Dr. Dominic D'Agostino Explains What Ketones Actually Do to Your Body | HOMe Podcast #021

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In this episode of the Health Optimization Medicine Podcast, Dr. Scott Sherr sits down with Dr. Dominic D'Agostino, the premier researcher in ketogenic metabolic therapies. Moving past the mainstream fads of keto ice cream and internet trends, they break down how exogenous ketones actually impact cellular energy, cardiovascular health, and environmental stress. From the liver toxicity associated with certain high-dose ketone esters to the hidden vasodilatory superpowers of L-BHB, this discussion separates the biohacking hype from the physiological reality of ketone supplementation. Join us as we delve into: Fad vs. Science: Why serious researchers use the term Ketone Metabolic Therapy instead of Ketogenic Diet, and why peer-reviewed science is growing exponentially despite Google trends. The Metformin VO2 Max Penalty: Exploring recent data showing metformin can blunt VO2 max adaptations to exercise by 50% and acts as a weak mitochondrial toxin. Mitochondrial Hydraulic Efficiency: How ketones physically tighten electron flow in the mitochondria, reducing superoxide (ROS) production and enhancing endogenous antioxidant capacity. The Danger of 1,3-Butanediol: Why relying on high doses of certain ketone esters and diols can trigger dizziness, liver abnormalities, and dependence, and how to formulate them safely. The L-BHB Advantage: Why the lesser-known L-enantiomer of BHB acts as a potent vasodilator, significantly increasing cardiac output and brain blood flow through adenosine signaling. Performance vs. Recovery: Why exogenous ketones might underwhelm a healthy athlete looking for a power boost, but shine in extreme stress environments like hypoxia, hyperoxia, and recovery. This episode is for you if: You want to know the difference between a nutritional ketogenic diet and simply taking exogenous ketone supplements. You are concerned about the side effects, liver stress, and acidic load of pushing your blood ketone levels too high. You are interested in the synergistic effects of Hyperbaric Oxygen Therapy (HBOT) c