Synopsis

Source of validity: Scientific
Rating (out of 5): 4

Beta Hydroxybutyrate (BHB) is a primary ketone body produced during states of ketosis, such as fasting or a ketogenic diet. Its relevance to seizure management is grounded in the longstanding use of the ketogenic diet—a high-fat, low-carbohydrate dietary approach—as a therapeutic intervention for refractory epilepsy, especially in children. The ketogenic diet induces ketosis, elevating BHB and other ketones in the blood. Multiple studies have established the ketogenic diet's efficacy in reducing seizure frequency, and BHB is thought to play a central mechanistic role.

Preclinical research demonstrates that BHB can influence neuronal excitability and neurotransmitter balance, potentially through effects on mitochondrial function, modulation of ATP-sensitive potassium channels, and by inhibiting excitatory neurotransmission. Clinical evidence for exogenous BHB supplementation (administering BHB directly rather than via dietary means) is less robust, but animal studies suggest that BHB itself has anticonvulsant properties. Human data are limited mostly to case reports and pilot trials; however, these point toward a promising adjunctive effect for BHB or ketone supplementation, especially in individuals unable to adhere to a strict ketogenic diet.

Therefore, while direct high-quality clinical trials on BHB supplementation for seizures are limited, the scientific rationale is strong and is supported by both mechanistic studies and the broader clinical efficacy of the ketogenic diet. Further research is warranted to define optimal dosing and long-term safety.

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