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Always use gentle swirling motions when mixing rather than shaking

Non-hepatic ketone body utilization occurs via a series of mitochondrial reactions (shown in the Figure below) that are essentially a reversal of ketone body synthesis

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Important Limitations of Use : [1] Not recommended as first-line therapy for patients inadequately controlled on diet and exercise

The medication should be taken as part of a medical weight loss treatment, not just on its own, in order to achieve much more substantial results

Some individuals also report using microdoses for appetite modulation without seeking the substantial weight loss associated with higher doses, or as a gentler introduction to the medication before escalating to standard doses