Well… what are many people on a Keto diet trying to do? Lose weight right?  I would guess that prior to discovering the Keto diet many of these people were caught in the trap of low fat dieting.  This lead to months or years of low fat intake and consequentially low gallbladder activity.  The gallbladder wasn’t needed to digest fat and so it sat idle and stones were more likely to form.  Once they made the shift to a ketogenic lifestyle and their fat consumption increased upwards of 1000%, the gallbladder kicked into high gear.  If the previous period of low fat dieting had caused stone formation they are going to have to deal with flushing those stones out now while on a high fat Keto diet.
Once the body gets used to manufacturing ketones as the main energy substrate, the body actually has more energy than it previously had, and you won't have to be fighting through all those low-blood-sugar crashes your high-carb meals previously gave you. Additionally, hydration should be an area of high priority, especially before, during, and after exercise.
I was diagnosed with Type 2 diabetes back in June, 2017. They wanted to put me on a special diabetic diet, and have me take two medications. I had done previous personal research into ketogenic diets. I also have a close friend who was diabetic, on meds, as well as medications for high blood pressure. He went on a ketogenic diet, and a few months later was off all of his medications.
Dr. Josh Axe, DNM, DC, CNS, is a doctor of natural medicine, clinical nutritionist and author with a passion to help people get well using food as medicine. He’s the author of the books “Eat Dirt: Why Leaky Gut May Be the Root Cause of Your Health Problems,” “Essential Oils: Ancient Medicine” and the upcoming “Keto Diet: Your 30-Day Plan to Lose Weight, Balance Hormones, Boost Brain Health, and Reverse Disease” (February 2019, published by Little, Brown Spark). He’s a co-founder of Ancient Nutrition, a health company where the mission is to restore health, strength and vitality by providing history’s healthiest whole food nutrients to the modern world.
Thanks Dr. Jockers…very informative article. Im into pure keto diet almost a week now but started illiminating sugar and carbs 3weeks ago and the side effects that i’ve encountered are frequently urinating and light headache only. Is it good or not? I’ve never consult a specialist before doing keto diet but i do my research, is it okay? As of now i’ve loose almost 11lbs. Im just curious how can i get the percentage of fats, protein etc in my meals? Do i need to measure it all? How can i measure the percentage of foods that i need to eat?is there any ways?
Initial research has found that the diet can help maintain lean muscle mass in active women — even as they shed pounds — and may also lead to increased appetite suppression. "A keto diet is an option for people looking to lose overall weight, lower fat mass, and even build muscle. As a dietitian who focuses on sports nutrition and weight loss, I also recommend it for my clients who need a strong break from their sugar cravings, as it lessens blood sugar spikes and the cravings that can accompany high sugar intake," Nisevich Bede says.
“Keto diets should only be used under clinical supervision and only for brief periods,” Francine Blinten, R.D., a certified clinical nutritionist and public health consultant in Old Greenwich, Connecticut, told Healthline. “They have worked successfully on some cancer patients in conjunction with chemotherapy to shrink tumors and to reduce seizures among people suffering from epilepsy.”
A ketogenic diet could be an interesting alternative to treat certain conditions, and may accelerate weight loss. But it is hard to follow and it can be heavy on red meat and other fatty, processed, and salty foods that are notoriously unhealthy. We also do not know much about its long-term effects, probably because it’s so hard to stick with that people can’t eat this way for a long time. It is also important to remember that “yo-yo diets” that lead to rapid weight loss fluctuation are associated with increased mortality. Instead of engaging in the next popular diet that would last only a few weeks to months (for most people that includes a ketogenic diet), try to embrace change that is sustainable over the long term. A balanced, unprocessed diet, rich in very colorful fruits and vegetables, lean meats, fish, whole grains, nuts, seeds, olive oil, and lots of water seems to have the best evidence for a long, healthier, vibrant life.
Inadequate calories: Keto’s satiating qualities are a double-edged blade. They help us eat less and lose body fat without really even trying, but they can also sometimes lead us to eat too little. This can cause a reaction in your body to slow down metabolic function and make you feel generally less energetic at rest. One solution is to cycle periods of generally increased caloric intake, and increased intake of nutritious carbs by default. This suggestion is totally different from the suggestion to engage in purposeful carb refeeds, where you binge on nutrient-devoid carbs in the name of a cheat day. This is never advised for any reason.
By now, most of us have heard about the ketogenic diet. Whether it's because of the benefits of eating high-fat and low-carb, or because you can eat cheese all day long, it's officially become one of the hottest diets of the year. It may not be easy to cut out all the carbs, but emerging research suggests that eating fat can actually help burn fat. So, for anyone trying to lose weight, you may find it worth the carb cut. Beyond weight loss, recent research has found some other serious health benefits of keto that may impact your life later on. Let's take a look at what the research has to say.
I was diagnosed in 2004 with Brittle Type 1 diabetes, peripheral and autonomic neuropathy, and Hypothyroidism. A short time later with Gastroparesis due to the nerve damage from diabetes. Since then, I had followed every guideline and rule that the Endocrinologist and Primary Care Doctors had told me to follow. NOTHING WAS GETTING BETTER. In fact, I was gradually getting worse. So many ups and downs. Extreme highs (250-500 bgl ) to seizures from crashes (drop from 300 to 13 in no time). It was a constant battle with adjustments in insulin intake (and different insulins NPH, R, Novolog, Humalog, Lantus), carb intake, exercise and one contributing factor was the Gastroparesis. Meds were taken for the Gastroparesis but I always had side effects from meds. To my point. I was kicking a dead horse and I told them this. My sister and mom had come across the ketogenic way of eating and it dramatically improved thier lives. Mom was diagnosed way back with Type 2 and within a week or two she was off of her meds completely. I was totally interested. So, I decided to go for it on April 17, 2017. I did go through some rough patches of what they call Keto Flu. It did pass after a couple weeks. I was gaining so much energy like never before as well as mental focus. The even greater aspect of this all was, I had DRAMATICALLY LOWERED MY INSULIN INTAKE TO ALMOST NONE! My Lantus was always being adjusted from 30-40 units daily (and changed from AM to PM to splitting it to half AM, other half PM). I was on a sliding scale of Humalog or Novolog. From 4-6 units per meal and then there were the corrections throughout my day (some daily totals could be up to 40 UNITS)! Very exciting for me to only take 2 units of Lantus in the AM and daily totals of Humalog/Novolog….1.5-3 units! Other great things I began to notice, neuropathy pains were fading and finally GONE. No more nights up stinging, burning and RLS (restless leg syndrome). So, in my life, there are no questions or hardships on whether I can get off of this way of eating. It’s either do or die. If someone truly wants to have a better life, they can. The sad thing is, doctors and nutritionists aren’t being educated in the real facts. My primary care doctor isn’t willing to help me with all the labs I need nor listen. Always telling me “You need carbohydrates and insulin to live.” All that know me see the dramatic change for the better. I’m doing the Ketogenic way of eating with intermittent fasting for the rest of my life. The alternative IS NOT WORTH a lifetime of illnesses and suffering.

Keto-adaption is a state, achieved through significant reduction of carbohydrate intake (typically to less than 50 grams per day), where the body changes from relying on glycogen as its main source of energy to relying on fat.  Specifically, the brain shifts from being primarily dependent on glucose, to being primarily dependent on beta-hydroxybutyrate.  This has nothing to do with what a diabetic patient is experiencing in DKA, but does illustrate how poorly informed and quick to react the medical community is.   DKA and nutritional ketosis (or keto-adaptation) have as much in common as a house fire and a fireplace.
Slightly increase carbs. If you wait a few more weeks and still have trouble with the ketone smell, you might consider eating slightly more carbs to reduce the ketosis. Try increasing to between 50 and 70 grams per day. You might also try combining this with intermittent fasting, such as only eating within an 8-hour window, to maintain the benefits of ketosis without the side effect of fruity breath.
Thank you so much for this article! My husband and I have been following keto for a little over a month now and we love it! I did a lot of research before starting, and am still doing lots of research because I like to be armed with the best information I can have when friends question my choices. Just yesterday I had a friend tell me that our brains need carbs to function (more than what we get from veggies). I hadn’t heard that before so I didn’t know what to answer. Thanks to your article now I know, and I have lots more answers in case more points come up. 😉 

The same is true for meat. You’ve probably been told to avoid red meat when in fact you should not. Meat is an integral part of any diet including the ketogenic diet. There is no reason to avoid it (OK you’re excused if you’ve been bitten by a lone star tick!). The ketogenic diet reduces cardiovascular risk factors and improves the lipid profile by increasing HDL and lowering triglycerides [9,10].
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. 
Multiple sclerosis diet tips Multiple sclerosis (MS) is a chronic condition that can lead to weakness and memory loss, among other symptoms. Some studies suggest that making dietary changes may help boost a healthy gut flora, which could improve symptoms. Find out more about which foods to eat and which to avoid, and get some lifestyle tips, too. Read now
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).
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.”
Others consider the keto diet a short-term solution for weight loss. Tyler Drew, a 34-year-old real estate broker from Los Angeles, first read about the diet on Reddit and used it to lose 45 pounds in six months before returning to a traditional diet. While on the keto diet, Drew’s cholesterol levels improved, even though a typical day of eating involved bacon at both breakfast and dinner.

The Ketogenic Diet is a low carbohydrate diet, consisting initially of less than 20 carbohydrates per day. Not per meal, yes, you heard me correctly, per day. It is not for the faint of heart and yes I am writing from experience. Of course I have tried it! Hasn’t everybody in America at some point who has wanted to lose weight? Does it work you ask? Of course it does! The problem is how long can you keep it up?
Keto Ultra Diet burns fat in the user’s body. It does so by two different ways. As mentioned above, the supplement plays a role in the mobilization of fats in the body. Consequently, the fats are burnt for energy. As long as these fats are kept in their stored form, they are not used up. Keto Ultra Diet removes excess fat from the body so that the user can be slim.
The ketogenic diet is a high-fat, very-low-carb diet plan. The goal of the diet is to reach a “ketosis” state. The more restrictive you are on your carbohydrates (less than 15g per day), the faster you will enter ketosis. Once in this state, rapid weight loss begins. Research does indicate that the ketogenic diet is most effective in weight loss by reducing visceral (body) fat.
What is more common throughout the history of the human race is fasting. Islamic Ramadan is a 28- to 30-day fast where food and drink are prohibited during the daylight hours. Christianity also has a strong fasting foundation, and in the Bible, Jesus fasted to have higher and clearer communication with God. Greek Orthodox Christians fast for a total of 150–200 days each year!
The diet calls for consuming high amounts of fat, a moderate amount of protein, and a very limited amount of carbs. It’s usually broken down to 75, 20, and 5 percent of your daily calories, respectively, says Pamela Nisevich Bede, RD, a dietitian with Abbott’s EAS Sports Nutrition in Columbus, Ohio. Compare that with the typical American diet — which is usually 50 to 65 percent carbs — and it’s safe to say this is a completely different way of eating, Nisevich Bede says.
I am curious about what has been referred to as “keto rash”. I decided to shift from a GAPS Diet to a ketogenic one. I wasn’t tracking my carbs specifically and was doing well. Then I developed this rash on various parts of my body. I originally thought it might have been either pecan or MCT (C8) that I started having, but I have eliminated both of those. Then I did some research and realized that others have also experienced this rash after starting a strict Ketogenic Diet. There are a few solutions running about–most of which include introducing carbs at higher levels. Antibiotics were also listed. Anyway, I was wondering if you have run across this type of rash as it relates to starting a low-carb diet? Any thoughts, Dr. Jockers?
To be clear, most of the hype you’ll hear about how the ketogenic diet can ward off cancer is taking things too far. While there is a fair amount of research regarding cancer, studies have been limited to animals. One review published in Redox Biology highlighted some of them, indicating promising results for colon, gastric, and prostate cancers. Maybe more interesting are the few case studies involving human subjects. Bear in mind, we’re talking about a handful of people. In these cases, implementing a ketogenic diet seemed to halt disease progression.
In 2013, researchers published a case study of two women with bipolar II who ate long-term ketogenic diets, one for two years and the other for three years. The authors reported that both “experienced mood stabilization that exceeded that achieved with medication; experienced a significant subjective improvement that was distinctly related to ketosis; and tolerated the diet well.” They noted, too, that “there were no significant adverse effects in either case” and that the two cases “demonstrate that the ketogenic diet is a potentially sustainable option for mood stabilization in type II bipolar illness.” .
In addition, on the day the diet was initiated, diabetes medications were reduced – generally, insulin doses were halved, and sulfonylurea doses were halved or discontinued. Due to the possible diuretic effects of the diet soon after initiation, diuretic medications were discontinued if of low dosage (up to 25 mg of hydrochlorothiazide or 20 mg of furosemide) or halved if of higher dosage. Participants were also instructed to take a standard multivitamin and drink 6–8 glasses of water daily, and were encouraged to exercise aerobically for 30 minutes at least three times per week.
I’ve been type 2 for about 15 years was pretty stable with diet and Metformin for 10 years. But eventually started trying more aggressive treatment like Victoza and without fail in 4 years I was on slow acting insulin. I lost weight lowered carb intake to 40mg or less in the morning my breakfast has been no carbs. People need to realize every diabetic is different you must manage it how it keeps you with good A1C levels. I myself got off insulin for a year and half but my fasting levels slowly increased again. Reversing diabetes is not possible. Reducing the effects is possible and more likely the better you monitor yourself and do what you need to do. Depending on medications or diets or counting carbs will all help but not cure the diabetes. These all are things that reduce its ability to affect your health negatively.
Another organ that plays an essential role in blood sugar regulation is the liver. It stores excess glucose as glycogen, and when glucose levels are low, glycogen is broken down to provide glucose [6]. This process is regulated by two hormones: insulin and glucagon. Insulin normally promotes glycogen synthesis and interferes with glucose release from the liver.
There are a number of different causes of acne, and one may be related to diet and blood sugar. Eating a diet high in processed and refined carbohydrates can alter gut bacteria and cause more dramatic blood sugar fluctuations, both of which can have an influence on skin health. Therefore, by decreasing carb intake, it's not a surprise that a ketogenic diet could reduce some cases of acne.
Ketoacidosis occurs when the level of ketones in the blood gets out of control, which poses a severe health risk for diabetics. When massive quantities of ketones are produced, the pH level of the blood drops, creating a high-acidic environment. Nondiabetics need not fear, as the regulated and controlled production of ketone bodies allows the blood pH to remain within normal limits.
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.
Why is intermittent fasting beneficial for women, especially if they’re in perimenopause or menopause? Fasting allows the body to take a break from digestive functions and instead to focus on essential repair work and reaping the many other benefits of rest. In other words, when fasting, the body’s energy resources go towards restorative work (like repairing tissue and balancing hormones) rather than digestive processes like producing stomach acid to break down food. 
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.

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.
Studies suggest that the KD helps improve metabolic health markers in several ways: the diet tends to reduce overall caloric intake, increases satiety (fullness after eating), may increase the thermal effect of eating (calories we burn digesting food) due to higher protein intake, and increases gluconeogenesis, which is increased with carbohydrate restriction and is energy demanding.
You may need more water. Going keto causes an initial reduction in fluid retention in cells throughout your body. Your digestive tract requires water to keep the fecal matter soft and moist. As you aspire to consume more fluid, be sure to add a pinch of salt to each cup of water you drink, and to sip steadily throughout the day instead of binge chugging. These measures will help you better absorb additional fluids instead of excrete them.
"Many of the richest sources of fiber, like beans, fruit, and whole grains are restricted on the ketogenic diet," registered dietician Edwina Clark told Everyday Health. "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."
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There is one precaution with keto and children who are under their ideal weight, though, and you will need to decide if the risks outweigh the benefits – being in ketosis is a natural appetite suppressant.  This will vary from person to person for how much this affects them, but if your child seems even affected by this appetite suppressant property, you may find that the GAPS or SCD diets are a better fit for healing the gut and encouraging weight gain. 

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.
Eat micronutrient dense foods every day. The most nutrient-rich foods are pasture-raised organ meat, wild-caught sardines and salmon, and low-carbohydrate vegetables like spinach, kale, and broccoli. During early pregnancy and prior to conception, foods higher in folate, such as liver and dark leafy greens, are essential. Vitamin D (high in beef liver and sardines), iodine (high in seaweed and raw cheeses), and DHA (high in sardines and fatty fish) are essential as well.

"Muscle loss on the ketogenic diet is an ongoing area of research," Clark told Everyday Health. "Small studies suggest that people on the ketogenic diet lose muscle even when they continue resistance training. This may be related to the fact that protein alone is less effective for muscle building than protein and carbohydrates together after exercise."
Chelsea is the site editor and nutritionist for Ultimate Paleo Guide and Paleo Meal Plans. In 2016, Chelsea graduated from the National University of Natural Medicine with a Master’s degree in Nutrition. When she’s not working for Ultimate Paleo Guide or coaching CrossFit, Chelsea enjoys hiking, traveling, cooking, and eating. You can keep up with her on Instagram at @chelsbrinegar and LinkedIn.
In essence, it is a diet that causes the body to release ketones into the bloodstream. Most cells prefer to use blood sugar, which comes from carbohydrates, as the body’s main source of energy. In the absence of circulating blood sugar from food, we start breaking down stored fat into molecules called ketone bodies (the process is called ketosis). Once you reach ketosis, most cells will use ketone bodies to generate energy until we start eating carbohydrates again. The shift, from using circulating glucose to breaking down stored fat as a source of energy, usually happens over two to four days of eating fewer than 20 to 50 grams of carbohydrates per day. Keep in mind that this is a highly individualized process, and some people need a more restricted diet to start producing enough ketones.
Heart disease. The connection between the ketogenic diet and cardiovascular disease risk factors is complicated. Many studies have found that the keto diet can lead to significant reductions in total cholesterol, increases in HDL cholesterol levels, decreases in triglycerides levels, and reductions in LDL cholesterol levels, as well as potential improvements in blood pressure levels.
Controlling your blood sugar levels helps you control your cravings, Dr. Burrows says. “When we are not on a sugar roller coaster from processed carbohydrates, most people make better food choices because they are not looking for their next hit of food,” she says. You may also find you’re able to go longer periods without eating, he says. Intermittent fasting is a common practice among dieters who’ve been eating keto for a while. Learn how one woman totally kicked her sugar habit by trying the keto diet.
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