N. Ketone Ester reduces ghrelin (the hunger hormone).10

With the benefits explained, it’s time to delve into the various types of exogenous ketone supplements. The most common—ketone salts and ketone esters—directly elevate blood ketones. In addition, MCTs and other sources of fat (coconut oil) can be consumed as supplements to provide a source of fat through which ketone production can be stimulated or maintained.

Ketone Salts

Ketone salts won’t be found in your table-side salt grinder. 

These supplements usually are found in a powder form which can be mixed with a liquid and consumed. Ketone salts are composed of a ketone body (usually BHB) bound to one of several minerals that might include sodium, potassium, calcium, or magnesium. 

Some salts also include an amino acid like lysine or arginine. The fact that ketones come bound to another mineral or amino acid makes ketone salts one way to consume ketones plus some necessary nutrients. But they aren’t without certain considerations of side effects.

The Science on Ketone Salts for Health

The use of ketone salts for health conditions isn’t exactly a new concept. Two of the earliest studies on these supplements investigated their potential therapeutic use for children with metabolic disorders (fatty acid oxidation defects). In these studies, ketone salts were found to improve heart function and cognitive performance, which resulted in a better walking ability and disappearance of many neurological symptoms.11 

In rats, exogenous supplementation with BHB salts has been shown to improve blood lipid profiles (higher HDL, lower LDL/HDL ratio), reduce blood glucose, and reduce the amount of visceral fat and the size of fat cells.12,13

More studies (again, in rats) show that ketone salts can reduce anxiety-like behavior. This suggests that ketosis achieved through supplementation may be one strategy to reduce anxiety in people, but more studies need to be done in this area, especially in humans.14

The Science on Ketone Salts for Performance

If you’re an evidence-based athlete, the published literature suggests you might want to steer away from ketone salts, or at least be aware of the potential performance-negating side effects that have been reported. But hey, you are your own experiment.

To date, there have been three studies on ketone salts and athletes. 

One study was done on cyclists. They were put through a maximal exercise protocol (essentially, a VO2 max test) after ingesting a BHB ketone salt. While ketosis was achieved, the BHB salt showed no advantage compared to a placebo beverage when comparing lactateappearance, perceived effort, or muscular efficiency. In fact, 13 out of the 19 participants complained that the ketone salt led to severe gastrointestinal issues that limited their athletic performance.15

In a second study, ketone salt ingestion prior to exercise (again, cycling) led to a 7% decrease in average power output throughout a time trial simulation (though the participants' fat oxidation was increased during exercise). Again, it’s important to note that the performance impairment likely occurred due to GI issues reported by many participants—and not to direct effects of ketosis itself.16 

A third study investigated how ingestion of a BHB salt would influence high-intensity cycling performance and cognitive measures during and after exercise. While the ketone salt induced ketosis (0.53mM), no improvement was seen in cycling or cognitive performance. In fact, a “fatigue index” measured in the study was higher in the participants consuming BHB compared to the control group not receiving a ketone supplement.17 

While the efficacy for ketone salts inducing ketosis is strong, the impact on performance is inconclusive, if not mostly negative.

Advantages and Disadvantages of Ketone Salts

Compared to other ketone supplements, ketone salts only mildly raise blood BHB (up to around 1mM). This is still well above the ketotic threshold (0.5mM) but below levels achieved with ketone esters.

Ketone salts are also cheaper to produce (and purchase) than currently available BHB ketone esters (discussed later).

Salts are also one way to deliver other nutrients (minerals, amino acids) along with BHB, which could have certain health benefits.

On the other hand, pairing BHB with a mineral comes with a cost. To get 50g of BHB in a formulation with a ketone salt would require consuming about 5,800mg of magnesium, 9,600mg of calcium, 11,0000mg of sodium, or 18,800mg of potassium—amounts way above any FDA recommended intake for these minerals.

Another obvious disadvantage is the possible side effects, often taking the form of gastrointestinal issues. This may be a result of the acid load and/or mineral load that is obtained when consuming BHB salts at high doses.

Finally, most BHB salts contain a mixture of BHB isoforms—essentially a different structural configuration of BHB. The D-form of BHB is the one we produce. The L-form, which is basically a “mirror image” of the D-form, is only obtained exogenously, and might not be as rapidly metabolized as the D-form, and thus may not have the same benefits; although studies are needed to confirm this. 

Ketone Esters: Acetoacetate Diester

The acetoacetate diester (1,3-butanediol acetoacetate diester) is one of two common supplements collectively known as ketone esters. It’s comprised of the ketone body acetoacetate and butanediol (BDO), connected by an ester bond (hence the name “ketone ester”). 

While fewer studies on this ester have been done compared to the more popular BHB ester (discussed later), there is still some science to support using this ketone supplement.

The Science on AcAc Diester for Health

Most studies to date on this ketone ester have been done in mice; application to humans should come with the necessary caveats. Nevertheless, the AcAc diester has shown promising results in regards to neurological health. 

Ketosis achieved through AcAc diester ingestion effectively delayed the onset of seizures due to central nervous system oxygen toxicity18—a danger encountered by undersea divers and patients on oxygen therapy. This same protective mechanism has also been shown to occur as a result of fasting, perhaps by altering brain energy metabolism.18 

In a mouse model of neurological disease, AcAc diester ingestion improved several aspects of brain health including motor coordination, learning, memory, and synaptic plasticity.19 This could have relevance for several human diseases of the brain, like cognitive decline, epilepsy, and other learning disorders. More research needs to be done here, however. 

The Science on AcAc Diester for Performance

There has been only one performance-related study to date conducted on AcAc; results were generally negative. When ingested prior to a 31-kilometer cycling time trial, AcAc ingestion led to a greater reduction in performance compared to consuming just carbohydrates and caffeine.20 These results should be interpreted with caution, however. A probable cause of the performance decline, similar to the ketone salts, was the severe and frequent GI symptoms experienced by the study participants who ingested the ketone.20 

Instead of ketosis, it seems like tummy trouble was a big reason for the bonk in performance.

Advantages and Disadvantages of AcAc Diester

The AcAc diester produces a milder elevation in blood BHB (~1mM) compared to other ketone supplements. 

As with some of the ketone salts, AcAc diester has been described as “unpalatable” and routinely produces GI symptoms in research study participants who consume it. This, or potentially some other reason, leads to performance declines. 

As such, this ketone supplement might not be recommended for athletes prior to competition or training, especially if it’s your first time experimenting with it.

Ketone Esters: BHB Monoester (HVMN Ketone)

The BHB Monoester (R-1,3-butanediol-R-3-hydroxybutyrate) is the ketone ester found in H.V.M.N. Ketone. 

In contrast to the BHB salts, this ketone ester, when broken down, releases D-BHB into the blood along with a molecule of butanediol (BDO), which is eventually metabolized to D-BHB in the liver. This results in two molecules of D-BHB in the blood, one reason why this particular ketone supplement is the most efficacious for elevating blood ketones.

The Science on BHB Monoester

There have been few studies regarding the BHB monoester in regards to general human health, but one study suggests that this ketone ester may have the ability to treat human conditions associated with metabolic abnormalities. 

When rats were given a diet containing the BHB monoester, they experienced an improvement in heart function, increase in endurance capacity, cognitive performance enhancement, and were more efficient at using energy from ATP breakdown.21

The data on human performance is much more promising for the BHB monoester than for the other exogenous ketone supplements.

Ketosis achieved through BHB ester ingestion has been shown to improve physical endurance in cyclists by switching the body’s fuel preference to favor ketone metabolism vs. glucose/glycogen oxidation even in the presence of high muscle glycogen.22 

The BHB ester has also been investigated as a recovery aid. When consumed along with a post-exercise carbohydrate or protein source, the BHB monoester increases activation of mTORC123 (which plays a role in protein synthesis) and also enhances the resynthesis of muscle glycogen.24 

A recent study provides compelling evidence that chronic BHB monoester (which is the key ingredient in H.V.M.N. Ketone Ester) ingestion during periods of strenuous endurance training can prevent symptoms of overreaching and improve endurance performance in fit individuals.25 

“The real magic isn’t what ketones do for you during exercise; it’s what they do afterwards.” - Alex Hutchinson, Outside Magazine

While the precise metabolic signals responsible for the benefits are not completely known, the evidence for using BHB ketone ester in the setting of athletic performance is strong.

Advantages and Disadvantages of BHB Monoester

The BHB monoester results in the most rapid and highest elevation of blood BHB of all the ketone ester supplements (3 - 6 mM within 30 minutes).8 One study demonstrated that blood BHB can be elevated to about 2.8mM following BHB ketone ester ingestion, while the same amount of BHB provided from a ketone salt will elevate blood ketones to around 1mM.7

Furthermore, this ketone ester delivers only the D-isoform of BHB (this is the isoform we naturally produce when ketogenic). Ketone salts also provide a greater amount (but usually a mix) of the L-isoform of BHB along with some of the D-isoform.

H.V.M.N. Ketone Ester is FDA generally recognized as safe (GRAS) for use as a food, and is approved by the world anti-doping association (WADA). No doping violations here, if you’re a serious athlete who has these types of considerations for your supplements. 

The side effects of BHB monoester appear to be generally mild, if not non-existent, at low doses. 

Most studies report no side effects of ketone ester ingestion.8,7 BHB ketone esters do have a distinct, bitter taste, which some may find unenjoyable. The tolerability of this aspect is highly individual, however. We like to say “it tastes like it works.”

Ketone Oils and Powders 

What are ketone oils and powders? This name may be a bit misleading, since technically these supplements are actually types of fats known as medium-chain triglycerides (MCTs) and not actually ketones. 

However, they can be considered as part of the family of exogenous ketone supplements because once they’re ingested, they can serve as substrates for ketogenesis. 

Popular among the keto crowd is a supplement known as MCT oil or powder. MCTs are fat molecules made up of a glycerol bound to medium-length fatty acids that are 6 - 12 carbons in length. Coconut oilis a rich source of MCTs. 

These fats are the most efficient type for producing ketone bodies. 

The medium-chain fats go right into the liver once ingested, where they are then broken down faster in comparison to short- and long-chain fatty acids. There are several MCTs: caproic acid (C6), caprylic acid (C8), capric acid (C10), and lauric acid (C12). Caprylic acid (C8) is the most “ketogenic” of the MCTs;26 if you’re looking for an MCT supplement, this should be the one you look for. Coconut oil is high in lauric acid (C12), which makes up about 50% of the stuff. 

Due to it’s ketogenic nature, we selected pure C8 a part of the base (along with prebiotic acacia fiber) of H.V.M.N.’s MCT Oil Powder. It’s 100% natural, real food, harvested sustainably and carefully purified into pure C8. No additives, no artificial ingredients, zero net-carbs. It’s a great source of MCT without all the other junk you might find in other MCT products.

The Science on MCTs

The benefits of MCTs for a ketogenic or low-carbohydrate diet might come in the form of appetite-suppression. 

This might be great for those having a hard time adhering to a dietary regimen and may indirectly aid in weight loss. Intake of MCT oil has been shown to lead to a reduction in food consumption, while also reducing the rise in blood glucose and triglycerides after eating.27 This satiating effect was observed with MCT, but not coconut oil.28Interestingly, the subjects also reported that the MCT oil was more palatable than the coconut oil. 

There is also interesting research on the ability of MCTs to assist in weight loss directly. Supplementation with MCTs led to weight loss in overweight men. 29 This might have been due to the effects that MCTs had on increasing energy expenditure, fat oxidation, metabolism, and body heat production (thermogenesis). 

MCTs have also been shown to lower cardiovascular risk factors like LDL cholesterol and increase lipoprotein particle size.30 

Advantages and Disadvantages of MCTs

Like any supplement out there, consuming a large amount of MCTs has been reported to induce GI issues as a side-effect.31,32 

Unfortunately, consuming enough MCTs or coconut oil to get blood ketones as high as you could with a ketone supplement (like H.V.M.N. Ketone Ester) might require a dose likely to upset your stomach. Expect an elevation of blood ketones to around 0.5 - 1mM following a reasonable dose of MCTs. This will depend highly on diet and other lifestyle factors, however. 

Another downside to MCT/coconut oil consumption might be the caloric load. When using these supplements in large quantities, it’s easy to overdo it. 

Even though MCTs result in a lower level of ketosis compared to ketone salts and esters, MCT oils are a cost-effective and approachable option for people new to the keto diet.

MCTs might be advantageous especially for people looking to lose weight. Through their thermogenic and appetite suppressing effects, MCTs might help you feel fuller longer and more satisfied when added to a meal, shake, or coffee.28,29 And, similar to ketones, MCTs have been shown to have a variety of protective effects for the cardiovascular system and other health markers.30 

How do MCTs Differ from Exogenous Ketones?

MCTs have their benefits, which include being a bit more tasty (especially if you’re mixing them in coffee or baked goods), less expensive, and versatile—you can use MCTs in everything from cooking veggies and meats to preparing smoothies and shakes. 

But MCTs aren’t direct ketone supplements, and therefore aren’t as effective at raising blood ketones when compared to salts or esters. The shorter length MCTs must first be broken down in the liver and then used to produce ketones, it’s not a “direct path” to ketosis. 

Nevertheless, feeding MCT oil has been shown to elevate blood ketones 18-fold (in rats) after just one hour, suggesting this fuel source is readily and rapidly oxidized.33 Furthermore, it was shown that MCT administration led to lower blood sugar and depressed lipogenesis, which appeared to potentiate ketosis, but not initiate it. Although these findings are interesting and may apply to humans, more studies are needed to confirm this. 

This suggests that MCTs might be more beneficial in terms of sustaining or maintaining ketosis rather than directly plunging you into it.

When and How to Use Exogenous Ketones

There are many different scenarios where exogenous ketones could make a big difference in your performance or help you reach your goals, whatever they may be. 

One situation to use ketone supplement is on top of your ketogenic diet. In this sense, exogenous ketones would be used to deepen your level of ketosis by raising blood ketones even further. They might also come in handy if you’re trying to re-enter ketosis after a cheat day or a carb-cycling routine.

You might give ketone supplements a try while you’re on a prolonged fast—say something like a 24 - 48-hour water-only fast. While ketones do contain calories, they’re negligible, and might help you last a bit longer in your fast, or help with mental clarity and focus, if those are your fasting goals. 

If you’re someone who likes to workout while fasting, exogenous ketones might be the perfect supplement to fuel your workout instead of some quick-burning carbohydrates.

But you don’t have to be on a keto diet or regularly fast to use exogenous ketones. 

Anyone wishing to raise blood ketones can use these supplements. Athletes might try them out before a workout or big race, or perhaps even consume exogenous ketone supplements regularly throughout a tough training stint to prevent overtraining.

Exogenous ketones are also great for recovery—take them after a workout with a meal high in protein and some carbohydrates to refuel.

What does dosing look like? This depends on how high you want your blood ketones to be. For acute benefits, supplements like the BHBketone ester should be taken about 30 minutes before activity and perhaps another serving during. For workout recovery, take one serving of a ketone supplement like H.V.M.N. Ketone Ester with your normal post-workout nutrition. 

For more information on dosing H.V.M.N. Ketone Ester, visit this page for instructions.

If you’re transitioning to ketosis, using ketone supplements for about 3 - 5 days is recommended to “jump start” ketosis and prevent some of the symptoms (from keto flu) that might occur before your body is naturally producing ketones. 

Final Thoughts on Exogenous Ketones

Whatever your goal, exogenous ketones and other ketone supplements have the potential to help you meet them. 

The advancing science is allowing new and more practical formulations of ketone supplements to be produced and consumed. The benefits of ketosis are now available to almost everyone.

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14.Ari, C., Kovács, Z., Juhasz, G., Murdun, C., Goldhagen, C.R., Koutnik, A.P., Poff, A.M., Kesl, S.L., and D’Agostino, D.P. (2016). Exogenous Ketone Supplements Reduce Anxiety-Related Behavior in Sprague-Dawley and Wistar Albino Glaxo/Rijswijk Rats. Front. Mol. Neurosci. 9, 137.

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16.O’Malley, T., Myette-Cote, E., Durrer, C., and Little, J.P. (2017). Nutritional ketone salts increase fat oxidation but impair high-intensity exercise performance in healthy adult males. Applied Physiology, Nutrition, and Metabolism, 1-5.

17.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. LID - 10.1139/apnm-2017-0724 [doi]. (1715-5320 (Electronic)).

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20.Leckey, J.J., Ross, M.L., Quod, M., Hawley, J.A., and Burke, L.M. (2017). Ketone Diester Ingestion Impairs Time-Trial Performance in Professional Cyclists. Front. Physiol. 8, 806.

21.Murray, A.J., Knight, N.S., Cole, M.A., Cochlin, L.E., Carter, E., Tchabanenko, K., Pichulik, T., Gulston, M.K., Atherton, H.J., Schroeder, M.A., et al. (2016). Novel ketone diet enhances physical and cognitive performance. FASEB J.

22.Cox, P.J., Kirk, T., Ashmore, T., Willerton, K., Evans, R., Smith, A., Murray, Andrew J., Stubbs, B., West, J., McLure, Stewart W., et al. (2016). Nutritional Ketosis Alters Fuel Preference and Thereby Endurance Performance in Athletes. Cell Metabolism 24, 1-13.

23.Vandoorne, T., De Smet, S., Ramaekers, M., Van Thienen, R., De Bock, K., Clarke, K., and Hespel, P. (2017). Intake of a Ketone Ester Drink during Recovery from Exercise Promotes mTORC1 Signaling but Not Glycogen Resynthesis in Human Muscle. Front. Physiol. 8, 310.

24.Holdsworth, D.A., Cox, P.J., Kirk, T., Stradling, H., Impey, S.G., and Clarke, K. (2017). A Ketone Ester Drink Increases Postexercise Muscle Glycogen Synthesis in Humans. Med Sci Sports Exerc.

25.Poffé C, Ramaekers M, Van thienen R, Hespel P. Ketone ester supplementation blunts overreaching symptoms during endurance training overload. J Physiol (Lond). 2019;597(12):3009-3027.

26.St-pierre V, Vandenberghe C, Lowry CM, et al. Plasma Ketone and Medium Chain Fatty Acid Response in Humans Consuming Different Medium Chain Triglycerides During a Metabolic Study Day. Front Nutr. 2019;6:46.

27.St-onge MP, Mayrsohn B, O'keeffe M, Kissileff HR, Choudhury AR, Laferrère B. Impact of medium and long chain triglycerides consumption on appetite and food intake in overweight men. Eur J Clin Nutr. 2014;68(10):1134-40.

28.Kinsella R, Maher T, Clegg ME. Coconut oil has less satiating properties than medium chain triglyceride oil. Physiol Behav. 2017;179:422-426.

29.St-onge MP, Jones PJ. Greater rise in fat oxidation with medium-chain triglyceride consumption relative to long-chain triglyceride is associated with lower initial body weight and greater loss of subcutaneous adipose tissue. Int J Obes Relat Metab Disord. 2003;27(12):1565-71.

30.Baba N, Bracco EF, Hashim SA. Enhanced thermogenesis and diminished deposition of fat in response to overfeeding with diet containing medium chain triglyceride. Am J Clin Nutr. 1982;35(4):678-82.

31.Henderson, S.T., Vogel, J.L., Barr, L.J., Garvin, F., Jones, J.J., and Costantini, L.C. (2009). Study of the ketogenic agent AC-1202 in mild to moderate Alzheimer's disease: a randomized, double-blind, placebo-controlled, multicenter trial. Nutr Metab (Lond) 6, 31.

32.Ivy JL, Costill DL, Fink WJ, Maglischo E. Contribution of Medium and Long Chain Triglyceride Intake to Energy Metabolism During Prolonged Exercise. Int J Sports Med. 1980;01(01):15-20.

33.Yeh YY, Zee P. Relation of ketosis to metabolic changes induced by acute medium-chain triglyceride feeding in rats. J Nutr. 1976;106(1):58-67.

MCT Oil on Keto: How to Supercharge Your Diet

Originally posted on HVMN and written by Ryan Rodal on July 19, 2019

If you’re in the keto diet community, you've likely used—or at least heard about—MCT oil. It’s a staple for helping people with satiety and energy while on keto.

But, that buzz is starting to spread beyond just keto. MCT oil is starting to appear in more and more products on the shelves of grocery and health food stores around the country. So maybe you've seen MCT oil out there, but you're not exactly sure of why you should be adding it to your diet, and what the potential benefits are. To understand why MCTs are so powerful, it's important to look at the science behind them.

Table of Contents

What are MCTs?

Types of MCTs

Caproic Acid (C6)

Caprylic Acid (C8)

Capric Acid (C10)

Lauric Acid (C12)

Benefits of MCTs

Improved Energy Through Ketone Production

Helps Promote Weight Loss

Enables Athletes to Burn Fat as Fuel

May Reduce Risk of Heart Disease

May Help Treat Diabetes

Why Use MCTs on Keto?

Ketones 101

Benefits of Ketones

How MCT Oil Increases Ketone Production

Disadvantages of MCT Oil

How to Use MCT Oil on the Keto Diet

Butter Coffee

MCT Smoothies

MCT Salad Dressings

MCT Fat Bombs

Why MCTs Work with Keto

Weight loss and increased energy are just a couple of the positive effects you might experience with MCT oil use. To get a better understanding of MCTs, you have to dive deeper into their chemical makeup, and how they trigger certain biological responses.

Let’s explore what MCTs are, how they work, and how they might be a particularly beneficial addition to a keto diet for improved results. And if you'd like to learn some ways of incorporating MCTs into your diet, be sure to check out our recipes at the bottom of the page.

What are MCTs?

To understand MCTs, let’s start with the basics. MCT stands for medium-chain triglycerides. Triglycerides are three fatty acid groups bound to a glycerol backbone; they’re the main constituents of body fat in humans and animals, and are natural fats found in food.

People tend to have a misconception when it comes to triglycerides—they usually associate triglycerides with bad cholesterol levels and risk of heart disease. There’s some truth to that.

High levels of triglycerides in the blood pose a risk of cardiovascular disease, but not all triglycerides should be viewed negatively.

In fact, some MCTs are considered to be the healthiest fats around.

There are three types of fatty acids: short-chain, medium-chain, and long-chain. The length of the “chain” refers to the number of carbon atoms linked together to form these fatty acids.

• Short-chain fatty acids (or triglycerides): composed of 0 - 5 carbon atoms

• Medium-chain fatty acids (or triglycerides): composed of 6 - 12 carbon atoms

• Long-chain fatty acids (or triglycerides): composed of 13 - 21 carbon atoms

Short-chain fatty acids are not obtained through food, but are actually produced by bacteria in the gut when dietary fiber is fermented. They help reduce inflammation and protect the digestive system.

Long-chain triglycerides can be found in olive oil, fish, nuts, avocado, and meats. Some long-chain triglycerides, such as Omega 3s, provide cardiovascular benefits.

Medium-chain triglycerides can be found in limited amounts in foods such as coconut oil and palm oil.

The distinction between MCTs and other types of fats (and lengths of fatty acid chains) is in how they're processed by the body.

Unlike other fatty acid chain lengths, MCTs are not digested and absorbed in the same way as other fat sources. MCTs go directly from the gut to the liver and can be used as an immediate energy source themselves, or they are quickly converted to ketones. MCTs can be extracted from food sources, such as coconut, and liquified into a pure form of 100% medium-chain triglycerides.

Now that you understand what makes MCTs unique from other types of fats, let’s get into the different types of MCTs.
Types of MCTs

MCTs contain anywhere between six and 12 carbon atoms in the fatty acid chain. It’s a range—and the term MCT covers all the triglycerides that have “medium” length fatty acid chains.

Although they are all considered MCTs, the different chain lengths have slightly different physical properties, metabolism in the body and therefore, different effects and uses. So, depending on your goals, not all MCTs are created equal.

Caproic Acid (C6)

Known as the shortest MCT, caproic acid contains six carbons in each fatty acid chain. Although it can be converted quickly to ketones, it has a bitter taste and may cause stomach problems.

It can be found naturally in plant and animal sources, but generally comes with an unpleasant odor. Some MCT products on the market contain caproic acid, but it’s not the optimal source of MCT to use as a dietary supplement.

Caprylic Acid (C8)

Caprylic acid, or C8, contains eight carbon atoms in each fatty acid chain. Known as the most ketogenic form of MCT, it can provide an array of health benefits because it can be converted to ketones faster than any other form of MCT.1

When it comes to enhancing fat burning and increasing energy levels, C8 is the MCT to choose. Its effect was significantly higher in the absence of an accompanying meal.1 So, taking MCT (C8) while fasted may increase ability to maintain a ketogenic state.

About 6% of C8 occurs naturally in coconut oil, so it makes sense to try and find a more concentrated version of C8 instead of just using coconut oil. While on keto, products with the highest levels of caprylic acid (C8) can help you hit your goals. H.V.M.N.’s MCT Oil powdercontains pure C8 and a gut-friendly prebiotic called acacia fiber. With zero net carbs, it’s a fast way to kickstart ketone production and boost your metabolism.

Some of the benefits of C8 include:

• Quick energy: when ingested, C8 turns into ketones rapidly.2Enhanced ketone production will help you stay in ketosis. MCTs may also increase mental and clarity and focus because ketones are such a potent brain fuel—they evolved to keep us sharp and functioning at a high level in situations of desperate need (like hunting between big meals)

• Helps fight infection: in studies performed on animals, researchers added C8 to milk and it helped kill streptococcus, staphylococcus, and E. coli3

• Reduces gut inflammation: C8 may help aid in digestion by lessening intestinal inflammation4

These are just some of the benefits associated with caprylic acid (C8). As the world’s most ketogenic form of MCT, you should strive to make sure the majority of MCTs in your diet contain C8 to maximize health benefits.

Capric Acid (C10)

Capric acid, or C10, can be found in coconut oil, palm kernel oil, and some forms of animal milks. It provides a few unique benefits in addition to what we’ve already mentioned regarding metabolism:

• Antifungal properties: one research study concluded C10 destroyed strains of Candida albicans, a yeast causing digestive gut issues5

• Boosting immunity: a study performed on breastfeeding mothers found nursing infants were able to fight off infections and viruses more effectively when the mother supplemented with C10.6Although the study has not been performed on adults, its reasonable to assume they may experience some of the same benefits

C10 is seen in many MCT products, but it might not be the optimal MCT for ketone production—that’s still C8.1

Lauric Acid (C12)

Lauric acid can most commonly be found in coconut oil, accounting for nearly half of coconut oil’s MCT content. The main benefit associated with lauric acid (C12) is its antimicrobial properties.

Lauric acid helps your body develop monolaurin, a compound responsible for killing pathogens such as measles, herpes simplex, staph, and E. coli.

Besides from the antimicrobial benefits, it can also serve a few other functions, including:

• Fighting acne: the antimicrobial properties were put to the test in a study performed on people with acne.7 People taking lauric acid in the study found it to be a better form of treatment than benzoyl peroxide, a leading acne fighting ingredient.

• Treatment for psoriasis: coconut oil (which contains nearly 50% lauric acid) was found to increase hydration and skin elasticity in a 2013 study.8

The topical benefits of lauric acid (C12) possibly make it a viable form of skin treatment in certain circumstances. But again, for purposes of ketone production, stick with C8.

Benefits of MCTs

You know the differences between different MCT chain lengths. Now, let’s look at the benefits of including MCT into your diet.

Improved Energy Through Ketone Production

Not only are MCTs a direct source of energy, they can also help create ketones for brain and body fuel.

MCTs are rapidly digested and absorbed—most fats travel slowly from the gut into the bloodstream, whereas MCTs are directly shuttered to the liver where they can be used for energy for the body or converted into ketones.

While fat can’t be used directly as brain fuel, that’s where the ketone production comes into play. Ketones pass through the blood-brain barrier making them a direct source of energy for the brain as well. This mechanism supports the anecdotal feelings of mental sharpness associated with MCT use and ketosis overall.

Helps Promote Weight Loss

One of the main benefits of MCTs are helping directly or indirectly aid in weight loss. MCT oil can help increase the production of certain hormones—like peptide YY and Leptin—which help you feel full.9 With an increase in fat consumption, you are more likely to feel satisfied for longer and thus, you’ll be less likely to overeat.

A research study showed that when people consumed a breakfast containing MCT oil they ate less food at lunch compared to those who had the same amount of coconut oil.10 This means that MCT, rather than coconut oil, is a better choice if you are looking to use fat to curb your appetite. That’s why many people choose to add MCT oil to their butter coffee in the morning.

MCT oil can also help to assist directly with weight loss through increased energy expenditure.

In one study, individuals taking MCT oil increased their energy expenditure, leading to weight loss.11 These people had a higher resting metabolic rate, so in essence, they were able to consume more calories without gaining weight.

Compared to long-chain fatty acids, MCT consumption resulted in greater fat loss (due to increased energy expenditure and fat oxidation).11 These studies lead researchers to believe MCTs could be used to prevent obesity or stimulate weight loss.

Studies performed on animals also showed MCT oils may result in decreased body fat through improved metabolism and enhanced thermogenesis.12

Enables Athletes to Burn Fat as Fuel

Consuming MCT oil may also boost your athletic endurance. One study showed that taking MCT prior to exercise enabled athletes to work at 80% of their VO2 max for longer when compared to athletes taking LCTs.13

The ingestion of foods containing MCTs may help suppress utilization of carbohydrates for energy production through increased utilization of fatty acids for generating energy. In other words, you replace the energy coming from carbs and glucose with energy coming from fat and ketones to fuel your workout. It takes a while to become fat adapted, but once you’re able to tap into the seemingly endless fat stores in the body, endurance performance may get better.

MCT oils may also impact athletic performance through reduction in lactate buildup due to a shift in balance from carb to fat metabolism. In that study where athletes could exercise for longer, the researchers also found that they had lower lactate levels.13

If you take MCTs prior to exercise, your fat burning capabilities may increase due to a higher resting energy expenditure. Essentially, you burn more fat during your workouts than you may have otherwise, in part because you’re consuming more fat.

May Reduce Risk of Heart Disease

Maintaining a healthy weight is one of the most effective ways of lowering the risk of heart disease.

Since MCT oil can help with weight and fat loss, this can in turn lower the incidence of heart disease in some people.

A study was performed on twenty-four healthy overweight men who consumed controlled diets designed to maintain weight over the course of two months.14 These diets contained 40% energy from fat, of which 75% was added fat in the form of an MCT oil based compound (also containing phytosterols and flaxseed oil) or olive oil. Body composition and blood samples were analyzed after each month. The MCT oil-based compound resulted in a ~14% decrease in LDL levels of cholesterol (the bad cholesterol) compared to the control group. Maintaining healthy cholesterol levels is crucial to reduce the risk of cardiovascular disease.

Poor diet, lack of exercise, and genetic predisposition can cause heart disease, but MCT oil consumption may be a tool capable of supporting heart health.

May Help Treat Diabetes

Building off the other metabolic benefits of MCT, it may be able to help treat individuals with diabetes.

A study was conducted on two groups of overweight type 2 diabetic patients.15 One group was given 18g of MCT and the other was given 18g of LCTs in the form of corn oil over the course of 90 days. The results of the study showed a reduction in body weight, waist circumference, and homeostasis model assessment of insulin in subjects taking MCT oil. No differences were noted in the LCT group. These results suggest MCTs have a positive effect on diabetic-related treatment.

Why Use MCTs on Keto?

While the benefits of MCTs obviously stretch outside of just ketone production, they’ve found a special home among keto diet practitioners.

Ketones 101

What’s so special about ketones?

Before we dive into specifics, let’s talk basics. Ketones are fundamentally different substrates than the carbohydrates or fats your body typically uses to create energy.16 They are produced when your body begins using fat instead of carbohydrates for fuel. Ketones may even be a more efficient source of fuel than glucose; they provide more energy per unit.17

Keto is a low-carb, high-fat diet. So when the body doesn’t have any carbohydrates to rely on for energy, it will begin using the copious fat stores we all carry with us.

The brain’s usual source of energy is carbohydrates. They’re a quick, easily-used fuel. But what about when the brain doesn’t have those carbs to rely on? That’s why we evolved to create ketones, to fuel our brain (ketones cross the blood-brain barrier). In our neanderthal days, we’d go days or weeks without food. Our bodies needed a way to create energy from what we already had—fat.

Once the body is producing ketones, ketosis in considered ketones present in the blood at greater than 0.5mM; when you hear people say they’re in ketosis, this is what they mean.

Ketosis can be achieved in two distinct ways. The first is endogenously, which means through internal mechanisms within the body. By following a low-carb diet and/or fasting, the body will eventually stop running on glucose and begin producing ketones.

However, there’s another way to get into ketosis. Exogenous ketonesare consumed through external means. Using exogenous ketones can raise blood ketones to a physiological level even if you aren’t following a high-fat diet or fasting.

The level of ketosis achieved can vary depending upon the type of supplement used. H.V.M.N. Ketone is a form of exogenous ketones (it’s the world’s first ketone ester drink) used to get into a deeper state of ketosis.18 Its patented technology is designed to deliver pure consumable ketones for sport, cognition, fasting or keto diet support. Ketone salts are another option, but can require a high amount of sodium be ingested to reach desired ketone levels.19

MCT oil has gained substantial traction in recent years as a product shown to enhance ketone production and provide an immediate source of energy, albeit a lesser levels than H.V.M.N. Ketone and salt-based products (because MCTs don’t actually contain ketones themselves).

Benefits of Ketones

Biologically, the body is designed to run on glucose and fat as its main forms of energy; but ketones are a more efficient fuel source when compared to glucose.17 Also, as you get into endogenous ketosis, the body is able to breakdown more and more fat for energy.

There are several evidence-based health benefits seen during a ketogenic diet, including:

• Losing weight: the most common reason people follow a ketogenic diet is for weight loss reasons.20 By changing your diet, you can help switch your body from a glucose-reliant to running on ketones and fat

• Managing diabetes: a keto diet may help control symptoms of type I and II diabetes by lowering carbohydrate intake and keeping blood glucose levels under control21

• Satiation: ketones can improve satiation, leading to less overeating.16 Research suggests a diet high in fat provides satiating benefits not seen with carbohydrates

• Treatment of certain diseases: the keto diet may help act as supplemental treatment for diseases such as epilepsy, Parkinson’s, and even Alzheimer’s22

• Lowers rate of inflammation and aging: ketogenic diets have been shown to improve survival, memory, and healthspan in animal studies.23 Future studies may show the same effects could be seen in humans as well

The keto diet has gained popularity for a reason. Not only are the physical benefits sought after, but the mental clarity of ketosis, along with other neurological benefits, have also emerged as some of the main reasons people decide to switch to keto.

How MCT Oil Increases Ketone Production

MCTs go directly to the liver, and it's here where they are converted into ketones through a process called ketogenesis. MCTs can help you stay in ketosis or get to ketosis faster, because they're a healthy source of fat and are less likely to be stored as body fat.24 Longer-chain fatty acids, on the other hand, do not directly enhance ketone production because of how they're metabolized.

MCT oil can be found in coconut oil, palm oil, and even some dairy products. However, these products do not contain 100% pure MCTs. They contain roughly a low percentage of C8 (the most optimal form of MCTs), along with other types of lower-quality fatty acids. In order to optimize the effects of high-quality MCT oil, it must be extracted from other sources into a highly-concentrated, stand alone product.

Disadvantages of MCT Oil

Although MCT oil can provide plenty of health benefits, it can be easy to go overboard on calories if you do not measure serving sizes correctly. Even on a ketogenic diet, you should still be cognizant of your overall caloric intake to avoid overeating.

Taking too much MCT oil can also cause gastrointestinal distress in certain individuals in the form of side effects such as diarrhea, vomiting, bloating, and cramping.

How to Use MCT Oil on the Keto Diet

MCT oils can be incorporated into your diet in a variety of different food and beverage choices.

You can use MCT oil as a cooking oil, smoothie ingredient, or even to create fat bombs. The possibilities are endless, and you can use a bit of creativity when determining how best to use MCT oil in your own diet. While we've discussed MCT oil at length, MCT oil powder is also a viable option for easy mix-ability.

Butter Coffee

One way many people choose to consume MCT oil as part of their diet is by making butter coffee (also called Bulletproof coffee). A unique blend of coffee, MCT oil, and grass-fed butter, butter coffee can provide a boost of energy to help jump start your day.

Traditional Butter Coffee

Ingredients:

• 1 cup of coffee

• 1 tbsp unsalted grass-fed butter

• 1 scoop chocolate or vanilla H.V.M.N. MCT Oil Powder

Instructions:

1. Brew a cup of coffee using your favorite coffee beans

2. Add coffee, butter, and HVMN MCT Oil Powder into a blender and blend for approximately ten seconds

3. Pour the finished drink into a mug and enjoy

Drinking butter is an easy way of incorporating MCT oil for a daily energy boost.

MCT Smoothies

If you prefer to get fruits and vegetables through smoothies, why not try adding some MCT oil to your drink?

Fruit MCT Smoothie

Ingredients:

• ½ frozen banana

• ½ cup frozen apple

• ¼ scoop chocolate or vanilla of H.V.M.N. MCT Oil Powder

• ¾ cup unsweetened almond milk

Add in other fruits and vegetables as desired, to taste.

Instructions:

1. Combine all ingredients into a blender and mix to desired consistency

2. Pour, drink, and enjoy

MCT-based smoothies are a satisfying, filling snack that can be made with limited time, and may even be used to replace a meal.

MCT Salad Dressings

If salads are a staple of your diet, you may want to try creating a MCT-based dressing to enjoy your greens and get a boost of healthy fat.

Green Keto Dressing

Ingredients:

• 1 scoop unflavored H.V.M.N. MCT Oil Powder

• ¼ cup olive oil

• 3 tablespoons chopped cilantro

• 1 tablespoon minced ginger

• 2 minced garlic cloves

• 1 teaspoon mustard

• ¼ teaspoon sea salt

• ¼ teaspoon black pepper

Instructions:

1. Whisk all ingredients together in a large bowl

2. Pour on top of salad or store in a glass container to use later on

Regularly eating salads is a great way of ensuring you get enough micronutrients in your diet. This recipe will add a dose of healthy fat to your greens.

MCT Fat Bombs

If you are unfamiliar with fat bombs, they are keto friendly snacks designed to curb sugar cravings.

They generally contain ingredients such as oil, butter, nuts, and seeds, designed to satisfy cravings and keeping you full. If you are following a ketogenic diet, but still get a sweet tooth, try making some fat bombs.

Chocolate Delight Fat Bombs

Ingredients:

• 2 cups macadamia nuts

• 2 tablespoons coconut oil

• 1 scoop chocolate H.V.M.N. MCT Oil Powder

• 1 teaspoon vanilla extract

• ⅓ cup monk fruit sweetener

• ¼ cup cocoa powder

Instructions:

1. Puree macadamia nuts in a food processor or blender. Add HVMN MCT Oil Powder, coconut oil, and vanilla. Continue blending until a nut butter like consistency is formed

2. Add cocoa powder and sweetener little by little and continue pureeing until smooth

3. Grab a muffin pan lined with parchment paper

4. Pour the batter into each liner until ⅓ of the way filled

5. Freeze for at least 30 minutes until a solid consistency is formed.

Instead of reaching for the candy bar, try making some fat bombs to get rid of that nagging sweet tooth.

Why MCTs Work with Keto

If you’re on keto, adding MCTs to your diet is almost a no-brainer.

Reducing body fat, improving satiety, and enhancing of ketone production—these are just a few of the potential health benefits of MCTs.

If you are practicing a ketogenic diet and want to get into ketosis faster, MCT is a great way to increase ketone production via healthy fat. Simply using an MCT-based supplement daily may supercharge the metabolic benefits associated with keto. And even if you’re not keto, adding a high-quality source of fat to your diet may help reduce cravings and help you feel fuller for longer throughout the day.

Scientific Citations

1.Vandenberghe, C., St-Pierre, V., Pierotti, T., Fortier, M., Castellano, C.-A., and Cunnane, S.C. (2017). Tricaprylin Alone Increases Plasma Ketone Response More Than Coconut Oil or Other Medium-Chain Triglycerides: An Acute Crossover Study in Healthy Adults. Current Developments in Nutrition 1.

2.Page, K.A., Williamson, A., Yu, N., McNay, E.C., Dzuira, J., McCrimmon, R.J., and Sherwin, R.S. (2009). Medium-chain fatty acids improve cognitive function in intensively treated type 1 diabetic patients and support in vitro synaptic transmission during acute hypoglycemia. Diabetes 58, 1237-44.

3.Nair NKM, Joy J, Vasudevan P. Antibacterial Effect of Caprylic Acid and Monocaprylin on Major Bacterial Mastitis Pathogens. Journal of Dairy Science. 2005;88(10):3488-3495. doi.org/10.3168/jds.S0022-0302(05)73033-2.

4.Hoshimoto A, Suzuki Y, Katsuno T, Nakajima H, Saito Y. Caprylic acid and medium-chain triglycerides inhibit IL-8 gene transcription in Caco-2 cells: comparison with the potent histone deacetylase inhibitor trichostatin A. Br J Pharmacol. 2002;136(2):280-6.

5.Bergsson G, Arnfinnsson J, Steingrímsson o, Thormar H. In vitro killing of Candida albicans by fatty acids and monoglycerides. Antimicrob Agents Chemother. 2001;45(11):3209-12.

6.Francois CA, Connor SL, Wander RC, Connor WE. Acute effects of dietary fatty acids on the fatty acids of human milk. Am J Clin Nutr. 1998;67(2):301-8.

7.Nakatsuji T, Kao MC, Fang JY, et al. Antimicrobial property of lauric acid against Propionibacterium acnes: its therapeutic potential for inflammatory acne vulgaris. J Invest Dermatol. 2009;129(10):2480-8.

8.Aziz, Azila & Sarmidi, Mohamad & Aziz, R & mohamed noor, Norhayati. (2013). The Effect of Virgin Coconut Oil Loaded Solid Lipid Particles (VCO-SLPs) on Skin Hydration and Skin Elasticity. Jurnal Teknologi. 62. 39-43.

9.St-onge MP, Mayrsohn B, O'keeffe M, Kissileff HR, Choudhury AR, Laferrère B. Impact of medium and long chain triglycerides consumption on appetite and food intake in overweight men. Eur J Clin Nutr. 2014;68(10):1134-40.

10.Kinsella R, Maher T, Clegg ME. Coconut oil has less satiating properties than medium chain triglyceride oil. Physiol Behav. 2017;179:422-426.

11.St-onge MP, Jones PJ. Greater rise in fat oxidation with medium-chain triglyceride consumption relative to long-chain triglyceride is associated with lower initial body weight and greater loss of subcutaneous adipose tissue. Int J Obes Relat Metab Disord. 2003;27(12):1565-71.

12.Baba N, Bracco EF, Hashim SA. Enhanced thermogenesis and diminished deposition of fat in response to overfeeding with diet containing medium chain triglyceride. Am J Clin Nutr. 1982;35(4):678-82.

13.Nosaka N, Suzuki Y, Nagatoishi A, Kasai M, Wu J, Taguchi M. Effect of ingestion of medium-chain triacylglycerols on moderate- and high-intensity exercise in recreational athletes. J Nutr Sci Vitaminol. 2009;55(2):120-5.

14.St-onge MP, Lamarche B, Mauger JF, Jones PJ. Consumption of a functional oil rich in phytosterols and medium-chain triglyceride oil improves plasma lipid profiles in men. J Nutr. 2003;133(6):1815-20.

15.Han JR, Deng B, Sun J, et al. Effects of dietary medium-chain triglyceride on weight loss and insulin sensitivity in a group of moderately overweight free-living type 2 diabetic Chinese subjects. Metab Clin Exp. 2007;56(7):985-91.

16.Gibson, A.A., Seimon, R.V., Lee, C.M., Ayre, J., Franklin, J., Markovic, T.P., Caterson, I.D., and Sainsbury, A. (2015). Do ketogenic diets really suppress appetite? A systematic review and meta-analysis. Obes. Rev. 16, 64-76.

17.Prince A, Zhang Y, Croniger C, Puchowicz M. Oxidative metabolism: glucose versus ketones. Adv Exp Med Biol. 2013;789:323-328.

18.Cox, P.J., Kirk, T., Ashmore, T., Willerton, K., Evans, R., Smith, A., Murray, Andrew J., Stubbs, B., West, J., McLure, Stewart W., et al. (2016). Nutritional Ketosis Alters Fuel Preference and Thereby Endurance Performance in Athletes. Cell Metabolism 24, 1-13.

19.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. 2018:1-11.

20.Westman EC, Feinman RD, Mavropoulos JC, et al. Low-carbohydrate nutrition and metabolism. Am J Clin Nutr. 2007;86(2):276-84.

21.Feinman, R.D., Pogozelski, W.K., Astrup, A., Bernstein, R.K., Fine, E.J., Westman, E.C., Accurso, A., Frassetto, L., Gower, B.A., McFarlane, S.I., et al. (2015). Dietary carbohydrate restriction as the first approach in diabetes management: critical review and evidence base. Nutrition 31, 1-13.

22.Barañano KW, Hartman AL. The ketogenic diet: uses in epilepsy and other neurologic illnesses. Curr Treat Options Neurol. 2008;10(6):410-9.

23.Ketogenic Diet Reduces Midlife Mortality and Improves Memory in Aging Mice Newman, John C. et al. Cell Metabolism , Volume 26 , Issue 3 , 547 - 557.e8

24.Takeuchi H, Sekine S, Kojima K, Aoyama T. The application of medium-chain fatty acids: edible oil with a suppressing effect on body fat accumulation. Asia Pac J Clin Nutr. 2008;17 Suppl 1:320-3.

Brain Fog: Why Aren't You Thinking Clearer?

Originally posted on hvmn.com and written by Brady Holmer

The mind is a terrible thing to waste. If you’re having a hard time thinking, trouble focusing, or just not feeling like yourself, you might be experiencing a condition known as brain fog.

It’s not a headache, not depression, but a general feeling that clouds your mind and prevents you from being you. Not only that, if you’re a high-achiever with lofty goals, brain fog could be preventing you from accomplishing them.

Table of Contents

Lost in the Clouds: What is Brain Fog?

What Causes Brain Fog?

Brain Food: How Our Cranium Gets Energy

The Brain and Glucose

Ketone Bodies and the Brain

Do Low-Carb Diets Cause Brain Fog?

Falling Blood Glucose

Insufficient Ketone Body Production and Utilization

Dehydration

Ketones Prevent Brain Fog

Other Reasons Brain Fog Improves on Keto

Fight the Fog

If brain fog sounds like something you might be experiencing, the good news is that there’s hope. Brain fog isn’t a terminal illness or a personality flaw, but rather, a fixable condition. All it takes is a little understanding of how the brain works, and how interventions like diet can work to improve its function.

Lost in the Clouds: What is Brain Fog?

Brain fog is a vague term. This means that the way each individual experiences the symptoms will be highly variable.

However, some common descriptions of brain fog include “forgetful,” “cloudy,” and “difficulty thinking, focusing, and communicating.”1 Low energy, physical and mental fatigue, irritability, headaches, anxiety, confusion, low motivation, hopelessness, memory loss, memory problems, and trouble sleeping—these can be more serious and life altering consequences of brain fog.

If you are suffering from brain fog, it could not only lower your mood and thinking ability, but alter your productivity in other areas of life.

Quality of work might suffer, no matter your profession. A poor ability to communicate or lack of interest in conversation might hamper relationships. Having brain fog may make it difficult to exercise and perform daily tasks that once were easy and enjoyable.

The negative life consequences of brain fog could be the result of a serious underlying condition, which we will cover shortly. Sometimes, it’s due to diseases like chronic fatigue syndrome, depression, Alzheimer’s disease, multiple sclerosis, or other debilitating medical condition. In these cases, medical intervention is sometimes necessary. Brain fog may also be due to some other lifestyle factor that can be easily changed—poor diet, environment, or stress.

Alternatively, brain fog could be a temporary side effect of the ketogenic diet. While this might seem paradoxical (keto is supposed to improve mental clarity, right?), the reason why this happens makes sense. And the good news is that once brain fog is “cured,” you’ll be a lot less likely to experience it again.

What Causes Brain Fog?

There are several potential causes of brain fog. These may take the form of a more serious clinical disease, or a less serious lifestyle-related factor.

One reason may be related to hormonal changes, especially those involving estrogen.

The transition to menopause (perimenopause) has been linked with difficulties in difficulty paying attention, memory complaints, and symptoms of depression, anxiety, and sleep disturbance—which all sound a lot like brain fog.2

Brain fog seems to afflict people with a condition known as fibromyalgia, a disorder characterized by widespread pain throughout the body, particularly in the muscles and the skeletal system. This disease is caused by alterations in the immune system, and may have other effects related to the nervous system. Along with the pain comes fatigue and impairments in memory and sleep.

People with fibromyalgia report difficulty thinking and remembering things, something that has been termed “fibro fog.” Patients with fibromyalgia rank “fibro fog” high on the list of how their disease impacts well-being.3 In one study, over 82% of patients with fibromyalgia reported cognitive dysfunction, and were more likely to report memory decline, mental confusion, and speech difficulty compared with a group of patients without fibromyalgia.4

There are other clinical conditions and treatments which can lead to symptoms of brain fog; these include chemotherapy,5 brain injuries, diabetes,6 neurodegenerative disorders,7,8 allergies,9 and any condition that might impair gut health or cause “leaky gut.” Even certain medications like statins and sleeping pills have been reported to cause brain-fog like symptoms such as cognitive impairment, difficulty in decision making, and poor executive function.10,11

Lifestyle factors may play a role too. Ultra low-fat diets, food additives like MSG, artificial sweeteners, industrial seed and vegetable oils, improper hydration, and nutritional deficiencies are all colloquially proposed to be a cause of brain fog. In addition, it is likely that and sleep deprivation or sleep disorders—which are widespread among Americans and throughout the world, play a causal role in brain fog. However, research is currently unavailable to conclude a causative role of any of these variables in brain fog.

Being physically inactive and a lack of sleep are known to lead to poor cognitive performance, worse memory, and less mental clarity, and may even contribute to cognitive decline throughout life.12,13 What’s more—physical activity and proper sleep are two ways to reverse brain fog and improve cognitive function and wellbeing!14 It’s something we all intrinsically know. Who doesn’t feel better after a great workout or a sound night of sleep?

Another condition where brain fog is reported has nothing to do with underlying disease, and isn’t necessarily due to some poor lifestyle factor. Sometimes, brain fog or related symptoms are reported in people soon after initiating a very-low carb or ketogenic diet. Before going into the specifics of why keto can lead to short-term reversible brain fog, let’s talk about some basics of brain energy metabolism.

Brain Food: How Our Cranium Gets Energy

Our brain is over 60% fat, and while it makes up only 2% of our entire body weight (give or take a little in some people) it consumes a disproportionate amount of the total energy our body uses on any typical day.15

Our brain is an energy-hungry organ. Let’s take a look at how it gets fed.

The Brain and Glucose

In terms of energy consumption, the brain uses about 25% of the total glucose and 20% of the oxygen made available to our body.15

Glucose is the obligatory energy substrate of the brain, with a few exceptions.

The process by which energy is harvested from glucose starts by glucose getting taken up by the brain through a transporter known at GLUT1 (and a few others). This transporter is necessary because the brain is protected by something known as the blood-brain barrier (BBB).

The BBB is a protective layer surrounding the brain, tightly controlling what goes in and out. This is important, since our body undergoes biochemical shifts and is exposed to a variety of environmental toxins and chemicals throughout the day—any one of which could harm the brain if they were allowed entry. Lucky for us, the BBB is a watchful sentry, maintaining our brain health throughout life.

GLUT1 sits on the surface of the BBB. When brain activity increases due to increased cognitive or physical work, the activated neurons in the brain also increase their work rate because energy requirements increase. This increases the amount of blood flow to the brain, carrying glucose along with it.16

Glucose binds to the transporter and is then able to cross the membrane and enter brain regions. Here, brain mitochondria break down glucose in two processes: glycolysis and the Krebs Cycle (a.k.a TCA cycle). ATP produced through these pathways is then used as an energy source for neurons.17

In addition to providing ATP, glucose also seems necessary for the brain to produce neurotransmitters including glutamate, GABA, and acetylcholine (AcH)—without which we could not function properly.

Glucose isn’t the only molecule that is allowed entry into the brain through the BBB.

Turns out that the monocarboxylates lactate and pyruvate (two breakdown products of glucose) are able to cross the BBB and be used for energy.17 This pathway may predominate during situations like moderate to vigorous exercise (when we are producing more lactate and pyruvate through glycolysis).

Ketone Bodies and the Brain

What happens when glucose is no longer available—like during conditions of prolonged fasting or starvation?

If no other route was available, the only option would be for the brain to shut down. This wouldn’t exactly be evolution’s greatest achievement now, would it? Luckily, our brain (and body) has developed adaptive mechanisms that allow utilization of other substrates besides glucose for energy. The adaptive mechanism in humans (and animals) is the utilization of ketone bodies in the brain. In particular, the ketone bodies acetoacetate (AcAc) and beta-hydroxybutyrate (BHB) are energy-rich substrates.

Studies have shown that during “starvation” (3.5 days of fasting), the influx of BHB into the brain increases more than 10x normal levels.18 This corresponds to the amount of ketones present in the blood.

The increase in brain ketones during food deprivation may be due to the fact that the BBB becomes more permeable to ketones during fasting to allow more ketones inside the brain.

Any condition where ketonemia (increased blood ketones) occurs also leads to increased ketone influx to the brain.19

The adaptive mechanism of ketone utilization by the brain ensures humans and animals can survive and function under conditions of low-energy availability. During times of glucose shortage (i.e. lack of carbohydrate), ketone bodies become the “preferred” energy source.

But what about fat? We know that the beta-oxidation of fatty acids is one pathway by which we burn fat to produce energy. Interestingly, unlike other body tissues, the brain does not oxidize fatty acids. While it’s known fatty acids can cross the BBB using a specific carrier—and that the brain even contains the enzymes for beta-oxidation—it appears the brain seems to avoid producing energy from fatty acids in order to protect neurons from oxidative stress and a hypoxic environment, which could result from beta-oxidation. Beta-oxidation is a “slow” process and the brain having to do this under situations where rapid neuronal firing is needed could cause impairment in cognitive abilities. So it looks like the brain avoids producing energy through this pathway in order to protect us and our ability to think.20

We are left with the knowledge that the brain can use two different substrates as an energy source. Under conditions of high-glucose availability, the brain preferentially oxidizes glucose to produce ATP and maintain function. When glucose becomes less available, it is the production and utilization of ketone bodies that dominate the brain-energy production pathways.

Ketone utilization by the brain may exert profound benefits above and beyond glucose—at least when it is adapted to do so.21

Of course, natural ketone production takes time. Whether through fasting or ketogenic dieting, it can take days or even weeks for the body to begin producing its own ketones. And when you cycle in and out of keto, you may experience brain fog more frequently.

“Getting back into ketosis with H.V.M.N. Ketone Ester makes a big difference. It helps get me back on track and powers me through my day.”—Lidice F.

H.V.M.N. Ketone Ester increases ketone levels rapidly,22 providing the body with keto energy as it ramps up to natural ketone production. With the evidence illustrating the power of ketones for the brain, this could be an excellent solution to help reduce symptoms of brain fog and bridge the gap between carb-depletion and ketone production.

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Do Low-Carb Diets Cause Brain Fog?

One of the purported benefits of going on a low-carbohydrate or ketogenic diet is the improved mental clarity.

For this reason, it might seem like a paradox that brain fog is a common symptom of something known as the “keto flu”—the term given to the panoply of symptoms experienced by people who begin a ketogenic diet. Along with brain fog, some of these symptoms include physical fatigue, cramps, irritability, dizziness, food cravings, and sleep problems. Like brain fog, most if not all of these symptoms are transient and resolve after a short adaptation period.

If keto is so good, why does brain fog happen? During the “transition period” from your habitual diet to a keto diet (also known as the “adaptation phase”), several changes can occur in the body and brain that can cause brain fog.

Falling Blood Glucose

Starting a ketogenic diet means you’ll have to cut out a majority (if not all) of your dietary carbohydrates; no external glucose will be coming in through food.

As a result, blood glucose levels will fall. While this is one of the long-term benefits of keto, it might have some short-term consequences. Short term reductions in glucose provision to the brain can lead to brain fog and related symptoms.

We already discussed how, in someone eating a high-carbohydrate diet, energy for the brain is provided mainly by glucose. Taking away this glucose by going low-carb means the brain is left without its main source of ATP and energy. Short term “hypoglycemia” deprives the brain of glucose.

In the initial days or weeks of keto, low glucose can cause brain fog.

What about glycogen? Can’t the brain use this for energy?

We know that stored glucose can be accessed in times when blood glucose is low to provide energy. Lactate and pyruvate from glycogen breakdown can maintain the function of neurons under conditions of hypoglycemia.15 However, glycogen stores in the brain are limited, and are consumed within minutes in the absence of exogenous glucose. What’s more, the process of creating new glucose—gluconeogenesis (GNG)—is negligible in the brain.

It’s important to remember that this period of low glucose availability is likely transient. One study reported that endogenous glucose production declines after one day on a carb-restricted diet and remains low for at least one week.23 This was accompanied by a 20% reduction in plasma glucose concentrations after two days on the low-carb diet. However, levels normalized after three days.

It is interesting to note that the authors of this study concluded that if adequate calories were provided in the form of protein and fat, hypoglycemia could be prevented. This is likely a result of increased GNG and the sparing of glycogen breakdown. These results were apparent at the whole-body level, however, and cannot be said to apply to the brain, per se.

It seems reasonable to conclude that, before sufficient glycogen sparing and GNG begin to occur, the brain may experience a short-term state of energy deprivation. This may be compounded by the fact that even though ketosis might be present, the brain may not be suited to use ketones quite yet. Luckily, this is a transient period and not a form of chronic stress your body will be put through.

A sufficient adaptation phase is probably required before everything starts running smoothly.

Insufficient Ketone Body Production and Utilization

In the absence of glucose, the brain can use alternate routes of energy production like ketolysis (the oxidation of ketones).

It has been shown that during starvation conditions, ketone bodies can provide as much as two-thirds of the total energy required by the brain.24

While a prompt increase in ketone production (ketogenesis) occurs when someone starts a ketogenic diet, this doesn’t necessarily mean that their use of ketones for energy increases at the same rate.

Adaptation must first occur before body tissues and the brain can take full advantage of ketones. Progressive adaptations in the brain need to occur.

A lifetime of a high-carb diet has left many enzymes and pathways of ketosis / ketolysis down-regulated, and we need time to build up these pathways.

The evidence for a downregulation of enzymes specific to ketosis can be seen in how we evolved to eat. The activities of ketone body metabolizing enzymes rise during the weaning period (to allow energy utilization from the high fat diet of breast milk) and fall in adulthood, presumably when diet transitions to contain more carbohydrates.25

For instance, in mice, eight weeks of a ketogenic diet was shown to increase enzymes related to the breakdown of ketones and enhance fatty acid oxidation capacity.26 This suggests these “fat-adapted” rodents were more able to both produce ketones from fat breakdown and use these ketones in metabolism.

Along with enzymatic changes, a high-fat diet and prolonged fastingcan both increase the permeability of the BBB to ketone bodies. Shorter periods of fasting, interestingly, don’t have the same effect.25 Changes may take some time to occur, providing evidence as to why brain fog and other symptoms may only resolve after a few days to weeks of keto.

Prolonged, high concentrations of ketone bodies may be necessary to upregulate the transporters (specifically, the MCT1 transporter) needed to effectively get ketone bodies past the BBB and into the brain along with other peripheral tissues.

Thus, enzyme and transporter activity may be a factor limiting ketone body metabolism in the initial stages of a keto diet, before adaptation occurs.

Dehydration

One of the major changes that occurs when you start a low-carb, ketogenic diet is a drastic difference in the amount of water you have in your body—this is one of the main reasons that quick and perhaps drastic weight loss occurs in the initial phases of a ketogenic diet.

This happens because of two reasons. First, your body will start using its glycogen reserves for fuel. Because glycogen is stored with water, when you lose glycogen, you also lose water, which can contribute to dehydration and rapid weight loss.27

Second, insulin, while normally thought of as regulating blood glucose, also regulates how much sodium our kidney retains. When insulin is high, the kidney holds on to more sodium, and water along with it.

However, insulin falls when you go low-carb, and this leads to more sodium excretion by the kidney.28 To maintain osmotic balance, an increase in sodium excretion means that water excretion will increase as well.

If you aren’t able to make hydration a priority by increasing your water intake a bit, this could lead to dehydration and electrolyte imbalances. Along with other keto flu symptoms, brain fog is a likely outcome of dehydration, imbalanced electrolytes, or both.

Studies have indicated that dehydration of only 2% can cause a deterioration of mental functions.29 Some studies indicate that dehydration of even 1% of body weight can adversely affect cognitive performance, short-term memory, and attention.30 Dehydration can also cause your blood pressure to drop too low—this may also contribute to impaired cognitive performance and brain fog-like symptoms.

Important to note is that most of these studies used experimental procedures like exercise and heat stress to induce dehydration, which adds a variable other than just dehydration to the mix.

Ketones Prevent Brain Fog

Current research is lacking to support the claim that ketosis has mind-altering capabilities that may lead to improved clarity, awareness, and creativity above and beyond your baseline function.

However, this “mental edge” is commonly reported among hard-core keto people. This feeling makes sense if you think about it in terms of evolutionary advantages. Our ancestors went into ketosis when they were starving, so having the advantage of mental clarity and focus would be beneficial for finding sources of food.

It isn’t uncommon to hear someone complain of brain fog when eating a high-carbohydrate diet full of processed foods and refined sugar. Upon transitioning to keto, symptoms of brain fog clear, making people feel better than they ever have before. This could be due to the elimination of processed foods in the diet or the presence of ketones. Most likely, it’s a combination of both.

Improving cognitive function suggests that ketosis—whether dietary or exogenous—has the potential to reduce brain fog.

While enhanced cognitive function in healthy people lacks scientific support, many studies on ketogenic diets have indicated their ability to improve cognition, mental clarity, and brain function in adults with impaired brain energy metabolism and neurological disorders.31,32Research consistently indicates that ketogenic diets have a strong neuroprotective effect in addition to their ability to improve social behavior and cognition.33

Exogenous ketones show similar benefits.

Provision of ketone esters (like the BHB monoester in H.V.M.N. Ketone Ester) and ketone salts provides several benefits for the brain including improved behavior and brain plasticity34, cognitive performance35, and reduced neurological impairment in diseases of metabolism.36

What about healthy individuals without cognitive or neurological impairments? Again, the benefits of ketosis here are largely speculative. We have to base the purported benefits on theoretical mechanisms of action, which are actually quite sound.

A fat-fueled brain may be more energy efficient than one that relies on glucose. This might have several benefits for brain fog and mental function, including the reduction of damaging free radicals and oxidative stress in the brain.37

Oxidation of ketone bodies generates fewer free radicals than does the oxidation of glucose.38 In addition, the metabolism of ketones generates more ATP per gram than does glucose—meaning your brain is getting more “bang for its buck” when using ketones instead of other fuel sources.39

Ketones may allow the brain to process more of the neurotransmitter glutamate to GABA. A proper balance of these two neurotransmitters is necessary to avoid over (and under) stimulation. Too much of either can result in brain fog. By increasing conversion of glutamate to GABA, ketones may improve focus.40

In addition, ketogenic diets might lead to a more robust brain that can produce and utilize more energy. This is because keto has been shown to increase brain mitochondria (known as mitochondrial biogenesis) and mitochondrial energy dynamics.41 The same increase was shown when the ketone body BHB was provided, suggesting this effect is due to ketones and not a different aspect of the low-carb diets.

Brain fog is no match for keto.

Whether you’re suffering from poor energy, reduced mental clarity, or trouble focusing, ketosis may improve symptoms by reducing oxidative stress in the brain, giving your neurons more energy, and boosting neurotransmitters that benefit mental health and function.

If you’re already on a ketogenic diet (or starting one) and want to supercharge it, taking keto supplements might help. An easy, everyday-use supplement is the use of medium-chain triglycerides (MCT).

MCTs aren’t ketones, but are actually highly ketogenic fats that readily convert into ketones. MCT Oil Powder by H.V.M.N. contains pure C8—the MOST ketogenic fat of all the MCTs. Plus, it comes in three delicious flavors that are all zero net-carbs, so it won’t kick you out of ketosis.

Other Reasons Brain Fog Improves on Keto

We’ve just discussed how the addition of ketones through a ketogenic diet or exogenous ketones can fight brain fog. However, the elimination of many things when you go keto could also explain improved brain fog.

One might be dietary clean up. Going keto means eliminating many food groups, several of which may have been harming your health. These might include food containing sugar, gluten (for some), artificial sweeteners, and other processed ingredients. Refined food and a “western diet” categorized by a high intake of saturated fat and refined carbohydrates has been associated with impaired cognitive function and neurodegenerative conditions.42 The modern way of eating isn’t particularly great for anyone.

Furthermore, stable daily blood sugar could explain the improved mental clarity and rock-solid focus that come with keto.

Rather than riding the highs and lows of blood sugar spikes and crashes, keto can lead to fewer and less severe blood glucose fluctuations. When you once may have had a post-lunch brain fog, you now have steady energy and focus until the end of the day.

Fight the Fog

If you are experiencing brain fog, it’s time to end it once and for all.

First, figure out what may be causing brain fog—diet, sedentary time, something in your environment. Next, look at all of the potential strategies that are known to help prevent brain fog, and experiment.

Maybe a ketogenic diet is your first-line strategy. If this is the case, be sure to eat enough fat and calories to provide your brain with all the energy it needs.

Maybe exogenous ketones are the solution. Taking something like H.V.M.N. Ketone Ester or MCT Oil Powder could be the super supplement you need to power through the fog.

Other smaller changes—drinking enough water, getting adequate sodium, exercising more, getting out into the sun—can have a huge impact on your mental function.

Your health is your own responsibility, your own experiment. Take control, and don’t let brain fog impede your journey toward self-optimization.

Experiencing the Keto Flu?

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41.Hasan-olive MM, Lauritzen KH, Ali M, Rasmussen LJ, Storm-mathisen J, Bergersen LH. A Ketogenic Diet Improves Mitochondrial Biogenesis and Bioenergetics via the PGC1α-SIRT3-UCP2 Axis. Neurochem Res. 2019;44(1):22-37.

42.Francis H, Stevenson R. The longer-term impacts of Western diet on human cognition and the brain. Appetite. 2013;63:119-28.

Bacopa Monnieri: Memory Boosting Herb For Anxiety

Originally published on HVMN by  Jamie Witherby

You’re in the waiting room of the dentist’s office, nervously tapping your foot on the patterned carpet and grinding your teeth until they finally call your name. You didn’t floss enough. You didn’t take care of that molar sensitivity when it first popped up three months ago. And you definitely didn’t schedule this cleaning a prompt six months after the last one. In short, you’re anxious.

Stress comes in many forms, and paths to relief are equally varied. Between the dizzying sound of the drill, you notice a fish tank: bubbles from the filter, fish floating through plastic pirate ships, swaying underwater plants. Interestingly, the simple sight of a fish tank can be a form of stress relief (maybe that’s why so many doctors’ and dentists’ offices have them). Hypnotic aquatic environments can lower your blood pressure and produce a state of relaxation.1 But if you really need extra tension relief, you may be better off reaching into the tank, pulling out the greenery, and feeding it through your chattering teeth.

Table of Contents

Bacopa Background

Bacopa: The Herb of Many Names

Bacopa Monnieri Mental Benefits

The Herb You Can’t Forget

Paying Attention

Anxiety and Stress

Depression

Bacopa Monnieri Physical Benefits

Radical Agent: Bacopa as an Antioxidant

Treat Yourself: Bacopa as Anti-inflammatory

Epilepsy: Bacopa Beginnings

Supplementing with Bacopa Monnieri

Testing Your Memory

Bacopa monnieri (buh-COH-puh moh-nee-AIR-ee) is an aquatic creeping perennial plant commonly sold to decorate fish tanks; but it can be used for much more than just underwater interior design. It can have a significant effect on cognitive function.

Let’s discuss how this powerful little plant can reduce anxiety and depression while enhancing memory and attention.

Bacopa Background

Before diving into the benefits, it’s best to know a bit more about why this herb has been used in medicine for centuries.

Bacopa: The Herb of Many Names

Native to the lush wetlands of South Asia, East Asia, and Australia, Bacopa monnieri has been an essential herb in Ayurvedic medicine for thousands of years. It joins a family of common medicines, Rasayanas, known for their youthful and rejuvenating enhancements, which is why they’ve primarily been prescribed to the elderly community.2

However, Bacopa monnieri is also part of the coveted Medhya Rasayana group along with another notorious nootropic, Ashwagandha. The prefix, “medha”, means “mind.” Thus, Medhya Rasayanas are prescribed to people of all age groups needing a mental boost. The list ranges from those recovering old memories to those recovering from brain injuries.2

Ayurvedic physicians in India have used Bacopa monnieri in combination with other herbs to treat conditions of the mind, such as anxiety, depression, ADHD, and dementia. The herb has also been used for inflammatory conditions, such as arthritis and ulcers.3,4,5

Bacopa monnieri goes by many names. If you’re buying it in a shop, you can ask for the classic carpeting varieties: moneywort or water hyssop. If you're researching its extracts, search for bacosides. If you’re talking to an Ayurvedic physician about it, try asking about Brahmi—a nickname based on the Hindu creator god, Brahma. Or if you're looking for the form of Bacopa monnieri extract, try changing a single letter: Bacopa monniera.

You won’t have to remember all those names to get through this article. But if you wanted to, you should consider taking a dose of Bacopa monnieri to help.

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Bacopa Monnieri Mental Benefits

From memory to anxiety, supplementing with Bacopa monnieri can be a powerful tool for the mind.

The Herb You Can’t Forget

It’ll take more than just a single dose to feel the full effects, but research has shown that regularly taking Bacopa monnieri for eight to twelve weeks can improve your memory.6,7,8,9,10

Human studies have found that supplementing with Bacopa monnieri can greatly increase your chances of acquiring and remembering new information.10,9 A 2001 double-blind study on healthy adults found that subjects increased their learning rates after Bacopa monnieri supplementation. While the results were evident in as little as five weeks, the most significant improvements were noted after the full twelve-week course.9

Not only was the information acquired more easily, but it was accessed from long-term memory more effortlessly.

A 2002 study echoed these findings after testing Brahmi’s memory capabilities in middle-aged adults.

Testing showed that Brahmi had significant effects on decreasing the rate of forgetting newly acquired information.10

Even after experiencing short delays to refocus the mind on other tasks, participants of all ages were able to recall new information more readily and fully after supplementing with Bacopa monnieri, including verbal processing.10 A 2012 meta-analyses of six memory intervention studies found that Bacopa monnieri can improve free memory recall.8 Imagine being able to actually remember the name of the road your maps app told you to take before your phone died. Or even just the name of that really cool plant you saw in a nature documentary last night. It could have been Bacopa monnieri.

Elderly participants even found Bacopa monnieri to be a very effective treatment for the unavoidable age-associated memory impairment (AAMI), enjoying increased memory procurement and retention.11,12 Grandma probably won’t stop confusing you with your sibling by taking Bacopa monnieri, but she will be more likely to remember the details of your life over time.

Commit this to memory: Bacopa monnieri can help the process of converting your short-term memories into long-term memories, known as memory consolidation.13

Every time you studied for a test, you engaged in this process. There’s a reason cramming the night before isn’t as efficient as studying over the period of a couple weeks. Your brain hasn’t had a chance to repeatedly fire this information on a pathway in your brain. The more frequently you study something, the stronger the pathways between the synapses in your brain become. That’s why mnemonic devices and other repetitive practices are suggested to help you rapidly store facts and figures. When it’s test time, strong pathways will allow you to more readily access information as needed.14

If you’re ready to spice up your daily routine a little, try testing your spatial memory in your current environment. Take a mental picture of your surroundings, close your eyes, and challenge yourself with questions: how many plants are on the window sill? What color is the book on the end table? Are the stripes on the area rug running vertically or horizontally? Then, open your eyes and see how you did. Supplementing with Bacopa monnieri could drastically improve your spotting skills because it boosts your spatial working memory. Working memory is about as straightforward as it sounds—it’s the part of your short term memory working to immediately process information. Add the spatial component, and you get an enhanced ability to remember things inhabiting space around you.6

Paying Attention

We can train many parts of our bodies, but Bacopa monnieri can help us focus on a soft spot: our eyeballs. Evidence supports that this herb can improve rapid visual information processing and speed of information processing.7 Translation? You can concentrate on what you’re seeing and comprehend it more quickly.

If faster processing didn’t get your attention, this will: elderly subjects also performed better on the infamous Stroop Test when taking the plant extract.7,15 You may have taken this tricky test yourself at some point. In it, participants are required to say the color of a word rather than reading the word itself. Easy, right? But all the words are colors…and the word does not match its hue. For instance, if the word "BLUE" is boldly scrawled in the color red, the subject should say ‘red.’ The test was developed to convey that embedded information about our environment strongly influences how we interact with it.

Doing well on the Stroop test assesses a few key things: cognitive processing speed, cognitive control, and attentional capacity, all of which were improved with Bacopa monnieri as an aide.15,7

These promising improvements are in line with the traditional Ayurvedic uses for the plant, further demonstrating why it’s been used as a memory aid for such a long time.

If you’ve been missing out on your memory’s potential, HVMN paired Bacopa monnieri with calming Ashwagandha and defensive Citicholine in Rise. Rise is a nootropic stack for long-term health benefits, including increased memory, adapting to chronic stress in order to reduce it, and building cognitive resiliency. The only thing you have to remember is to take two pills every day. In as little as two weeks of consistent supplementation, you could begin to see an increase in memory, stamina, and cognitive task efficiency.8,9,16

Anxiety and Stress

From the start, you were hooked with the promise of this plant being able to reduce anxiety. Like your hand in the fish tank, let’s dive right in.

In patients with anxiety, Bacopa monnieri had an anxiolytic effect, simply meaning an anti-anxiety effect. Participants in clinical trials experienced reduced heart rates and anxiety levels.15 These physiological effects point to the adaptogen potential of Bacopa monnieri.17Note the word “adapt” nestled inside. Adaptogens are classified by their abilities to help us adapt to stress by normalizing the body’s physiological responses to them.

But the criteria for being labeled an adaptogen are rather strict. The herb must not only be able to assist the body in coping with stress but also decrease stress-induced damage and produce beneficial effects over time.18 The kicker? Adaptogens must be devoid of significant negative side effects.

One of Bacopa monnieri’s adaptogenic effects is cortisol reduction.19 Although cortisol is the infamous “stress hormone,” it’s responsible for numerous processes—many of them beneficial. Cortisol is made in the adrenal glands and released into the bloodstream to transport it all over your body. Most of our cells contain cortisol receptors, which allows cortisol to have different effects depending on which cells it acts upon. The hormone can manage blood sugar levels, regulate metabolism, and influence blood pressure. Our cortisol levels are constantly fluctuating, but they generally cycle in a sensical way for a steroidal hormone, like being higher when we first wake up. Don’t worry if you’re not eager to jump out of bed every morning, though; cortisol doesn’t quite have the same vigor as caffeine.

When we feel stressed, we release cortisol to help us respond appropriately to the situation.

Fight-or-flight response, anyone? This reaction is very important for our survival. But we aren’t really supposed to engage this response over a long period of time, and elevated cortisol levels from chronic stress can negatively impact your body’s systems. On the minor side, you may suffer from digestive distress, such as diarrhea or constipation.20 Muscle tension could lead to daily soreness, headaches, or even migraines.21 On the major end, you could experience higher blood pressure, which is associated with an increased risk of heart attack and cardiovascular disease.22

In a 2013 study examining the anxiolytic effects of Bacopa monnieri supplementation, human subjects dosing with 640mg of the herb experienced a significant reduction in cortisol levels in as little as two hours after taking it.19

Depression

Bacopa monnieri’s calming effect may also be attributed to its modulation of serotonin levels, which Bacopa monnieri has been shown to regulate.9,15 Serotonin is the targeted neurotransmitter for the most successful antidepressive agents: the selective serotonin re-uptake inhibitors (or SSRIs).

Antidepressants also often increase the availability of dopamine in synapses, which is another neurotransmitter involved in regulating mood and motivation. Both dopamine and serotonin levels can decline with age, but Bacopa monnieri may be able to mitigate this decline by protecting dopaminergic neurons from death.23

In animal models, bacosides isolated from the Bacopa monnieri plant exhibited antidepressive effects.24 Better yet, human subjects reported a significant improvement in depression symptoms after supplementing with Bacopa monnieri for a twelve-week period.15

Bacopa Monnieri Physical Benefits

We can’t just let the brain have all the fun. Bacopa monnieri is a strong fighter for the body as well.

Radical Agent: Bacopa as an Antioxidant

Twelve weeks may seem like a long time, but Bacopa monnieri does its best work when given ample time to shine. Remember that in order for Bacopa monnieri to be classified as an adaptogen, it must be able to decrease stress-induced damage and produce beneficial effects over time. If you’re patient, it will react like an antioxidant in your system.25

Joining the ranks of other common antioxidants such as vitamins C and E, Bacopa monnieri can help remove free radicals such as nitric oxide from your system. Free radicals are unstable molecules missing an electron, which they attempt to take from our lipid membranes (known as lipid peroxidation). Over time, lipid peroxidation can cause tissue and muscle damage and contribute to a scary list of diseases: diabetes, heart disease, and cancer.25

Treat Yourself: Bacopa as Anti-inflammatory

If one disease-reducing quality wasn’t enough, here’s another.

In vivo studies on rats found that Bacopa extracts inhibit the release of cytokines and enzymes associated with inflammation in the brain, leading to an overall reduction in inflammation of the central nervous system (CNS).3,5

A 2016 study on the effects of Bacopa on signaling enzymes and inflammatory markers found that Bacopa monnieri targeted specific inflammatory mediators found in the central nervous system and the periphery that are linked to arthritis and neuroinflammation.3Similarly, a 2011 in vivo study found that the isolated bacosides prevented age-dependent elevation of pro-inflammatory markers in the aged cortex.4

While this doesn’t imply that Bacopa monnieri reduces aging, it does encourage further research into using the herb to reduce systemic inflammation.

This is especially promising because reducing inflammation can assist with the treatment of serious CNS disorders, such as Alzheimer’s disease, schizophrenia, and multiple sclerosis.3,5

Epilepsy: Bacopa Beginnings

While the research on Bacopa monnieri’s effects in individuals with epilepsy is in its infancy, the herb’s mechanisms are promising.

Epilepsy is a neuronal disorder often characterized by memory and learning impairments.26Frequent recurrent seizures can adversely affect cognition and contribute to brain injuries associated with cognitive degradation. For genetic epilepsies, the mechanisms of seizure activity are actually quite similar to the mechanisms of cognitive impairment.26 These mechanisms appear to occur as a result of abnormal signaling patterns, which result in modified synaptic function and hyperexcitability. Don’t get too excited—normal cognitive function requires a stable balance of excitatory and inhibitory drive.27

In epileptic animal models, Bacopa monnieri treatment significantly reversed the down-regulation of essential gene expression during seizure activity. In other words, neuronal cell receptors appeared to function normally again.28

Bacopa monnieri’s effects on epilepsy behavioral deficits were also researched in 2010. Because the herb has been tested for its antioxidant, anticonvulsant, and cognition improving properties, the authors posit that it may be a beneficial herbal medicine for ameliorating the neuronal deficits associated with frequent seizure activity.29

Supplementing with Bacopa Monnieri

Daily doses range from 200mg - 400mg of the standardized extract with no major adverse effects reported. Minor side effects include diarrhea, nausea, and an upset stomach. The extract is also not known for having the most pleasant flavor.

Bacopa monnieri is generally considered safe to pair with other medications and supplements.11

Remember: Bacopa monnieri is most effective after being used consistently for an eight to twelve week period. With its hefty list of benefits, this is one herb that’s worth the wait.

Testing Your Memory

Whether you need to train your brain to process new information more quickly or train your body to process new movements more gracefully, adding Bacopa monnieri to the mix can help you achieve your memory goals and boost cognitive function.

You may not have started supplementing yet, but try to see how many of Bacopa monnieri’s benefits you’re able to remember on your own:

• Increased memory acquisition and retention

• Defense against age-associated memory impairment

• Increased verbal processing

• Increased rapid visual information processing

• Increased spatial working memory

• Increased memory consolidation

• Defense against lipid peroxidation

• Reduced inflammation in the central nervous system

• Reduced heart rate

• Decreased anxiety

• Decreased depression

• Potential for those with epilepsy and seizure activity

Bacopa monnieri's cognitive enhancement and protective effects won’t get you out of going to the dentist. But it could help you remember to floss and keep you calm while the dental hygienist does it for you anyway.

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Scientific Citations

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O’Haire M. Companion animals and human health: Benefits, challenges, and the road ahead. Journal of Veterinary Behavior: Clinical Applications and Research, 2010; 5(5), 226–234.

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Kulkarni R, Girish KJ, Kumar A. Nootropic herbs (Medhya Rasayana) in Ayurveda: An update. Pharmacogn Rev. 2012;6(12):147-53.

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Nemetchek MD, Stierle AA, Stierle DB, Lurie DI. The Ayurvedic plant Bacopa monnieri inhibits inflammatory pathways in the brain. J Ethnopharmacol. 2017;197:92-100.

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Rastogi M, Ojha RP, Devi BP, Aggarwal A, Agrawal A, Dubey GP. Amelioration of age associated neuroinflammation on long term bacosides treatment. Neurochem Res. 2012;37(4):869-74.

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Viji V, Helen A. Inhibition of pro-inflammatory mediators: role of Bacopa monniera (L.) Wettst. Inflammopharmacology. 2011;19(5):283-91.

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Stough C, Downey LA, Lloyd J, et al. Examining the nootropic effects of a special extract of Bacopa monniera on human cognitive functioning: 90 day double-blind placebo-controlled randomized trial. Phytother Res. 2008;22(12):1629-34.

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Neale C, Camfield D, Reay J, Stough C, Scholey A. Cognitive effects of two nutraceuticals Ginseng and Bacopa benchmarked against modafinil: a review and comparison of effect sizes. Br J Clin Pharmacol. 2013;75(3):728-37.

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Pase MP, Kean J, Sarris J, Neale C, Scholey AB, Stough C. The cognitive-enhancing effects of Bacopa monnieri: a systematic review of randomized, controlled human clinical trials. J Altern Complement Med. 2012;18(7):647-52.

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Stough C, Lloyd J, Clarke J, et al. The chronic effects of an extract of Bacopa monniera (Brahmi) on cognitive function in healthy human subjects. Psychopharmacology (Berl). 2001;156(4):481-4.

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Roodenrys S, Booth D, Bulzomi S, Phipps A, Micallef C, Smoker J. Chronic effects of Brahmi (Bacopa monnieri) on human memory. Neuropsychopharmacology. 2002;27(2):279-81.

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Morgan A, Stevens J. Does Bacopa monnieri improve memory performance in older persons? Results of a randomized, placebo-controlled, double-blind trial. J Altern Complement Med. 2010;16(7):753-9.

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Raghav S, Singh H, Dalal PK, Srivastava JS, Asthana OP. Randomized controlled trial of standardized Bacopa monniera extract in age-associated memory impairment. Indian J Psychiatry. 2006;48(4):238-42.

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Department of Biochemistry and Molecular Biophysics Thomas Jessell, Steven Siegelbaum, and A. J. Hudspeth. Principles of neural science. Eds. Eric R. Kandel, James H. Schwartz, and Thomas M. Jessell. Vol. 4. New York: McGraw-hill, 2000.

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Bellezza FS. Mnemonic Devices: Classification, Characteristics, and Criteria. JSTOR, 1981; 51 (2), 247-275.

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Calabrese C, Gregory WL, Leo M, Kraemer D, Bone K, Oken B. Effects of a standardized Bacopa monnieri extract on cognitive performance, anxiety, and depression in the elderly: a randomized, double-blind, placebo-controlled trial. J Altern Complement Med. 2008;14(6):707-13.

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Marcora SM, Staiano W, Manning V. Mental fatigue impairs physical performance in humans. J Appl Physiol. 2009;106(3):857-64.

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Rai D, Bhatia G, Palit G, Pal R, Singh S, Singh HK. Adaptogenic effect of Bacopa monniera (Brahmi). Pharmacol Biochem Behav. 2003;75(4):823-30.

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Tripathi S, Mahdi AA, Hasan M, Mitra K, Mahdi F. Protective potential of Bacopa monniera (Brahmi) extract on aluminum induced cerebellar toxicity and associated neuromuscular status in aged rats. Cell Mol Biol (Noisy-le-grand). 2011;57(1):3-15.

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Benson S, Downey LA, Stough C, Wetherell M, Zangara A, Scholey A. An acute, double-blind, placebo-controlled cross-over study of 320 mg and 640 mg doses of Bacopa monnieri (CDRI 08) on multitasking stress reactivity and mood. Phytother Res. 2014;28(4):551-9.

20.

Mayer EA. The neurobiology of stress and gastrointestinal disease Gut 2000;47:861-869.

21.

Leistad, R, Sand, T, Westgaard, R, Nilsen, K, Stovner, L. Stress-Induced Pain and Muscle Activity in Patients with Migraine and Tension-Type Headache. Cephalalgia 2006; 26(1), 64–73.

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Dimsdale JE. Psychological stress and cardiovascular disease. J Am Coll Cardiol. 2008;51(13):1237-46.

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Aguiar S, Borowski T. Neuropharmacological review of the nootropic herb Bacopa monnieri. Rejuvenation Res. 2013;16(4):313-26.

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Zhou Y, Shen YH, Zhang C, Su J, Liu RH, Zhang WD. Triterpene saponins from Bacopa monnieri and their antidepressant effects in two mice models. J Nat Prod. 2007;70(4):652-5.

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Tripathi YB, Chaurasia S, Tripathi E, Upadhyay A, Dubey GP. Bacopa monniera Linn. as an antioxidant: mechanism of action. Indian J Exp Biol. 1996;34(6):523-6.

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Holmes GL. Cognitive impairment in epilepsy: the role of network abnormalities. Epileptic Disord. 2015;17(2):101-16.

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Yizhar O, Fenno LE, Prigge M, et al. Neocortical excitation/inhibition balance in information processing and social dysfunction. Nature. 2011;477(7363):171-8.

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Paulose CS, Chathu F, Khan SR, Krishnakumar A. Neuroprotective role of Bacopa monnieri extract in epilepsy and effect of glucose supplementation during hypoxia: glutamate receptor gene expression. Neurochem Res. 2008;33(9):1663-71.

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Mathew J, Paul J, Nandhu MS, Paulose CS. Bacopa monnieri and Bacoside-A for ameliorating epilepsy associated behavioral deficits. Fitoterapia. 2010;81(5):315-22.

P.S. I Love You IZOD, or, the Best Brands for Men with Large Thighs

As someone who has always had thunder thighs, I have struggled to find the perfect shorts and pants that fit my waist, and sit comfortably down through. Often times, I’ve had to make the decision: size up to accommodate my seat and thighs and suffer form a baggy short or pant at the waist, or get the right pants for my waist but suffer with an uncomfortable fit at my thighs?

Thankfully for me, I discovered IZOD a few months back. My bottom-half has thanked me ever since.

Here are my top shorts and pants recommendations for thick-thighed, bootylicious males, all courtesy of IZOD:

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IZOD Men's Saltwater Stretch Chino

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What I love about these pants: stylish but unbelievably comfortable. Sit comfortably just above the waist, and the pant maintains a wide opening through the leg.

One complaint I have about the pants, they can get a little baggy actually after wearing it a few times. Recommended you wash after every use or couple of uses.

Cadet navy is the color that I purchased.

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IZOD Men's Saltwater Flat Front Shorts

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I live in a very warm place, and I do have the luxury of wearing shorts for most of the year. A common problem I have had with shorts is how snug they wrap around my thighs and groin area when I sit down. . For me this always meant I needed to get a size or two up, literally just to accommodate for my thighs and groin area, but this meant that the shorts were large around my waist.

These shorts accommodate to you seat and thighs. Give them a wear or two and you’ll notice how they seemingly stretch to fit your body; at least that’s been my experience.

I have these shorts in both “Federal,” and “High Rise.” I particularly love High Rise because it’s a unique color. I have gotten four or five compliments on them, and you can dress them up a little bit compared with other common short colors such as khaki.

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IZOD Men's Saltwater Chambray Walking Short

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Our final IZOD product featured in this blog post. These Chambray walking shorts are a perfect summer short. They add some color to your collection and strike a great balance every man should strive for in his wardrobe.

The shorts in my experience are a little bit wider through the leg, but sit just a bit snug on the waist. While perhaps not as comfortable as the flat front shorts featured above, the color and style of these shorts still makes me want to recommend them to any thunder-thighed male.

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There you have it: my love for IZOD is out there. On a serious final note, if you, or anyone you know have large thighs or a booty, consider these IZOD shorts and pants. They are stylish, supremely comfortable, and very affordable.