The main cause for keto flu is your body lacking electrolytes, especially sodium. When starting keto, you cut out lots of processed foods and eat more whole, natural foods. Although this is great, it causes a sudden drop in sodium intake.
Factory-farmed animal products and seafoods, which are lower in nutrients and often worse for the environment than their healthier counterparts; and processed sausages and hot dogs, which, more often than not, have preservatives called nitrates that have been linked to cancer.
In more moderate amounts, foods that are high in protein but low- or no-carb, including grass-fed meat, pasture-raised poultry, cage-free eggs, bone broth, wild-caught fish, organ meats and some full-fat (ideally raw) dairy products.
The last thing I suggest doing is buying the speciality items prior to needing them. Normally some of these items you can only find online, and by the time you need them, you’ll actually have them. There are no speciality items used in Week 1 for that reason. Make sure you order what you need and have it by the time you need it.
In the first week, many people report headaches, mental fogginess, dizziness, and aggravation. Most of the time, this is the result of your electrolytes being flushed out, as ketosis has a diuretic effect. Make sure you drink plenty of water and keep your sodium intake up.
This is perhaps one of the most well-known ketogenic diet side effects. Keto flu is exactly what it sounds like, the onset of flu-like symptoms that arises shortly after beginning a ketogenic diet. This includes symptoms like fatigue, runny nose, nausea, and headache.
In yet another study, the ketogenic group lost 24.4 lbs (11.1 kg), compared to 15.2 lbs (6.9 kg) in the higher-carb group. This is an important benefit when considering the link between weight and type 2 diabetes (2, 31).
Conklin’s fasting therapy was adopted by neurologists in mainstream practice. In 1916, a Dr McMurray wrote to the New York Medical Journal claiming to have successfully treated epilepsy patients with a fast, followed by a starch- and sugar-free diet, since 1912. In 1921, prominent endocrinologist H. Rawle Geyelin reported his experiences to the American Medical Association convention. He had seen Conklin’s success first-hand and had attempted to reproduce the results in 36 of his own patients. He achieved similar results despite only having studied the patients for a short time. Further studies in the 1920s indicated that seizures generally returned after the fast. Charles Howland, the parent of one of Conklin’s successful patients and a wealthy New York corporate lawyer, gave his brother John a gift of $5,000 to study “the ketosis of starvation”. As professor of paediatrics at Johns Hopkins Hospital, John Howland used the money to fund research undertaken by neurologist Stanley Cobb and his assistant William G. Lennox.[10]
Although many hypotheses have been put forward to explain how the ketogenic diet works, it remains a mystery. Disproven hypotheses include systemic acidosis (high levels of acid in the blood), electrolyte changes and hypoglycaemia (low blood glucose).[18] Although many biochemical changes are known to occur in the brain of a patient on the ketogenic diet, it is not known which of these has an anticonvulsant effect. The lack of understanding in this area is similar to the situation with many anticonvulsant drugs.[55]
Dr. David Jockers is a doctor of natural medicine, functional nutritionist and corrective care chiropractor. He currently owns and operates Exodus Health Center in Kennesaw, Georgia. He has developed 6 revolutionary online programs with thousands of participants.
On a “strict” (standard) keto diet, fats typically provides about 70 percent to 80 percent of total daily calories, protein about 15 percent to 20 percent, and carbohydrates just around 5 percent. However, a more “moderate” approach to the keto diet is also a good option for many people that can allow for an easier transition into very low-carb eating and more flexibility (more on this type of plan below).
Christopher D. Gardner, PhD; Alexandre Kiazand, MD; Sofiya Alhassan, PhD; Soowon Kim, PhD; Randall S. Stafford, MD, PhD; Raymond R. Balise, PhD; Helena C. Kraemer, PhD; Abby C. King, PhD, “Comparison of the Atkins, Zone, Ornish, and LEARN Diets for Change in Weight and Related Risk Factors Among Overweight Premenopausal Women,” JAMA. 2007;297(9):969-977. http://jama.jamanetwork.com/art icle.aspx?articleid=205916.
Typically, anywhere between 20-30g of net carbs is recommended for everyday dieting – but the lower you keep your carbohydrate intake and glucose levels, the better the overall results will be. If you’re doing keto for weight loss, it’s a good idea to keep track of both your total carbs and net carbs.
Love cooking though I may, I still work a day job, social commitments, exercise, and all the other things everyone does, which is to say that time is scarce. Here’s one of my fast and easy dinners that you might enjoy too.
A high-carb diet (especially when it comes to dairy products and refined sugar) has been shown to trigger sebum (oil) production in the skin, which is a major cause of acne (20). Removing sugar from your diet may also help improve inflammatory skin conditions such as eczema and psoriasis (21). The healthy fat intake on the keto diet also provides the building blocks of healthy skin cells (22).
You can have a completely smooth transition into ketosis, or…not. While your body is adapting to using ketones as your new fuel source, you may experience a range of uncomfortable short-term symptoms. These symptoms are referred to as “the keto flu.” Low-sodium levels are often to blame for symptoms keto flu, since the kidneys secrete more sodium when you’re in ketosis, says Volek. A few side effects:
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Hey Darlene, sorry to hear about this. Start with making sure you are consuming plenty of water with electrolytes from a natural salt as outlined in this article. Using a multi vitamin could be beneficial too. If it resides I would suggest working with one of our coaches to see what is going on.
Water weight loss is common when you first start a low carb diet. Ketosis has a diuretic effect to it that can cause many pounds of weight loss in only a few days. While I hate being the bearer of bad news, this isn’t fat. But on a side (and more positive) note, that shows that your body is starting to adjust itself into a fat burning machine!
Most carbs you consume are broken down into sugar that enters the bloodstream. When you rein in carbohydrates on the keto diet, you have lower levels of blood glucose (high blood glucose can lead to diabetes). A study in the journal Nutrition reveals that a ketogenic diet improves blood glucose levels in type 2 diabetics more significantly than a low-calorie diet and can also decrease the dosage of your diabetes meds.
Increased Urination. Keto is a natural diuretic, so you have to go to the bathroom more. Acetoacetate, a ketone body, is also excreted in urination and can lead to increased bathroom visits for beginners.
Animal proteins (meat, fish, etc.) have very little, if any, carbs. You can consume them in moderate amounts as needed to control hunger. Overall, choose fattier cuts of meat rather than leaner ones. For example, chicken thighs and legs are preferable to chicken breasts because they contain much more fat.
For most normal people, the amounts of fats and protein will be enough to naturally keep you satiated and naturally keep you in a calorie deficit. Though, the average American is not always normal. There’s tons of hormone, endocrine, and deficiency problems that we need to take into account.
One major downside to the ketogenic diet regarding diabetes is that you’re eating a lot of fat, and that fat may be saturated, which is unhealthy. Because people with type 2 diabetes are at an increased risk for cardiovascular disease, there’s concern that the saturated fat in the diet may drive up LDL, or “bad,” cholesterol levels, and further increase the odds of heart problems. If you have type 2 diabetes, talk to your doctor before attempting a ketogenic diet. They may recommend a different weight-loss diet for you, like a reduced-calorie diet. Those with epilepsy should also consult their doctor before using this as part of their treatment plan.
Magnesium Supplementation:  This is outlined above but I want to touch on it again here. Magnesium is powerful support for the HPA axis. Magnesium L-threonate in particular is the only form proven to be able to cross the blood-brain barrier which means it can exert its effect on the hypothalamus and pituitary glands.
This may be more of a maybe, but recent studies on mice fed a ketogenic diet lived longer, according to Cell Metabolism. “Not only did these mice live longer, they had expanded health in terms of physical and cognitive functioning,” says Volek. “Meaning, they lived happy, healthy lives.” Obviously, human studies need to be performed.
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.
Option 1: BLT roll-ups with turkey and avocado. “Create a roll using bacon, lettuce, tomato, turkey, and avocado for the perfect mix of fat and protein,” says Dr. Axe. (You Could Also Try This Kale Avocado BLT Salad.)
If you have type 1 diabetes, consult with your doctor before starting a keto diet. Diabetic ketoacidosis (DKA) is a dangerous condition that can occur if you have type 1 diabetes due to a shortage of insulin.
The ketogenic diet is a mainstream dietary therapy that was developed to reproduce the success and remove the limitations of the non-mainstream use of fasting to treat epilepsy.[Note 2] Although popular in the 1920s and 30s, it was largely abandoned in favour of new anticonvulsant drugs.[1] Most individuals with epilepsy can successfully control their seizures with medication. However, 20–30% fail to achieve such control despite trying a number of different drugs.[9] For this group, and for children in particular, the diet has once again found a role in epilepsy management.[1][10]
In terms of protein, it is often recommended that ketogenic athletes set protein between 0.6 and 1.0 grams per pound of lean mass—not per pound of body weight. Below is an example of how you could calculate the protein needs of a 180-pound lifter who has 15 percent body fat:
Our main goal here is to stay pretty simple at first. In my eyes, simplicity is key for someone that is just starting out on a low carb diet. You don’t want it to be a difficult transition (kitchen-wise), because it will be hard to just get rid of your cravings.
It is possible to consume too much protein on the ketogenic diet. While low carb diets call for a higher protein intake, those on the standard ketogenic diet eat only a moderate amount of protein. Why? Because your body can actually break down protein for glucose (known as gluconeogenesis), thus preventing the body from reaching full ketosis.
If you stumble on a recipe without a macro count, you can enter the ingredients into a diet app like KetoDietApp or MyFitnessPal to get the macros and calorie count of any meal sans complicated math equation.
As a precaution, you should always check with your physician if you have any concerns about starting a keto diet. You should especially be wary if you’re currently taking medications for a pre-existing condition as extra monitoring may be needed. Be careful when breastfeeding as you may need to increase carb intake.
The main difference between keto and low carb is the macronutrient levels. In most keto variations, 45% of your calories or more will come from fat, to help transition your body into ketosis. In a low carb diet, there’s no specified daily intake of fat (or other macronutrients).

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While getting rid of this extra water is helpful in releasing toxins from the body, you want to make sure you are taking in additional fluids, electrolytes, and minerals to avoid other related side effects.
The low glycaemic index treatment (LGIT)[48] is an attempt to achieve the stable blood glucose levels seen in children on the classic ketogenic diet while using a much less restrictive regimen. The hypothesis is that stable blood glucose may be one of the mechanisms of action involved in the ketogenic diet,[9] which occurs because the absorption of the limited carbohydrates is slowed by the high fat content.[5] Although it is also a high-fat diet (with approximately 60% calories from fat),[5] the LGIT allows more carbohydrate than either the classic ketogenic diet or the modified Atkins diet, approximately 40–60 g per day.[3] However, the types of carbohydrates consumed are restricted to those that have a glycaemic index lower than 50. Like the modified Atkins diet, the LGIT is initiated and maintained at outpatient clinics and does not require precise weighing of food or intensive dietitian support. Both are offered at most centres that run ketogenic diet programmes, and in some centres they are often the primary dietary therapy for adolescents.[9]
Now you are aware of the physiological changes that contribute to frequent urination, constipation, diarrhea, muscle cramps, and heart palpitations. Fortunately, the strategies to mitigate these side effects are quite simple. With a little proactivity and planning, these keto side effects will likely be less of an issue.
Freeman, J. M., E. P. Vining, D. J. Pillas, P. L. Pyzik, J. C. Casey, and L M. Kelly. “The Efficacy of the Ketogenic Diet-1998: A Prospective Evaluation of Intervention in 150 Children.” Pediatrics 102, no. 6 (December 1998): 1358–63. www.ncbi.nlm.nih.gov/pubmed/9832569/.
According to the reported results, patients lost an average of 10.2 kilograms, or about 22 pounds, after 2.5 cycles of the keto diet. Cappello concluded that the diet was a successful way for overweight and obese people to lose weight, and the few side effects, such as fatigue, are easily managed.
Gary D. Foster, Ph.D., Holly R. Wyatt, M.D., James O. Hill, Ph.D., Brian G. McGuckin, Ed.M., Carrie Brill, B.S., B. Selma Mohammed, M.D., Ph.D., Philippe O. Szapary, M.D., Daniel J. Rader, M.D., Joel S. Edman, D.Sc., and Samuel Klein, M.D., “A Randomized Trial of a Low-Carbohydrate Diet for Obesity — NEJM,” N Engl J Med 2003; 348:2082- 2090. http://www.nejm.org/doi/full/10.1056/NEJMoa022207.
Vegetables are tricky on a ketogenic diet because we’ve been raised under the idea that vegetables are healthy and they are. However, almost all of the vegetables that you consume today contain carbs.
The keto diet has been used for preventing seizures in epileptic patients, especially those who don’t respond well to medication. While it’s not entirely clear how this process works, research suggests removing carbs and mimicking the effect of starvation may block the neuron channels that lead to seizures (17).
Nutrition data from the 1970s told us saturated fats are bad, causing the United States to enter the era of low fat. During this time, obesity in America soared while consumption of fat (particularly saturated fats) plummeted. Fad, low-fat diet products became the norm at grocery stores as a high-carb, low-fat diet became the preferred method for weight loss. Yet, people kept gaining weight.
If you’ve decided to move forward in trying the keto diet, you will want to stick to the parameters of the eating plan. Roughly 60 to 80 percent of your calories will come from fats. That means you’ll eat meats, fats, and oils, and a very limited amount of nonstarchy vegetables, she says. (This is different from a traditional low-carb diet, as even fewer carbs are allowed on the keto diet.)
The more common ones aren’t usually serious: You might have constipation, mild low blood sugar, or indigestion. Much less often, low-carb diets can lead to kidney stones or high levels of acid in your body (acidosis).
Contrary to popular opinion eating ‘low carb’ does not limit your lifestyle! Get rid of the ideas that all you can eat is broiled chicken and lettuce leaves, that you can’t go out to lunch with your co-workers and that restaurant delivery service is a thing of the past.
“It was extremely difficult,” he recalls. “You spend your entire life hearing that fat makes you fat and causes heart attacks and strokes. Now, all of a sudden, you’re eating 200 grams of fat per day. There is a huge psychological component to conquer before you can become successful with the keto diet. In the beginning, it’s like trying to convince people 1,000 years ago that the world is in fact round, not flat.”
Jump up ^ Muzykewicz DA, Lyczkowski DA, Memon N, Conant KD, Pfeifer HH, Thiele EA. Efficacy, safety, and tolerability of the low glycemic index treatment in pediatric epilepsy. Epilepsia. 2009 May;50(5):1118–26. doi:10.1111/j.1528-1167.2008.01959.x. PMID 19220406
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