Here are a few of the most common side effects that I come across when people first start keto. Frequently the issues relate to dehydration or lack of micronutrients (vitamins) in the body. Make sure that you’re drinking enough water (close to a gallon a day) and eating foods with good sources of micronutrients. To read more on micronutrients, click here >
When carbs go missing from a person's diet, the body uses up its glucose reserves and then breaks down stored fat into fatty acids. When fatty acids reach the liver, they're converted into an organic substance called ketones. The brain and other organs feed on ketones in a process called ketosis, which gives the diet its name. Keto-dieters eat lots of fat to maintain this state.

In February, after internet commenters were attacking Hadid for her slimmer-than-usual figure, she fired back on Twitter, explaining that being diagnosed — and then treated — for Hashimoto’s has played a role in her weight fluctuations: “For those of you so determined to come up w why my body has changed over the years, you may not know that when I started @ 17 I was not yet diagnosed w/Hashimoto’s disease; those of u who called me ‘too big for the industry’ were seeing inflammation & water retention due to that.”
The ketone bodies are possibly anticonvulsant; in animal models, acetoacetate and acetone protect against seizures. The ketogenic diet results in adaptive changes to brain energy metabolism that increase the energy reserves; ketone bodies are a more efficient fuel than glucose, and the number of mitochondria is increased. This may help the neurons to remain stable in the face of increased energy demand during a seizure, and may confer a neuroprotective effect.[56]
After about two to seven days of following the keto diet, you go into something called ketosis, or the state your body enters when it doesn't have enough carbs for your cells to use for energy. That's when you start making ketones, or organic compounds that your bod then uses in place of those missing carbs. At this point, your body also starts burning fat for more energy, says Beth Warren, R.D., founder of Beth Warren Nutrition and author of Living A Real Life With Real Food.
Excess body fat promotes insulin resistance, a condition in which the body produces insulin but doesn’t use it effectively—leading the body to produce even more insulin. A hormone that helps control blood sugar, insulin is a potent stimulator of prostate cancer growth. By cutting calories and increasing exercise, you may be able to reduce excess body fat, preventing or overcoming insulin resistance and limiting the amount of insulin your body produces. Also, exercising and building muscle mass help control blood sugar, lowering your need for and production of insulin.
Reduced hunger. Many people experience a marked reduction in hunger on a keto diet. This may be caused by an increased ability of the body to be fueled by its fat stores. Many people feel great when they eat just once or twice a day, and may automatically end up doing a form of intermittent fasting. This saves time and money, while also speeding up weight loss.

•Choose lower-fat dairy products, leaner meats and alternatives, and foods prepared with little or no fat. Shop for low fat (2% or less) or fat-free products such as milk, yogurt, and cottage cheese. Eat smaller portions of leaner meats, poultry, and fish; remove visible fat from meat and the skin from poultry. Limit the use of extra fat like butter, margarine, and oil. Choose more peas, beans, and lentils
On Phase One: Induction, you’ll eat scrumptious proteins like fish, poultry, meats , eggs, and cheese, as well as wonderfully satisfying, buttery vegetables and healthy fats like avocado. Later on, you’ll be able to add virtually all food groups, from the acceptable food lists including full-fat yogurt, nuts, seeds, fruits, starchy vegetables like sweet potato, and even whole grains.

Make sure that the diet has been studied extensively for safety — and discuss any changes with your physician or registered dietitian before beginning a new diet. (If you don’t have a dietitian, find one in your area at the Academy of Nutrition and Dietetics website.) And do a self-check to ensure the diet fits with your own values and preferences.
Folate: This vitamin became a mandatory addition to certain foods due to its role in producing and maintaining new cells. The folate fortification project was implemented for the protection of developing fetuses. A folate deficiency in a woman who is pregnant can cause neural tube defects that result in malformations of the spine (spina bifida), skull, and brain (anencephaly). Since the fortification of foods with folate began, the incidence of these defects has declined. Dietary sources of folate are fortified cereals, beef liver, pinto beans, lentils, spinach, asparagus, avocados, and broccoli.
It's hard to avoid that 3 p.m. stomach rumble, when nothing can stand between you and the office vending machine. And while it's fine to eat something to hold you over until dinner (in fact, we encourage it!), some choices will help you keep on your weight-loss track—while others can surely derail you. So at the vending machine, instead of choosing that ever-so-tempting pack of Twizzlers, try a 100-calorie cookie pack or a Nature Valley granola bar. Better yet, bring a snack from home! We're fans of sliced veggies dipped in hummus. Delish!
A: The amount of weight you lose is entirely dependent on you. Obviously adding exercise to your regimen will speed up your weight loss. Cutting out things that are common “stall” causes is also a good thing. Artificial sweeteners, dairy, wheat products and by-products (wheat gluten, wheat flours, and anything with an identifiable wheat product in it).
Dr. Walter Willett, chairman of the nutrition department at the Harvard T. H. Chan School of Public Health, said the study did not support a “precision medicine” approach to nutrition, but that future studies would be likely to look at many other genetic factors that could be significant. He said the most important message of the study was that a “high quality diet” produced substantial weight loss and that the percentage of calories from fat or carbs did not matter, which is consistent with other studies, including many that show that eating healthy fats and carbs can help prevent heart disease, diabetes and other diseases.
Another way to stave off fatigue is to load your diet with foods rich in flavonoids, like blueberries, blackberries, and acai juice. “Our research shows that flavonoids interact with receptors in the brain that lessen the perception of tiredness. So while they’re not necessarily energy-boosting, they are fatigue-reducing,” says Talbott. About half a cup of blueberries will do the trick. Another easy strategy? Drink water throughout the day. The sluggish feeling that you get late in the afternoon, which then drives you to the vending machine, is often your body telling you that it’s low in fluid, says Talbott. The best gauge of hydration is the color of your urine, which should be almost clear if you’re well hydrated. Keep a bottle of water nearby and sip it all day, and drink a large glass of water with every meal or snack.
Fuels and feeds your brain: Ketones provide an immediate hit of energy for your brain, and up to 70% of your brain’s energy needs when you limit carbs.[6] Fat also feeds your brain and keeps it strong. Your brain is at least 60% fat, so it needs loads of good fats to keep it running.[7] Essential fatty acids such as omega-3s help grow and develop the brain, while saturated fat keeps myelin — the layer of insulation around the brain — strong so your neurons can communicate with each other.

Also make sure that you know what foods have mostly carbs, fat, and protein, so you can make the right choices. For instance, it’s not just bread, pasta, chips, cookies, candy, and ice cream that contain carbs. Beans may contain protein, but they’re also very high in carbohydrates. Fruit and veggies also mostly contain carbs. The only foods that don’t contain carbs are meat (protein) and pure fats, like butter and oils (including olive oil and coconut oil).

The modified Atkins diet reduces seizure frequency by more than 50% in 43% of patients who try it and by more than 90% in 27% of patients.[18] Few adverse effects have been reported, though cholesterol is increased and the diet has not been studied long term.[48] Although based on a smaller data set (126 adults and children from 11 studies over five centres), these results from 2009 compare favourably with the traditional ketogenic diet.[18]


Besides the well-known medical problems individuals can develop as a result of weight gain (high blood pressure, diabetes, cancer, stroke, and heart disease), extra weight puts additional stress on joints and bones. For example, the corticosteroid prednisone causes weight gain to some degree in nearly all patients who take the medication and can lead to redistribution of body fat to places like the face, back of the neck, and abdomen.

Nuts are a great source of heart-healthy fats and also provide protein and essential nutrients. They can give you a source of sustained energy for your workout. Pair them with fresh or dried fruit for a healthy dose of carbohydrates. However, test these options to see how they settle. High-fat foods can slow digestion, and they may make food sit in your stomach too long if your workout is coming up quickly.
And there's another benefit to using exercise as a weight-loss tool. If you lose weight by only reducing calories from your diet, you also run the risk of losing muscle and water in addition to fat. But exercise not only burns calories - it can also help you to increase your lean muscle mass. Since muscle burns more calories than fat, even when you are at rest, adding exercise to the mix can help make you a lean, mean, calorie-burning machine!

First reported in 2003, the idea of using a form of the Atkins diet to treat epilepsy came about after parents and patients discovered that the induction phase of the Atkins diet controlled seizures. The ketogenic diet team at Johns Hopkins Hospital modified the Atkins diet by removing the aim of achieving weight loss, extending the induction phase indefinitely, and specifically encouraging fat consumption. Compared with the ketogenic diet, the modified Atkins diet (MAD) places no limit on calories or protein, and the lower overall ketogenic ratio (about 1:1) does not need to be consistently maintained by all meals of the day. The MAD does not begin with a fast or with a stay in hospital and requires less dietitian support than the ketogenic diet. Carbohydrates are initially limited to 10 g per day in children or 20 g per day in adults, and are increased to 20–30 g per day after a month or so, depending on the effect on seizure control or tolerance of the restrictions. Like the ketogenic diet, the MAD requires vitamin and mineral supplements and children are carefully and periodically monitored at outpatient clinics.[48]


Children who discontinue the diet after achieving seizure freedom have about a 20% risk of seizures returning. The length of time until recurrence is highly variable, but averages two years. This risk of recurrence compares with 10% for resective surgery (where part of the brain is removed) and 30–50% for anticonvulsant therapy. Of those who have a recurrence, just over half can regain freedom from seizures either with anticonvulsants or by returning to the ketogenic diet. Recurrence is more likely if, despite seizure freedom, an electroencephalogram shows epileptiform spikes, which indicate epileptic activity in the brain but are below the level that will cause a seizure. Recurrence is also likely if an MRI scan shows focal abnormalities (for example, as in children with tuberous sclerosis). Such children may remain on the diet longer than average, and children with tuberous sclerosis who achieve seizure freedom could remain on the ketogenic diet indefinitely.[46]
Thiamin: Also known as vitamin B1, thiamin is involved in nervous-system and muscle functioning, the flow of electrolytes in and out of nerve and muscle cells, carbohydrate metabolism, and the production of hydrochloric acid. Very little thiamin is stored in the body, so depletion can occur in a little as 14 days. Chronic alcohol intake and an inadequate diet can lead to a thiamin deficiency. Beriberi is the deficiency disease for thiamin. Sources of thiamin are pork chops, sunflower seeds, green peas, baked potatoes, and enriched and whole grain cereals and pastas.
A: The most common ways to track your carbs is through MyFitnessPal and their mobile app. You cannot track net carbs on the app, although you can track your total carb intake and your total fiber intake. To get your net carbs, just subtract your total fiber intake from your total carb intake. I have written an article on How to Track Carbs on MyFitnessPal.
So is a once-a-day salad a good habit? “In general, it’s a smart idea, but it depends on what’s in your salad,” says Turoff. “For a well-balanced meal, salads should have a protein source, like chicken or tofu, nonstarchy veggies,” and a dressing for fat, she says. People run into trouble, she adds, when their salads have nuts, dressing, cheese, and avocado, for a total of four servings of fat or more.

The original therapeutic diet for paediatric epilepsy provides just enough protein for body growth and repair, and sufficient calories[Note 1] to maintain the correct weight for age and height. The classic therapeutic ketogenic diet was developed for treatment of paediatric epilepsy in the 1920s and was widely used into the next decade, but its popularity waned with the introduction of effective anticonvulsant medications. This classic ketogenic diet contains a 4:1 ratio by weight of fat to combined protein and carbohydrate. This is achieved by excluding high-carbohydrate foods such as starchy fruits and vegetables, bread, pasta, grains, and sugar, while increasing the consumption of foods high in fat such as nuts, cream, and butter.[1] Most dietary fat is made of molecules called long-chain triglycerides (LCTs). However, medium-chain triglycerides (MCTs)—made from fatty acids with shorter carbon chains than LCTs—are more ketogenic. A variant of the classic diet known as the MCT ketogenic diet uses a form of coconut oil, which is rich in MCTs, to provide around half the calories. As less overall fat is needed in this variant of the diet, a greater proportion of carbohydrate and protein can be consumed, allowing a greater variety of food choices.[4][5]

Wondering what fits into a keto diet — and what doesn’t? “It’s so important to know what foods you’ll be eating before you start, and how to incorporate more fats into your diet,” says Kristen Mancinelli, RD, author of The Ketogenic Diet: A Scientifically Proven Approach to Fast, Healthy Weight Loss, who is based in New York City. We asked her for some guidelines.

Choosing the right kind of carbohydrates is important. Too many people rely on the simple carbs found in sweets and processed foods. Instead, you should focus on eating the complex carbs found in whole grains, fruits, vegetables, and beans. Whole grains have more staying power than refined grains because you digest them more slowly. They can help you feel full for longer and fuel your body throughout the day. They can also help stabilize your blood sugar levels. Finally, these quality grains have the vitamins and minerals you need to keep your body running at its best.
The day before admission to hospital, the proportion of carbohydrate in the diet may be decreased and the patient begins fasting after his or her evening meal.[19] On admission, only calorie- and caffeine-free fluids[37] are allowed until dinner, which consists of "eggnog"[Note 8] restricted to one-third of the typical calories for a meal. The following breakfast and lunch are similar, and on the second day, the "eggnog" dinner is increased to two-thirds of a typical meal's caloric content. By the third day, dinner contains the full calorie quota and is a standard ketogenic meal (not "eggnog"). After a ketogenic breakfast on the fourth day, the patient is discharged. Where possible, the patient's current medicines are changed to carbohydrate-free formulations.[19]
Those issues can be part of what's known as the “keto flu,” Warren says. Other side effects of the keto diet, all of which are tied to carb withdrawal, can include lightheadedness, nausea, mental fog, cramps, and headaches, in addition to tiredness. Luckily, the keto flu doesn't usually last more than a week—which is coincidentally about when people start to see the number on the scale go down, says Warren.
Protein is needed to help keep your body growing, maintained, and repaired. For example, the University of Rochester Medical Center reports that red blood cells die after about 120 days. Protein is also essential for building and repairing muscles, helping you enjoy the benefits of your workout. It can be a source of energy when carbohydrates are in short supply, but it’s not a major source of fuel during exercise you’re well-fed.

The strategy worked for people whether they followed diets that were mostly low in fat or mostly low in carbohydrates. And their success did not appear to be influenced by their genetics or their insulin-response to carbohydrates, a finding that casts doubt on the increasingly popular idea that different diets should be recommended to people based on their DNA makeup or on their tolerance for carbs or fat.
Vitamin B12: Like folate, vitamin B12 is needed for producing and maintaining new cells. It is also needed to maintain the sheaths that surround and protect nerve fibers. An inadequate amount of B12 causes pernicious anemia. Signs of vitamin B12 deficiency are fatigue, weakness, constipation, loss of appetite, weight loss, and numbness and tingling in the hands and feet. An excess intake of folate can mask the symptoms of B12 deficiency, so it's important to have your levels checked by a blood test, especially if you consume a vegetarian diet. Vitamin B12 is found in animal products like trout, salmon, beef, and dairy foods. There are fortified cereals that provide B12 as well. Doctors do not routinely check vitamin B12 levels.
Take action: All types of exercise can make you feel better about yourself, but yoga is one of the best for women with low libido, says Lori Brotto, an associate professor in the department of obstetrics and gynecology at the University of British Columbia, in Vancouver. Brotto, who conducts research on women’s sexual health and counsels women who struggle with such issues as low sexual desire and loss of arousal, says that studies have found that yoga helps to decrease stress and anxiety, induces a state of relaxation, and helps women to remain focused—all of which can improve sexual health. She adds that strength training can also help tone perceived trouble spots and help women “feel more comfortable about being touched.”
In the mid-1990s, Hollywood producer Jim Abrahams, whose son's severe epilepsy was effectively controlled by the diet, created the Charlie Foundation to promote it. Publicity included an appearance on NBC's Dateline programme and ...First Do No Harm (1997), a made-for-television film starring Meryl Streep. The foundation sponsored a multicentre research study, the results of which—announced in 1996—marked the beginning of renewed scientific interest in the diet.[1]
Reduced hunger. Many people experience a marked reduction in hunger on a keto diet. This may be caused by an increased ability of the body to be fueled by its fat stores. Many people feel great when they eat just once or twice a day, and may automatically end up doing a form of intermittent fasting. This saves time and money, while also speeding up weight loss.
Meat – Unprocessed meats are low carb and keto-friendly, and organic and grass-fed meat might be even healthier. But remember that keto is a high-fat diet, not high protein, so you don’t need huge amounts of meat. Excess protein (more than your body needs) is converted to glucose, making it harder to get into ketosis. A normal amount of meat is enough.
There are theoretically no restrictions on where the ketogenic diet might be used, and it can cost less than modern anticonvulsants. However, fasting and dietary changes are affected by religious and cultural issues. A culture where food is often prepared by grandparents or hired help means more people must be educated about the diet. When families dine together, sharing the same meal, it can be difficult to separate the child's meal. In many countries, food labelling is not mandatory so calculating the proportions of fat, protein and carbohydrate is difficult. In some countries, it may be hard to find sugar-free forms of medicines and supplements, to purchase an accurate electronic scale, or to afford MCT oils.[54]

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Diarrhea can also be due to a lack of fiber in the diet, says Kizer, which can happen when someone cuts way back on carbs (like whole-grain bread and pasta) and doesn’t supplement with other fiber-rich foods, like vegetables. It can also be caused by an intolerance to dairy or artificial sweeteners—things you might be eating more of since switching to a high-fat, low-carb lifestyle.

Consequently, researchers have widely discredited the hCG diet, which involves using hCG injections, pellets, sprays, or drops, and consuming  as few as 500 calories daily. The diet is problematic not only because there’s a lack of research on hCG supplements, but also because the calorie requirement is dangerously low, potentially leading to nutrient deficiencies, fatigue, hormone imbalances, blood clots, and other issues. Thus, most experts agree the hCG diet is not safe for anyone, the Mayo Clinic notes. (35)
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