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Exploring the Potential Benefits of Exogenous Ketones and EPO Boosting

DeltaG ketone bottles

Exogenous ketones are gaining popularity in the endurance sports community.(6) They are ingested as a supplement, similar to carbohydrates in sports drinks. There are different types of exogenous ketones, with ketone monoesters receiving the most attention. Research suggests that exogenous ketones may reduce glycogen use during exercise (2) through some kind of signalling response (3) and aid in recovery. (5) Recent data also indicates that they may promote cardiovascular adaptations through effects on the hormone erythropoietin (EPO). (4)

Erythropoietin (EPO) is a hormone produced by the kidneys that signals bone marrow to produce more red blood cells, enhancing oxygen transportation in the body. Increasing red blood cell count through natural means can improve endurance performance.

Artificial EPO was misused in sports, like professional cycling, as a performance-enhancing drug in the 1990s. (1) Even small doses of EPO have been shown to boost endurance performance. However, using artificial EPO is illegal and risky, while naturally stimulating EPO production can enhance endurance performance.

New study findings:

A recent study conducted by researchers at the University of Bath has shed light on the potential benefits of incorporating a ketone monoester into post-exercise recovery nutrition. The study involved nine male participants who engaged in high-intensity cycling sessions, comparing the effects of post-exercise nutrition with and without ketones. The results, as revealed by blood samples taken over a four-hour period, demonstrated a noteworthy 20% increase in peak erythropoietin (EPO) concentration when ketones were included in the recovery regimen.

Furthermore, the study findings indicated a remarkable three-fold greater overall EPO exposure in the resting values with the presence of ketones, suggesting a potentially significant impact on the body's erythropoiesis process.

This research contributes valuable insights into the realm of sports nutrition and exercise physiology, highlighting the promising effects of ketone supplementation on post-exercise recovery and EPO levels. The implications of these findings may have far-reaching consequences for athletes and fitness enthusiasts seeking to optimise their training outcomes and enhance recovery processes.

Practical implications

These findings are causing considerable excitement in the sports nutrition field, as discovering a safe and legal method to increase EPO levels could potentially enhance red blood cell production and performance. However, the authors were careful to point out that they only studied the immediate EPO response, so we should be cautious in interpreting the results. It remains uncertain whether boosting EPO in this way actually leads to increased red blood cell production – it is probable, but further long-term studies are needed to confirm this. Nonetheless, it is indeed promising!

What should be your course of action? Well, these results appear to support the existing literature suggesting that consuming ketones during recovery could be beneficial for endurance athletes. Note that not all ketone supplements are created equally. The high salt content in ketone salt drinks limits the volume that can be consumed, so salt drinks produce lower blood ketone levels than the ketone ester, deltaG. △G and △H both contain deltaG, which the body metabolises completely to βHB (beta-hydroxybutyrate). As it contains no salt, deltaG can be consumed in volumes sufficient to produce blood ketone levels that are normally found with strict ketogenic diets and extended fasting. △G and △H are made using patented deltaG technology.


  1. Breenfeldt Andersen AGraae JBejder JBonne TCSeier SDebertin MEibye KHostrup MNordsborg NB. Microdoses of recombinant human erythropoietin enhance time trial performance in trained males and females. Med Sci Sports Exerc 55: 311–321, 2023. doi: 10.1249/MSS.0000000000003052.

  2. Cox PJKirk TAshmore TWillerton KEvans RSmith AMurray AJStubbs BWest JMcLure SWKing MTDodd MSHolloway CNeubauer SDrawer SVeech RLGriffin JLClarke K. Nutritional ketosis alters fuel preference and thereby endurance performance in athletes. Cell Metab 24: 256–268, 2016. doi: 10.1016/j.cmet.2016.07.010.

  3. Dearlove DJHarrison OKHodson LJefferson AClarke KCox PJ. The effect of blood ketone concentration and exercise intensity on exogenous ketone oxidation rates in athletes. Med Sci Sports Exerc 53: 505–516, 2021. doi: 10.1249/mss.0000000000002502.

  4. Evans EWalhin JPHengist ABetrts JADearlove DJGonzalez JT. Ketone monoester ingestion increases postexercise serum erythropoietin concentrations in healthy men [Online]. Am J Physiol - Endocrinol Metab 324: E56–E61, 2023.

  5. Poffé CHogan MMittendorfer B. Ketone ester supplementation blunts overreaching symptoms during endurance training overload. J Physiol 597: 3009–3027, 2019. doi: 10.1113/JP277831.

  6. Shaw DMMerien FBraakhuis AMaunder EDulson DK. Exogenous ketone supplementation and keto-adaptation for endurance performance: Disentangling the effects of two distinct metabolic states. Sports Med 50: 641–656, 2020. doi: 10.1007/s40279-019-01246-y.

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