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I sure wish the scale would decline! In Death Becomes Her , writer Helen Sharp develops an eating disorder to cope with losing her fiance to her bitter rival Madeline Ashton, and spends a few years being belittled in a mental hospital because of her psychotic obsession with Madeline. Elastigirl expresses quite a bit of depression after getting a glance of her butt on a mirror in Syndrome's Base. Ketosis is safe as it simply enhances fat-burning processes that are completely normal in our body. Then, I ran into people on YouTube who were praising Paleo and the health benefits. Melissa has lost 90 pounds on keto. However, they are good for snacking on if hungry or travelling.

Common Weight Loss Pattern on Keto

Ketogenic Diet FAQ

Because the overwhelming majority of the long-term ketogenic diet studies have thus far been performed in the context of epilepsy, this is the field of research that has most thoroughly reported adverse reactions. The body of scientific literature on ketogenic diets is surprisingly sparse when you consider the therapeutic applications of this diet have been in effect for nearly a century.

Frankly, research is just beginning to scratch the surface in terms of understanding how ketogenic diets work to reduce seizures in epilepsy or to provide the other documented benefits.

Why is that important? Because the extensive list of documented side effects and adverse reactions indicate that the positive health effects of a ketogenic diet comes at a cost, one that may not be acceptable to many. Understanding how a ketogenic diet works to provide a benefit, also gives clues as to why it causes adverse reactions. And because the documented adverse reactions include serious illness and death, understanding why these might come about is a prerequisite for adopting this therapeutic strategy in a more widespread way.

What insight we can glean from mechanistic studies will be the topic of several future articles. Does the need for more science give ketogenic diets a green light or a red light? I certainly agree with the ketogenic diet community that more long-term and mechanistic studies are required. We need to look at the information currently available for guidance.

The studies do not ubiquitously show benefits; not everyone responds positively to a ketogenic diet; many unanswered questions regarding the effects both positive and negative of ketogenic diets remain; serious adverse reactions have occurred. As a community, we have a choice: I support the latter and believe the capacity for harm needs to be just as much a part of the conversation as the therapeutic potential.

Other diets do not trigger the same biochemical pathways that are activated by a ketogenic state. And while certainly other diets Paleo , or the autoimmune protocol being good examples stake therapeutic claims, the mechanisms of action are purely through micronutrient saturation and avoidance of foods known to be inflammatory. The ketogenic diet is different in that it was designed to emulate starvation, taking advantage of the biochemical benefits of starvation for certain body systems mainly neurological, but this is also why weight loss is a common result of a ketogenic diet while tolerating the detriments to other body systems such as endocrine and immune systems.

These are even different mechanisms that a standard low-carb diet. And this is why a thorough understanding of both the pros and cons of a ketogenic diet are necessary in order for every individual to make the best decision for themselves.

Normally, my science-based posts contain a dozen or so references at the bottom. This post is special. With the help of the sa ga cious Denise Minger, author of Death by Food Pyramid , I have compiled an review of the literature, with a particular focus on the studies that report on and potentially explain the mechanisms behind adverse reactions there are plenty of reviews available on the internet reporting the documented benefits.

Download this free PDF here. Right now, new subscribers get an awesome bonus: Award-winning public speaker, New York Times bestselling author and world-renowned health expert, Dr. Sarah Ballantyne, PhD aka The Paleo Mom believes the key to reversing the current epidemics of chronic disease is scientific literacy. She creates educational resources to help people regain their health through diet and lifestyle choices informed by the most current evidenced-based scientific research.

The paleo Mom's FREE Member's Area provides an epic collection of absolutely free e-books, exclusive recipes, guides, videos, and discounts! Nice to read a balanced view.

It helped with many of my symptoms including numbness and heartburn. I lost about 20 pounds. About 3 months ago I stopped getting my period. I want to start eating carbs again but I have leaky gut and suffered with candida. How would someone like me transition back to eating a diet with a moderate amount of carbs???? If anyone could explain to me how low-carb diets cause amenorrhea that would help as well…. I have never wanted to get my period so badly.

Very, very, very slowly. Like increasing a teaspoon at a time slow. Where I would start is a focus on non-starchy veggies first and lower glycemic load veggies and fruits cooked if they cause digestive symptoms , and monitoring blood sugar levels carefuly ketogenic diets can make you insulin resistant.

You could look at the Perfect Health Diet, it could be very safe for you and your gut. All of their evidence is very scientific. They do advocate specific starchy veggies, so please take the time to read through their explanations and info for individuals who have health issues. I found it when I realized keto was not for me after my hair started falling out and I began to have an adverse physical reaction to eggs and am looking to transition myself.

I hope this helps! Late response but did you ever get your period back? And if so how long did it take? She practices nutritional ketosis and has cured her 7 year bout with amenorrhea no period using it.

She practices a whole foods approach to ketosis, regular carb ups, and she has lots of free content that could help you get your period back. So every two weeks I sub in some good complex carbs, hummus, beans, and wild rice yah I sneak some pita in there too and so far so good! I would think if your period stopped completely, I would first rule our PCOS blood test and track you macros are you really getting enough fat.

For the earlier comment with regards to Candida; I was a sufferer myself. But alas, carb free life is just for me as I feel more energized and have zero joint pain when there are no carbs in my life. Also started on a probiotic then too and never looked back. I have been AIP since January of It is now February of , I just got my Spectracell results back from my fx med doc. I have an extreme deficiency in all my B vitamins, probably due to the high phytic acid containing foods I have been eating.

I have eliminated coffee, chocolate, and nuts and seeds. Lots of joint pain and tendonosis. My Omega 3s also tanked. I was eating fish, sardines and eggs and grass fed beef and fish oil supps and seaweed and still my levels are bottomed out. I have also eliminated the dairy now. My cholesterol topped out at !

I have switched from saturated fat to polyunsaturated some of the time. I did lower my blood glucose levels to acceptable avg 88 instead of high between for the last 30 years.

And while this was not a primary concern for me, I did lose and maintain a 12 lb weight loss. As usual, a balanced and clear-eyed explanation of a complex topic. Thank you for all that you do for so many! Do you think the problem is that people restrict carbs too much?

You claim that there needs to be more research done, but its out there — yet there is a failure to read it. I am certain that the cause of deaths and adverse reactions is because of the electrolyte flush caused by keto diets combined with the sodium-corrupting anticonvulsant drugs In fact i never saw you mention your understanding of HOW keto helps with seizures — only links to the research you claim to have read.

A truly sustainable ketogenic diet includes heavy water intake as well as lots of salts. This is known to remove all uncomfortable and unhealthy symptoms of this extreme metabolic change. If you look into it you will find that most anticonvulsants work by inhibiting the sodium channels.

So, if a patient was taking even a minor dosage of any of these medications, and then began to impliment rapid depletion of sodium via nutritional ketosis — there would be a unavoidable corruption of PH and all the systems to restore the balance have their hands tied behind their backs.

Also, this is the most common way for people to die by starvation. Not because of nutritional lack, and therefor end of energy production; but because of electrolyte depletion. I totally agree Amanda K. I have been in Ketosis for months, with zero side effects. I have actually started getting normal periods for the first time in 25 years, being diagnosed with PCOS about 9 years ago struggled getting pregnant for 3.

I have also seen a HUGE reduction in inflammation in my joints. Lost my excess weight over time. Much more healthier now than I used to be. My sister had other health benefits which included her reflux disappear, also normalised menstruation cycle and she has been on a Keto diet for 2 years without having the need to lose weight. Our skins are glowing, no more breakouts.

I have become very skeptic about all the so-called scientific research on this and that. Do yourself a favour and watch That Sugar Film by the Australian Damon Gameau, which documents the effects of eating supposedly healthy low fat foods and how the Carb industry covers up in the USA.

And this is not just because they lose weight. The improvements and conception often happen really quickly once they change their diet and start to eat exclusively clean, real, unprocessed foods. The difference here I think is that as well as dropping our net carbs to about 25g, we eat plenty of healthy fats — avocado, nuts, cheese, butter, streaky bacon, eggs, olives, chicken with the skin, oily fish.

Exactly, anyone who does even the most minor research on Keto will first and foremost come across the precautions one should take if you have ANY health issues or are on ANY medications and to consult your doctor if so BEFORE attempting the diet. If you have any health issues or taking medications and you decide to not consult a doctor you have ignored the first and usually most foremost highlighted recommendation and cautions of the diet. Hi Sarah I really do appreciate all your research!

But as a nutritionist working with a therapeutic Keto Paleo diet for a lot of different applications, with great success yes for only 2 years now I have to ask you few questions: What kind of ketogenic diet was studied in the research you quote?

I am aware of certain communities who do an indiscriminate keto diet for weight loss which includes foods like Crisco and Spam and does not even consider supplementation…. A ketogenic diet per se, does not say anything about the quality of the foods you are eating, it just means you are using ketogenic ratios to achieve nutritional ketosis. I recently attended the Epilepsy Summit and was appalled at what kind of foods where served to sick children only in order to maintain them in ketosis….

I have absolutely no doubt that following that kind of ketogenic diet, any of the adverse reactions you list could easily ensue. Any diet can be done either very well or very poorly, including Paleo! You should be very aware of that with all your experience! What I think is a more accurate point of view is to inform and educate people on the quality of different styles of Ketogenic diets, and to suggest working with a professional, or at least to do a good amount of research before embarking on one on their own.

That is what I do for people through my blog, I educate them about the right foods, the right supplementation and the best way to stay healthy, still maintaining all the benefits of being in ketosis. I hope you can reconsider some of your assumptions under this light and maybe give the right kind of ketogenic diet its earned value! I think you will find both the Literature Review linked to in this post and my future mechanistic posts on this topic interesting one of which will discuss fat quantity versus quality.

In terms of increased atherogenic profiles with a keto diet, do you have any comment on the role of lipoproteins in the innate immune system? This has been cited in a few studies and was the focus of a section of Dr. Ravnskov also discusses lipoproteins and the immune system in an editorial letter he sent to the ACC: There are many ways to demonstrate it. One example is that researchers have looked at mixtures of lipoproteins and bacterial toxins with an electron microscope.

What they saw was that the toxin molecules stuck to each other and became attached to the LDL molecules, 12 and similar experiments with virus gave the same result. Most of such mice survived, whereas normal mice died immediately, a beautiful proof that high cholesterol is advantageous.

Most surprising is that apart from those who have been directly involved in the research in this field, very few know anything about this system, not even experts in infectious diseases or immunology, and hitherto I have not found a word about it in any current textbook.

Ann Clin Lab Sci ; A short version in Swedish is available in Medicinsk Access ; Huemer HP and others. Superti F and others. Med Microbiol Immunol ; Flegel WA and others. Cavaillon JM and others. Northoff H and others. Feingold KR and others. Netea MG and others. J Clin Invest ; In terms of increased atherogenic profiles with a keto diet, do you have any comment on the role of LDL in the innate immune system? The lipoprotein immune system Sixty years ago researchers discovered that the lipoproteins participate in our immune system by binding and inactivating bacteria, viruses and their toxic products.

There are varying degrees of ketosis from mild to fully ketogenic. I think we all agree that we should just eat real food to minimize blood glucose spikes and inflammation. The metabolically challenged by eating too much bad carbs for too long would probably do better in ketosis then someone brought up eating real food.

I think the problem has more to do with micronutrients than the ratio of your macronutrients. You can eat a nutritially poor high carb diet or ketogenic diet, and in both cases it will lead to health problems. Anyone registering the food they eat for a few weeks can see this. But it is also clear that you can get enough micronutrients and fibre by eating gr carbohydrates per day. Nice post Vivica, I am with you as a I utilize not only auto-immune protocols, but well-done mild to moderate forms of a ketogenic diet based off of high food quality sources, etc.

Just the red and green visual of pros and cons is ridiculously biased. Did anyone else notice that? The spacing of the wording and drawings to clearly make the red cons side look much longer. Does the keto diet threaten the future of your blog? It does not need to. One thing I have definitely noticed is how very unpleasant and short-tempered you all seem to be.

It reminds me a bit of how I feel when my blood sugar is low — except that I make sure to not open my laptop and start yelling at strangers. Can you eat this way and still be kind to others? What about all of the animals consumed in this diet? Or does that just not matter, as long as your skin is all shiny or whatever? What about the ethics of consuming animals? Have you visited the slaughter houses? Would you be willing to kill animals so you truly know what you are consuming?

Call bacon what it really is. How can a dead thing do your body any good at all? Does none of this matter to you pro-keto people? Vegans are body builders and firemen and pastors and teachers.

Just for the record. So, you eat plants while they are alive in the dirt-root and all? I think such a deep emotional guilt for eating animals should be some sort of mental disorder. Humans would have never survived without dead animal flesh-no indigenous people ever lived solely as vegans and certainly not optimally.

Also, many humans have an intolerance and allergies to many types of plants-but I guess they should just get over it to spare the animals. What about your house? Are you tied to the electrical grid and the water systems? Do you get mad at lions for eating antelope? What about chickens eating grasshoppers? You can forgive animals for eating others animals, why is that? They are so insensitive to not just go against their biological functions and eat plants.

If you take a look at science and the organs that are part of our digestive tract compared to herbivores the cow with his many stomachs , you would see that we are designed not only to eat meat but to digest it fully in the stomach before entering the small intestine-giving you the optimum absorption of vitamins and minerals…compared to your vegetables that rot and ferment in the digestive tract.

Maybe you are reading the words with too much emotion. Hilarious, fruits are not toxic, can you consume too many yes, but u can consume too much water also. Fruit has a high sugar content which is great for storing energy over long distances.

If you abuse it now then it can be detrimental but like anything moderation is key. It is a bit bonkers how sure people are, with nothing to back it up whatsoever. Fruit is in no way toxic, unless you only eat fruit, and then kiss your pancreas good bye. It killed Steve Jobs. Seriously…are we still fear mongering about sugar?! Come on insert eye roll! Often times, the praises of keto wonders are hard to ignore while the adverse reactions are rarely mentioned.

The terrible feeling you had, if you had done even minimal research on the diet, was because of the transitional period. It can last weeks and there are plenty ways to minimize these adverse effects known as the keto flu, which include making SURE you drink plenty of water AND absolutely get enough electrolytes sodium, pottasium and magnesium being the most important Failure to do so is not good for you and will feel awful and is often the reason keto gets a bad rap in addition to people who attempt the diet who have health issues and take medications and do not consult a doctor prior to, which can be dangerous.

I think in addition to a temporary Keto flu, one can be depleted in electrolytes on this diet at other times as well. Maybe women a little more susceptible to this. I drink this about once per day, and if I forget, I can wind up not feeling very well.

I love that you are acknowledging this. Thank you for your courage in talking about things that some people are reacting to versus considering and seeking to understand.

There is always a lot to learn. The nutritional industry can be so confusing, biased, and full of fear on both sides. With any extreme change, precaution is wise and having a good practitioner guide you along the way. I am happy someone is talking about this topic. Hopefully we can find the truth. There appears to be some misunderstanding in the origins of the ketogenic diet, modern medicine may claim its discovery in a therapeutic sense, however the diet was used as far as I can tell by explorers and natives for centuries for the sole objective of avoiding starvation!

I got really sick after trying a keto diet. Lost hair, developed psoriasis which I never had before, became paranoid, anxiety attacks, lethargy, and other things.

I developed racing heartbeat, in the ER twice, the docs think it is a tachycardia, but my heart rate went back down by the time I got to the ER. I was so scared, even after adding carbs back for a couple of months, I unfortunately just had another episode, and my anxiety around it is so bad. Maybe your potassium was low. I read somewhere that because alot of water weight is flushed out on a keto diet that potassium gets flushed out in the crossfire and needs to be supplemented back in.

Thank you Sarah, I appreciate the work you do. I was gaining weight alarmingly, fatigued, enormous pain in hips to knee area. This hugely restrictive diet, and hormone treatment is starvation though the fat levels eaten are very low. During the 4 weeks I was on it, I guess I was in ketosis. I felt like I was taking a pause, a deep breath.

I plateaued weight wise on the diet and investigated further and discovered I had Hashis. I would never do that diet again, loosing another 6 kilos, and most of the pain on the AIP and medication for my thyroid, but I wonder if being ketogenic has to be an all or nothing affair.

Could some people cycle it, say 2 or 3 short periods a year to mitigate symptoms, but guard against adverse effects? Heather, I believe there are methods of cycling ketogenic diets. I have heard of body builders cycling ketogenic diets with carbs.

That would be interesting to see. I believe the risks you enumerate are present with most diets and I think you article lacks of that specific balance and probably the studies that you refer too.

Its like all these possible side effects are only associated with keto. Eat crappy food keto or not and yes you can die sooner or later. I totally agree with Vivica comments and there is more to it than fat and low carbs for keto and same thing for Paleo and other diets.

I eat a wide variety of food dense in nutrients Paleo style while avoiding carbs. My blood panel improved significantly within less than a year. Is this mean that everybody going keto will react the same? Im sure you can cook commercial bacon in hydrogenated fats and drink the juice and be in ketosis big time.

Would I ever do that? I think it is all about food quality and variety. The real question is: The answer is probably yes. And this the main reason I would not recommend keto to everyone and this is probably why it is even probably a risky business for some and in that sense I agree with the above risks.

If you are like me… like testing, researching, trying new food, aim for quality over quantity, make adjustments based on evidence… keto might be for you. Insulin resistance in keto as been shown to be temporary and when you think about it is kind of a normal mechanism to maintain a minimum blood glucose level.

At the end, we are all on the same side, aiming for healthy lifestyle and promote it. Hi Eric, i have been keto-ing for weeks now. I have been quite a health nut over these years.

I try and eat lots of veggies non starchy ones in my keto diet and my daily test strips say i am in ketosis, altho have started eating some meats again and also bone broths. I try and get organic and free range meat and bones whenever i can but for someone who has been veggie and recently pescaterian for many years, the reintroduction to meat is the hardest part to keto for me. I like what you have written here and i wonder what your daily diet intake looks like?

I have not had one migraine in the weeks of going keto which was my reason to try it as before this i was in an awful migraine pattern of 3 a week. I was desperate to change my health. This has undoubtably worked for me although i have been feeling very low energy in the last week and also needing to drink a lot of water.

I am currently in keytosis for the first time. Call me shallow, but my buddie and i are simply doing it to try to get a six pac in 30 days. I am a hige believer in eating healthy grains, and am slowly adding them back into my diet while still staying in keytosis. I can definitely see that staying in this diet for long periods of time could be detrimental. But to loose unwanted pounds and then add carbs in through veggies and ezekiel bread seems like a great method to me.

I am not an expert. But i have done a lot of research on the subject, and your artical is one of 2 articals that i have ever found that are against it.

Most of the sites and articles are very for it. And the reviews i have read from people who have done it are all awesome. What do you think about using it for a short period of time? I am still getting spinach, leafy greens, and 1 slice of ezekiel bread every day and staying in ketosis.

We are all going to die some time, Paleo diet, ketogenic diet, vegetarian diet……whatever diet. Nutritional ketosis via carbohydrate restriction is a natural phenomena, and can accompany a therapeutic diet or a maintenance diet. There are a variety of ketogenic diets for epilepsy, cancer, diabetes, weight loss, dementia……. Among the pediatric population there are a variety of diseases, including congenital and inborn errors of metabolism, some of which are not compatible with normal survival.

For some of them, the ketogenic diet is not the appropriate solution for their metabolic disease. This is not the fault of the dietary regimen, rather the person prescribing it. And, extrapolations from rodents ……………. Sarah has produced brilliant and clear nutritional guidance for the Paleo autoimmune diet. It sounds like there will be more to come about the macronutrient composition of the ketogenic diet. Thank you for doing this research!

It is way more in depth than I could have done. So many places only talk about the positives. Give us a paper to go to. Seems to be a lot of general criticism. Everyone has to discover their own nutrition and their own way. But cutting carbs is proven to be effective to lower blood sugar. It seems that reading the actual studies, rather than the review, is necessary here.

I started reading this article with great interest until I read through some of the peer reviewed articles referenced in the blog post. The first question that comes to mind is for how long and when did subjects experience adverse effects e.

What was the nutritional composition and macronutrient balance of the experimental diet? The answers to these questions are not consistently detailed or clear in the study methodologies if addressed at all.

Another concern is whether this post and the literature review reflects an understanding of research design and statistical analysis. For example, the discussion of death being an adverse effect gave me pause. Which begs the question: I was hoping for an objective discussion of the pros and cons of a ketogenic diet and sincerely appreciate the amount of work that went into the post. However, this ultimately felt quite biased towards a particular point of view based on a questionable review of the literature.

This diet occurs in nature. How do bears survive when they enter hibernation? They are starving, but sustained on their own stored body fat and the nutrients within.

This is very well documented. All mammals have this capability. The fact that you left out insulin resistence, leptin resistence, and metabolic disorders leaves quite the crater in your article.

You spouted much data on epilepsy which has far less impact than the obesity epidemics that follow the style of eating like the standard american diet. Epilepsy is a serious condition, but far less prevelent than obesity.

Is this article your answer to the recently popular documentary Fed Up? Which in and of itself did not specifically promote a ketogenic diet, but it did cite a WHO report about a carbohydrate limitation which is ketogenic? Being critical of your view I would be interested to see how a very low carbohydrate diet could cause nutrient deficiencies. I have the upmost respect for the Paleolithic viewpoint. Eating whole foods, real foods, no GMO, no toxins, no hormones, etc.

A ketogenic diet has a lot in common with Paleo, and both can be undertaken simultaneously. They are NOT the same of course. Maybe that is your angle, you want to keep Paleo distant and above this ketogenic trend. Do as you wish. But I guess you got website hits, that is what counts, right? I went keto in Feb I was Paleo for months before that so I was already quite fat-adapted and then I went the Paleo-ketogenic route so that includes bone broth, offal, the whole shebang.

Within 2 months, my thyroid started acting out, and my hair started falling out. I will never do keto again. And yes, when I was ketogenic, I felt like I was hibernating. My eyes were closing off in the middle of the day, and I was so cold, and I wanted to sleep. I was that bear you are speaking of. And you want to know the other thing too? I have ALL of my days in keto written down on Cronometer. And it works for me best. Eugenia, do you mind sharing your records of eating keto.

I personally am interested to see and I think it would help give others something to compare to. What do you mean your eyes were closing off? I am having eye issues, been in ketosis 9 weeks. I am not super strict with it and do not count every single thing so I am somewhere under 50 g carbs.

I feel good otherwise, lost weight and no cravings for foods like before. This reads very biased toward no keto. It seems pretty balanced to me. She mentions both the pros and cons and that we rightly need more research. No one has any real-life help to offer. Look up Stephanie Person on youtube. I love when 20 something guys try and preach to 45 year old woman what works for them. When estrogen is too high and progesterone already too low. Wenchypoo, Trina, Brenda — we need to form a club or new forum.

You have to step out of the Paleo arena to find more mature men and women like us addressing our issues. I appreciate so many of the brilliant Paleo minds and all they have to offer, but it does get tiresome sometimes hearing the 20 and 30 something perspective on life and health most of the time. IMO not enough real life mileage to fully appreciate the intricacies and complexities of aging.

That said, I feel that Dr Sarah is very balanced in her approach and in this article. IMO the big point is that there is a LOT of ketogenic emphasis right now in the Paleo community and so young people are perhaps at greatest risk as a group of thinking that they should be following this type of diet.

It is important for us to understand the difference between short term therapeutic protocols and sustainable lifestyles including diet. I say Kudos to Dr. Sarah for standing up to the movement and presenting a more complete picture of the pros and cons. I do not consider this article to be a slam against ketogenic diets at all. She is arguing that they are not a panacea, not that they are evil. Yes, that would be great. You can find her on youtube.

She talks a lot about metabolic derangement and how it causes massive troubles in preventing you from adapting to keto. This is what happened to me when I went keto which made me ill. I have metabolic syndrome. Which means no keto for me.

This is so scary, did any of you speak with your doctors or a doctor before eating this way? Do you really want a stranger to tell you how to eat? I went into menopause early, lived with so much illness my entire life, now I am a healthy, happy vegan. I was a Keto missionary a few years ago. I was convinced that it was the right diet for everyone. I lost a lot of weight, but I have now gained it all back again mostly because I have been eating crap.

Two years ago, whilde still on a ketogenic diet, I started fainting, and get severe shivers and it was really hot. I bought a blood sugar mesuring device.

But my blood sugar acted strange. I remember checking my blood sugar, and it was at 3,5. So I would eat a banana. When I checked after half an hour it was 1,9. I would then eat some meat and veggies, and it would stabilize around ,5 which is still low.

But still I think fainting of low blood sugar levels is serious. I still do sometimes get low levels. Especially if I eat to much fruit og sugar. My blood sugar never seems to go above 6 or maybe 7 if I had a lot of sugar. But my doctor said that it is not high enough to be diabetes. Anyways my blood sugar regulation seem to be very bad, and I have suspected that I actually do have diabetes.

I have two questions. The first is; how do eating a fruit result in low blood sugar in only half an hour? The second questopn is; what can I do to better regulate blood sugars?

Is there any nutriens I should focus on, or fibers, type of carbs or any other foods that might help? Thank you for talking about this. A lot of my experiences makes more sence I listen to you and Stacy, and already knew a bit of her struggles. Nobody here can diagnose you, but your symptoms are consistent with reactive hypoglycemia. Your blood sugar spikes because you are most likely insulin resistant already. It takes a lot of insulin to finally get the cells to respond to glucose levels in your blood, and when they do, all that insulin drops your blood sugar low—it can make you feel awful.

The best way to avoid these symptoms is to reduce carbohydrates so that less insulin has to be secreted. Eating protein and fat and restricting carbohydrates to non-starchy vegetables will keep your blood sugar on an even keel and get rid of the hypoglycemia symptoms. Fruit is clearly causing you issues. Reactive hypoglycemia is definitely an early symptom of insulin resistance—and unchecked it is very likely progress to Type II diabetes, although it may take decades to get there.

Thank you for taking the time to respond to my post. Just to clearify, I was on a keto diet when this started hapening.

I just tried bananas to get my blood sugar back to a normal level, I would never eat a banana back then, as I was on a less than 20g carbs a day diet. When I was in ketosis my blood sugar was constantly low for the last few months, and I felt bad all the time the first two years I felt good. My blood sugar levels have become a bit better after I started to eat more carbs, but sometimes I still have these symptoms.

I can now eat bananas without my blood sugar going crazy and sweet potatoes and other starchy vegs. My question was on what micronutrions could help, rather than a macronutrient question.

One Of Sarahs points in the Paleo approach is that micronutrients are much more important than the macros, and that is what I find interesting. I think my macros are under control. But if I eat high glycemic foods I have problems, but medium GI is perfectly fine now. And when it comes to diabetes, I am just wondering, if I had gotten tested before I did my diet change, maybe I would have been diagnosed with diabetes.

I am now pretty well checked by a doctor. And they are not concerned about low blood sugars. The first study she linked to is a case study of a single child. The child died of acute pancreatitis, and the paper simply assumes the ketogenic diet was to blame.

How do we know that? It appears as just guesswork. The studies which show deaths with the ketogenic diet were done specifically on epileptic children and not healthy children or adults. They studies have no control, and do not take into consideration existing health complications. One of the papers actually states: So those studies show nothing. Long term research on the ketogenic diet is non-existent. More research would be nice for sure. Why not post studies of deaths of sick people who are NOT an a ketogenic diet?

Not being in ketosis must have killed them, right? I started adding back in carbs in the form of fruits, sweet potatoes, occassional rice, ditched the low carb sweeteners for maple syrup and honey and the weight started falling off and now I feel like I could sprint three miles! I think from my research that some people,like myself, need the carbs for their thyroid or liver to turn T4 into T3? My conclusion as well, from experience.

Keto is important for either specific problems e. Two-three months later, regular low carb for life is healthier e. Ketogenic sure made me lose weight… far TOO much. I also developed a slew of neurological problems orthostatic hypotension, near syncope, vagus nerve activation, tachycardia.

I was trying to starve gut fungus while on antifungals. I think it was far too much stress on my adrenals. I felt like my digestion came to a halt, as did my blood. I have gained 12 pounds still lean and have much more energy bringing back starchy tubers, rice, and some fruit, and cutting back on protein and fat. I have fat malabsorption even with less daily intake. Ashley this is very interesting. I too was on the ketogenic diet for a month or so and was just diagnosed with gastritis.

I was wondering if the ketogenic diet was a precursor to this. So how have you been feeling? Are you back to normal? I have been suffering with stomach pain and slow digestion for a couple months now. Just FYI — there is one more side effect missing from your list: In my case this was so severe I ended up at the opthamologist half thinking I was going blind. Eye drops helped but when I upped my carbs, it went back to normal.

I had a number of the other adverse reactions including such severe disruption of my menstrual cycle I was worried I had triggered pre-mature menopause. That took months to return to normal after resuming a higher carb intake. The ketogenic diet has the potential though to have positive effects on digestive symptoms, for example it has been shown to be beneficial for treating reflux symptoms in obese individuals as well as being helpful in treating IBS symptoms with diarrhea-predominant IBS.

These are the people we also need to be consulting with on how to properly design this type of protocol. I read your article and started doubting my diet. I started 1 year ago — because I am over 40 and what ever I ate — I gained weight. I read many many articles about ketogenic diet, about the metabolism boost and I do agree with you as for the hair loss.

But it took just about 1 month and then the hair loss stopped. And now my hair is longer, shinier and went from thin to thicker. My face is glowing, many people told me that I look much better than 10 years ago in may ties. And I am happy. I am full of energy, though I live in a warm and humid place, and eating gluten and processed foods made me feel always tired and then hungry again. But you know what? I have never felt better, I eat eggs, proteins, soups, whipping cream, sour cream, bacon, sweet potato which I hated before , green salads, tomatoes, broccoli, cauliflower, … butter and coconut oil.

Newer studies predominantly on athletes which have been long enough to either allow the sample set to become fat adapted or which compared already fat adapted vs. Non fat adapted subjects do not find these cons to have merit. As with any science we are limited by the methodology. The methodological flaws of most studies are in duration.

It is now relatively common knowledge that the interim conversion of a glucose burning to an efficient ketone burning metabolism not only takes time, but is also no fun. The cons are temporary the benefits are not.

I chose it because I had an advanced case of papillary thyroid cancer. I am doing well. I can see where any diet would not be a panacea for everyone, absolutely not. I eat mostly an organic diet, tons of greens, grass fed or organic meats, and very little fruit. I do love bacon which I special order from Whole Foods because it is specially prepared without any sugar.

Years ago, I heard and followed to live on a very low fat diet because fat would give you a heart attack or something else. I only eat fats such as organic coconut oil, oil, butter, but it has to be a good, high grade, not any junk. I enjoyed each and every post above, even though I agreed with some more than others, but on a personal level.

I enjoyed, as well, that these posting are so current. My very best to each person who contributed so much to these postings. I tried the keto diet for a long period last year.

There were benefits but also costs. I feel like it burnt me out, stress wise, and since eating a lot more carbs recently I feel they have allowed me to recover somewhat from all that stress. One thing that did improve on keto were my vitamin d levels…without supplements!

My doctor was amazed. I do wonder if that was down to having a fat based metabolism since vit d is a fat soluble vitamin. I would always recommend it to anyone suffering from migraines. I really enjoy your posts and agree that most people need to carefully consider the type of diet they try due to individual biology.

I do agree with Vivica, Sara Keough and Jana though. I did the Atkins diet for 1 year back in the mid 90s and had wonderful results. The main thing I noticed though was how many people doing the diet did not make wise food choices and would think they had a license to consume bacon all day everyday or some other issue where they were not varying their diet to get enough of all the nutrients they needed.

The food quality choices were questionable that I saw some others make and goes to previous posters comments about the need for some to consult with a nutritionist.

I fell off the wagon after a year and made bad food choices incorporating grains, legumes and sugar and the weight came back. Years after that I did the Rosedale diet with its more moderate protein carbohydrate ratio and also did really well with that.

I had my doctor review the diet before I started it and he thought it was really well balanced. I am now a middle aged woman and the drop in progesterone has revealed numerous food allergies that the progesterone had shielded me from. I think it takes careful consideration of the stage you are in and the diet requirements you personally need. There is a vast difference between the research done with epileptic children and the LCHF diet followed by people today that can increase ketone levels.

Even if the author repeatedly tries to deny it. While the medical literature typically defines starvation as the lack of glucose or carbohydrates, this article tries to create the impression of a continues lack of food.

You are doing a wonderful and meaningful work. I feel overwhelmingly grateful that I started researching Paleo and incorporating AI just as you began sharing the results of your personal research and journey. Just keep acting with integrity and courage, head held high. I hope Paleo keeps moving more towards open frank discussions with all points of view being offered, discussed and aired opening with excitement. With our enthusiasm to improve health we often forget about any caution and keto diet is a good example.

We just want to believe in some cure. And there are almost no doctors willing to help us with dieting approach at least outside of USA. So we are just all alone with our different health conditions which are not well understood and not cured with medicines. In our lonelyness all we have are blogs and sites. But people tend to speak louder about their success, not about their fail. So actually we have not well balanced picture. The articles like yours are like a cold water: Thank you for your great job!

Looks like it is not so about them. Sarah, Thank you for this balanced article. When it comes to fasting and keto, I always wondered… How are gender differences relevant?

This does not seem to be really addressed or considered in the research, but you are one of the few Paleo experts that have addressed the issue of gender and nutrition. When one thinks about fasting, I find very remarkable that in traditional cultures practicing fasting of which there is great evidence it is usually men, and not women, who do fasting. Or women do it in a lighter form. Also, traditional cultures typically had special diets and no fasting for fertile women who may potentially concieve, pregnant women or breastfeeding women which women being practically always in one of the three categories.

Wait till you watch your child sit and drool having seizures a hour and not even swallOw her own salvia. You would try the diet in a heart beat! Read the side effects of the drugs they put your 3 year old on then get back to me. This diet saves lives. You do what it takes to save them today! Sarah never said that a ketogenic diet was not appropriate for medical issues, such as seizures. I would think he probably has metabolic damage that would cause such weight gain. Going off keto never caused me to gain tons of weight.

I see that there is more to come and maybe my two cents here will be addressed. First I do not think there is any one diet suitable for everyone. We all know there are vegans living long, healthy, vibrant lives. And there are stories of people eating only meat living healthy lives.

I think it creates more divisiveness. On to my main point: Not only do I have metabolic and neurological issues but I have a very difficult to beat sugar addiction. Paleo for two years left me heavier than I have ever been because I could not get rid of the cravings and even though I was very active, and so thought I could handle the sweet potatoes and honey sweetened treats, they were horrible for me.

At one point I got so frustrated that I decided to attempt the Wahls protocol. Oh my gosh it was a disaster. I stuck with it for about two weeks thinking at some point all of these fruits and veggies will kick in and heal me! Nope…I could barely leave the house bathroom and I felt awful! Just about as bad as I was as a vegan. Now, I have been doing keto and the cravings are gone. This is huge for me. I feel better than I have in a very long time.

Complete calm in there! I will be carefully watching for any symptoms of something going wrong but for now I actually feel like I am healing. I feel Paleo is a godsend for many people but I think that everyone needs to assess their own body and figure out what is going on for themselves. I still believe in Paleo but also see the benefits of a ketogenic approach so am sad to see this divisiveness when there is a lot of crossover in the recommendations and benefits of each.

Perhaps the controversy lies within the context of when and how someone is in a ketogenic or nonketogenic state. Is it possible we are having mixed results as not only an effect from our current biochemistry which may be imbalanced but because we are trying a keto diet in the wrong season?

Most sources of carbohydrates do not grow year round in most places. That, friends, was the beginning of my Regret Phase. I remember little else.

So much felt like a waste. This blog started as an attempt to turn a period of strife into something that could help people—and it ended up being one of the most rewarding endeavors of my life. After all, how else would I ever have met YOU? Which brings me to the whole point of this post. Something about that prompted me to reflect. And you know what I realized? One right in front of my eyes. Loved ones got cancer and diabetes and broken bones and lupus and other scary things. There were breakups and break downs.

Gang shootings happened outside my front door. I had ferocious, claws-out brawls with partners who drew out an anger I never knew I had. I narrowly dodged a van abduction while being followed down the street at night. I got trapped in Mexico with no money during riots that closed the border. I was pregnant, and then not pregnant.

In March, a friend died in a motorcycle crash a few hours after leaving my house. He left his broom here. I sweep with it every morning. The problem was what I did with them all. That is my regret. I complained about my situation but changed absolutely nothing. I let this poor blog nearly die. And I neglected my most important goal in life: Where did my 20s go? What came of it all? More than a few sobby freak-outs occurred. It got messy and weird. And then I remembered the last time this happened.

After all, well-being is about way more than just diet. Do you ever wonder why some people seem to do just fine as vegans and vegetarians, while others turn into quivering heaps of deficiency and woe? Also, I promise— promise— that Low Fat Part 2 is still on its way. Garth Davis—a Houston-based weight loss surgeon whose personal and professional journey led him away from animal foods and down the fibrous, veggie-lined path of plant-based eating. Animal protein, according to Davis, is not the key to weight loss—but rather, a chief cause of our expanding waistlines.

Far from making us healthier, it drives the progression of cancer, heart disease, diabetes, and other ailments crippling the Western world. Those who swap it out for the bounty of the plant kingdom are rewarded with greater longevity and disease protection, Davis argues. But that leads us to the question: Or is it an example of some kernels of truth swathed in selective interpretation and bias? Let the analytical games begin! And for my verbally dyslexic mouth.

In truth, though, this post started brewing long before my talk. There are too many exceptions to the rule, too many gaps in the theory, and too many skinny fruitarians frolicking in the sun-dappled fig orchards. But even beyond that, this post is born of a belief I hold dearly—one that guides my approach to research and underlies the very mission of this blog:.

On the flip side of cherry picking, we cherry-throw-out:

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