Here we are, with another popular diet generating a huge amount of buzz, promising things like sustained weight loss, increased energy, decreased inflammation, and more. When a fad diet surfaces I always err on the side of caution, especially when it seems like a magic pill that can take all of your worries away. In my experience, and over all of the years of research I have conducted, a balanced diet with real foods and ingredients always triumphs over a fad diet for long term sustainable weight loss and decreased inflammation. Now I know that keto may benefit some, just like paleo benefits some people. I encourage you to fully do your research before jumping into a diet like ketosis. Ketosis may have serious consequences on your metabolism, weight, and mood. Frankly, keto may not be good for you.

What is Ketosis?

I am going to steer clear of giving you a long, technical definition of ketosis. I do however think it’s worth learning the biochemistry if you plan to experiment. In that case, I highly recommend Dr Peter Attia’s posts or Dr Chris Masterjohn’s.

In short, ketosis is a state the body enters when there is an excess of molecules called acetyl groups over oxaloacetate. This happens when there is a shortage of glucose supplied to the metabolic processes that create energy, like when you eat a very low carbohydrate diet. Yet interestingly enough the body will also produce ketones when medium-chain fatty acids enter the metabolic processes.

So then, when there is this excess of acetyl groups relative to oxaloacetate, the body produces something called ketone bodies. Ketone bodies come from fatty acids that the body has liberated from fat tissue, which can be used as an alternative fuel to carbohydrates. This is important because the body (and specifically the brain and heart) literally need carbohydrates or ketone bodies in order to function. When carbs are gone, basically, ketone bodies step in to do their work.

People typically achieve ketosis by fasting or by eating diets very low in carbohydrate (high fat, moderate protein). This calls for at least fewer than 50, and maybe more like 20, grams of carbohydrate a day. This depends on your age, body type, activity level and the like.

You can verify how deeply your body has gone into ketosis by peeing on a stick, which reveals the level of ketone bodies being circulated in and used by your body.

Who Keto May Be Good For:

Those with Epilepsy disorder.

Those that struggle with seizures have been studied and proven to benefit from the keto diet. This is the only disorder that has been studied and proven to help with symptoms. No other conclusive research has been conducted on keto’s effects for any other condition (studies are happening, they are just in infancy). So tread lightly with all of the articles that tell you WHY keto is good for you, because a lot of this research has not been studied clinically.

When Keto May Not Be Good For You:

• If you have type 1 or type 2 diabetes: Keto can trigger a very dangerous condition in those that have Type 1 or Type 2 diabetes. The body essentially starts to hoard ketones which can cause an acid overload, damaging the kidneys, liver and even brain. This condition can be fatal. 
• You are looking to not regain weight back: The keto diet is generally known as not being easy to stick to long-term. It is in the same category as other fad diets; people will often use to loose a few pounds, and then quickly see the weight come back after stopping the diet. It is also known that most of the weight loss attributed to keto is from removal of access water, another common reason the weight resurfaces rapidly after stopping the diet.
• You are not willing to eat lean meats and fats: There is a lot of red meat, butter, and foods generally high in saturated fat and that are common for those to eat on the keto diet. That is part of the allure right? What other “diet” allows you to eat cheese, eggs and bacon all the time? (Note to self, you can not be on a diet and eat this way 🙂 ). A lot of people forget to add in lean meat and healthy fat, resulting in adverse health affects.
• You are trying to reproduce: Women of reproductive age who are attempting to conceive or are pregnant should probably not undergo low-carb ketosis, as carbohydrates play an important role in A) pregnancy, and B) assuring the hypothalamus that the body has been properly fed. In fact, insulin is actually an important satiation hormone. For women who want to conceive, it may be best to err on the side of caution and make sure you get bountiful carbs.
• If you have a sensitive reproductive system:  If you have a history of low hormone levels, hypothalamic amenorrhea, dieting, or irregular menstrual cycles, the hormone changes involved in low carb ketosis as well as the uptick in stress hormone levels may hinder your reproductive hormone production.
• If you have thyroid Issues: People (mostly women) with sensitive thyroid systems may also be in jeopardy from low carb ketosis. Ketosis is well known to down regulate thyroid production. T3 (the form of thyroid hormone that is actually active in cells) decreases, and reverse T3, a molecule that blocks the activity of T3, increases. Ketosis advocates may bend over backwards trying to make this phenomenon seem hunky dory, but I would advise anyone with thyroid issues to step carefully around ketosis. If you have clinical hypothyroidism I would consider consulting a doctor first.
• If you are stressed out:  People with adrenal issues or a lot of stress are not great candidates for this diet. Adrenal glands may become more active with low carb ketosis, which can exacerbate  feelings of being wired, stress, and all the attending symptoms that come along with it.
• If you are having trouble sleeping: Low carb ketosis may up-regulate the production of stress hormones, which can have a negative impact on sleep.
• If you’re an athlete:  If you are trying to gain muscle mass or improve performance as an athlete, keto is not a great option. The bodies preferred fuel source is glucose or glycogen, not fat. So when we force the body to run on fat, whether adipose or dietary, we are inhibiting athletic performance because it is a slower and more energy consuming process to burn fat.
• If you’re trying to maintain and moderate inflammation: Some of our cells lack mitochondria, meaning they are dependent on glucose from carbohydrates to survive. When in ketosis, we are basically starving these cells that can be found in our blood, retina, corneas, testis and renal medulla. These are not just aesthetic cells, we need our blood and eyes for instance, to be fully functioning.
• You are not willing to commit to gradual transitions: When you transition off of keto, it has to be a gradual transition or you can damage your metabolism and most likely gain back any weight you have lost. It is not the best idea to jump right back in to processed refined carbohydrates, it is better to slowly introduce carbohydrates. You can start by adding a few carbohydrates to one meal a day, and slowly work up towards incorporating them into your diet.
• If you struggle with restrictive eating: If you have a history of punishing yourself for falling off the wagon, feeling guilty about food, engaging in cycles of over- and under- eating, or confining yourself to strict dietary rules, I would not recommend ketosis. In order for someone to truly achieve wellness, then psychological health must be prioritized, perhaps above whatever ketosis-based goals you may have (and of course this varies by the individual. If you have brain cancer then please feel free to try ketosis regardless of how much you love your body).
• If you seek any of these things:
  • Self love
  • Body acceptance
  • Overcoming an obsession with food
  • Overcoming cravings
  • Eating intuitively
  • Eating guilt-free
  • Keto is NOT diet freedom.

Then I would never recommend a set of diet rules – and again, especially one where you can’t eat for days or one where you have to pee on a stick —  to help you.

Side Effects of Keto

I completely understand wanting to try a particular type of eating to see if it may have any benefits for your metabolism, energy levels, and overall well-being. I know that some of you are, or have, tried keto. One unfortunate side effect of keto, as with any diet where you are trying to manipulate your bodies biochemistry, is that there are going to be ways our body lets us know that change is occurring.

• Keto Flu: There are no solid facts to what is causing keto flu, but it is speculated that keto flu is caused by changing the metabolism and experiencing sugar withdrawal. There are also speculations that the body is purging toxins from fat storage during the transition into a fat burning state. While purging the toxins the body may experience the following:
  • Fatigue
  • Cravings for carbs and sugar
  • Dehydration
  • Loss of appetite
  • Constipation
  • Diarrhea
  • Heartburn or other symptoms of indigestion
  • Low motivation to exercise and poor recovery from workouts
  • Brain fog
  • Dizziness
  • Trouble sleeping
  • Moodiness or irritability

This is a huge less for little promised returns. Ask yourself, is it truly worth it to hop on a new diet bandwagon, and experience this obnoxiously long list of side effects?

Still Not Sure?

Robb Wolff provides this super handy quiz  that you can take to determine whether keto is a great option for you. I definitely recommend consulting with your primary care physician before making any transitions, even if the handy dandy quiz says keto may be for you. Check it out here: Quiz

I know my thoughts on the keto diet are controversial, but I am coming from a place of love and education, and hoping the best for you. I would never want you to embark on a diet journey that has negative long-term consequences for immediate returns. It does scare me that the long-term research is not available for the keto diet, meaning we really don’t know how it effects our metabolism and biochemistry, ultimately. I have heard that Arctic nations have actually developed a gene that blocks ketosis. Arctic indigenous people have a much different climate, diet and lifestyle than us, yes, but doesn’t it seem a little strange that a culture would develop a gene to block ketois, a state that so many people are trying to live in?