Rittig · European journal of endocrinology 2025 · randomized crossover trial · n=20

Ketone supplementation acutely lowers androgen and glucose levels in women with polycystic ovary syndrome: a randomized clinical trial.

Cited 9 times in the scientific literature.

Level 2 - randomized trial

Randomized, placebo-controlled crossover clinical trial

PubMed 40393075 · doi:10.1093/ejendo/lvaf106 · record verified 2026-08-29

What was done

A randomized, placebo-controlled crossover trial was conducted in 20 women diagnosed with polycystic ovary syndrome (PCOS). Participants underwent fasting blood sampling on two occasions after receiving either a ketone supplement (D-beta-hydroxybutyrate) or a taste-matched placebo. Each intervention was given over 10 hours, with one dose taken the evening before and another two hours prior to blood collection.

What was found

Blood D-beta-hydroxybutyrate reached 2.4 ± 1.2 mM following supplementation versus 0.1 ± 0.1 mM with placebo (P < .001). Fasting plasma glucose was 4.6 ± 0.7 mM after ketone supplementation compared with 5.1 ± 0.4 mM after placebo (mean difference -10%, 95% CI -15% to -5%, P < .001). For circulating androgens, 11-ketotestosterone decreased significantly (-21%, 95% CI -38% to -4%, P = .020). Reductions in other androgens did not reach conventional statistical significance: testosterone decreased by -13% (95% CI -27% to 1%, P = .067), free testosterone by -21% (95% CI -43% to 1%, P = .057), and androstenedione by -14% (95% CI -29% to 0%, P = .050).

Why it matters

This study provides initial evidence that beta-hydroxybutyrate may directly and acutely lower glucose and androgen concentrations in PCOS, highlighting a potential mechanism for ketone-based therapies.

Limits

The sample size was small (n = 20), and the intervention evaluated only an acute 10-hour exposure. Several androgen outcomes did not reach statistical significance. Long-term clinical outcomes, safety, and symptom improvements were not measured.

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