Short ReportA new way to produce hyperketonemia: Use of ketone ester in a case of Alzheimer's disease

BackgroundProviding ketone bodies to the brain can bypass metabolic blocks to glucose utilization and improve function in energy-starved neurons. For this, plasma ketones must be elevated well above the ≤0.2 mM default concentrations normally prevalent. Limitations of dietary methods currently used to produce therapeutic hyperketonemia have stimulated the search for better approaches.MethodDescribed herein is a new way to produce therapeutic hyperketonemia, entailing prolonged oral administration of a potent ketogenic agent-ketone monoester (KME)-to a patient with Alzheimer's disease dementia and a pretreatment Mini-Mental State Examination score of 12.ResultsThe patient improved markedly in mood, affect, self-care, and cognitive and daily activity performance. The KME was well tolerated throughout the 20-month treatment period. Cognitive performance tracked plasma β-hydroxybutyrate concentrations, with noticeable improvements in conversation and interaction at the higher levels, compared with predose levels.ConclusionKME-induced hyperketonemia is robust, convenient, and safe, and the ester can be taken as an oral supplement without changing the habitual diet.