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)

I am also working to share personal success stories on my blog. If you are planning to start this keto diet, please take before pictures, progress pictures, keep a food diary, and keep track of your weight and measurements. Then when you are ready (maybe at your halfway point, or once you reach your goal weight, you can send me your results for me to share with others).
When you cut back on carbs or just haven't eaten in a while, your body looks for other sources of energy to fill the void. Fat is typically that source. When your blood sugar drops because you're not feeding your body carbs, fat is released from your cells and flood the liver. The liver turns the fat into ketone bodies, which your body uses as its second choice for energy.

Protein: Keep in mind that keto is high-fat, and not high-protein, so you don’t need to eat very much meat. Too much protein turns into glucose in the body, making it harder to stay in ketosis. Stick to fatty cuts of grass-fed, pasture-raised, or wild meat, and wild-caught fish. Red meats, offal/organ meats, pork, eggs (preferably pastured), fish, shellfish, and whey protein concentrate.
Over 8–10 mmol/l: It’s normally impossible to get to this level just by eating a keto diet. It means that something is wrong. The most common cause by far is type 1 diabetes, with severe lack of insulin. Symptoms include feeling very sick with nausea, vomiting, abdominal pain and confusion. The possible end result, ketoacidosis, may be fatal and requires immediate medical care. Learn more

In order to transition and remain in ketosis, aiming for about 30–50 net grams is typically the recommended amount of total carbs to start with. This is considered a more moderate or flexible approach but can be less overwhelming to begin with. Once you’re more accustomed to “eating keto,” you can choose to lower carbs even more if you’d like (perhaps only from time to time), down to about 20 grams of net carbs daily. This is considered the standard, “strict” amount that many keto dieters aim to adhere to for best results, but remember that everyone is a bit different.


Beverages: It’s common to become dehydrated on the keto diet. Your insulin levels drop when you restrict carbs, and low insulin makes it harder for your body to retain sodium and water.[9] Drink plenty of plain water, and sip on bone broth to replenish electrolytes, especially during the first couple of weeks when your body is adjusting to the new diet.
Following a diet that drastically restricts carbohydrates requires carefully monitoring your food choices to ensure you are meeting your nutritional needs. Working together with a registered dietitian can make sure you follow this diet in a healthy manner without increasing your risk for complications or negative side effects. You can find a registered dietitian at EatRight.org.
Steve, thank you for the amazing article! Your style of writing was so funny and easy to follow, and had me actually laughing out loud so many times! Low carb is the only diet that has ever worked for me. I freaking love it. I got away from it, though, and started eating too much sugar again. My daughter is getting married next year, and I have to squeeze this badonkadonk into a cute dress next year, hopefully without looking like a mama hippo, so low carb it is. I see the basic program is the same, but there have been some advancements with the science of the diet which is great. I’m excited to get at it! Today is day 1 for me. Wish me luck; I’m going in…..
• Constipation: No one likes to feel backed up, and sadly if you're not careful about your diet choices when going keto, it could become a regular concern. One 10-year (albeit small) study looking at the effects of a keto diet on young children found that 65 percent experienced digestive woes. Thankfully, going keto is not a life sentence for problem bowels. Since you're cutting out whole grains and fruit (two of the most common sources of fiber), aim to up your fiber-rich veggies, and consider a supplement.
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)

Frederick F. Samaha, M.D., Nayyar Iqbal, M.D., Prakash Seshadri, M.D., Kathryn L. Chicano, C.R.N.P., Denise A. Daily, R.D., Joyce McGrory, C.R.N.P., Terrence Williams, B.S., Monica Williams, B.S., Edward J. Gracely, Ph.D., and Linda Stern, M.D., “A Low-Carbohydrate as Compared with a Low-Fat Diet in Severe Obesity,” N Engl J Med 2003; 348:2074-2081. http://www.nejm.org/doi/full/10.1056/NEJMoa022637.
But what does the science say? Results are mixed. In one Spanish study of 20 obese adults, participants were put on a low-calorie keto diet and lost an average of 40 pounds over four months. Another small experiment had a similar outcome. In a six-month Experimental & Clinical Cardiology study of 83 obese adults, those on the keto diet lost an average of 33 pounds, while lowering their bad (LDL) cholesterol levels and increasing their good (HDL) cholesterol.
There are two major ways fasting is beneficial for overall health. First, it gives the body a break from digestion. Digestion is a surprisingly stressful activity, and if there is a longer period of time where your body can focus on simply using the nutrients it’s been given already without having to handle more, digestion tends to improve, as well as energy levels.
I’m honestly a little skeptical about it the idea of keto permanently. My brief glance at the literature seems to imply that it can have side effects of kidney stones, skeletal fractures, and slow the growth rate of children, but that was a study on kids with epilepsy (which it treated very effectively), so who knows how that applies to adults. And the other studies I found dealt with overweight and obese subjects, so it may be hard to find something on the long term effects on otherwise healthy adults.

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Medical Disclaimer: The material on this site is provided for informational purposes only and is not medical advice. Always consult your physician before beginning any diet or exercise program.

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