Our body needs some time to get used to ketones being elevated in the blood stream to begin using them effectively and efficiently for cellular energy.  By consuming an exogenous ketone supplement, you get the body adapted to ketones faster and using them as an energy source before the body has built the metabolic machinery to produce its own ketones effectively.
In March 2018, our friend Vickie, who is a type 1 diabetic, told us about the keto way of life. She shared some interesting data Dr. Ken Berry puts out on YouTube. The things Dr. Berry said made total sense to us and we decided we needed to give keto a try. Both I and my girlfriend decided to give this Keto way of life a try. We officially started on March 5, 2018.
“As soon as you start consuming a normal amount of carbohydrates again, you immediately go out of ketoacidosis or the fat burning state”. I am sure you know the difference between nutritional ketosis and ketoacidosis yes? One is the natural fat burning state, and the other is toxic. Right now i am in ketosis but not ketoacidosis. One has a natural balance of Ph level, the other not. Once you make that statement, i have a sick feeling i am not getting the right information here.
The high-fat, very low-carb keto diet lets you enjoy lots of avocado, butter, bacon and cream—but requires cutting way back on added sugars, most processed foods, sweets, grains, and starchy veggies (whew). The eating plan is mega-popular among Hollywood A-listers (including Halle Berry, Megan Fox, and Gwyneth Paltrow); but if you don’t have a private chef who can futz with fats to make delicious meals and snacks, the carb-restricted lifestyle can be extremely challenging to follow. 
Let me introduce myself. My name is Mark Sisson. I’m 63 years young. I live and work in Malibu, California. In a past life I was a professional marathoner and triathlete. Now my life goal is to help 100 million people get healthy. I started this blog in 2006 to empower people to take full responsibility for their own health and enjoyment of life by investigating, discussing, and critically rethinking everything we’ve assumed to be true about health and wellness...

The whole area of calcium supplementation is rife with misinformation. Mainstream docs assume that osteoporosis is due solely to lack of calcium, ignoring that you need to have adequate Vit D levels to absorb the calcium in the first place (and their idea of adequate D blood levels are absurdly low) as well as Vit K2. Since bone is made of calcium phosphate, you also need adequate phosphate as well. Milk contains calcium phosphate – no surprise since it is designed to build the bones of the growing animal – so dairy is your best source of calcium. You also need protein since bone is calcium phosphate within a protein matrix. To rebuild osteoporotic bone you need 1.2gm/Kg of body weight, 50% more than the RDA of 0.8gm/Kg.


When the body is first deprived of carbohydrates, usually felt at around 50 grams per day or less, the body starts with gluconeogenesis which is the body using stored glucose (glycogen) from the liver and muscles for energy. When the stored glucose can no longer keep up with energy demands, which will happen because there’s limited storage of glucose, the body turns to using ketone bodies for energy.


Another possible nutrient deficiency: potassium, a mineral important for both electrolyte balance and blood pressure control, notes MedlinePlus. “Inadequate intake of potassium is likely when consumption of fruits and starchy vegetables are decreased,” says Asche. She recommends adding lower-carb sources of potassium to the diet, including avocado and spinach — as well as lower-carb sources of fiber, such as chia seeds and flaxseed (be sure to enjoy ground for the best health benefits).
She adds that the research supports the safety and effectiveness of following a keto diet even in older adults with obesity as it seems to help improve body composition and improve metabolic health.6 “We saw significant reduction in body fat while lean mass was preserved and significant improvements in insulin sensitivity and the lipid profile in response to a ketogenic diet when compared to a standard ‘balanced’ diet,” Dr. Goss explains.
You work out for a few months and get in shape and fall back to the old habits because you were not conditioned mentally, only physically. Physical fitness is only a part of journey, fitness is over 75% percent mental. Gyms, nutritionists, and personal trainers give most people a temporary Band-Aid but never address the actual issue. The 3-Week Ketogenic Diet includes secret mindset strategies to make your journey so much easier.

On keto, I’ve adjusted my basal rates and I barely need to bolus at all. My blood glucose numbers have definitely improved and what I find really extraordinary is that I’m needing about 60% less total daily insulin, than I did before starting keto. What’s even more fascinating to me is seeing a steady straight line across my pump for 6, 12, and even 24 hours – no crazy spikes or dips in my blood sugar.
And that’s the kicker -- most people “going keto,” may not actually be following a true ketogenic diet since it’s hard to know for sure if your body’s in ketosis. Mancella explains that the only formal and valid method of determining if your body is in ketosis is if there are ketone bodies being excreted in your urine. “There are strips for purchase at local drug stores that are available to determine this,” she says. “Otherwise, we’re not actually sure if we’re in ketosis, and we’re just following a ‘low carbohydrate’ diet.” 

Keto flu symptoms and side effects can include feeling tired, having difficulty sleeping, digestive issues like constipation, weakness during workouts, being moody, losing libido and having bad breath. Fortunately, these side effects don’t affect everyone and often only last for 1–2 weeks. (And yes, you CAN build muscle on keto.) Overall, symptoms go away as your body adjusts to being in ketosis.
The popular low-carb diets (such as Atkins or Paleo) modify a true keto diet. But they come with the same risks if you overdo it on fats and proteins and lay off the carbs. So why do people follow the diets? "They're everywhere, and people hear anecdotally that they work," McManus says. Theories about short-term low-carb diet success include lower appetite because fat burns slower than carbs. "But again, we don't know about the long term," she says. "And eating a restrictive diet, no matter what the plan, is difficult to sustain. Once you resume a normal diet, the weight will likely return."
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.
I think you should take some of your own advice…you are being judgmental and thinking your diet will work for everyone. Look at the scientific facts; your body’s life blood is carbohydrates, the bread of life. Simple carbohydrates are what is killer to American society. Any diet that cuts out junk food like greasy potato chips and ice cream and cake will make you lose weight, not rocket science. Where do you think your body is getting fuel from? Muscle mass! It has to use that because you are depriving it of fuel! Why go on extreme diets when all you need to do is practice portion control and get up off the couch and walk around?
The research on how diet affects PCOS is minimal, but there is one compelling study on the ketogenic diet and women with PCOS. In this study, five overweight women ate a ketogenic diet (20 grams of carbohydrates or less per day) for 24 weeks. The results were astounding — average weight loss was 12%, free testosterone decreased by 22%, and fasting insulin levels dropped by 54%. What’s even more impressive is that two of the women became pregnant despite previous infertility problems.
Thankfully, a few keto variations have been developed that are a little more flexible, and easier to stick with long-term. The traditional or standard ketogenic diet puts your body into ketosis: In this metabolic state, you burn fat (rather than carbs) as your primary fuel source, and that promotes fat loss. On a modified keto diet, your body will go in an out of ketosis, but still shed weight and body fat. Check out the guide below to see how each of the four keto diet types work. 

Now, there’s even evidence that a low-carb, high-fat regimen (as the keto diet is) helps you live longer, compared to a low-fat diet. In a study by the medical journal The Lancet that studied more than 135,000 adults from 18 countries, high carbohydrate intake was associated with higher risk of total mortality, whereas total fat and individual types of fat were related to lower total mortality. Total fat and types of fat were not associated with cardiovascular disease, myocardial infarction or cardiovascular disease mortality.


Eating cholesterol has very little impact on the cholesterol levels in your body. This is a fact, not my opinion.  Anyone who tells you different is, at best, ignorant of this topic.  At worst, they are a deliberate charlatan. Years ago the Canadian Guidelines removed the limitation of dietary cholesterol. The rest of the world, especially the United States, needs to catch up.
Now, there’s even evidence that a low-carb, high-fat regimen (as the keto diet is) helps you live longer, compared to a low-fat diet. In a study by the medical journal The Lancet that studied more than 135,000 adults from 18 countries, high carbohydrate intake was associated with higher risk of total mortality, whereas total fat and individual types of fat were related to lower total mortality. Total fat and types of fat were not associated with cardiovascular disease, myocardial infarction or cardiovascular disease mortality.
Considered a symptom of the keto flu, your breath on this diet often smells fruity at first. This is because acetone is a by-product of ketosis and is eliminated mostly through the lungs and the breath, according to a study in the journal International Journal of Environmental Research and Public Health in February 2014. Acetone is a type of ketone known for having a fruity aroma in smaller concentrations. “It’s hard to say exactly how long it will last as it depends on the person, but it’s common for someone to experience this side effect for a few weeks,” says Asche.
What others (many of them) out there provide is just incomplete knowledge, claims, and advises that are not backed by enough evidence. And they do it all for the sake of pioneering in the debate/argument. Just because someone else is wrong about something, doesn’t automatically make you right. I have spent the complete day searching for Keto, learning about it, the risks, and how to implement it. And my search ended right here on this article. I feel I am finally ready to adapt and take the benefits of it. Thank you, Jordan for providing us with such an informational piece of writing. 🙂

thank you Dr. Jockers for the informative article. I have hypothyroidism from 3 parathyroid cysts being removed along with 80% of my thyroid. It is under control with Levothyroxine and liathyronine. I have been on the keto diet for almost 4 weeks and am still experiencing heart palpatations, dizzyness and low energy. I have been quite strict and feel disappointed. I have Chronic Lymphocytic Leukemia and my oncologist was ok with me going on it. I feel like this diet would help me have more energy and help my overall health. Any advise would be appreciated. thank you, Inika
That's certainly the case with the ketogenic diet—a very low-carb meal plan—based on the findings of two recently published studies.1,2  Dr. Saslow and her team report that the individuals with type 2 diabetes who followed the keto diet lost significantly more weight than those on the low-fat diet espoused by the American Diabetic Association.1 These dieters also were able to get their hemoglobin A1c (HbA1c) below 6.5%, suggesting that some may have reversed their type 2 diabetes.1
There are two main types of diabetes: Type 1 and Type 2. Type 2 is by far more common, accounting for 90 percent of all diabetes cases worldwide. In this type, the body does not make or does not use insulin well. It can happen to anyone but is more common in people over the age of 40, those who are overweight and inactive, those with a family history of diabetes and patients whose diets consist mainly of refined carbohydrates.
But when you consume a high-carbohydrate diet, your brain often can't convert enough glutamate into GABA because it's using glutamate as an energy source. This imbalance can lead to neurotoxicity, and this impaired functioning could potentially lead to brain fog. For reasons not completely understood, ketosis seems to favor an increased production of GABA, which can lead to reductions in neurotoxicity and, therefore, brain fog.
Let’s talk about a keto side effect that may not be so sexy: constipation. “Many of the richest sources of fiber, like beans, fruit, and whole grains are restricted on the ketogenic diet,” says Clark. “As a result, ketogenic eaters miss out on the benefits of fiber-rich diet such as regular laxation and microbiome support. The microbiome has been implicated in everything from immune function to mental health.” Indeed, in a long-term study in the Journal of Pediatrics in April 2015, constipation was noted as a very common side effect in children receiving ketogenic diets for epilepsy treatment.
if this is true how did humans survive before agriculture? high carbohydrate foods simply didn’t exist in abundance before the agriculture age. Hundreds of thousands of years of evolution where humans would hunt for their food, and in between hunting eat whatever berries grew nearby….going days at a time or even weeks without food our bodies HAD to evolve into a state where they could conserve and store it’s energy then supply us with that energy burst for when that deer wandered by. Ketones are that energy source. Glucose simply doesn’t last long enough for us to survive and still have the energy to hunt. A little over 10,000 years of agriculture cannot undo hundreds of thousands of years of evolution.
Chronic exercise patterns: Fat-based metabolisms are great for long, slow movement, quick bursts of speed with rest in between, and feats of explosive strength. In other words, making your way through the world, doing some strength training, going for hikes, playing with kids, running some sprints, and are all tenable on keto. Heavy CrossFit training or anything else that burns a lot of glycogen at a lot of workouts each week, however, might pose issues. Resolve this by either scaling back the training or eating some carbs before, during, or after your workouts.
However, this diet isn’t for everyone. If traditional bread, pasta, rice, potatoes and/or fruit are what you live for, then you might just be miserable on keto. However, if you’re open to exploring different tastes, then the good news is there are substitutes for many of these foods. Cauliflower pizza crust, rice, and even gnocchi; zoodles (noodles made from zucchini); almond flour bread and almond milk are all readily available from most stores now.  A small amount of berries is acceptable, but for the most part say goodbye to apples, melons, plums and peaches. Booze and sugar are also out, but if you’re living with diabetes, you likely already know how to manage these desires.
Brain fog and a lack of focus can be caused by having too much glutamate and very little GABA. This will happen if your brain has to use glutamate and glutamic acid for fuel, which leaves little left over to be processed into GABA. By giving the brain another form of energy when you break down ketones, you’re able to balance out the neurotransmitter production.
I’m desperate to find some answers~I have no history of sensitivity to anything, no allergies. I understand allergies can happen at any time. I started the Keto diet and in a one month time I had four separate episodes of my tongue swelling~each episode worse than the one before. I LOVED this diet~felt great, handled it with ease. The last episode almost put me in the hospital~my tongue was so swollen it was coming out of my mouth making it difficult to swollen and breath. I had no choice but to narrow it down to Ketosis. All the foods were the same that I have eaten all my life. No new meds. The last episode I took 2 Benadryl and pulled myself out of Ketosis with consuming a Dr.Pepper, and 2 pieces of white toast. I was terrified. Everyone on Facebook in all these Keto sites tell me it has nothing to do with Ketosis….but I’ve tried literally everything I consumed when a was on that WOE and I’ve had no reaction in days. My body feels horrible, I have no energy, my entire body aches. I want back on the Keto diet because my body was responding really well to it~except for my tongue.
Technically speaking, you're in ketosis when your blood ketones are higher than 0.5 mmol/L, but the optimal level for fat-burning purposes is 1.5 to 3 mmol/L. Nisevich Bede says that seasoned keto dieters report that they can actually feel a difference in this state, citing that they're less hungry and experience mental clarity once they reach ketosis.
Luckily today, we do not have to treat any type of diabetes with this barbaric method. There are so many healthy food options for most people today in modern society. In America, most of us are blessed to have access to healthy food options. I did see the research that Dr. Westman has completed at Duke University and did reference one of his articles above (reference #7 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1325029/). I have no doubt the diet works, I’ve done it and lost weight really fast, so I know from firsthand experience that it works. You will lose weight which will have wonderful effects on every aspect of your health. The problem I have is, can anyone go the rest of their life without consuming anything white EVER? Do you think every author of all those books actually does that? I would offer to put them all on a lie detector to prove that they haven’t lived 40 years without consuming one white thing or one fruit or anything with sugar in it. My question is, what quality of life do they really have if they have? I for one will NOT be giving up my or my family’s birthday cake!
Two years in and I am this exact same story. I do agree that if one is not insulin resistant or diabetic and has normal insulin response there are other less restrictive diets that will work. I would also add that people fail and drop out of almost EVERY diet program for one reason or another so that argument is null and void. I am under a doctor’s care and am healthier than I have been in years. My only dietary “sin” is artificial sweeteners and I am not looking back! I have not cheated at all on high carb foods and am rarely even tempted. It is doable if your motivation is there and you have support which is true for any kind of life altering decision.
When the body is first deprived of carbohydrates, usually felt at around 50 grams per day or less, the body starts with gluconeogenesis which is the body using stored glucose (glycogen) from the liver and muscles for energy. When the stored glucose can no longer keep up with energy demands, which will happen because there’s limited storage of glucose, the body turns to using ketone bodies for energy.

One of the keto side effects people may complain about is keto breath.  Although this is not quite related to the three major causes we’ve discussed so far, keto breath is something that many people experience in the early stages of keto adaptation. When you begin producing ketones, you produce them in several different forms. The ketone that is released through the breath is acetone and is responsible for the keto breath that some people experience.
Despite its explosive popularity, there’s a lot of confusion about what the ketogenic (keto) diet really is. “Many people think they’re following a keto diet when they’re really just consuming a low-carbohydrate diet,” says Patti Urbanski, MEd, RD, CDE, a certified diabetes educator with St. Luke’s Hospital in Duluth, Minnesota. “So one person’s ‘keto diet’ may look very different than another’s.”
I’ve been following a ketogenic based “Way of Eating” or almost a year now, and I’ve never felt better. Fats are the main source of calories with it—NOT protein. Fats and proteins ARE essential for the body. Carbohydrates are not. The 20g of carbs are for net carbs, NOT total carbs. This means you can have a great deal of fiber from very nutrient filled veggies that don’t spike your blood sugar.

While the science of nerve signaling and genetic mutations is incredibly complex, it makes sense that a therapy, the ketogenic diet, that has been used successfully in epilepsy for 100 years might be helpful in conditions that share some similar features. Could changing the brain’s fuel, help change the malfunctions in its nerve cell firings and neuron excitability?


The ADA has recommended since 2013 we use our best clinical judgement in recommending a low carbohydrate diet for people with diabetes, recognizing it needs to be individualized. 60-75 grams is the carbohydrate amount I would give to a very tall, large boned man or perhaps an active teen or young adult. I would never recommend that many carbohydrates for an average size man who was trying to lose weight; he would get 45-60 grams of carbohydrates per meal and 15-30 grams for snacks. A women trying to lose weight would get 30-45 grams of carbohydrates per meal and 15 grams for snacks.
Another way to test the body’s response to nutritional ketosis is through breath acetone levels. This essentially shows how much of the ketones are being utilized by the body. I used a Levl meter (use the code wellnessmama at this link for $25 off) to test breath acetone levels. This device is more pricey but does not require strips so it can be used more often. I used it to test my response to certain foods or exercises and to see if they pulled me out of ketosis.
Eating slightly more carbs may potentially slow down weight loss and mute rapid, dramatic health improvements, but it can still lead to better health, especially if you are cutting out sugar and processed foods. And keto flu will no longer be an issue. Once you’ve adapted to low-carb eating, feel free to try eating less than 20 grams of carbs again to see whether your body prefers this or slightly higher carb intake.
Just as people can vary dramatically in their response to carbs, I would not be surprised if that’s the case for some people. Might this be another case of copy numbers of AMY1 SNPs? But most people need to assume that WB/Undoctored is not a full-time KD. The goal of the 50g/day, 15g/interval is not for elevated ketone levels; it’s for ideal average and peak blood sugars.
Yes. The ketogenic diet is very healthy. As a matter of fact, it comes with lots and lots of health benefits which we have already looked at. Even though this diet comes with a few side effects, it comes with a lot more health benefits ranging from providing more energy to helping with weight loss and controlling blood sugar. In all, the ketogenic diet is a very healthy diet.
After reading that article I have to say that the “USC experts” are full of it. It’s the usual scare stuff that the mainstream docs and dietitians trot out to attempt to discredit LCHF and keto diets. There’s no reason why a keto diet should be any worse for bone health than any other diet provided it has adequate calcium, phosphate and Vit K2 and you have good Vit D levels. As for the recommendations of dietitians – eat lots of healthywholegrains and “vegetable” oils but no saturated fats – we know what the long-term results are of that: diabetes, heart disease and osteoporosis.
A recent pilot study put five patients on the ketogenic diet (less than 20 grams per day of carbohydrate). At the end of six months, the average weight loss was 28 pounds (but this wasn’t the most surprising finding). Each patient underwent a liver biopsy, and four of the five patients had a reduction in liver fat, inflammation, and fibrosis. However, this is a small pilot study that also used supplements, so the results are not conclusive. What does the rest of the research say?
People With a History of Eating Disorders Going on a strict diet that eliminates food groups could trigger a relapse if you have a personal history of having an eating disorder. And while there’s a growing popularity in treating binge eating disorder (BED) with keto, experts strongly advise against it. Treatment of BED requires regular, adequate food intake without restriction, says Sumner Brooks, MPH, RDN, a certified eating disorder dietitian in Portland, Oregon.
"There is still some debate on the effects of saturated fats and what constitutes a healthy dose.  There has been quite a bit of buzz around grass-fed cows producing cream, dairy, and butter.  Ghee has been popular on the market as well, as a clarified form of butter," Ms. Zarabi says.  "It's really the trans fats that I think people need to understand and the harmful effects on the heart and cholesterol."
The keto diet is one of the hottest weight-loss strategies today. That’s not surprising—who wouldn’t want to lose weight fast without counting calories or feeling hungry? But it’s not without controversy: Yes, you can eat all the fatty foods you want, but the tradeoff is the extreme restriction of carbohydrates: bread, potatoes, even fruit. Keto dieters are advised to keep carbs to just 10 percent of their daily intake.
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Reduce daily net carb intake to less than 20 grams: Although it’s possible that you may not need to be this strict, eating fewer than 20 grams of net carbs every day virtually guarantees that you’ll achieve nutritional ketosis. What does 20 grams of carb look like? Use our visual guide to find out, or simply try our keto recipes and meal plans that limit carbs to less than 20 grams per day.

Type 1 diabetics, for now, nearly always need some insulin. How much they need and how effective the exogenous insulin is at controlling their blood sugars largely depends on how well they followed a well-formulated low-carb or ketogenic diet. What it comes down to is that the diet allows you to deal with the easier task: covering your basal insulin needs. Off the diet, people are faced with the harder task: covering basal insulin needs + those arising from carby foods.
Earlier in this article, I briefly mentioned how consuming too much sugar can impair brain function and cause plaque build up in the brain. Many studies on Alzheimer’s disease patients agree with the biochemistry as well. In fact, A group of scientists reviewed the literature and concluded that “high carbohydrate intake worsens cognitive performance and behavior in patients with Alzheimer’s disease.” This means that eating more carbohydrates cause more problems in the brain. Will the opposite (eating fewer carbs) improve brain function?
Ketogenic diet for diabetics is a highly controversial topic, but we will break down everything here for you! As a Certified Diabetes Educator (CDE), I have to tell you from the start I will have a biased view here. Sorry, but I feel that I need to be completely honest right up front! I will however, present all the evidence that is available currently on the subject.

But wait, there’s one loophole. Have polycystic ovary syndrome (PCOS)? Then the keto diet may help regulate your periods. “Women with PCOS have high insulin levels, which cause sex hormone imbalances,” notes Yawitz. In a small study published in the journal Nutrition & Metabolism, subjects with PCOS following a ketogenic diet for six months noted improvements in their menstrual cycles — and a small number of women became pregnant, overcoming previous infertility obstacles. “This study was very small, so we can’t make recommendations for all women with PCOS based on its findings,” says Yawitz. “And really, any diet that leads to weight loss should help in PCOS.”

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