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.
"That being said, using this diet as a kick start for two weeks and then following it with a healthier way of eating is not a bad thing," Amselem says. "For example, one can start on the ketogenic diet for a two-week period and then follow a plan that is healthy and sustainable for life by limiting the high-fat red meat and dairy and adding fish, olive oil, fruit, and healthy carbohydrates such as whole grains, sweet potato, brown rice and quinoa."
The only evidence I could find for the long-term safety of a keto diet is from one 12 month trial. As a result of the study, the researchers found that overweight adults with elevated A1c that followed the keto diet experienced more significant reductions in A1c, lost more weight, and decreased their medications more than those instructed to follow a moderate-carbohydrate, calorie-restricted, low-fat diet.
The ketogenic diet may seem like the latest weight-loss craze, but it’s actually been around for nearly a century. Developed in the 1920s, this ultra-low-carb, high-fat eating plan was originally used to treat seizures in people with epilepsy. Today, it’s getting some serious attention for an entirely different reason. “There’s growing research showing that the ketogenic diet is effective for managing blood sugar in people with diabetes,” says William Yancy, MD, program director at the Duke Diet and Fitness Center in Durham, North Carolina. “However, because we don’t have studies [lasting] longer than two or three years, we don’t know what can happen with regard to complications over longer periods of time.”

Author’s note: I want to stress again the importance of consulting with your doctor before you try ketogenic dieting. The more I study this area of science, the more I realize that every individual is extremely unique when it comes to health issues and there are a ton of reasons why you should NOT go full-on keto (especially if you are prone to kidney, heart, or gallbladder issues). That being said, for many people this form of eating is life changing, and the amount of scientific research supporting a ketogenic lifestyle is significantly increasing. Subscribe to my newsletter to stay posted when I publish new articles, and I’d appreciate any and all feedback/corrections on the content I’ve written above. Thanks! (Image credit)
Maria Emmerich: I struggled with my weight most of my life. I tried exactly what I was told to do – eating low fat and working out more and more. I even got to where I ran a marathon and still ended up gaining weight! I knew there had to be another way. I spent years researching all the latest science, and that led me to a ketogenic lifestyle and I have never looked back. I cured my irritable bowel syndrome (IBS), acid reflux and polycystic ovary syndrome (PCOS) and lost the extra pounds.
Also, consider supplementing with the amino acid leucine, as it can be broken down directly into acetyl-CoA, making it one of the most important ketogenic amino acids in the body. While most other amino acids are converted into glucose, the acetyl-CoA formed from leucine can be used to make ketone bodies. It’s also present in keto friendly foods like eggs and cottage cheese.

Maria Emmerich: I struggled with my weight most of my life. I tried exactly what I was told to do – eating low fat and working out more and more. I even got to where I ran a marathon and still ended up gaining weight! I knew there had to be another way. I spent years researching all the latest science, and that led me to a ketogenic lifestyle and I have never looked back. I cured my irritable bowel syndrome (IBS), acid reflux and polycystic ovary syndrome (PCOS) and lost the extra pounds.


I’m not Edward, but I’ve been on a keto diet for 3 weeks. I don’t find it difficult at all. I’ve attended 2 birthday parties, and it’s easy to say “No thank you” when I’m offered cake because my health is my top priority. Drinking a lot of water to support the kidneys is an absolute must. Also, supplementing sodium, potassium and magnesium keeps electrolytes in balance. A Naturopathic doctor is a great source of information on true lifestyle modifications.


Keto dieters often commiserate about experiencing symptoms as their bodies adjust to the diet, but experts say this period of transition is no joke. "When your body first enters ketosis, you may experience a series of side effects termed the 'keto flu,'" says Jennifer M. Brown, R.D., a faculty associate at Arizona State University's School of Nutrition and Health Promotion. "These include fatigue, dizziness, lightheadedness, poor sleep, difficulty with exercise, and constipation, all resulting from extreme restriction of carbohydrates." While these symptoms usually subside after the body adjusts to relying on fat for fuel, it can take anywhere from a few days to a few weeks. Is losing weight really worth potentially feeling ill for three weeks?! "Given that low-carb diets have not been shown to have an advantage when it comes to weight loss, I would say these side effects aren't worth it and are unnecessary," Brown says. (Related: Is It Possible to Follow a Vegetarian Keto Diet?)
The primary outcome was the change from baseline to week 16 in hemoglobin A1c. Changes in all variables were analyzed by the paired t-test or Wilcoxon signed-ranks test, as appropriate. Linear regression analysis was used to examine predictors of change in hemoglobin A1c. A p value of 0.05 or less was considered statistically significant. Statistical analysis was performed using SAS version 8.02 (SAS Institute, Cary, NC).
In addition, as the Harvard School of Public Health points out, “Carbohydrate metabolism plays a huge role in the development of type 2 diabetes, which occurs when the body can’t make enough insulin or can’t properly use the insulin it makes.” When a food containing carbohydrates is eaten, the digestive system has to process these carbs and turns them into sugar which then goes into the bloodstream. The ketogenic diet majorly minimizes carbohydrate intake so prediabetics, as well as type 1 and type 2 diabetics, aren’t challenging their bodies with carbohydrate breakdown that can raise blood sugar levels and create problematic insulin demands for the body.
Keto diets are high in healthy fats and protein also tend to be very filling, which can help reduce overeating of empty calories, sweets and junk foods. (4) For most people eating a healthy low-carb diet, it’s easy to consume an appropriate amount of calories, but not too many, since things like sugary drinks, cookies, bread, cereals, ice cream or other desserts and snack bars are off-limits.

In order to stay in ketosis, you have to limit carbs, but also to some extent protein. This is the predominant difference between keto and traditional lower-carb diets like Atkins. By relying on dietary fat for most of your calories per day, you limit fiber-rich sources (like fruit, veggies, and legumes) and sources of lean protein (like fatty fish) — some of the most nutrient-dense foods on the planet.


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.

"Most of the work in this field is still pre-clinical, meaning it's been conducted in animal models," Angela Poff, a research associate in the Department of Molecular Pharmacology and Physiology at the University of South Florida, told U.S. News & World Report. "It's been done in various cancer types, but most of the work has been done in brain cancer specifically. But there's very little clinical data all around. There's some case reports and very small preliminary clinical studies in small groups of patients, usually very late-stage patients with various types of cancers. So in the clinical realm, which is the most important in telling us whether this is going to be useful, we have a long way to go."

Regarding metabolism: one study found when men on either the ketogenic diet or the low-fat diet were compared, their resting metabolic rates were not different despite lowered T3 on the ketogenic diet.21 Of the several studies done on the ketogenic diet, none have reported significant cases of hypothyroidism–essentially, the thyroid can function fine while following a ketogenic diet.
The benefits of a ketogenic diet have been well documented for those living with Type 2 diabetes. Not only does the diet help manage blood sugar but it promotes weight loss as well. The results for those living with Type 1 are less conclusive. Many studies tend to address low carb diets like paleo and Atkins, which focus more on types of low carb food to eat, unlike a keto diet, which pays close attention to macronutrients and staying in ketosis. There seem to be fewer studies exploring the latter, but there is observational information that seems to indicate the diet offers a way to manage A1C levels and glycemic control. Many people with diabetes who abide by the keto diet have found that they significantly reduce their use of insulin.

I think what bothered me most about the article was the way in which the writer has put her own fears about living without cake onto the shoulders of any diabetic she might treat. In the same way an epileptic might choose a life without cake in order to remain seizure free I choose a life without cake to remain “undiabetic”. I must admit that when I was researching this diet I did worry that I would not have the stamina, but the thought of going blind is a useful motivator.

An extensive review published in 2013 looked at the research and evidence of ketogenic diets enhancing fertility (long story short, it looks promising). Studies also show that Polycystic Ovary Syndrome (PCOS) can be treated effectively with low-carb dieting, which reduces or eliminates symptoms such as infrequent or prolonged menstrual periods, acne, and obesity.


Klein S, Sheard NF, Pi-Sunyer S, Daly A, Wylie-Rosett J, Kulkarni K, Clark NG. Weight management through lifestyle modification for the prevention and management of type 2 diabetes: rationale and strategies. A statement of the American Diabetes Association, the North American Association for the Study of Obesity, and the American Society for Clinical Nutrition. Am J Clin Nutr. 2004;80:257–263. [PubMed] [Google Scholar]
The most obvious sign that your electrolyte/mineral balance is being affected is an increase in urination. On a low-carb diet, insulin levels drop which promotes the secretion of sodium in the urine. Sodium pulls more water into the urinary system which then is excreted as well.  This is a very normal one of the keto side effects and a positive sign you are moving towards keto adaptation.
“Keto is not a great long-term diet, as it is not a balanced diet,” says Nancy Rahnama, MD, MS, an internal medicine and bariatric specialist in Los Angeles. “A diet that is devoid of fruit and vegetables will result in long-term micronutrient deficiencies that can have other consequences. The keto diet can be used for short-term fat loss, as long as it is under medical supervision.”
Disagree. I’ve been eating like this for ten months. I still enjoy carbs on the rare occasion but stick to a ketogenic diet most of the time. Ive lost 94lbs. I understand people lose weight in other ways but for me this worked. I eat 10x as many green vegetables as I ever have (at least 2 meals a day). My blood pressure dropped drastically in the first month. My cholesterol, triglycerides and blood sugar all normalized within the first 90 days. I don’t see any reason not to continue. I find this way of eating empowering and not restrictive. Before you call something a fad, because you obviously don’t fully understand this, you ought to read something from people other than the people you agree with. This is the problem I have with dieticians and most doctors. You don’t think for yourselves. You follow whatever the accepted guidelines are and spout them off without ever asking if they are right. It’s easier to stand with the crowd. I get that. But do not use your expertise as a means to criticize real progress. I would think as an expert your would be a proponent of what works! Have you ever been morbidly obese? Do you know what it is like to think your going to die from a heart attack at a young age? Do you know what it’s like to know your going to get type 2 if you can’t overcome your weight? Eating this way got me out of all of that and gave me my life back. Come down from the Ivory tower… Just maybe a little less judgement, a little more open minded
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.
Additionally, people with gallbladder disease, pancreatic insufficiency, a history of kidney stones, or a history of anorexia should talk with their doctor regarding the safety of a ketogenic diet program. Last, women who are pregnant or breastfeeding require higher protein intake and should adjust the ketogenic diet plan to meet this macronutrient need.
Thank you for your wonderful comments Marcia. To share more about me personally with you all…I am not a completely non-diabetic Certified Diabetes Educator. I found out I had Prediabetes 15 years ago when I became a Diabetes Educator. I tested my own A1c and found it was 5.8%. The incredible news? There have been years when my A1c dropped to a normal level of 5.4%…out of the prediabetes range. My last A1c in May was 5.8%, so I still have Prediabetes 15 years later, but not diabetes, and without any medication, just the sensible diet I’ve discussed and exercise, so I really am living with this. I feel it everyday, I wonder what my A1c is going to be just like you every 6 months when I go to have it drawn.
As CDE’s, we individualize our recommendations for each of our patients. One person’s diet may not be appropriate for another person. For example, a six foot 6 inch tall man weighing 220 lbs of mainly muscle, who exercises 2 hours per day at the gym cannot have the same number of carbs per meal as a petite 5 foot 1 inch 75 year old lady who does not exercise.
Keto has become synonymous with low carb, but as you have just read, reaching ketosis is much more complex than just eating fewer carbs. Healthy, young active people are taking up ‘the keto diet’ recreationally without any clinical reason in an attempt to lose weight, drop body fat, get a six-pack, or just to follow a trend their friends have taken up.

The data presented in the present study showed that a ketogenic diet acted as a natural therapy for weight reduction in obese patients. This is a unique study monitoring the effect of a ketogenic diet for 24 weeks. There was a significant decrease in the level of triglycerides, total cholesterol, LDL cholesterol and glucose, and a significant increase in the level of HDL cholesterol in the patients. The side effects of drugs commonly used for the reduction of body weight in such patients were not observed in patients who were on the ketogenic diet. Therefore, these results indicate that the administration of a ketogenic diet for a relatively long period of time is safe. Further studies elucidating the molecular mechanisms of a ketogenic diet are in progress in our laboratory. These studies will open new avenues into the potential therapeutic uses of a ketogenic diet and ketone bodies.


The struggle as a prescriber is that you have to follow the “standard of care,” lest you open yourself up to a lawsuit. So I talk to my patents about what “the” recommendations are, and then I talk to them bout what the evidence says and what my experience says. Plain and simple, patient’s trust the government’s recommendations and can’t wrap their head around the idea of not eating carbs because they have learned their entire lives that the body “needs” carbs to survive.
The studies done on ketosis and endurance sports performance paint a pretty clear picture – it helps.  One of the most detailed studies on fat utilisation and performance (compared to a standard carb diet) was named the FASTER study - the results found that those who were on a ketogenic type diet had more mitochondria than the control group, lower oxidative stress, lower lactate load and that the fat adapted and fuelled athletes could function off fat for a much higher intensity than the non-fat adapted counter parts.
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.
The present study shows the beneficial effects of a long-term ketogenic diet. It significantly reduced the body weight and body mass index of the patients. Furthermore, it decreased the level of triglycerides, LDL cholesterol and blood glucose, and increased the level of HDL cholesterol. Administering a ketogenic diet for a relatively longer period of time did not produce any significant side effects in the patients. Therefore, the present study confirms that it is safe to use a ketogenic diet for a longer period of time than previously demonstrated.

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Constipation is a common side effect of low-carb eating plans, including the ketogenic diet. Severely curbing your carb intake means saying goodbye to high-fiber foods like whole grains, beans, and a large proportion of fruits and vegetables, says Ginger Hultin, MS, RDN, Seattle-based nutritionist and spokesperson for the Academy of Nutrition and Dietetics.
Your kidneys flushing out all that water is also part of the reason people see dramatic scale drops in the beginning of their keto journeys. "I wish people knew that the weight loss they will initially experience on this diet is largely due to water loss," Brown says. That means you're most likely not actually losing fat in the first couple of weeks, but instead losing water that will come back in the form of glycogen stores if and when you start eating carbs again. (BTW, Here's How to Safely and Effectively Come Off the Keto Diet.)
The same goes for people with type 2 diabetes. While some preliminary research suggests the keto diet may be safe and effective for certain people with type 2 diabetes, there’s still the risk for low blood sugar, especially for those on insulin, and the keto diet omits certain food groups known to benefit those with this disease. For example, a study published in September 2016 in the journal Nutrients highlights the importance of whole grains for helping to control weight as well as episodes of high blood sugar. Whole grains are off-limits on the ketogenic diet.
One of the mechanisms of a ketogenic diet in epilepsy may be related to increased availability of beta-hydroxybutyrate, a ketone body readily transported through the blood-brain barrier. In support of this hypothesis, it was found that a ketogenic diet was the treatment of choice for glucose transporter protein syndrome and pyruvate dehydrogenase deficiency, which are both associated with cerebral energy failure and seizures (26).

Type 2 diabetes is a metabolic disorder resulting from many things, with the greatest risk factors being weight, lifestyle and dietary habits contributing to its onset. Since the disease typically starts with a sedentary lifestyle paired with a poor diet, it makes sense to approach treatment with lifestyle changes. One effective strategy is adopting a ketogenic diet, a diet that’s proven to stabilize blood glucose and promote weight loss.

In order to save you time and money (from printing and shipping costs), instead of being mailed, The 3 Week Ketogenic Diet is provided to you as an instant download E-Book or e-books which you can read on your PC, Mac, iPad, iPhone, Android, Smartphone, Tablet or E-Reader. You can transfer it to as many devices as you like, and even print out pages.
By switching to a ketogenic low-carb diet, you are essentially transitioning yourself from a water-retaining diet, to a water-flushing diet. There are a variety of reasons for this, including reduction of inflammation (water tends to be bound up in inflammation) and the depletion of glycogen stores (glycogen retains water) in your liver and muscles.
She has found that when women stick to eating a lighter dinner, and then abstain from eating for about 13–15 hours between dinner and breakfast, they experience improvements in their weight, blood sugar control, etc. She recommends that women try avoiding eating after 8 p.m. or experiment with eating only two meals per day, with tea or broth between meals to help curb hunger. Another option is to try skipping dinner altogether on 1–2 days per week. For most women, when attempting IMF, it’s not recommended to snack between meals unless the woman is very active (such as an athlete in training) or dealing with a hormonal issue such as adrenal burnout.
One study from 2005 followed 22 people with Type 1 Diabetes for 12 months. The difference here however is they consumed 70-90 grams of carbohydrates per day versus the restrictive less than 20 grams per day on the Ketogenic Diet. Remember my motto? Moderation is the key! The results were positive; less hypoglycemia, insulin requirements were reduced and their A1c dropped from 7.5% to 6.4%.
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