One of the most common side effects of starting the ketogenic diet is the “keto flu.” This term describes the often unpleasant, fatigue-inducing symptoms that occur as the body adjusts from a high-carbohydrate to a low-carbohydrate diet. During the keto flu, the body’s stored glucose begins depleting, and the body starts adapting to producing and utilizing ketones as energy. (2)
Most condiments below range from 0.5–2 net grams per 1–2 tablespoon serving. Check ingredient labels to make sure added sugar is not included, which will increase net carbs. (Stevia and erythritol will become your go-to sweeteners because neither raise your blood sugar — combine for a more natural sweet taste and, remember, a little goes a long way!)
The biggest challenge with vegan and vegetarian diets is getting enough protein. These diets are traditionally lower in protein anyway, since they exclude the concentrated proteins in animal flesh. These individuals may want to include plant-based protein powders and shakes. Be wary of the ingredients, since these powders may contain various sugars that aren’t compatible with a ketogenic diet.
Your body is still growing — In one study, epileptic children experienced a reduction in symptoms and improved cognitive performance when a ketogenic diet was introduced.49 However, this may have a negative effect on the growth of their bodies in the long run, according to a study published in the journal Developmental Medicine & Child Neurology.50
This is an adaptation period, where we’re essentially re-training our muscles and our brain to use fat as the primary fuel source instead of glucose. This adaptation can take a couple of weeks to a couple of months. As a hallmark of being keto-adapted and not just in ketosis, the skeletal muscles are able to burn fat directly for fuel, and the brain relies on the higher volume of ketones in the blood as its main source of energy.
Ketogenic diets, like most low carb diets, work through the elimination of glucose. Because most folks live on a high carb diet, our bodies normally run on glucose (or sugar) for energy. We cannot make glucose and only have about 24 hours’ worth stored in our muscle tissue and liver. Once glucose is no longer available from food sources, we begin to burn stored fat instead, or fat from our diets.

The ketogenic, or "keto," diet — which first became popular in the 1920s as a treatment for epilepsy and diabetes— limits carbohydrates to no more than 50 grams a day, which is the rough equivalent of a plain bagel or a cup of white rice. By comparison, dietary guidelines from the US Department of Agriculture recommend from 225 to 325 grams of carbs a day.
During week 1 (and sometimes week 2) your body is transitioning to this whole new metabolic state, and there may be some initial side effects.  These are collectively known as the "keto flu".  The good thing is that if you don't take them for granted and think you're "superman" and that your body will be different, you can easily prevent these symptoms.
[i] Hussein M Dashti, MD PhD FICS FACS, Thazhumpal C Mathew, MSc PhD FRCPath, Talib Hussein, MB ChB, Sami K Asfar, MB ChB MD FRCSEd FACS, Abdulla Behbahani, MB ChB FRCS FACSI PhD FICS FACS, Mousa A Khoursheed, MB ChB FRCS FICS, Hilal M Al-Sayer, MD PhD FICS FACS, Yousef Y Bo-Abbas, MD FRCPC, and Naji S Al-Zaid, BSc PhD. "Long-term effects of a ketogenic diet in obese patients"
Keep eating low carb to continue losing weight, feeling good and becoming healthier!Try making any of our hundreds of recipes available on the site. We make sure each and every recipe is delicious, nutritious and will keep you under your daily carb limit, even if you go for seconds. In addition, we provide step-by-step instructions to make the process as easy as possible. If you ever run into any issues or have any questions, be sure to leave a comment or contact us directly! We’re always happy to help.
This means that if you have risk factors for heart disease — such as elevated cholesterol levels, high blood pressure (hypertension), or a strong family history of the disease — you should use caution when following this diet. The diet's heavy reliance on fat, especially saturated fat, can elevate cholesterol levels, further increasing your chances of developing heart disease in the future. (7)
For some, ketosis can cause more negative than positive side effects. Dorena Rode, a 52-year-old author, and speaker from Occidental, California, tried the diet for a month and experienced heart palpitations and dizziness. Unlike Drew, Rode says her cholesterol increased from 192 to 250 mg/dL after she introduced more fat into her diet. (Less than 200 mg/dL is considered desirable, while anything over 240 mg/dL is considered high.)

For athletes, research on the keto diet highlights potential improvements in athletic performance, especially when it comes to endurance activities. An article suggests ketogenic-type diets may allow endurance athletes to rely mostly on stored fat for energy during exercise rather than having to refuel with simple carbohydrates during endurance training and competition while additionally improving recovery times. (10)
On a ketogenic diet, your entire body switches its fuel supply to run mostly on fat, burning fat 24-7. Insulin levels become very low, and fat burning increases dramatically. It becomes easy to access your fat stores to burn them off. This is great if you’re trying to lose weight, but there are also other less obvious benefits, such as less hunger and a steady supply of energy. This may help keep you alert and focused.
You should know that the side effects of a ketogenic diet are still being studied. In addition, there have not been significant studies for long term dieters.  There are plenty of people that have used the diet long term (10+ years) and very happy with it.  It is up to the unique individual, so regular checkups with your doctor are recommended to check that "everything looks good".
At the core of the classic ketogenic diet is severely restricting intake of all or most foods with sugar and starch (carbohydrates). These foods are broken down into sugar (insulin and glucose) in our blood once we eat them, and if these levels become too high, extra calories are much more easily stored as body fat and results in unwanted weight gain. However, when glucose levels are cut off due to low-carb dieting, the body starts to burn fat instead and produces ketones that can be measured in the blood (using urine strips, for example).
We add collagen peptides to our coffee every morning because it’s beneficial for healthy joints, skin, hair, etc. If you use collagen peptides or want to add it to your diet after talking with your health care professional, we recommend Naked Nutrition Collagen Peptides Protein Powder. This product is grass-fed and pasture-raised, and is GMO free, dairy free, soy free, gluten free, and free of growth hormones.
This was a great read , Steve, thanks! I’m 19 days in but forever educating myself. Wish I’d been more prepared for the keto flu cos’ that hit me HARD! Out the other side now though and hoping to see some improvements in my cycling endurance and less reliance on the gels and goos! I’ll also be doing lots of HIIT for some racing that I’ll be doing this winter (in the UK) so looking forward to experimenting with that! As a former (and maybe still current) sugar lover, the dessert tips were especially useful. Thanks again!
Yes, you can drink alcohol on keto, but there are a couple of catches. The first thing to watch out for is, obviously, the carbohydrates in your drink of choice. If you’re choosing clear liquor, it tends to have a low amount of carbs, but it still has some. Your mixers also may have carbs in them, so choosing something like tonic water over a soda will keep you within your limits. Beer, cider, wine, and other bottled alcoholic drinks tend to be high in sugars, so you might just want to avoid them.
Yes, you can drink alcohol on keto, but there are a couple of catches. The first thing to watch out for is, obviously, the carbohydrates in your drink of choice. If you’re choosing clear liquor, it tends to have a low amount of carbs, but it still has some. Your mixers also may have carbs in them, so choosing something like tonic water over a soda will keep you within your limits. Beer, cider, wine, and other bottled alcoholic drinks tend to be high in sugars, so you might just want to avoid them.
The transition is rougher for some people than others, though it’s worth it to KCKO, or Keep Calm and Keto On. Once you’re keto-adapted, weight loss becomes easier, your body feels like it moves more smoothly, your energy levels and appetite are easily regulated, and your thoughts are clear and fast. Performance in the gym also begins to improve at this stage, since it sometimes suffers during the adaptation period.
I have been on keto for about 3 weeks now thanks for all the info what I have lost probably fluid but my main thing is my stomach going doen slowly..I have some medical pre diabetic. BP and 2 strokes.must lose at least 70 pounds but I sincerely fo not understand the macros how do you count them I am rating only 2 meals now though loving that staying full not hungry walk about 3 days a week..more during summer…the grocery list I have down but can’t quite undetstand the macros..very happy to have people to talk to thanks glad you are available
A related clinical diet for drug-resistant epilepsy is called the medium-chain triglyceride ketogenic diet, in which MCT oil is extensively used because it’s more ketogenic than long-chain triglycerides. (13a) Another dietary therapy for epilepsy called Low Glycemic Index Treatment (LGIT) was developed in 2002 as an alternative to the ketogenic diet. LGIT monitors the total amount of carbohydrates consumed daily, and focuses on carbohydrates that have a low glycemic index.) (13b)
Net carbs are what we track when following a ketogenic diet. This calculation is pretty straightforward. Net Carbs = Total Carbs – Fiber. For example, one cup of broccoli has 6g of total carbs and 2.4g of fiber. That would mean one cup of broccoli has 3.6g of net carbs. We count Net Carbs  because dietary fiber does not have a significant metabolic effect. 

This is an adaptation period, where we’re essentially re-training our muscles and our brain to use fat as the primary fuel source instead of glucose. This adaptation can take a couple of weeks to a couple of months. As a hallmark of being keto-adapted and not just in ketosis, the skeletal muscles are able to burn fat directly for fuel, and the brain relies on the higher volume of ketones in the blood as its main source of energy.

Some people just cut out the bulk of carbohydrates from major sources like breads, pastas, and sodas, and these people are on a Low Carbohydrate plan. There isn’t anything particularly strict about it, it’s more about being mindful of overall carb intake, often without tracking. This can be a good place to test the waters of a keto diet, though many people on this kind of plan never get into ketosis without further restriction.


When you’re first getting started, it can be helpful to use a blood or breath ketone meter.  What these meters do is measure the amount of ketones (the energy source your body is switching to) in your blood or your breath.  Knowing those amounts and seeing how they increase or decrease depending on what you’re eating daily can often be a motivating and helpful indicator of the transition occurring in your body.
The ketogenic diet works by eliminating carbohydrates from the diet and keeping the body’s carbohydrate stores almost empty, therefore preventing too much insulin from being released following food consumption and creating normal blood sugar levels. This can help reverse “insulin resistance,” which is the underlying problem contributing to diabetes symptoms. In studies, low-carb diets have shown benefits for improving blood pressure, postprandial glycemia and insulin secretion. (7) Therefore, diabetics on insulin should contact their medical provider prior to starting a ketogenic diet, however, as insulin dosages may need to be adjusted.
Your glycogen stores can still be refilled while on a ketogenic diet. A keto diet is an excellent way to build muscle, but protein intake is crucial here. It’s suggested that if you are looking to gain mass, you should be taking in about 1.0 – 1.2g protein per lean pound of body mass. Putting muscle on may be slower on a ketogenic diet, but that’s because your total body fat is not increasing as much.5Note that in the beginning of a ketogenic diet, both endurance athletes and obese individuals see a physical performance for the first week of transition.
Probably, and there are a few reasons why, Keatley says. For starters, people usually reduce their daily caloric intake to about 1,500 calories a day because healthy fats and lean proteins make you feel fuller sooner—and for a longer period of time. And then there’s the fact that it takes more energy to process and burn fat and protein than carbs, so you're burning slightly more calories than you did before. Over time, this can lead to weight loss.

When it comes to weight loss — a big possible draw of the plan for many individuals — the benefits of the ketogenic diet may not be much different from any other diet plan. “There is no magical weight loss benefit that can be achieved from this diet,” says Spano. “The ketogenic diet may help weight loss in the same way other diets help — by restricting food choices so you eat fewer calories.”


At 4 weeks you should be feeling pretty darn good.  If you are feeling better, but not awesome, give it a little more time.  If you have not felt better throughout this time and have stuck strictly to your low carbs and high fat, your body may not align with the keto diet.  If you only feel bad because you're craving bad food, this may be a mental "block" that you need to deal with.  Coaching can help.

• Reducing appetite — Constant hunger can cause you to consume more calories than you can burn, which can eventually lead to weight gain. A ketogenic diet can help you avoid this problem because reducing carbohydrate consumption can reduce hunger symptoms. In one study, participants who were given a low-carbohydrate diet had reduced appetites, helping them lose weight easier.2


Historically, a targeted ketogenic diet consists of limiting carbohydrate intake to just 20–30 net grams per day. “Net carbs” is the amount of carbs remaining once dietary fiber is taken into account. Because fiber is indigestible once eaten, most people don’t count grams of fiber toward their daily carb allotment. In other words, total carbs – grams of fiber = net carbs. That’s the carb counts that matter most.
This process of burning fat provides more benefits than simply helping us to shed extra weight — it also helps control the release of hormones like insulin, which plays a role in development of diabetes and other health problems. When we eat carbohydrates, insulin is released as a reaction to elevated blood glucose (an increase in sugar circulating in our blood) and insulin levels rise. Insulin is a “storage hormone” that signals cells to store as much available energy as possible, initially as glycogen (aka stored carbohydrates in our muscles) and then as body fat.
I decided to try going “keto-ish” after nearly a year of unsuccessful weight loss. Before trying Keto, I was hungry all the time and the number on the scale wasn’t budging despite meticulously sticking to my meal plan and exercising 3-5 days a week. It’s been about three weeks since I’ve started this new approach to eating and the pounds are flying off. It’s amazing. I’ve discovered riced cauliflower and zoodles, two things I never knew that I loved.

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