Yes I do find it odd that there are no warnings. I've been using the diet for over 4 years and I'm surprised how little there is on side effects. Other than "constipation" which I think is parroted from normal medical info (because I didn't experience it), there isn't much. I think it's because the "ketogenic" diet as described in popular books don't go beyond a 1:1 ratio of Protein + Carbs : Fat, in grams.
A properly done, epileptic, keto diet is 4:1 or 3:1, that's colossally harder than what you find in something like the Wahl's Protocol (which I think is the best one to start with). All food has to be weighed in grams, and you have to be aware of where there is "fudging" in the reporting of macro and micro molecules.
Here's what I've noticed on the debit side (the positives are well documented elsewhere). Although I think the diet is extremely valuable and even necessary for some healing to occur (it was for me), there are downsides:
1. B1 is low, which makes some kind of sense because that vitamin is mainly used for carb metabolism. However, I don't like having even a minor nutritional deficit, so I take a vitamin.
2. If you are strict about it, you will probably need to take carnitine in some form, you can run out of it from diet alone and feel not so well.
3. Don't combine it with low salt intake, AND your electrolytes will need to be more manually managed with something like "EmergenC" or another electrolyte mixture. Consider using "No Salt" in your food also, because that's honestly the best way to get potassium.
4. It's very hard to do this diet without dairy, especially once you get up to 3:1, so it's a consideration.
5. Bifidus probiotics and Sacharomycetes are vital. If you're going to eat a fruit, make it grapes (best source of good fungus that protects you from the bad ones). I haven't found a pure bifidus "natural" supplement. Align from the pharmacy is the only one I know of. Also Dannon activa yogurt has a proprietary strain of bifidus.
6. If you have lost your gallbladder already, then you may need to supplement with bile and a good lipase containing digestive enzyme, at least in the beginning. It can be done and I do it without a gallbladder, but it takes a while for your liver to start making enough and it helps to have a little supplement in the beginning to enter into the bile recycling process.
7. Tiredness can result for up to 3 weeks. The best way I've learned to deal with it is to begin by fasting for at least 24, or better, 48 hours first. A medical keto diet begins with a 24 hour fast, even for children (generally in a hospital setting but I think they're being alarmist).
8. If you go with a "popular" keto diet, it's better to also use intermittent fasting (one day a week, or two days of 16 hour fasts per week) because your balance of keto to sugar metabolism can shift too much and then you get hungry.
9. Don't take it too literally and try to eat buttered cooked ground beef. Not good eats. But consider portion size. It goes way down on a keto diet for an equal amount of calories. And all that stuff about "calories don't matter" well, yeah they do. I asked Dr. Westman why my diet wasn't helping me lose weight, he said "maybe portion size." So that's just a baldfaced lie. Even kids on a medical keto diet have to watch portion sizes, because for them, too much food = epileptic fit.
10. Some drugs make it harder to be keto. For example, I am less keto than I used to be, anything more strict than 1:1 and I don't feel so good. The drug that causes this is more useful to me than the strict keto, so I live with it. Other specific drug warnings I've noticed are: Metformin, Topamax, and even some herbs like Berberine. Those are much harder to track down, some are in the book below.
I haven't really had a lot of constipation, but I also use a lot of flax seed powder and my "cheats" are all vegetable soup and such things. Consider making cauliflower rice, and getting a spiralizer for spiral zucchini and carrots with peanut sauce (lots of great vegan recipes for spiralizer machines (they're like $20), and they fit perfectly into a Paleo-keto diet.
Squashes will save you from total food boredom. But also consider learning to cook with plantains. Incredibly yummy and full of "resistant starch" at least when they're green (ripe black ones are chopped and fried). Green ones can be treated like potatoes, peel, boil, mash. The water may turn black due to a tannin. It's not a problem.
There are other warnings, tips and special cases in this book (medical keto):
http://www.alibris.com/Ketogenic-Di...rs-Eric-H-Kossoff-MD/book/36585025?matches=24
He also has other books on the subject, including a "Modified Atkins" diet that is 1:2 I think, maybe 1:1.
Another myth about the diet is that meat contains all you need because some explorer guy in 1906 proved it by eating just meat in a hospital... etc... you'll find that story eventually.
a. He was eating meat before modern meat processing and factory farming ruined it
b. When he was exploring, he was eating the ENTIRE animal, even eyeballs (high omega 3's, but he didn't know it then), and I am lucky if I can find some liver and maybe some chicken gizzards and hearts from a factory farm.
c. You're likely to go broke if you try for purely grass fed and purely organic meat. But I do think the ground beef should be grass fed, because PU it stinks to me. That factory farmed smell is probably what drives veganism among kids. Ignore words like "sustainably" etc. If it's not organic, they're deceiving somebody.
d. Game meat is now sold via online markets, google for elk or bison online and you'll find at least one, but it's incredibly hard to get any fat or organs from them, which I think is much more valuable than the muscle.
