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4 peer-reviewed studies
What the evidence says
Most Exogenous Ketones studies are mechanism or observational rather than RCTs that measure a clinical effect — keep findings provisional.
Most evidence is from medium-quality randomised trials published 2018–2023 with a typical study size of 12 participants.
Based on 4 studies · 3 RCTs · 23 total participants
Confidence
ModerateBy outcome
1 study in the last 5 years
A double-blind crossover trial (n=11 athletes) found a ketone ester improved cognitive performance late in prolonged intermittent exercise.
Evans M et al. · Med Sci Sports Exerc (2018)
A controlled crossover study found exogenous ketosis did NOT spare muscle glycogen or improve cycling performance.
Poffe C et al. · J Appl Physiol (1985) (2020)
A randomized trial examined acute beta-hydroxybutyrate effects on left-ventricular function.
Oneglia AP et al. · J Appl Physiol (1985) (2023)
A review concluded ketone supplements reliably raise blood BHB but performance benefits are inconsistent.
Margolis LM et al. · Adv Nutr (2020)