Exogenous ketones are gaining more attention as scientific research continues to support their use in improving human health. They are popular supplements to take alongside a ketogenic diet, to improve athletic performance, to induce therapeutic ketosis without the need to change your diet, or just to improve quality of life!

The most widely available ketone supplements fall into the category of “ketone salts.” A ketone salt is a ketone body (beta-hydroxybutyrate; BHB) bound to an electrolyte, most commonly, sodium (Na), potassium (K), calcium (Ca), and magnesium (Mg), often made in a balanced electrolyte formulation. So, when consuming ketone salts, you are also consuming electrolytes. But, electrolytes aren’t just coming along for the ride; they serve a purpose, too. In this way, ketone salts may offer additional benefits than just ketones alone!

What are Electrolytes and what do they do?

Electrolytes are essential minerals vital for maintaining the body’s hydration level, acid-base balance, and muscle and nerve function. Ultimately, electrolytes are necessary for normal body functions, including heartbeat, brain function, muscle contraction and relaxation, and so much more.

Electrolytes on a Ketogenic Diet

The need for supplementation increases when we cut carbs from the diet since the hormone insulin (which is suppressed on a ketogenic diet) plays a vital role in the kidney’s regulation of electrolyte levels, and more specifically, sodium levels. When insulin levels fall, the kidneys retain less water and excrete more sodium in the urine, which can cause other minerals to become imbalanced. The ketogenic diet can also lead to increased water loss through glycogen loss (stored glucose). Every gram of glycogen stores around 3-4 grams of water, flushed out as glycogen is burned for energy, carrying electrolytes out with it.

It is well-known that a ketogenic diet can lead to increased sodium excretion and water loss through the urine, which is associated with unwanted symptoms, such as fatigue, muscle cramps, and headaches. If you’ve ever experienced or heard of the “keto flu,” these symptoms may sound familiar and are actually more related to electrolyte imbalances than anything to do with ketosis, and replacing lost electrolytes is the easiest solution.

Altogether, supplementing with electrolytes and increasing salt intake is encouraged when following a ketogenic diet, especially in the beginning stages as the body becomes more adapted to ketosis. This is when ketone salts may be particularly beneficial, both supplying energy in the form of ketones, aiding in the transition into ketosis, and providing electrolytes, thereby preventing the common side effects associated with ketogenic diets.

Let’s narrow in on the specific electrolytes widely used in ketone salts: 

Sodium

Sodium takes the spotlight when maintaining electrolyte balance while following a low-carb diet since urinary sodium loss without replacement tells the kidneys to reabsorb sodium at the expense of potassium. Sodium is also essential for proper muscle and nerve function.

Despite general guidelines and conjecture that we should all be lowering our salt intake, some studies suggest that consuming between 3-6 grams of sodium per day is optimal.

Many experts suggest that sodium intake has been wrongfully villainized for its causal role in hypertension and heart disease. For those worried about sodium’s effects on blood pressure, drinking water with salt may prevent the blood’s sodium concentration from rising. The rise in concentration is what links sodium with increased blood pressure, and consuming salt with water has been shown to offset any potential change in blood pressure. The good news here is that ketone salts are almost always consumed as a beverage dissolved in water. When consumed in combination with a whole-foods based diet, the sodium load from a ketone salt may offer health benefits instead of being something to worry about, especially if the diet is ketogenic. That said, to avoid an extremely high salt load from a ketone salt supplement, it’s best to find a product with a balanced blend of electrolytes.

Potassium

Potassium often functions in conjunction with sodium, regulating muscle contractions, heart rate and maintaining the body’s fluid balance. As mentioned, low sodium levels cause the kidneys to reabsorb sodium at potassium’s expense, which leads to potassium wasting. Low potassium levels can cause constipation, muscle weakness, fatigue and can also lead to more severe complications, such as increased blood pressure, risk of kidney stones, and reduced metabolic health.

Due to the increased risk of potassium imbalances, while following a ketogenic diet, managing sodium and potassium intakes may be a critical player in your overall keto experience. An extensive systematic review showed that most health benefits were seen with a potassium intake of about 2.6grams (females)-3.4grams (males) per day.

Magnesium

All cells require magnesium. Magnesium is involved in over 300 enzyme reactions in the body, needed for protein synthesis, muscle and nerve function, energy production, sleep, and more. It is also vital for the metabolism of vitamin D and optimal immune function. A 2016 meta-analysis found that increasing magnesium intake is associated with a reduced risk of stroke, heart failure, diabetes, and all-cause mortality. Unfortunately, magnesium deficiency is quite common, no matter what type of diet you follow. Ketone supplements that contain magnesium, therefore offer the benefits of magnesium supplementation. If you are experiencing muscle cramps, this may be a sign that your body is in a magnesium deficit.

Calcium

Many know of the importance of calcium in maintaining healthy bones, hair, skin, and teeth. Calcium is also essential for heart health, and once again, muscle and nerve function. The calcium in ketone salts may benefit those who don’t consume much calcium in their habitual diet.

Benefits of consuming electrolytes with exogenous ketones

Exogenous ketones aren’t only for those who follow a ketogenic diet. They can be used to induce therapeutic ketosis to manage metabolic diseases that benefit from nutritional ketosis, by athletes who want to improve their performance without following a ketogenic diet, or those who just want the energy boost from ketones! For all applications, there are benefits to consuming electrolytes alongside a ketone supplement.

• Prevents the “keto-flu” and allows for a smooth transition into ketosis

The symptoms associated with the “keto-flu” are often symptoms of electrolyte imbalances. Electrolyte imbalances can occur when we dramatically reduce dietary carbohydrates, and they can cause unwanted symptoms (e.g., fatigue, light-headedness, decreased physical performance). Consuming exogenous ketone salts that supply a balanced electrolyte formula can help prevent these side effects while also delivering energy in the form of ketones that can help mitigate some of the side effects associated with low blood sugar levels in the beginning stages of ketosis.

• Prevents dehydration

When following a ketogenic diet, it’s easier to become dehydrated due to increased urine output, in addition to athletes who might be losing electrolytes through sweat regardless of carbohydrate intake. Often, ketone salts are delivered as a beverage, which not only helps increase your daily water consumption, but provides electrolytes that are key to proper hydration. This can help both those on a ketogenic diet and athletes who might not necessarily be reducing carbohydrates, but are taking exogenous ketones to improve performance.

• Promotes improved muscle and nerve function

As mentioned already, electrolytes are essential to proper muscle and nerve function. Nerves first signal to the muscle cells to contract, and both rely on electrolytes to function correctly. In this way, exogenous ketone salts deliver both energy to skeletal muscle and provide the necessary electrolytes for muscle contraction. This may be particularly­­ beneficial for athletes and those using ketones as a therapy for neuromuscular disorders.

• Helps prevent muscle cramps

Muscle cramps often indicate dehydration and/or decreased sodium, potassium, magnesium, and/or calcium concentrations (i.e., electrolyte imbalances). Not surprisingly, electrolyte supplementation can help prevent these symptoms, especially during keto-adaptation.

In summary

Ketone salts deliver both ketones and electrolytes, the latter of which often gets overlooked or perhaps raises red flags (e.g., sodium load). However, there are benefits to consuming electrolytes alongside your ketone supplement. Yes, they serve to physically deliver ketones, but they also dually help to maintain the body’s electrolyte levels. This is especially important for those following a ketogenic diet, as failing to replace lost electrolytes can make for an uncomfortable transition to keto-adaptation (e.g., “keto-flu”). Ultimately, ketones + electrolytes can combat the symptoms of low blood sugar and electrolyte imbalances when transitioning into ketosis, or when using exogenous ketones to improve health and performance. A well balanced electrolyte formulation is best when choosing a ketone supplement.

Written by: Kristi Storoschuk; Edited by: Dominic DAgostino, Csilla Ari Dagostino