The properties of BHB
What Exactly is BHB?
Beta-hydroxybutyrate (BHB) is also known as beta-hydroxybutyric acid or 3-hydroxybutyrate.
Under the umbrella of ketones in human metabolism, BHB is considered one of the three “physiological” ketone bodies produced and burned in our cells. But opening an organic chemistry textbook, BHB won’t fit the true criteria of a “ketone.”
A ketone is defined as having carbonyl carbons (carbon joined to oxygen with a double bond) bonded to two other carbon atoms. BHB has a carbonyl carbon, but it’s only bound to one other carbon atom.
Despite this technicality, BHB is still considered one of the three ketone bodies because this family of metabolites are closely related and affect the body similarly. BHB levels increase in the brain, heart, muscle, liver and other tissues when restricting calories, fasting, following a ketogenic diet, or even as a result of exercise.
BHB like the other ketone bodies (acetoacetate and acetone), levels of 3-hydroxybutyrate in blood and urine are raised in ketosis. In humans, 3-hydroxybutyrate is synthesized in the liver from acetyl-CoA and can be used as an energy source by the brain when blood glucose is low. Blood levels of 3-hydroxybutyric acid levels may be monitored in diabetic patients to look for diabetic ketoacidosis. Persistent mild hyperketonemia is a common finding in newborns. Ketone bodies serve as an indispensable source of energy for extrahepatic tissues, especially the brain and lung of developing mammals. Another important function of ketone bodies is to provide acetoacetyl-CoA and acetyl-CoA for the synthesis of cholesterol, fatty acids, and complex lipids. During the early postnatal period, acetoacetate (AcAc) and beta-hydroxybutyrate are preferred over glucose as substrates for synthesis of phospholipids and sphingolipids in accord with requirements for brain growth and myelination. Thus, during the first 2 weeks of postnatal development, when the accumulation of cholesterol and phospholipids accelerates, the proportion of ketone bodies incorporated into these lipids increases. On the other hand, an increased proportion of ketone bodies is utilized for cerebroside synthesis during the period of active myelination. In the lung, AcAc serves better than glucose as a precursor for the synthesis of lung phospholipids. The synthesized lipids, particularly dipalmitoylphosphatidylcholine, are incorporated into surfactant, and thus have a potential role in supplying adequate surfactant lipids to maintain lung function during the early days of life (PMID: 3884391). 3-Hydroxybutyric acid is found to be associated with fumarase deficiency and medium-chain acyl-CoA dehydrogenase deficiency, which are inborn errors of metabolism.