Abstract: The present disclosure relates to highly purified (R)-3?-hydroxybutyl (R)-3?-hydroxybutyrate and biomedical uses thereof. In particular highly purified (R)-3?-hydroxybutyl (R)-3?-hydroxybutyrate, is provided for enhancing bodily function and treating various disease states. The methods described herein provide for production of a highly purified (R)-3?-hydroxybutyl (R)-3?-hydroxybutyrate via processes external to the human body and administering effective amounts of highly purified (R)-3?-hydroxybutyl (R)-3?-hydroxybutyrate to human subjects to achieve a range of therapeutic benefits, including but not limited to, one or more of: inhibiting inflammasome activation, reducing pro-inflammatory cytokines, improving insulin sensitivity, enhancing mitochondrial biogenesis, and promoting muscle protein synthesis.