Intermittent exogenous ketosis increases erythropoietin in healthy adults: A randomized, placebo-controlled study with preliminary sex-specific observations

This study in healthy adults used an oral beta-hydroxybutyrate ketone monoester (KE) to induce intermittent ketosis. It assessed the acute erythropoietin (EPO) response to a single dose in 16 adults, followed by a 2-week randomized study comparing KE twice daily with placebo. After 2 weeks, EPO levels were approximately 30 percent higher with KE (95 percent CI 6 to 60, p = 0.01), with a stronger effect in females than in males, and ferritin was higher in females with KE than placebo (42 vs 16 micrograms/L, p < 0.001). Hemoglobin and red blood cell count were unaffected at 2 weeks.