How to Use Exogenous Ketones for Different Types of Sport

Soccer player juggling with red smoke in background

Depending on what sort of athlete you are and the type of physical activity you’re doing on a given day, there are different ways you can use exogenous ketones to optimize your performance and recovery. Like many other aspects of your regimen, the most effective use of exogenous ketones will be different if you’re an ultra-marathon runner vs. basketball player vs. Olympic weightlifter, etc.

There is a growing list of exogenous ketone supplements available, and an increasing number of athletes are taking exogenous ketones including ketone salts, MCT oil (technically a precursor to ketones that your liver turns into ketones over time), and HVMN Ketone, the world’s first ketone ester. One key difference between exogenous ketones is the levels of blood beta-hydroxybutyrate (BHB) reached after consumption. Ketone esters can raise blood BHB to over 3 mM,1,2 whereas ketone salts and MCTs tend to deliver a much smaller bump in BHB: 0.5-1 mM. 3,4 It looks like getting high enough BHB is important to optimize performance, as positive effects have been seen with ketone esters 1 but not ketone salts. 3,4

Because these supplements are still relatively new, we are still learning about how best to use them, but let’s take a look at the research to date on the what’s, why’s, and how’s of exogenous ketones for athletes. 

Is There a Difference Between Sports?

Boxer punching a bag

Yes. Each sport has a particular set of physical demands, meaning that athlete nutritional needs are different between sports. Clearly, an NFL linebacker needs to eat differently to an Ironman triathlete! This affects how athletes should use exogenous ketones, and we will discuss this in detail below. While there is obviously some nuance, for this article we’ll group sports into three broad categories:

  • Endurance: Exercise is prolonged for many minutes or even hours. Most of the effort is sub-maximal and relies on burning a mix of fat and carbohydrate aerobically to fuel exercise. Examples include road cycling and distance running. 
  • Power: Exercise is a short, sharp, maximal burst, reliant on anaerobic strength and power. Examples are sprinting and weight-lifting.
  • Mixed intensity: Exercise is a mixture of maximal efforts, relying on the anaerobic use of carbohydrates, with sub-maximal aerobic efforts in between. Many team games fit into this category. Examples include soccer and basketball.

Why and When Could Athletes Take Exogenous Ketones?

Image of HVMN Ketone bottle

Athletes take exogenous ketones, such as HVMN Ketone, to raise levels of the ketone body D-BHB (D-beta-hydroxybutyrate). Different sources of exogenous ketones will vary in their effectiveness in raising D-BHB; for instance HVMN Ketone, a pure ketone ester, will be more effective than a ketone salt. Pure D-BHB is an energy source and so can be used in the body as a performance fuel if taken before sport, but it also has many interesting effects that can boost recovery if taken post-workout. During the activity, aerobic endurance sports will likely see a bigger performance benefit with D-BHB than anaerobic power sports, but both types of exercise can benefit from adding D-BHB into recovery protocols. 

How do Ketones Boost Aerobic Performance?

Ketones can act as a fuel and also alter the way the body uses its other fuel reserves.

Acting as a fuel: When taken before or during exercise, D-BHB is 28% more efficient as a fuel than carbohydrates alone — meaning your body does more work with the same amount of oxygen.5 

Altering use of other fuels: Having high levels of D-BHB slows down the need to breakdown carbohydrate stored in the muscle and from blood sugar during exercise. When the muscles run out of stored carbohydrate, this usually means the athlete ‘hits the wall’ and can’t carry on. Taking D-BHB means that this happens later on in exercise, so you can keep going for longer.

Taking D-BHB as ketone ester before a workout decreases the demand of exercise on muscle protein and glycogen stores: athletes showed a decrease in the breakdown of intramuscular glycogen and protein during exercise, compared to carbohydrates alone.1 

It seems to be important that D-BHB levels need to be quite high (over 2 mM) to have a performance effect. In studies of HVMN Ketone, blood D-BHB levels reached between 2.5-5 mM, and elite athletes were shown to cycle ~2% further in a 30 minute time trial.1

But in studies using ketone salts where D-BHB reached ~1 mM, athletes didn’t perform any better compared to the control condition.3,4 

Chart from study showing cyclists going further after fueling with HVMN Ketone

And What About Anaerobic Sports?

When you do a short, sharp, maximal effort in an anaerobic sport, you need to produce a lot of energy very quickly and often with a short supply of oxygen. To do this, the body relies on two pathways called the phosphocreatine system and anaerobic glycolysis. 

Taking D-BHB will not directly aid in enhancing this type of explosive power. This is because D-BHB needs oxygen to burn and thus cannot provide anaerobic energy for explosive athletic activity. However, taking D-BHB could aid in recovery between bouts of intermittent explosive activity.

How Does D-BHB Help with Recovery?

Regardless of type of sport - endurance, power, or mixed - taking ketone esters post-workout could expedite the re-synthesis of glycogen (by 60%), protein (by 2x), and allow faster recovery.6,7 

HVMN Ketone expedites re-synthesis of glycogen and protein.

Endurance exercise triggers a cascade of stress signals within the body, causing oxidative stress and inflammation. D-BHB is a powerful anti-oxidant and anti-inflammatory molecule, so taking exogenous ketones could help to reduce the strain of exercise on the body and speed recovery.8 As this is an area of active investigation, stay tuned for future research into the effects of exogenous ketones on recovery.

What are the Effects on Mental Performance in Sport?

In some sports, athletes’ decision making, reaction time, and cognition is just as important as their physical output. Normal sugary sports drinks can cause fluctuations in blood glucose levels, which can lead to peaks and troughs in concentration. D-BHB is the only other fuel (other than glucose) that is used in the brain, and it doesn't trigger an insulin spike and crash, so taking exogenous ketones may help athletes maintain peak mental clarity during sports. The effect of exogenous ketones on the brain hasn’t been studied yet, but many people report feeling in ‘flow state’ while in ketosis. It will be intriguing to see the results of testing cognitive performance following exogenous ketones. 

Does Exogenous Ketone Supplementation Work Better for Athletes on a Keto Diet?

This is a great question, and it remains to be answered in the scientific research. Firstly it’s important to highlight that all people (whether on a long-term low carb diet or not) have the enzymes and transporters that are needed to take up and burn D-BHB as a fuel. D-BHB is taken up into cells through the same transporter as lactic acid, so athletes who are trained and have adapted to handle lactic acid are likely to be able to take up D-BHB better than sedentary people.

Athletes who are on a keto diet may well have more of the enzymes that breakdown ketones because they have increased endogenous ketone production from body fat and therefore naturally higher blood ketone levels. However, this has not yet been proven definitively. That said, it stands to reason that if an athlete is usually in a metabolic state where they are burning fatty acids and ketones, they may get an accentuated boost in energy levels from exogenous ketones.

However, athletes on a high carb diet have the advantage that they may consume D-BHB as well as carbohydrates to fuel their performance. Some people think that following a keto diet increases fat burning capacity at the expense of the ability to do high intensity (carb dependant) exercise. So, while exogenous ketones might be a great fuel source for athletes on a keto diet, athletes on a mixed diet taking ketones with carbs may have superior performance as they maintain their high-intensity capacity but can also take advantage of the addition of ketones as fuel.

How Do I Take HVMN Ketone?

African American athlete drinking HVMN Ketone with red smoke in background

HVMN Ketone takes effect in under 30 minutes. HVMN Ketone contains D-BHB ketone ester plus water — it quickly and effectively raises blood D-BHB to 3-5 mM, which is believed to be the optimal ketone levels for athletic performance.1,2 As a comparison, it can take up to 3-4 days of fasting to raise blood D-BHB this high naturally.9 

We would recommend using HVMN Ketone for the first time around a training session that you are used to completing, that way you will get the best feel for how it affects you. If you’ve never tried ketones before you might experience a ‘keto-buzz’ that’s a new and novel feeling; like any modification to your protocol, it’s key to practice in training before you use HVMN Ketone for a race or game.

For performance, consume one whole bottle (65ml) of HVMN Ketone about 30 minutes before your workout along with your standard pre-workout carbohydrates. The BHB energy source in HVMN Ketone works best when you take it along with carbs, although athletes following a low carb or a ketogenic diet can use HVMN Ketone alone. If you want to feel energized, consider adding caffeine to your protocol, it goes fine with ketones. You can ‘top-up’ BHB levels with another bottle after 90 minutes - 2 hours to act as an energy boost. We generally advise waiting at least approximately 90 min between consecutive servings of of HVMN Ketone. 

For recovery, take one whole bottle of HVMN Ketone with your normal post-workout nutrition as soon as you can after exercise (within 30 minutes). This should be a mix of carbs and protein to refuel and restore your muscles. Adding ketones will boost the effects of carbs to restore glycogen,6 and protein to trigger muscle growth and repair.7 

What’s Next?

While much is known about exogenous ketone use for exercise, and athletes at all levels have used ketones to positive effect, we continue to learn more about the best practices and protocols. Within HVMN and beyond, research is being done on the use of exogenous ketones across a variety of athletic contexts, as well as for general metabolic benefit, cognitive benefit, and other areas of investigation. Join our email list to stay up to date on the latest.

  1. 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.

  2. Stubbs, B.Cox, P.; Evans, R.; Santer, P.; Miller, J.; Faull, O.; Magor-Elliott, S.; Hiyama, S.; Stirling, M.; Clarke, K. (2017). On the metabolism of exogenous ketones in humans. Front. Physiol.

  3. 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.

  4. Rodger, S., Plews, D., Laursen, P., and Driller, M. (2017). The effects of an oral β-hydroxybutyrate supplement on exercise metabolism and cycling performance.

  5. Sato, K., Kashiw.aya, Y., Keon, C.A., Tsuchiya, N., King, M.T., Radda, G.K., Chance, B., Clarke, K., and Veech, RL. (1995). Insulin, ketone bodies, and mitochondrial energy transduction. FASEB J. 9, 651-658.

  6. 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.

  7. 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.

  8. Newman, J.C., and Verdin, E. (2017). Ketone bodies as signaling metabolites. Trends Endocrinol. Metab. 25, 42-52.

  9. Cahill, G.F., Jr. (1970). Starvation in man. New Engl J Med 282, 668-675.

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