Dominic D'Agostino

When you consume large doses of beta-hydroxybutyrate, it's an anion and you're creating an acidic condition that your body needs to mitigate through respiratory and renal compensation.

So I think that can be problematic, especially in people like purchasing maybe ketone esters in elderly population where liver function is not good, they're not very stable, and they're already under metabolically compromised situations.

So that's something I think that people don't think about is energy toxicity in the context of supplemental ketones.

We think energy toxicity in the form of supplemental calories, which is problematic and in reversing that.

It's context dependent, but I think these things can be given orally or IV in the context of acute situations.

So I'm in favor of ketone esters and more potent ketone molecules for medical applications, quickly elevating ketones under, for example, status epilepticus, a traumatic brain injury, like a blast.

Depends.

No, I'm talking about maybe a ketone diester of acetoacetate, which we use.

Okay, so the monoester.

I think they can be formulated.

So this comes to something that's a gap in the literature, and there's a gap because

Every company or university with IP wants to study a single molecule in isolation.

I think what we need to do is actually formulate things, and that's what we do.

So every molecule will have pros and cons and caveats, and you could largely mitigate the problem with ketone esters by simply mixing it with MCT, but you're still going to have the 1,3-butanediol issue.

If you're consuming that

over long periods of time, that is something to consider.

But you can also have a glycerol triester of beta-hydroxybutyrate or acetoacetate.

We published, the title is like novel ketogenic formula where we had a beta-hydroxybutyrate or a glycerol triester.

So we're working with those compounds too.

But I think, yeah, it's very context dependent.