Two brilliant scientists are racing to be the first to commercialise exogenous ketones. The applications include athletic performance and metabolic therapies for CNS oxygen toxicity, epilepsy, and neurodegenerative diseases. In the red corner, Dr. Richard Veech, one of the greatest living minds in basic biochemistry. In the blue corner, the also brilliant renegade chemist Patrick Arnold. Stuck somewhere in the middle is superhuman researcher Dominic D’Agostino, associate professor in the department of molecular pharmacology and physiology at the University of South Florida, and a visiting research scientist at the IHMC.

Patrick clearly has the head start, and I’ve been supplementing with his KetoForce and KetoCaNa products for over two years for bike races. Imagine my horror then when Dr. Veech appeared on the Bulletproof and Ben Greenfield podcasts to claim that Patrick’s racemic ketone salts were “harmful and inhibitory” and “a dumb for convenience of manufacturing”.

Caution is warranted.

A racemic mixture is one that includes both the D and L enantiomers. The source of the D and L labels was the Latin words dexter (on the right) and laevus (on the left). You may also have seen the labels R and S. R comes from rectus (right-handed) and S from sinister (left-handed). The physiological form of beta-hydroxybutyrate (BHB) is the D form. This is the same reason why Tommy would never recommend synthetic vitamins (vitamin E is a good example), because you get a racemic mixture and the inactive form tends to inhibit the more active form.

L-BHB is also metabolised.

BHB is not like the synthetic vitamins. Through some elegant radiotracer studies, Dr. Veech’s colleague  Dr. Henri Brunengraber showed that the L-form is neither harmful nor inhibitory, and is also metabolised and converts to acetoacetate and back to D-BHB. The conversion is less efficient from the L-form, and relatively more of it is used for lipid synthesis and direct oxidation. 100% D-BHB might be better than a racemic mixture, but it’s not harmful or inhibitory. As Dominic points out, racemic compounds have anti-seizure, anti-cancer and anti-inflammatory effects.

If this all sounds a bit cloak and dagger.

It’s because it probably is. After an in depth conversation and then interview for the Keto Summit, Professor Kieran Clarke of Oxford University made a compelling case for the D-BHB ester that has yet to be commercialised. My feeling is that her and Dr. Veech have a superior product, but that Dr. Veech’s recent comments about racemic mixtures are anticompetitive opinion not backed up by evidence.

Is Dominic completely neutral in all this?

Probably not. See US patent US20140350105 and US20140073693 (Savind, Inc is Patrick Arnold’s company). Are we neutral? Nope. We sell an MCT oil powder!

Do you have questions for Dominic or Patrick? Please leave them in the comments section below then sign up for the Keto Summit and I’ll do my best to ask the experts when I interview them next month.

Also see the two new excellent podcast interviews with Dominic on STEM-Talk and The Quantified Body.

Here’s the outline of this interview with Dr. Tommy Wood:

0:00:20    Podcast: Bulletproof Radio.

0:00:26    Podcast: Ben Greenfield.

0:01:10    Dr. Richard Veech.

0:02:28    1995 paper: Insulin, ketone bodies, and mitochondrial energy transduction.

0:03:08    Prototype Nutrition.

0:07:37    Atrial natriuretic peptide.

0:08:10    KetoCaNa.

0:10:04    Dominic and Patrick’s study Effects of exogenous ketone supplementation on blood ketone, glucose, triglyceride, and lipoprotein levels in Sprague-Dawley rats.

0:13:19    Khan Academy: Stereochemistry.

0:15:03    D-L-alpha tocopherol.

0:22:32    NAD+/NADH ratios. See The Secret Life of NAD+: An Old Metabolite Controlling New Metabolic Signaling Pathways.

0:22:35    Ubiquinone.

0:23:25    Khan Academy: ATP hydrolysis: Gibbs free energy.

0:25:13    28% increase in cardiac efficiency

0:33:12    Dr. Mary Newport.

0:33:25    Steve Newport case study.

0:35:07    Sirtuins.

0:35:41    Lactate and pyruvate.

0:41:52    Kraft dried blood spot oral glucose tolerance test with insulin.

0:44:35    PHAT FIBRE hypoallergenic MCT oil powder.

0:44:56    Concierge Clinical Coaching private membership group.