Dominic D'Agostino

With that said, exogenous ketone supplementation tends to lower blood glucose independent of carbohydrate restriction.

Well, that's what I originally thought.

Actually, I do remember talking with Dr. Veach about this, and his opinion was that you're enhancing insulin sensitivity and facilitating glucose disposal by virtue of enhancing insulin sensitivity.

But I think it's a combination of different factors.

I think consuming exogenous ketones influences the liver in ways that we don't understand.

So the next big project that I want to do is liver metabolomics.

giving exogenous ketones because the liver is the master regulator of metabolism, especially in the context of everything, really everything that we study.

So what I think is happening is that it's decreasing gluconeogenesis, decreasing glycogenolysis, and also simultaneously enhancing insulin sensitivity for greater glucose disposal.

However, if ketones get too high, then you have competition.

The tissues are basically

happy with ketones and they probably decrease glucose consumption to some extent.

So an important message that I want to send is that higher ketones are not advantageous and I think potentially very problematic.

We've killed quite a bit of animals inadvertently in early studies by putting them into ketoacidosis with

different ketone esters.

We've never done that with ketone salts, although we can achieve therapeutic ketosis with ketone salts or MCT.

So high ketosis would be in animals.

Once we get above six or seven, then they start sort of like hyperventilating.

They get sluggish and sometimes we can't bring them back.

So that has made me a bit scared about some of the ketone esters.

And I think some of them could be in the bucket of a drug, especially if used in pediatric population.