If you take exogenous ketones every day, does the formulation matter, and which one?

Dominic P. D'AgostinoPhD · physiologist and pharmacologist, University of South Florida

Prefer ketone salts. Esters and 1,3-butanediol are the formulations that showed hepatic harm under chronic dosing.

What it rests onHis and Csilla Ari's rodent study (Pharmaceuticals, Sep 2025): four weeks and 83 days of oral dosing, with ketone salts maintaining normal liver structure while 1,3-butanediol and ketone ester produced macrovesicular steatosis, vascular congestion and raised TNF-alpha. Funded by the Office of Naval Research and a USF departmental grant. He declares his ketone patent portfolio and Ketone Technologies LLC, and separately, a company his wife founded sells ketone salts.

Benjamin T. BikmanPhD · Professor of Cell Biology and Physiology, Brigham Young University; director of the Laboratory of Obesity and Metabolism

Prefer the newer esters and bioidentical BHB. The early ketone salts were limited by mineral load and poor taste.

What it rests onHis case is about how well they work and how they taste, not long-term safety: he describes esters and bioidentical BHB as 'more effective and palatable' than early salts, which had 'mineral imbalance and poor taste'. He makes no claim about the liver. On the joint 2026 paper he declares advising Unicity International and receiving royalties.