High Ketones track with Worse Liver Health...

Physionic

22 sept 2025

Episode description

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0:00 - Introduction
0:15 - More Ketones, Sicker Liver
2:25 - Why?
3:55 - How do we apply this?
6:35 - Ketone Supplementation?
7:40 - Main Points

References
[Study 518] Queathem ED, Stagg DB, Nelson AB, et al. Ketogenesis mitigates metabolic dysfunction–associated steatotic liver disease through mechanisms that extend beyond fat oxidation. J Clin Invest. 2025;135(12):e191021. doi:10.1172/JCI191021.

Funding/Conflicts: Public Funding [Supported by the US National Institutes of Health — grants DK091538, DK122832, HL166142, DK136772, and AG069781; no public-sector conflicts reported.] // Potential Conflicts of Interest: Peter A. Crawford (PAC) has served as an external consultant for Selah Therapeutics

[A] Browning JD, Baker JA, Rogers T, Davis J, Satapati S, Burgess SC. Short-term weight loss and hepatic triglyceride reduction: evidence of a metabolic advantage with dietary carbohydrate restriction. Am J Clin Nutr. 2011;93(5):1048-1052. doi:10.3945/ajcn.110.007674

[B] Holmer M, Lindqvist C, Petersson S, et al. Treatment of NAFLD with intermittent calorie restriction or low-carb high-fat diet - a randomised controlled trial. JHEP Rep. 2021;3(3):100256. Published 2021 Feb 17. doi:10.1016/j.jhepr.2021.100256

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Episode description

Mindsip insights from this episode:

Leverage ketone production to protect liver health

The production of ketones by your liver is not just for energy but also allows normal fat metabolism to function, culminating in less fat being pathologically stored.

#liver

#metabolism

Recognize ketones as signals of liver injury, not causes

Although higher ketone production is associated with more liver injury, this is likely a protective response from the liver, not the cause of the damage.

#liver

#metabolism

Utilize ketogenesis as a pressure release valve for liver health

Ketogenesis acts as a 'pressure release valve' for the liver to metabolize and deal with an influx of fat.

#liver

Avoid blocking ketones to prevent worsening fatty liver disease

When the liver's ability to produce ketones is removed, the amount of fat stored in the liver significantly increases, worsening fatty liver disease.

#fatty-liver

Utilize fasting to induce ketogenesis for liver protection

For those that do it, fasting is the most potent way to induce the necessary ketogenesis that protects the liver.

#fasting

#liver

Prioritize liver production of ketones for optimal benefits

You cannot simply increase ketones through supplements to get these liver benefits; the protective mechanism is the liver's *production* of ketones itself.

#liver

#supplement

Implement low-carb diet to reverse fatty liver disease

A very low carbohydrate diet that raises ketone levels may be uniquely potent at reversing fatty liver disease, possibly more so than just calorie restriction.

#fatty-liver

#low-carb

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