Doubly labeled water may be administered by injection, or orally (the usual route in humans). Since the isotopes will be diluted in body water, there is no need to administer them in a state of high isotopic purity, no need to employ water in which all or even most atoms are heavy atoms, or even to begin with water which is doubly labeled. It is also unnecessary to administer exactly one atom of O for every two atoms of deuterium. This matter in practice is governed by the economics of buying O enriched water, and the sensitivity of the mass-spectrographic equipment available.
In practice, doses of doubly labeled water for metabolic work are prepared by simply mixing a dose of deuterium oxide (heavy water) (90 to 99%) with a second dose of HO, which is water which has been separately enriched with O (though usually not to a high level, since doing this would be expensive, and unnecessary for this use), but otherwise contains normal hydrogen. The mixed water sample then contains both types of heavy atoms, in a far higher degree than normal water, and is now "doubly labeled." The free interchange of hydrogens between water molecules (via normal ionization) in liquid water ensures that the pools of oxygen and hydrogen in any sample of water (including the body's pool of water) will be separately equilibrated in a short time with any dose of added heavy isotope(s).