{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T05:28:50Z","timestamp":1786685330666,"version":"build-2736575974"},"reference-count":38,"publisher":"Wiley","issue":"15","license":[{"start":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T00:00:00Z","timestamp":1785715200000},"content-version":"vor","delay-in-days":2,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["physoc.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Physiological Reports"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Exogenous ketosis may stimulate erythropoietin (EPO), yet its impact on erythropoiesis, iron metabolism, and potential sex\u2010specific responses in humans remains unknown. We investigated these effects in healthy adults using oral \u03b2\u2010hydroxybutyrate ketone monoester (KE) to induce intermittent ketosis. Acute EPO responses to a single dose of KE were assessed in 16 healthy adults (pre\u2010post), followed by a 2\u2010week randomized study (KE twice daily vs. placebo). After 2\u2009weeks, EPO levels with intermittent ketosis were approximately 30% higher (95% CI 6, 60),\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.01, an effect more evident in females (9.7\u2009IU\/L (95% CI 6.0, 13.5) vs. 6.4\u2009IU\/L (95% CI 4.0, 8.8),\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.008) than in males (10.7\u2009IU\/L (7.2, 14.2) vs. 9.6\u2009IU\/L (6.3, 12.9),\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.46). Ferritin was elevated in females with KE vs. placebo (42\u2009\u03bcg\/L vs. 16\u2009\u03bcg\/L,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001). Hemoglobin and red blood cell count were unaffected at 2\u2009weeks. Over 2\u2009weeks, intermittent exogenous ketosis was associated with a modest increase in erythropoietin levels, with a stronger signal in females. Although hemoglobin and red blood cell count did not change significantly, females showed higher ferritin levels and a trend toward increased hematocrit, suggesting subtle effects on erythropoietic stimulation and iron handling.\n                  <\/jats:p>","DOI":"10.14814\/phy2.71041","type":"journal-article","created":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T04:31:05Z","timestamp":1785817865000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Intermittent exogenous ketosis increases erythropoietin in healthy adults: A randomized, placebo\u2010controlled study with preliminary sex\u2010specific observations"],"prefix":"10.14814","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0522-0320","authenticated-orcid":false,"given":"Henrik Holm","family":"Thomsen","sequence":"first","affiliation":[{"name":"Medical Diagnostic Center University Clinic for Innovative Patient Pathways, Regional Hospital Central Jutland  Viborg Denmark"},{"name":"Department of Clinical Medicine Aarhus University  Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9884-9165","authenticated-orcid":false,"given":"Birgitte","family":"Sandfeld\u2010Paulsen","sequence":"additional","affiliation":[{"name":"Department of Clinical Biochemistry Regional Hospital Central Jutland  Viborg Denmark"},{"name":"Department of Clinical Biochemistry Aalborg University Hospital  Aalborg Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0133-5131","authenticated-orcid":false,"given":"Lise N\u00f8rkj\u00e6r","family":"Bjerg","sequence":"additional","affiliation":[{"name":"Department of Clinical Biochemistry Regional Hospital Central Jutland  Viborg Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0605-1277","authenticated-orcid":false,"given":"Jesper N\u00f8rgaard","family":"Bech","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine Aarhus University  Aarhus Denmark"},{"name":"University Clinic in Nephrology and Hypertension G\u00f8dstrup Regional Hospital  Herning Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,3]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/GERONA\/GLT154"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.123.067971"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCHEARTFAILURE.124.012167"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1080\/00365513.2025.2460198"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.3390\/IJMS22063248"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2016.158857"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.3390\/foods12173219"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1152\/ajpendo.00264.2022"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc14\u20103082"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.14814\/phy2.70009"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1113\/jphysiol.2010.195057"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1152\/ajpendo.00415.2024"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1039\/d1fo00729g"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.2196\/85548"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc18\u20101421"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.14814\/phy2.70829"},{"key":"e_1_2_13_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00421\u2010025\u201005987\u20109"},{"key":"e_1_2_13_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.blre.2013.12.003"},{"key":"e_1_2_13_20_1","doi-asserted-by":"publisher","DOI":"10.3390\/nu12030854"},{"key":"e_1_2_13_21_1","doi-asserted-by":"publisher","DOI":"10.1113\/JP284346"},{"key":"e_1_2_13_22_1","doi-asserted-by":"publisher","DOI":"10.1093\/ejendo\/lvaf106"},{"key":"e_1_2_13_23_1","doi-asserted-by":"publisher","DOI":"10.1210\/clinem\/dgaa483"},{"key":"e_1_2_13_24_1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev\u2010med\u2010042921\u2010102602"},{"key":"e_1_2_13_25_1","doi-asserted-by":"publisher","DOI":"10.1126\/science.1227166"},{"key":"e_1_2_13_26_1","doi-asserted-by":"publisher","DOI":"10.1007\/S00421\u2010019\u201004157\u2010Y"},{"key":"e_1_2_13_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinbiochem.2013.08.011"},{"key":"e_1_2_13_28_1","doi-asserted-by":"publisher","DOI":"10.1152\/japplphysiol.00097.2025"},{"key":"e_1_2_13_29_1","doi-asserted-by":"publisher","DOI":"10.3389\/fphys.2017.00848"},{"key":"e_1_2_13_30_1","doi-asserted-by":"publisher","DOI":"10.3389\/fphys.2019.01534"},{"key":"e_1_2_13_31_1","doi-asserted-by":"publisher","DOI":"10.1155\/2024\/9301369"},{"key":"e_1_2_13_32_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/nqy170"},{"key":"e_1_2_13_33_1","doi-asserted-by":"publisher","DOI":"10.1111\/dom.14402"},{"key":"e_1_2_13_34_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2023.8020"},{"key":"e_1_2_13_35_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pbio.3003462"},{"key":"e_1_2_13_36_1","doi-asserted-by":"publisher","DOI":"10.3389\/FNUT.2018.00062\/TEXT"},{"key":"e_1_2_13_37_1","doi-asserted-by":"publisher","DOI":"10.3390\/cells14040280"},{"key":"e_1_2_13_38_1","doi-asserted-by":"publisher","DOI":"10.1038\/nm.3804"},{"key":"e_1_2_13_39_1","doi-asserted-by":"publisher","DOI":"10.1096\/fj.201601223RRR"}],"container-title":["Physiological 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