Your Guide to The Best Keto Supplements

The keto diet was introduced in 1920 to help children with epilepsy who did not respond to traditional medication.

The diet works by depriving the body of glucose, which is the main source of energy for our cells and comes from carbohydrates. When an individual strictly limits their carb intake, the body needs to use an alternative source of energy from stored fat called ketones. When enough ketone bodies collect in the blood, it’s called “ketosis.”

Typically, individuals following a keto diet consume foods like eggs, nuts, seafood, meat, cheese, oils, seeds and butter, and limit or avoid many starchy vegetables and fruits as well as other carbohydrate-rich foods.

Keto supplements are often taken by people on a ketogenic diet to aid in reaching ketosis quicker or to supplement the body with nutrients, such as vitamins and minerals, that may be lacking on such a strict eating plan. “Supplements help fill the gaps, and for someone following keto, there are usually going to be gaps,” explains Wendimere Reilly, a registered dietician nutritionist and the director of nutrition at InnovaCare Health in Clermont, Florida.

A keto diet restricts the types of food a person can eat, which may pose a risk of vitamin and mineral deficiencies. Some common ingredients in keto supplements, according to Reilly and Lindsay Malone, a registered dietitian and an adjunct professor of nutrition at the School of Medicine at Case Western Reserve University in Cleveland, Ohio, include:

• MCT (medium chain triglyceride) oil: MCTs are saturated fatty acids commonly found in sources such as palm kernel oil and coconut oil. “MCT oil bypasses the lymphatic system and the calories are available for fuel in the bloodstream quicker than other types of fats,” explains Malone.
• Omega-3 fatty acids: Supplementing the keto diet with omega-3 fatty acids can help to improve a person’s fatty acid profile, as well as help prevent hyperlipidemia, a condition that refers to an increase in lipids, such as cholesterol, in the blood^[1]Hyperlipidemia. StatPearls [Internet]. Accessed 1/172024. .
• Vitamins: Low carbohydrate diets such as the keto diet may cause a person to be deficient in a number of important vitamins. As a result, keto supplements may contain vitamin B1, vitamin B6, vitamin B9, vitamin B12, vitamin A, vitamin D, vitamin C and iron, explain Malone and Reilly.
• Electrolytes: Just like vitamins, some essential minerals, like electrolytes, may be lacking in a strict keto diet. Keto supplements are most likely to contain electrolytes such as sodium, potassium, calcium, iron and magnesium, according to Malone and Reilly.

People may decide to start taking keto supplements for a number of reasons, including:

Balancing Electrolytes

As the keto diet is low in carbohydrates and high in fat, it’s likely to cause some deficiencies of essential nutrients in the body. “The right keto supplements, such as [those that contain] green and red superfoods, can enhance a keto lifestyle and help prevent nutritional deficiencies,” explains Reilly.

“Low carbohydrate diets can reduce electrolytes such as sodium, potassium and magnesium that are required for proper hydration and nervous system function,” explains Malone. “You will generally feel better and maintain better physiologic functioning if you take electrolyte supplements during a ketogenic diet.”

Electrolyte supplementation is also thought to alleviate the symptoms of “keto flu,” which refers to a group of common symptoms, such as fatigue, nausea and headaches, often experienced by people starting a keto diet. However, it’s also important not to take an excess of electrolytes, says Malone. “High blood sodium or potassium can be very dangerous for involuntary muscle function.”

Increased energy

Some keto supplements may be associated with potential benefits in increasing energy, according to research.

A 2021 study in Advances in Nutrition notes that taking ketone supplements prior to or during exercise might provide extra energy, since the body would be able to rely on the supplemented ketones, rather than those occurring naturally in the body^[2]Valenzuela P L, Castillo-García A, Morales J S, Lucia A. Perspective: Ketone Supplementation in Sports—Does It Work?. Advances in Nutrition. 2021;12(2):305–315. .

Potential Benefits for Some Health Conditions

Some studies have shown that ketone supplements (which may come in the form of esters or salts) may be beneficial to people with neurodegenerative conditions such as Alzheimer’s disease, multiple sclerosis, Parkinson’s disease and amyotrophic lateral sclerosis, although more research is needed on the subject^[3]Saris C G J, Timmers S. Ketogenic diets and Ketone supplementation: A strategy for therapeutic intervention. Frontiers in Nutrition. 2022;9:947567. .

Keto supplements may not be suitable for those with certain health concerns or restrictions, such as:

• High blood pressure (hypertension): These individuals may be sensitive to high sodium intake.
• Heart failure or kidney disease: Ketone salts may not be suitable for those who need to restrict their salt intake, such as individuals with heart failure or kidney disease.
• Liver disease: Individuals who have liver disease may need to avoid ketone monoester supplements (those that increase the amount of ketone body concentrations when ingested without excess sodium), which are an alcohol precursor and may be difficult to tolerate.

Additionally, a 2021 study in Advances in Nutrition notes that more research into the long-term effects of regularly taking ketone supplements is needed^[2]Valenzuela P L, Castillo-García A, Morales J S, Lucia A. Perspective: Ketone Supplementation in Sports—Does It Work?. Advances in Nutrition. 2021;12(2):305–315. .

Potential Side Effects of the Keto Diet

The following side effects may occur while following the keto diet, with or without supplementation. However, they may intensify with the use of supplements, explains Reilly. Per Reilly and Malone, side effects may include:

• Electrolyte imbalances
• Bad breath
• Increases in cholesterol
• Gastrointestinal complaints, such as constipation and loose stools
• Fluctuations in blood sugar
• Increased urination
• Dehydration

“Selecting quality supplements is important given the prevalence of substandard options available on the market,” says Reilly. According to Reilly and Malone, it’s important to search for the following attributes when selecting a keto supplement:

• Low in carbohydrates: “Keto-friendly supplements would need to be low in carbohydrates to be suitable for a keto diet,” explains Reilly. “Avoid supplements that contain added sugars such as gummies or flavored enhanced beverages.”
• Only buy from reputable companies: “Look for companies with a solid reputation that are transparent about quality control methods and are committed to avoiding exaggerated claims about their products,” says Reilly. Products that make unrealistic promises, seem too cheap or appear too good to be true should also be avoided, as they’re unlikely to be reputable, she adds.
• Look for verified products: As supplements aren’t regulated by the U.S. Food and Drug Administration (FDA), it’s crucial to seek out verified products wherever possible, notes Malone. “Brands should be evaluated for purity, potency and quality,” she explains. “[The U.S. Pharmacopeia] (USP) and [the National Science Foundation] (NSF) are two organizations that test and verify supplements.”
• Seek professional advice: Ultimately, everyone is different, which means that anyone starting a new supplement regimen should take into account their personal health needs, explains Reilly. “Work with a registered dietitian or another qualified health practitioner that specializes in keto diet planning to help you create a wellness plan that includes the best supplements for you,” she advises.

The best alternative to keto supplements is ensuring that your diet contains all of the nutrients you need, explain Malone and Reilly.

However, the restrictive nature of the keto diet may necessitate the usage of supplements, at least at first, says Malone. “Sometimes starting with supplements to keep it simple and transitioning to whole food sources can be a manageable plan for most people.”

For those hoping to avoid supplements, Reilly suggests a “food first” approach. “With good planning, you can get adequate fiber on a keto diet, especially when consuming foods such as avocado, flaxseed or chia seed,” she says. However, a whole-food-based fiber supplement may serve as a more realistic, simpler choice for many.