My son started the Keto Diet (not perfectly) with the ok of his Dr and a Different Oral Chemo at the same time. Last Tuesday an MRI indicated no new growth or no new tumors. We don’t know if the new Chemo, Keto diet, lots of prays or what has stopped the tumors from growing.I found your site after looking for possible adverse reactions to Keto Diets, and appreciate your research. His platelets are low now and never have been low before. This is stopping the next Chemo treatment. I understand that being on Chemo for 12 months could have created the low platelets and now the possibility that the Keto Diet could also be causing low platelets is frustrating. They will do a new blood test Tuesday to see if the platelets have increased. Any suggestions about how if possible to increase the platelets on the Keto Diet would be helpful.

I am sorry you had this experience. I feel that this educator was not giving you good advice. All my women who want to lose weight are recommended to consume 30 grams of good carbohydrates at each meal, and 15 at each snack. If you were not trying to lose weight, I would have recommended 45. I find this is all it usually takes to begin to lose some weight as you start to get active. Patients set their own goals with motivational help from their Certified Diabetes Educator. Our intent is never to insult, and you should not have gone through that. It sounds that you have now found the right path. There are many CDEs who could help you, so see what tools and motivation others may offer. I wouldn’t let one bad apple spoil the whole bunch. Many CDEs are also diabetic.


Examples include non-starchy fruits and vegetables such as leafy greens, mushrooms, bell peppers, and berries. The trace minerals and vitamins found in grains can also be obtained at higher percentages in good-quality meats and dairy products. Moreover, compounds such as phytates and tannins in grains hinder the bioavailability of several minerals.13


In part, keto diet weight loss is a real thing because high-fat, low-carb diets can both help diminish hunger and boost weight loss through their hormonal effects. As described above, when we eat very little foods that supply us with carbohydrates, we release less insulin. With lower insulin levels, the body doesn’t store extra energy in the form of fat for later use, and instead is able to reach into existing fat stores for energy.
Something that makes the keto diet different from other low-carb diets is that it does not “protein-load.” Protein is not as big a part of the keto diet as fat is. Reason being: In small amounts, the body can change protein to glucose, which means if you eat too much of it, especially while in the beginning stages, it will slow down your body’s transition into ketosis.
MCTs are natural sources of essential healthy fats for energy. They are easily digestible and absorbed by the body, providing instant but lasting energy. Including MCT oil in the keto diet can stabilize blood sugar levels and enhance the production of ketones. Since that is the goal of your keto diet, optimal blood ketone levels, MCT Oil is a no-brainer.
Holy cow Batman i started keto diet on the 9th of January within 4 days I was no longer on bydureon (weekly insulin) levemir 60units 2x daily and no more Novolog 25 units3x daily all that and metformin 10002x and this all didn’t have my sugars under control amazingly keto diet got sugars in check within four days I’ve been on diet now for 15 days and have honestly never fealt better I’m still green on diet and have had some issues while my body is healing itself (keto flu,low electrolytes very sluggish) .. My aunties actually have been on diet for a year now and were the ones that referred me to it after seeing there transformation i was on Board I’m having my first cheat day cause it’s my bday and other family members haven’t and don’t need the diet so I eat what they make a couple times a year this diet had been literally a life saver to me I’m down to my metformin 2x a day and sugars are at 90-140 depending on when I test after/before a meal with all the meds sugars haven’t been under 200 for the last two years so woot woot to Keto I’ll keep y’all posted thanks for the article my doctor is concerned about ketoacidosis so she’s not on Board and I need forums like this to help me move forward
You say keto is a highly controversial topic. For those of us following a keto diet, there is no controversy whatsoever because the diet proves itself efficacious very quickly. I think the real controversy comes in because the ADA has been recommending dangerous levels of carbs for decades now, and they would lose face if they had to change their recommendation and admit they’ve been wrong for so long. You say there are not many studies on the keto diet, and I disagree with you. You’ll find the evidence if you look for it. Eric Westman, Steve Phinney, Jeff Volek and many other researchers have written volumes about this.

Reynolds, AN. "Comment on 'An Online Intervention Comparing a Very Low-Carbohydrate Ketogenic Diet and Lifestyle Recommendations Versus a Plate Method Diet in Overweight Individuals with Type 2 Diabetes: A Randomized Controlled Trial." Journal of Medical Internet Research. 2018; 20(5):e180, May 2018. Available at: http://www.jmir.org/2018/5/e180/  Accessed May 4, 2018.


I believe that nature teaches us in wonderful ways about what works. Take the four seasons for example. I’ve adapted a ketogenic way of eating that is a cyclic method. I workout a lot, and a focus of mine is increasing muscle mass and strength. While I wouldn’t be able to maintain and/or increase those two factors with the amount of intense workouts I have, I don’t follow a strict ketogenic “diet”. I go about 3 weeks of being in keto, and then for a couple of days, I eat whatever I want. That means, I can eat cake, cookies, pies, whatever I want, for those two days. I even get to enjoy birthday cake ;). Then after that, I go back to keto. It’s work WONDERS. It’s EXTREMELY maintainable, I’m still loosing weight and achieving my goals. I’ve also been getting better at listening to my body and understanding how certain foods affect my body—which is something we’re not taught. It’s really amazing how we have such intelligent systems that are ALWAYS communicating with us. We just have to understand how to listen to them. Truly. The problem with a lot of our society, is that we are stuck in the high-end of the cyclic, or the feasting mode, and we think it’s normal! Hence the many ailments and medical conditions that keep increasing. The point is, there are many variations of following a ketogenic way of eating, and it DOES require a life-style change. Just like any other recommendation from a dietician or educator.
For me, I chose to become a CDE because I had worked as a Registered Nurse first on a medical unit, then in a Medical ICU. These are the units where most of the people with diabetes are, so I had seen every horrific complication that diabetes can cause. When I had a chance to become a Diabetes Educator…to actually help PREVENT some of those horrible complications…I jumped at the chance!
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It builds mitochondria. Mitochondria are the power plants of our cells, transforming incoming nutrients into ATP. The more mitochondria we have, the more energy we can utilize and extract from the food we eat—and the more performance we can wring out of our bodies. Ketosis places new demands on our mitochondria, who adapt to the new energy environment by increasing in number.

I am a holistic health coach and focus on women and keto primarily. I have thought of checking out your box. After running across this article {which I shared with all my current keto groups I am coaching!} I am definitely going to sign up! AMAZING article! I am all about digging into as much good science and research as I can to help people better understand health in general and particularly keto. This article is right up my ally! Thank you, thank you, thank you! ❤️
From baseline to week 16, the mean body weight decreased significantly from 131.4 ± 18.3 kg to 122.7 ± 18.9 kg, BMI decreased from 42.2 ± 5.8 kg/m2 to 39.4 ± 6.0 kg/m2, and waist circumference from 130.0 ± 10.5 cm to 123.3 ± 11.3 cm (Table ​(Table3).3). The percent change in body weight was -6.6%. The mean percent body fat decreased from 40.4 ± 5.8% to 37.0 ± 6.0%. Systolic and diastolic blood pressures did not change significantly over the 16 weeks. The mean heart rate decreased from 81.2 ± 12.9 beats per minute to 74.6 ± 14.0 beats per minute (p = 0.01).
One of the keto researches commented, (I think it was Steve Phinney) that change will come about only because enough of the the public will be become educated about this and will demand that the ADA change their recommendations because those recommendations are just wrong. What is the proof they are wrong? If you eat 45-60 g of carb daily, you will continue to have diabetes, and the epidemic will continue as it has for the last 25 years.
Losing essential micronutrients is another concern raised by keto diet skeptics. People say eating a diet based on fat and protein from animal sources means losing those micronutrients found in higher-carb grains, legumes, fruits, and vegetables. Some also claim low-carb diets contain too little fiber, and thus may cause long-term constipation. That’s inaccurate.
And that’s the kicker -- most people “going keto,” may not actually be following a true ketogenic diet since it’s hard to know for sure if your body’s in ketosis. Mancella explains that the only formal and valid method of determining if your body is in ketosis is if there are ketone bodies being excreted in your urine. “There are strips for purchase at local drug stores that are available to determine this,” she says. “Otherwise, we’re not actually sure if we’re in ketosis, and we’re just following a ‘low carbohydrate’ diet.”
In January 2017, at 63 years of age, I was diagnosed with type 2 diabetes. I had probably been living with it unknowingly for years. In 2009 my doctor recommended the South Beach diet because I was showing blood-sugar levels that were considered pre-diabetic. I stayed on it for a while but then, as with all other diets I’ve tried in my life, I failed and put all the weight back on, plus some. When I was officially diagnosed last year with type 2 diabetes I was a whopping 284 pounds (129 kg). I was always fatigued, could barely walk a block without getting tired and my health was failing.
Once you click the “Add to Cart” button that is right above, you will be taken to the secure checkout page. Just enter your information and then you will be given an instant access to the entire 3-Week Ketogenic Diet. You can view all the materials, the list, and the guides right on your computer, tablet, or smart phone. You could also download everything and print out as many copies as you would like. 
In part, keto diet weight loss is a real thing because high-fat, low-carb diets can both help diminish hunger and boost weight loss through their hormonal effects. As described above, when we eat very little foods that supply us with carbohydrates, we release less insulin. With lower insulin levels, the body doesn’t store extra energy in the form of fat for later use, and instead is able to reach into existing fat stores for energy.
But the question remains, can you keep it off? Aside from the fact that it’s a pretty hard diet to keep up (ah, no birthday cake!), one large meta-analysis found that while low-carb dieters tended to lose more weight than low-fat dieters at first, the differences disappeared by the one-year mark. This may be because cutting carbs tends to reduce bloating and water weight, which may level out over time. But the bottom line on weight loss? Calorie restriction is calorie restriction. You just have to find what works best for you, and slashing carbs for fat might or might not work.
Great article! Sustainability is key and Keto diet is extremely restrictive compared to others. Many of the comments I see don’t understand the importance of many years of research before stating something has a “significant difference” than the recommendations that are already in place. Also, understanding the pro/carb/fat balance in each meal instead of focusing on just carbohydrates. We have practiced the same modified Mediterranean diet at my practice where someone can enjoy life, eat complex carbohydrates and years later they are still successful and hundreds of pounds have been lost for good 🙂 Thank you for the reminder (and the comparison of Adkins supported research).
So my question to all of you is: why do most people trying to improve their health appear to not care at all about how their food choices impact the earth and the future of all our children? (Not to mention the horrific conditions that the great great majority of animals bred for food endure?) Is it because you have not been told or do not believe how bad it is (our society has many many who are in total denial about global warning, for instance), or is it because you truly don’t care?
What are the side effects of the ketogenic diet?  It’s not uncommon for people beginning the keto diet to experience “keto flu” symptoms, which can include: irritability, cravings, menstruation issues in women, constipation, fatigue, headaches and poor exercise performance. These side effects are due to the body going through major metabolic shifts and essentially withdrawing from carbs and sugar.
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!
Most people already know about the keto flu, which can happen when you start the diet. It’s a result of the body adapting to the low-carb state. Lowering carb intake forces the body to burn ketones for energy instead of glucose. Once the body is in ketosis — burning fat instead of glucose — the keto diet is working. But you may not feel so great at first, hence the term keto flu.
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.
Test ketones in the late morning or afternoon. Blood and urine ketones are usually lowest right after waking up. Try testing later on, preferably a few hours after eating. Even if you’re only in ketosis for a portion of the day, you’re still getting some benefits, as discussed in this talk by Dr. Steve Phinney: Achieving and maintaining nutritional ketosis.
This type of information has also been on the Internet. When I first saw what the consequences could be if this is planned by the person following the Keto diet as being for a lifetime thing, I immediately sent the article to my brother & his wife . They’ve been on this for some time & have lost weight on it. All good, but may not be well for my brother, who has one kidney. It was removed because it was no longer functioning at full capacity.

“As soon as you start consuming a normal amount of carbohydrates again, you immediately go out of ketoacidosis or the fat burning state”. I am sure you know the difference between nutritional ketosis and ketoacidosis yes? One is the natural fat burning state, and the other is toxic. Right now i am in ketosis but not ketoacidosis. One has a natural balance of Ph level, the other not. Once you make that statement, i have a sick feeling i am not getting the right information here.
“If not done right, this diet can cause havoc on our bodies,” says Mancella. “As a society, we’ve turned to a culture of restriction and extremes in order to obtain unrealistic beauty and aesthetic standards without considering the long-term consequences. This diet doesn’t only affect metabolism, but also every other component of our bodies. By introducing potential vitamin and mineral deficiencies, we’re possibly trading the present moment for quality ones in the future.”

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.
Cost. At the grocery store, your shopping cart can take on a whole new look (and price tag) thanks to high-ticket items such as beef, fish, poultry, pork, and cheese, which are replacing budget-friendly pasta, potatoes, rice, and bread. And chronic constipation may require fiber supplements or stool softeners. Before beginning a keto diet, determine whether it’ll fit within your budget.
Ketoacidosis, on the other hand, is a complication of poorly managed diabetes. It results in uncontrolled production of ketone bodies that can change the pH of the blood, which can prove fatal. Ketoacidosis is more common with Type 1 diabetes rather than Type 2. It’s also important to note that the keto diet cannot cause ketoacidosis – but rather puts the body into the beneficial state of ketosis.
A ketogenic diet helps control blood sugar levels. It is excellent for managing type 2 diabetes, sometimes even leading to complete reversal of the disease. This has been proven in studies. It makes perfect sense since keto lowers blood-sugar levels, reduces the need of medications and reduces the potentially negative impact of high insulin levels.
You’ve lost weight. By far the most common cause of unexplained hair loss is simply rapid weight loss or dietary change. This disrupts the normal growth and decline cycle of your hair follicles, shunting a greater proportion of them into the “rest” phase to be pushed out by incoming hairs. Even though you may see extra hair in the shower or on the brush, your actual hair thickness shouldn’t change much.

Unfortunately, there’s no long-term data on ketogenic diets versus other diets. In a 2015 Italian study, those on a ketosis diet lost 26 pounds in three months. About half of the participants stayed on the diet for a year but lost little additional weight in the next nine months. People in a 2014 Spanish study who followed a very-low-calorie ketogenic diet lost an average of 44 pounds in a year—but a third of them dropped out, possibly because it was too hard to maintain.


After seeing thousands of patients now for years and from personal experience, I still believe it comes down to staying away from processed foods and cooking at home whenever possible. Eating a variety of fresh fruits, vegetables, proteins, and fiber. Also, cutting out any sugary liquid calories; staying away from sodas, juices and the infamous sweet tea! Keeping stress levels under control and incorporating exercise into your routine will also be key to breaking through challenging times when you are having trouble with continued weight loss.
Based on what we know from the available research, is the keto diet safe? The evidence is clear that the KD can reliably help to treat obesity and improve insulin resistance, but the long-term impact of the KD on cardiovascular risk factors, liver disease and glucose tolerance is more controversial. Experts agree that genetics seem to play a role in how different people respond to the KD, meaning some may be more likely to thrive on very low-carb diets, while others are more susceptible to developing side effects.

The problem is: it flies in the face of the way we have been taught. Our society (as an American), and our medical community, have preached for years that FAT is bad, and you should limit it. However, recent FACTS beg to differ. So many people rail against the keto diet because they just feel that it can’t be good…after all, you eat so much fat on it, it can’t be good for you! Facts are facts…they don’t care about your feelings. Fat is not the enemy. Sugar is. 

"Most of the work in this field is still pre-clinical, meaning it's been conducted in animal models," Angela Poff, a research associate in the Department of Molecular Pharmacology and Physiology at the University of South Florida, told U.S. News & World Report. "It's been done in various cancer types, but most of the work has been done in brain cancer specifically. But there's very little clinical data all around. There's some case reports and very small preliminary clinical studies in small groups of patients, usually very late-stage patients with various types of cancers. So in the clinical realm, which is the most important in telling us whether this is going to be useful, we have a long way to go."


The ketogenic diet is a low-carb, high-fat diet, similar to a number of popular diets such as the Atkin’s diet. It is primarily known as a weight-loss diet, as it can help boost the metabolism and speed up the burning of calories. While many people think of a high-fat diet as being unhealthy, it is all about the type of fats that you consume. In a ketogenic diet, for example, your protein intake will be quite high, rather than having a carb-heavy diet. Both carbs and fats can be used by the body for energy, but when fat is the primary source of energy metabolism, the body enters a state known as ketosis.
A well-balanced keto diet includes enough fat so that you are not hungry after a meal, can go for several hours without eating, and have ample energy. Make sure to increase your intake of fat at the start of your keto journey until your body adapts to using fat and ketones for most of its energy needs. Once you’re fat adapted, let your appetite guide you in cutting back on fat a bit until you reach the point where you can easily maintain the balance between hunger and satiety.
Now, there’s even evidence that a low-carb, high-fat regimen (as the keto diet is) helps you live longer, compared to a low-fat diet. In a study by the medical journal The Lancet that studied more than 135,000 adults from 18 countries, high carbohydrate intake was associated with higher risk of total mortality, whereas total fat and individual types of fat were related to lower total mortality. Total fat and types of fat were not associated with cardiovascular disease, myocardial infarction or cardiovascular disease mortality.
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Common complications of diabetic ketoacidosis include very low blood sugar, or hypoglycemia, and swelling of the brain (cerebral edema). As such, when a person is in ketoacidosis, there is such a high level of ketones produced that can push a person into cardiac arrest (heart attack) or kidney failure. Hence, the very important reason for taking occasional keto breaks go give your body a bit more nourishing carbs. 
Great article! Sustainability is key and Keto diet is extremely restrictive compared to others. Many of the comments I see don’t understand the importance of many years of research before stating something has a “significant difference” than the recommendations that are already in place. Also, understanding the pro/carb/fat balance in each meal instead of focusing on just carbohydrates. We have practiced the same modified Mediterranean diet at my practice where someone can enjoy life, eat complex carbohydrates and years later they are still successful and hundreds of pounds have been lost for good 🙂 Thank you for the reminder (and the comparison of Adkins supported research).
Thanks Dr. Jockey…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?

It is important to point out however, that type 2 diabetes also improves during any form of caloric restriction and it is likely that a keto diet is not unique in that aspect, rather it is causing a caloric deficit by severely restricting carbohydrate intake. We have helped numerous clients lose fat while on a moderate carb intake in a caloric deficit.
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