Adverse Reactions on the Ketogenic Diet

Empty

Well-Known Member
I can't find much information anywhere, which seems odd.

So I am linking here, as a resource, an information page written by The Paleo Mom. A stay at home scientist. She distinguishes the ketogenic diet from the paleo diet.

She likens the ketogenic diet to being like a drug with adverse reactions which people need to be made aware of:

https://www.thepaleomom.com/adverse-reactions-to-ketogenic-diets-caution-advised/

I have looked on Dr.Myhills website too and there doesn't seem to be any warnings.. can someone link me to her warning page? This is all I can find and may be helpful to some who don't know about this page who are wanting to try this diet...

http://www.drmyhill.co.uk/wiki/Ketogenic_diet_-_the_practical_details


Thanks!
 

Not dead yet!

Well-Known Member
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-Diets-Treatments-for-Epilepsy-and-Other-Disorders-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.
 
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Empty

Well-Known Member
Thanks @Notdeadyet! In particular, I thought the Keto diet regularly excluded dairy, so that was news to me. I couldn't finding any warning information on your link, I imagine you have to buy the book.
Are you wanting/having to remain on this diet forever?

MT



Adverse reactions are not the same thing as side effects. An adverse reaction is an, unwanted/unexpected and dangerous reaction to a therapeutic agent. In contrast, a side effect is a secondary, typically undesirable effect of a therapeutic agent. More simplistically, side effects are minor and adverse reactions are not. Side effects are typically what are reported in shorter-term studies, where as both side effects and adverse reactions are reported in the long-term ketogenic dietstudies (typically 6 months to 2 years, but any study that allows for keto-adaptation, which takes up to a month, can be considered long-term). This article is not a discussion regarding side effects, the list of which has some overlap with the list of adverse reactions (for example common side effects include minor gastrointestinal symptoms). This article is to draw attention to the documented adverse reactions, which include...
 

Not dead yet!

Well-Known Member
Thanks @Notdeadyet! In particular, I thought the Keto diet regularly excluded dairy, so that was news to me. I couldn't finding any warning information on your link, I imagine you have to buy the book.
Are you wanting/having to remain on this diet forever?

MT

I found more warnings and special cases in that book, but I can't remember them all. Later of course I thought about mentioning use of liquid coconut oil or purified MCT oil, but I have a feeling there are more "if this happens, do this" type of messages in that book, but I don't know them all by heart. The ones I did mention affected me. It's been about 3 years since I read it for more than recipes. Keto Eggnog is awesome :)

I'm thinking I will keep it up most of my life. I took a 6 month break and had much better health than before on carbs, but my TG shot up to 400 or so. I guess I have to agree with the "blood type" diet that I'm a typical Type O. The real reason I started keto is, I have a form of migraine that is very epileptic in nature and it really helps to the point of being able to stop the beta blocker, which is a huge source of tiredness in my life. Now I only take the bb if I have a headache and the usual things aren't working. It's actually a better rescue than those expensive rescue meds, at least for me.
 

Empty

Well-Known Member
@Not dead yet!

Are you including refined carbs in with your carbohydrates (eg: sweet potato) when you state "carbs"? http://www.webmd.com/food-recipes/features/carbohydrates#1

I was wondering if you are being regularly monitored by a Doctor who is aware you are on a ketongenic diet? If you are, can I ask what does that monitoring entail?

(As an aside, I don't know if you have revisited the "blood type diet" information recently as you may find it has been debunked to your satisfaction. It has to mine).

I have been reading all over the internet that any adverse reactions on the keto diet are a myth, its perfectly safe, the only time you can have problems is if you are diabetic or an alcoholic.
Did you test for diabetes before starting the diet? Is this something one should do?

However, I found this article reported in the newspaper which was serious, she was not diabetic. A new mum nearly dies. http://www.dailymail.co.uk/health/article-3262230/New-mother-nearly-DIES-low-carb-diet-32-year-old-developed-life-threatening-condition-ditching-bread-rice-pasta-breastfeeding.html

Dr Ekelund said:
'This woman didn't realise the risks.
'People should be aware of the potential danger of these kinds of diet, especially when breastfeeding or when the body is under any other kind of stress, such as when they are ill.
He goes on to say:

'Authors on the internet might be people supporting the diet or advertisers with commercial interests'.

If someone is following a low carb diet and begins to feel nauseous, or their breath begins to smell of acetone, they may be going into ketoacidosis and should see a doctor immediately, he said.
Acetone on the breath might smell like nail polish.

That symptom checker sounds useful, is it helpful to know this?

MT

p.s.
Btw I cured my Migraines years ago by cutting out dairy, common detoxing (as opposed to the more recent specialist detoxing) and being on a plant based diet (as opposed to more recent concentration on wholefoods and Gluten Free and the last 6 months on low fat, whole foods I am now on). But I find in general, anecdotal accounts a bit...unhelpful although interesting.
 

Not dead yet!

Well-Known Member
Are you including refined carbs in with your carbohydrates (eg: sweet potato) when you state "carbs"? http://www.webmd.com/food-recipes/features/carbohydrates#1

I was wondering if you are being regularly monitored by a Doctor who is aware you are on a ketongenic diet? If you are, can I ask what does that monitoring entail?

(As an aside, I don't know if you have revisited the "blood type diet" information recently as you may find it has been debunked to your satisfaction. It has to mine).

I have been reading all over the internet that any adverse reactions on the keto diet are a myth, its perfectly safe, the only time you can have problems is if you are diabetic or an alcoholic.
Did you test for diabetes before starting the diet? Is this something one should do?

However, I found this article reported in the newspaper which was serious, she was not diabetic. A new mum nearly dies. http://www.dailymail.co.uk/health/article-3262230/New-mother-nearly-DIES-low-carb-diet-32-year-old-developed-life-threatening-condition-ditching-bread-rice-pasta-breastfeeding.html

Dr Ekelund said:


He goes on to say:



Acetone on the breath might smell like nail polish.

That symptom checker sounds useful, is it helpful to know this?

MT

p.s.
Btw I cured my Migraines years ago by cutting out dairy, common detoxing (as opposed to the more recent specialist detoxing) and being on a plant based diet (as opposed to more recent concentration on wholefoods and Gluten Free and the last 6 months on low fat, whole foods I am now on). But I find in general, anecdotal accounts a bit...unhelpful although interesting.

@Empty Having a bad day so I'll answer as best I can. Not sure if sweet potato would be a "refined" carb, I'd call a refined carb something like white bread or pasta, or white sugar. I mostly do not eat sweet potatoes, I stick to veggies and squashes, the highest "carb" veggies I eat are some roots (check the carbs out on parsnips, wow).

My doctor is aware that I am on the diet. He has seen firsthand what happens to my triglycerides when I backslide into too many carbs. Early on I was obsessive about my ketogenic state and etc, but now I'm not checking it much, I know how I feel. He still checks my lipids, but be aware that many of those numbers are merely calculated, not measured. I once got a special in-depth test done, and it had illogically high numbers in it. I mean impossible numbers. It turned out to be a calculation.

I've been begging to be classified as diabetic, but no go. My blood sugar is never bad enough and my A1c is extremely low for my age. I certainly have "metabolic syndrome" though. Funny thing, I haven't had even one ovarian cyst since I went keto. Lots of women online will tell you it cures PCOS or maybe "treats" is the better word.

I'm not going to comment on that woman's specific case, but I will say that such feelings of shaky nausea weakness can occur with keto, especially at first. In her situation, and I've felt that, only not as badly, I would've reached for an electrolyte balancing drink (Emergen-C or similar), which worked for me perfectly. Can't say anything about her because I don't know all the facts from news articles. I never count the first 10 lbs of weight loss because it's all water loss. After that I start to count weight loss. When anyone starts any diet, especially if they're doing it with a calorie deficit, dehydration and hypoglycemia should be taken into consideration.

It also looks like the woman tells a different story than the one in the news, so anything anyone says in response to the Daily Mail news article alone is iffy: https://www.dietdoctor.com/breastfeeding-low-carb-diet-dangerous#more-69005

The acetone breath thing goes away after a week. It does take at least a week for the body to adjust the enzyme levels to handle more fat metabolism than before. The epigenetics doesn't fully "kick in" for 3 weeks for most people.

If you haven't done it before, try a 24 hour fast and you will feel what it's like. If you're nervous about fasting, read this: https://www.amazon.com/Fasting-Eating-Health-Medical-Conquering/dp/031218719X That's the doctor that was featured in the "Supersize Me" movie, he maintains his own research into the blood pressure effects of fasting.

I got into keto because I was on a plant based diet (the Eat to Live one most recently, though I've been a Raw Vegan at times also), and it just wasn't working. I picked up Dr. Atkins's first book for $.50 at a book sale thinking it would be a laugh because he has to be wrong. Instead he convinced me. /shrug Different strokes.

(I hope by now I don't have to say... you can get it at the library ;) ) Good luck!
 
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Empty

Well-Known Member
Not dead yet!

Thanks.

Sorry to hear you have had a bad day.

He still checks my lipids, but be aware that many of those numbers are merely calculated, not measured. I once got a special in-depth test done, and it had illogically high numbers in it. I mean impossible numbers. It turned out to be a calculation
I am not sure I understand what you mean here. Are you saying your LDL numbers are high but not accurate?
What was the special in-depth test with high number calculations/results? Has it been a fake test that you were duped into?


MT

p.s. Sorry, must have completely missed the point you were making here, why do you want to be classed as a diabetic?
 

Not dead yet!

Well-Known Member
Not dead yet!

Thanks.

Sorry to hear you have had a bad day.



I am not sure I understand what you mean here. Are you saying your LDL numbers are high but not accurate?
What was the special in-depth test with high number calculations/results? Has it been a fake test that you were duped into?


MT

p.s. Sorry, must have completely missed the point you were making here, why do you want to be classed as a diabetic?

Well on cholesterol testing, I no longer pay attention and haven't for several years, I think you might find the answers to which numbers are calculated and which are measured faster with a google search, it might take me a while to find the reference. Edit: actually that's not exactly true, I do care about my triglycerides and they stay around 130 as long as I stay moderately in keto. There is a connection to diabetes there.. the pancreas can become inflamed, even permanently damaged, if your TG is consistently above 500 for long enough. Mine was.

The "want" part is from having metabolic syndrome. I honestly thought life would be easier if my body just got it over with and I could deal with the diabetes instead of the nebulous Metabolic Syndrome. Only in the past few years has it become standard to give people metformin for it.

For most of my teen and adult life, there was no treatment except "exercise more." So when I discovered the positive effect of keto on the syndrome, I went for it. It still took another 3 years for my doctor to prescribe metformin, I'm only just a few months into using it. Yet by a modern definition, I should've been on it at age 14. Not grudgingly given it as a "test" at age 43. PCOS rendered me infertile by age 16. I never had a hope of having children.

I honestly am angry that the med community discredited Dr. Atkins so badly, I might've had a normal life if I'd heard of him during the rebellious teen years.
 
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Empty

Well-Known Member
Not sure why you would be angry Not dead Yet! at the medical community who debunked the Atkins diet. (Aside: http://www.onlinejacc.org/content/accj/43/11/2142.full.pdf (*Lauren Cordaine - founder of paleo movement -"Optimal Low-Density Lipoprotein Is 50 to 70 mg/dl Lower Is Better and Physiologically Normal")/ http://www.scielo.br/pdf/abc/v88n1/en_a06v88n1.pdf)

If you look here http://nutritionfacts.org/video/metabolic-syndrome-and-plant-based-diets/

Even after controlling for lifestyle factors such as smoking and exercise, risk was highest in those eating non-vegetarian, intermediate for those eating semi-vegetarian, and lowest in those eating vegetarian, cutting the odds of having metabolic syndrome by more than half.
Metabolic syndrome may be avoided via this route and is also nutritionally balanced (no need for supplements other than b12) ,
This also offers significant protection from developing cancer/diabetes/heart attack etc.
Links can be followed for info on PCOS.


http://atkinsfacts.com/

The world's largest organization of food and nutrition professionals,[7] calls the Atkins Diet "a nightmare of a diet".
A 2003 review of Atkins "theories" in the Journal of the American College of Nutrition concluded: "When properly evaluated, the theories and arguments of popular low carbohydrate diet books... rely on poorly controlled, non-peer-reviewed studies, anecdotes and non-science rhetoric. This review illustrates the complexity of nutrition misinformation perpetrated by some popular press diet books. A closer look at the science behind the claims made for [these books] reveals nothing more than a modern twist on an antique food fad."[23]


Please don't think that I am attempting to change any of your habits. It is of no consequence to me.

But we digress as a ketogenic diet is different to an atkins/paleo one.

In order to minimise adverse reactions I have been wondering about bypassing the restrictive animal based ketogenic diet model and supplementing with ketones. But haven't looked into it in any great detail.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4743170/

This study demonstrates the efficacy and tolerability of oral exogenous ketone supplementation in inducing nutritional ketosis independent of dietary restriction.
(*rat study).
 
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Not dead yet!

Well-Known Member
Sigh. I guess we do diverge in opinion there. Although why you would quote an "organization of professionals" is beyond me. Are we really supposed to be that trusting? I'm not that trusting. A short list of why:

https://www.amazon.com/Doctoring-Data-medical-advice-nonsense-ebook/dp/B00TCG3X4S
(He actually mentions Fibro and CFS and calls them "corporate created diseases" or something like that. I happen to agree with him that it's more economically beneficial to the pharmaceutical companies if the cause is NOT known.)


https://www.amazon.com/Death-Food-Pyramid-Politics-Interests/dp/0984755128
(does not mention CFS to my recollection)

https://www.amazon.com/Rising-Dead-Suzanne-Humphries-M-D/dp/0692648186
(Autobiography of an MD who actually started using https://vaers.hhs.gov/index and found that she was becoming alienated from her fellow doctors. I don't think vaccines are bad, but I am repulsed by dogma.)

https://www.amazon.com/What-Your-Doctor-Wont-Cant/dp/0399151508
(there used to be an older version of this by another author, but this is good too)

I've had a great many reasons to question the science to medical clinical practice gap, but I won't bore you. Sadly almost everyone knows someone who died needlessly because medicine was helpless (nearly everyone who knows a cancer patient at the very least, I'd think).

I think it's a miracle that I still take into consideration what Medscape, Mayo Clinic, Cleveland Clinic, WebMD, etc have to say. But I now consider them just one of the many voices out there, each having its own value.

As for the Atkins diet, please don't make me reference the JAMA study that compared it to four other diets (the researcher was a lifelong vegetarian!) and found it to be best at reducing triglycerides. Anyone can prove anything with the right references. Have you seen the hoax article that "proves" kale is bad for you? The author did it as a joke, and yet people treated it as real. The purpose was to show that you could use cherrypicked data to prove anything.:playful:

I appreciate your view, and am actually glad that your diet works for you. It definitely works for some people. Sadly, not me, so when someone asked for negatives on the keto diet, I obliged. I'm sure you could give us a list of negatives and pitfalls of your diet too.

Everyone who diets puts a great deal of effort and good intention (faith) into it, it's never nice to try and shake that faith, especially if you are on a diet too, even if the diets are different.
 
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Remy

Administrator
I'm looking forward to looking at these papers in far greater detail. I very much enjoyed Death By Food Pyramid by Minger but I'm afraid they are probably way off base here. And we already know from other studies that at least half of the scientific literature has a fatal flaw. I suspect there will be a higher preponderance of errors here in this collection as well but I'm looking forward to spending some time reviewing.

My personal experience is that a true ketogenic diet is the single best intervention into my health that I've ever made (and I've made a lot). I find that people don't ever actually manage to truly eat a ketogenic diet and half the common criticisms are not really applicable anyway.

I also trust the work of scientists like Dr Dom d'Agostino who have done so much to correct popular misconceptions about the diet.

I can't for the life of me understand the mindset of people who would take any numbers of drugs or wait patiently to get in line for something like Rituximab but who won't even consider using their diet as medicine. It boggles the mind.
 

Not dead yet!

Well-Known Member
I'm looking forward to looking at these papers in far greater detail. I very much enjoyed Death By Food Pyramid by Minger but I'm afraid they are probably way off base here. And we already know from other studies that at least half of the scientific literature has a fatal flaw. I suspect there will be a higher preponderance of errors here in this collection as well but I'm looking forward to spending some time reviewing.

My personal experience is that a true ketogenic diet is the single best intervention into my health that I've ever made (and I've made a lot). I find that people don't ever actually manage to truly eat a ketogenic diet and half the common criticisms are not really applicable anyway.

I also trust the work of scientists like Dr Dom d'Agostino who have done so much to correct popular misconceptions about the diet.

I can't for the life of me understand the mindset of people who would take any numbers of drugs or wait patiently to get in line for something like Rituximab but who won't even consider using their diet as medicine. It boggles the mind.

Yeah I'm a bit disappointed that most of the popular keto books don't discuss the ratio concept. Too mathy, probably. But it can then be proven whether or not the diet is helpful, because if you do the math, then you have no doubt that you're doing it right. Can't say that for the endless mousewheel arguments around doing this or that diet "right." Having left the vegan/vegetarian diet behind I am sensitive to the shaming that happens when it isn't working for someone, cries of "you did it wrong" are extremely hurtful. At least with keto there is certainty, as long as it's done by the ratio method.

I didn't lose weight on it, I actually do better losing weight via "rabbit starvation" (the all-protein diet). However, that's definitely a temporary scenario. A permanent weight solution will probably elude me until I find out how to reverse the metabolic damage that ME/CFS has done to me. But the benefits to wellbeing are very clear.

Perhaps I should add another drawback, if a person is female, it is nearly impossible to be both sick (like with CFS) and have your period, and stay ketogenic. The one-two-three punch is too much. About two days a month, I take a break from my keto diet, having learned over years that to deny my body carbs during that time cases menstrual cramps that aren't touched even by a bottle full of pills. Maybe some women don't have the issue because they have normal menstrual function, but I may have mentioned before that mine isn't normal with PCOS playing the central role in the problems.

I think the problem with menstruation and keto is more a function of sickness. Sick kids become anti-ketogenic due to muscle breakdown, even if they eat a 4:1 diet. In fact the diet is often modified if a child has a long illness because otherwise they undergo too much muscle wasting. (According to the book I mentioned.)
 

Empty

Well-Known Member
I'm looking forward to looking at these papers in far greater detail. I very much enjoyed Death By Food Pyramid by Minger but I'm afraid they are probably way off base here. And we already know from other studies that at least half of the scientific literature has a fatal flaw. I suspect there will be a higher preponderance of errors here in this collection as well but I'm looking forward to spending some time reviewing.

My personal experience is that a true ketogenic diet is the single best intervention into my health that I've ever made (and I've made a lot). I find that people don't ever actually manage to truly eat a ketogenic diet and half the common criticisms are not really applicable anyway.

I also trust the work of scientists like Dr Dom d'Agostino who have done so much to correct popular misconceptions about the diet.

I can't for the life of me understand the mindset of people who would take any numbers of drugs or wait patiently to get in line for something like Rituximab but who won't even consider using their diet as medicine. It boggles the mind.
I can understand where you are coming from but its a tad harsh for those with ME imo @Remy. :)

If you look at Deliciously Ella who cured her POTS (had a pulse increase from 60 to 180), allergies, chronic fatigue, stomach issues etc. she states that it was a challenge for her and very hard. When you have ME also, often lack of support, cognitive issues, PEM and a mass of conflicting information to wade through, plus the added difficulty of results not always as expected through random unknown mechanisms, it can become disheartening. Plus family members often don't like to buddy up with you on whatever diet and instead shovel addictive junk that people are trying to get free from (POTS and ME are a particularly bad but common combination), or worse decide for you that you should be on some sort of diet and the inspiration is not coming from within.

https://deliciouslyella.com/philosophy/about/

Physically, my autonomic nervous system struggled to function properly which meant that I couldn’t control my heart rate and blood pressure properly (my heart rate would go from about 60 when I was sitting to 180 or so as soon as I stood up!), I also had a whole host of other issues form terrible stomach problems to constant headaches, lots of allergic reactions and chronic fatigue – so I spent almost all my time on my own in bed.

Its also a fine line between knowing if people are doing it "wrong" and if it just simply isn't working. If it is a detox or if it is a side effect or adverse reaction. Everything is so much more difficult. Look at all the information just on the ketone strips alone. I have certainly read a few accounts of people with ME who have been seriously effected by being on the ketogenic diet. Stopping it has not reversed the damage. Whether they did it "wrong" is impossible to know.

Also one can't help but wonder if a form of orthorexia is being developed in some cases. Fear of whole starches, calorie restriction, dependency on supplements, etc.

Food also has strong emotional links and can be a psychological crutch for the majority of the "normal" population and some of it has an opiate addictive effect like cheese.

"Panda eyes" are apparently common on the ketogenic diet. It sounds cute. I am guessing that you don't have this @Remy? However it is a symptom that the body is under stress. In people without ME, cortisol levels are usually higher on the ketogenic diet reflecting that the body is under stress. I think the body will be raging against "nutritional" ketosis (with supplements) as it thinks it is starving to death.

Can I ask is your "true ketogenic diet" (thanks for using that term as there are different variations) dairy free?
 
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Not dead yet!

Well-Known Member
I think the body will be raging against "nutritional" ketosis (with supplements) as it thinks it is starving to death.

Can I ask is your "true ketogenic diet" (thanks for using that term as there are different variations) dairy free?

Not sure if you meant me or Remy, my keto diet has almost always included dairy, I make a distinction between keto and Paleo. Technically as long as your ratio is at least 1:1 so that, Carbs + Protein : Fats, measured in grams, then you're doing it "right" it takes all the mystery out, but requires a lot of work. Then, after 3 weeks, you have the clarity to say "the keto diet works for me" or "it doesn't work for me" because there is a mathematical proof that you did it right.

OTOH, it takes a firm knowledge of fats, avoidance of trans fats is not enough, you need to make sure you're getting omega-3's and easy to use fats like butter and coconut oil, plus, I've noticed it's harder to get omega-6, so you can either include non-grass fed meats, or some people like unrefined sesame oil in salad dressing. Actually one of the best reasons to try keto is that - all those good nutrients in salad? Most of them require fats to be absorbed. So a low fat salad dressing is just wasting nutrition. Even WebMD acknowledges that, but there's a lot more on that subject if you look:

http://www.webmd.com/food-recipes/news/20040727/fat-helps-vegetables-go-down

I'm not sure I understand what you mean by the body raging against keto, the body activates epigenetics to change the ratio of enzymes over a 3 week period, to make the use of fat for fuel more efficient. That's epigenetics, not raging.

Another example would be the number of GLUT receptors in your gut. If you've been keto for a while, and you go back to eating more carbs, your gut may take a week to make more GLUT receptors (which it did not need on a low-carb diet because that receptor absorbs glucose). The reverse is also true if you go from carbs to fats mainly. The body isn't going to waste resources on receptors that are not needed.

How do you mean "starving to death"? Carbs are not an essential nutrient, but fats are. Find me just one essential carb. Essential nutrients are those the body can't make on its own, glucose can be made via several mechanisms.

I've never heard of anyone "permanently damaged" by the diet. If that was possible, do you think they'd put children on it? Certainly some people have a genetic problem with some enzymes that make it impossible for them to fast, they begin to vomit and feel dizzy in just 12 hours, it's not something "subtle" that can be mistaken. Another thing I mentioned that can cause problems is if the person is unaware that they have hypoglycemia, making them shaky and anxious on the diet. Depending on the severity of the hypoglycemia, it will either resolve, or it will be an insurmountable problem and they should just do another diet.

The connection between fasting and keto dieting is simple, when your body has no food coming it, it knows that it can make more energy for a longer time by breaking down fat and using it. This is why all diets are high fat diets, by the way, because your body burns its own fats whenever there is a deficit.

If instead your body used mechanisms to make glucose, enough for all your cells, you'd be experiencing muscle wasting and thus (in the wild) would probably die before you could catch another meal, or even gather one. Therefore, fasting is ketosis, and so is "rabbit starvation" where a person eats nothing but protein and the body relies on its stores of fat for energy plus the excess protein.

The keto diet provides fats as a fuel from the diet, instead of carbs as a fuel. It's a simple swap. But starvation would require that there be a severe deficit of calories. Keto is not starvation. A typical blood glucose level in ketosis is around 70 or 80 (in USA measurements, the cutoff for diabetes is around 120, and a "normal" person will be in the 90-100 range). But glucose levels can be much lower while fasting.

Many technical questions on the diet are explained fully in this book, however, as with all popular books on keto, it does not highlight the negatives (which are provided in this thread):

http://www.alibris.com/Keto-Clarity-Your-Definitive-Guide-to-the-Benefits-of-a-Low-Carb-High-Fat-Diet-Jimmy-Moore/book/28221994

This website has a biochemistry section that I think is more informative than most: http://www.ketogenic-diet-resource.com/low-carb-dieting.html

By the way, low-carb is not a radical thing, at least 5 MD's in my life have recommended I try to cut carbs, one of them (a neurologist) specifically pointed me to a book on the Keto diet. Ask your neurologist next time you see them what they think of low carb or of keto. Don't need to take my word for it.
 

Empty

Well-Known Member
Thanks @Not dead yet! I am a post or two behind replying to your posts. I was asking @Remy if her version excluded dairy. I recall you saying that you found it difficult to be in ketosis without having dairy in it.

I've never heard of anyone "permanently damaged" by the diet. If that was possible, do you think they'd put children on it?
Yes, a few children have died from being put on it.

A few children developed kidney stones on it, bone fractures, stunted growths etc.

One of the adverse effects is it is a nutritionally deficient diet, however this is corrected to a reasonable degree with the use of supplements alongside it.

MPT
 
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Remy

Administrator
Thanks @Not dead yet! I am a post or two behind replying to your posts. I was asking @Remy if her version excluded dairy. I recall you saying that you found it difficult to be in ketosis without having dairy in it.



Yes, a few children have died from being put on it.

One of the adverse effects is it is a nutritionally deficient diet, however this is corrected to a reasonable degree with the use of supplements alongside it.

MPT
OK, so let's clear up some of this with some actual facts about the ketogenic diets. Because this is exactly what I'm talking about in terms of fear mongering. What else do you call saying that children have DIED from this diet except fear mongering?

The truth is that a handful of children with epilepsy (so by definition already very ill) regretfully died while eating a ketogenic diet. This was found to be due to a selenium deficiency, not from anything inherent in the diet or how it affects the body. Probably it was due to the horrific content of some sort of canned "nutritional" formula that contained mostly corn and soy oils. These are horrible for all people, ketogenic dieters or not.

I have no idea why their version of a ketogenic diet was low in selenium but it apparently was designed that way. Every food on your average typical list of foods high in selenium are foods that are not only allowed but are actively encouraged on a ketogenic diet. Think tuna, sardines, beef, eggs, chicken, liver...the list is very long. There is NO REASON AT ALL for someone to become selenium deficient on a ketogenic diet unless the diet that was designed was very poorly designed in terms of trace minerals.

Further studies have shown exactly that...that there is absolutely nothing in common with cardiac dysfunction or increased risk of death due to the ketogenic diet, provided that one takes care to eat with a balanced approach, certainly the same as with any other type of diet.


J Clin Neurosci. 2012 Jan;19(1):181-2. doi: 10.1016/j.jocn.2011.05.012. Epub 2011 Nov 30.
The ketogenic diet and the QT interval.

Sharma S1, Gulati S.Abstract
Cardiac complications have been rarely reported associated with the ketogenic diet. Prolonged QT interval in the electrocardiogram and torsades de pointes arrhythmias have been described in a few cases. The effect of the ketogenic diet on QT interval has not been systematically evaluated. We obtained serial electrocardiograms in our patients on the ketogenic diet to look for changes in the mean QT interval. Twenty seven children aged 6 months to 5 years with refractory epilepsy were enrolled. Classic ketogenic diet was introduced using a non-fasting gradual initiation protocol. All patients were supplemented with oral calcium and selenium. Electrocardiograms were obtained at baseline and after 1, 3, 6, and 12 months on the ketogenic diet. There was no statistically significant change in the corrected QT interval over time. There were no ST segment changes or dysrhythmias in any of the electrocardiograms.
Finally, case studies do not prove causation. At best they can prove correlation and given the number of compounding factors in epileptic children, that's even a stretch too. Most of the adverse effects listed are a direct result of eating a crap diet, ketogenic or not cannot save you from not eating a wide range of nutrients. Further, it's just lazy to rely on something processed in a can for the entirety of the diet.

On to cortisol,

In people without ME, cortisol levels are usually higher on the ketogenic diet reflecting that the body is under stress. I think the body will be raging against "nutritional" ketosis (with supplements) as it thinks it is starving to death.
Again, not at all based in fact, but a common myth repeated by people that don't understand the diet or its effect on the HPA axis.

There is some reason to believe that cortisol dysregulation is a key underlying factor in metabolic syndrome [10], [11]. The dysregulation has a particular pattern that seems to be caused by a tissue-specific expression of the enzyme 11β-HSD1.

There is a belief among some researchers that ketogenic diets worsen cortisol metabolism (which could lead to metabolic syndrome and heart disease), but an examination of the specific pattern of cortisol metabolism related to metabolic sydrome shows the opposite.

This is what should have been expected in the first place, since ketogenic diets have already been shown to improve insulin sensitivity (the defining symptom of metabolic syndrome) in repeated randomized controlled trials.

One mechanism by which keto diet improves metabolic syndrome may be its beneficial effect on cortisol metabolism.
I recommend reading the entire post here because it clearly lists the process and studies that support the fact that the ketogenic diet improves cortisol metabolism.

Panda eyes are probably caused by low salt and dehydration. These are not problems with not having enough carbohydrates. They are problems with not drinking enough water to replace that which has been lost during the very beginning stages of the diet. Electrolytes are important on any kind of diet.

And yes, I do eat dairy, sparingly, and mostly in the form of cheese and butter. I no longer drink milk or milk products. I eliminated dairy for a period of time and did not find it significantly changed my symptoms enough to make a difference. Cheese is worth it to me, though many with autoimmune diseases will find they are better off without any dairy.

I agree, changing the diet is hard. But so is being sick. And being sick means making hard choices sometimes. Choices that others in your life may or may not support. But who gets the last laugh? Make fun of my diet all you want but I'm the one doing things I enjoy again and fitting into my clothes again for the first time in years. That's worth it to me.
 

Empty

Well-Known Member
I have not been making fun of your diet Remy. If you are referring to my use of "Panda Eyes", this seems to be a commonly accepted Ketogenic term.
Who gets the last laugh?
 
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Empty

Well-Known Member
It seems there are special ketogenic facts that one is learning. Its nothing to do with not understanding.

This nutritional starvation diet which I agree has its place (initially created for epileptic children) is now being touted for everything. Weight loss can be achieved really well by eating a plentiful, fully nutritious plant based diet, which includes receivng all the cancer/heart/diabetes etc. protective properites.

Its the Eskimos all over again :)

Blinten does warn of some dangers here: http://www.healthline.com/health-news/keto-diet-is-gaining-popularity-but-is-it-safe-121914#1

a keto diet will do more harm than good for the majority of patients, especially if they have any underlying kidney or liver issues.
“People are using this for cosmetic reasons, but it’s so extreme that it’s dangerous,” she said.
Because there may be initial motivation from the diet in the short term, the long term is a different ball game.

I think therefore an important consideration is that those on the ketogenic diet long term should never become complacent with medical supervision of it, which I expect is really easy to do.
 
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Not dead yet!

Well-Known Member
Hmm, well it looks like you already know the answers, @Empty, I'm at a loss to understand why you asked in the first place. While I agree that there is a lack of information on downsides, it is, as I said before, likely to be because people are seeking to discredit the diet, so when that happens, those who support it close ranks. A similar mechanism protects the DASH diet from the criticism it surely deserves, and several others.

I reiterate that anyone who puts a lot of effort into a diet is to be commended, not criticized. And that not all diets are for all people. People are different, and the "diet wars" only obscure the truth. Someone who foams about how "bad" something is can't be trusted, even when they do say something insightful. In the end we're back to trusting our friends and family plus doctors because all the passionate vitriol leads to misjudgement and confusion.

There's even a backlash against all diets. There have been some medical people joining this backlash, but here's a patient community that refuses to diet: https://danceswithfat.wordpress.com/blog/

Things like that wouldn't exist if everyone could just follow one diet and have it work every time. Actually that booklet she sells helped me to understand the fallacies that underlie dieting and how we are made to run on the mousewheel of "weight loss" to our financial and physical detriment. It made me consider carefully whether a diet is even worth putting effort into. Contact with that community has been very therapeutic.
 

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