This review describes how D-beta-hydroxybutyrate (D3HB) is produced and metabolized in the body, its roles as an alternative energy fuel and an intracellular signaling molecule, and the applications of exogenous ketones explored in nutritional and therapeutic settings. It states that serum D3HB usually rises during ketogenic diets but that this requires a very long adaptation period (over 3 months) and shows unwanted adverse effects.
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