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.
Those issues can be part of what's known as the “keto flu,” Warren says. Other side effects of the keto diet, all of which are tied to carb withdrawal, can include lightheadedness, nausea, mental fog, cramps, and headaches, in addition to tiredness. Luckily, the keto flu doesn't usually last more than a week—which is coincidentally about when people start to see the number on the scale go down, says Warren.
When carbs go missing from a person's diet, the body uses up its glucose reserves and then breaks down stored fat into fatty acids, which, when they reach the liver, are converted into an organic substance called ketones. The brain and other organs feed on ketones in a process called ketosis, which gives the diet its name. Keto dieters eat lots of fat to maintain this state.
I love your site but your note about Diabetic Ketoacidosis is completely wrong. DKA is not something that happens because your body produces too many ketones. It is something that happens when your body produces too many ketones, and you don’t have any insulin in your system. As long as a Type 1 Diabetic takes insulin they will NOT go into DKA. Especially since DKA requires high ketones, high sugars, and low insulin.
• Multiple Sclerosis: In a small 2016 study, patients with multiple sclerosis (MS) were put on a ketogenic diet. After six months, they reported improved quality of life, as well as physical and mental health improvements. Before doctors or researchers can make a connection between keto and MS, they need bigger sample sizes and more thorough research. Still, the preliminary findings are exciting.
Here are a few of the most common side effects that I come across when people first start keto. Frequently the issues relate to dehydration or lack of micronutrients (vitamins) in the body. Make sure that you’re drinking enough water (close to a gallon a day) and eating foods with good sources of micronutrients. To read more on micronutrients, click here >
First, let’s start with the fact that most of the food in your cabinets just won’t work anymore. They’re not keto. Period. Lock them up, throw them out, donate them to a neighbor – whatever you have to do to get them out of the house. In the first week, when you’re craving carbohydrates, these foods will be the death of your ketogenic diet. Purge your pantry of carbohydrate foods!
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).

The Atkins diet, on the other hand, is solely focused on weight loss. There is no restriction on artificial sweeteners or manufactured foods, as long as the foods consumed fit the Atkins prescribed ratios. There are four phases to the Atkins diet. The first phase is the most strict, designed to get you into ketosis. The second phase is a tolerance testing phase, where you add more foods to see how many grams of carbohydrate you can still eat and lose weight. The third phase is more generous with carbs, and the fourth phase is the most generous, and it’s in either the third or fourth phase that most people find a good maintenance level.
[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"
Don’t stick to chicken and steak just because you’re comfortable cooking them. Make dinner time the place where you can try new meats and recipes that increase your keto recipe resources. “At lunch and dinner, you can be creative and experiment,” Weaver says. “Just focus on cooking meat—pork, chicken, lamb, beef, or seafood. Meat is rich in iron and fish contains omega-3 fatty acids and vitamin D. Use only organic oils, such as avocado oil, coconut oil, and olive oil.”
H. Guldbrand, B. Dizdar, B. Bunjaku, T. Lindström, M. Bachrach-Lindström, M. Fredrikson, C. J. Östgren, F. H. Nystrom, “In Type 2 Diabetes, Randomisation to Advice to Follow a Low-carbohydrate Diet Transiently Improves Glycaemic Control Compared with Advice to Follow a Low-fat Diet Producing a Similar Weight Loss,” Diabetologia (2012) 55: 2118. http://link.springer.com/article/10.1007/s00125-012-2567-4.
There are reasons a strange diet like this has stuck around since the 1920's.  A diet like keto that is low in sugar lowers blood glucose and insulin levels has several positive effects on the body, especially in overweight or obese people. The ketogenic diet gives your body the chance to re-adjust its glucose and insulin levels.  In addition, there are health benefits that will enhance daily life, as well as help treat disease.  Check out these benefits of the ketogenic diet:

A: The amount of weight you lose is entirely dependent on you. Obviously adding exercise to your regimen will speed up your weight loss. Cutting out things that are common “stall” causes is also a good thing. Artificial sweeteners, dairy, wheat products and by-products (wheat gluten, wheat flours, and anything with an identifiable wheat product in it).
[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"

Diets high in healthy fats and protein also tend to be very filling, which can help reduce overeating of empty calories, sweets and junk foods. (6) For most people eating a healthy low-carb diet, it’s easy to consume an appropriate amount of calories, but not too many, since things like sugary drinks, cookies, bread, cereals, ice cream or other desserts and snack bars are off-limits.
Anecdotally speaking, people do lose weight on the keto diet. Heather Wharton, a 35-year-old business relationship manager from Tampa, Florida, lost 140 pounds since starting the keto diet in January 2016: “I plan on being on the keto diet for the rest of my life,” says Wharton. “My husband and I consider ourselves to be food addicts, and the keto diet is what we use as a form of abstinence from trigger foods that have sugar and other carbohydrates." A typical day of eating for Wharton includes coffee with a protein supplement, a cup of unsweetened cashew milk, cauliflower rice with ground turkey and liquid aminos (a carb-free substitute for soy sauce), spinach, six slices of turkey bacon, six eggs, and a little salsa.

Another great keto flu cure is bone broth! This is also a great healer when you are actually sick with a cold or flu or just want something comforting. Instead of its high carb alternative chicken noodle soup or even worse, store bought chicken broth (which is typically loaded with MSG and other preservative junk), bone broth is a delicious way to alleviate your flu symptoms. Bone broth is a great way to hydrate & it is also packed with electrolytes, good for you sodium and potassium.
3) Now that you have the information you need about your body’s present condition and info on ketosis, head over to this Keto Calculator Tutorial, and figure out how many grams of Carbohydrates, Fat, and Protein you need each day to lose weight. These numbers are critical so don’t forget to write them down. I keep a piece of paper pinned to my wall so I can easily see them when planning meals.
Spices are an easy way of adding more flavor, vitamins and antioxidants into your food. Furthermore, they are low in carbohydrates. Make sure that you're using fresh, organic spices for maximum flavor and nutrients. Some spices sold in packets found at the local grocery should not be used, as they often contain fillers that can increase your carbohydrate consumption, thus putting you out of ketosis.26
This is one reason why tracking your food intake should be a priority. There are apps like Cronometer, MyFitnessPal, and LoseIt! that allow you to record all your foods for the day, and each has a large database of fresh foods, packaged foods, and restaurant meals, plus you can enter in your own recipes. This way you can know exactly what macro- and micro-nutrients you’re getting, with no guess work.
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)
Because the main tenet of the keto diet is counting and cutting carbs — a commonly used way to control blood sugar — this eating approach has become increasingly popular among people with type 2 diabetes who are looking to lower their A1C, which is the two- to three-month average measurement of blood sugar levels. Indeed, research suggests this diet may lead to fast weight loss and potentially lower blood sugar for people with the disease. (13)
The biggest shifts in your daily habits will be how you food shop and how you cook, and recipes that are ketogenic need to be followed rather than just low-carb. You will require the healthy fats in order to get into ketosis and have enough energy without the carbs. And you will be considerably more energetic and healthier when cooking your own keto-friendly food rather than buying supposedly keto foods off the shelf. So visit my page on keto recipes as well as keto snacks (including fat bombs!), and get started on a ketogenic meal plan!
• Cardiovascular Disease: This is definitely a point of confusion and controversy since a diet that relies so heavily on meat and fat is naturally thought to raise blood cholesterol and cause heart issues. However, some evidence suggests that this may not be the case. In fact, the keto diet may help improve triglyceride, HDL and LDL levels. A 2017 review looked at all of the available evidence around the ketogenic diet and cardiovascular health and found that the diet may be associated with some improvements in cardiovascular risk factors. Mind you, the authors also expressed their concerns with maintaining the diet in the long term, and they proposed that these benefits may not be long-lasting. It's clear that we need long-term studies to fill that gap.

Sleep enough – for most people at least seven hours per night on average – and keep stress under control. Sleep deprivation and stress hormones raise blood sugar levels, slowing ketosis and weight loss a bit. Plus they make much it harder to stick to a keto diet, and resist temptations. So while handling sleep and stress will not get you into ketosis on it’s own, it’s still worth thinking about.

Taking your first step into the ketogenic diet is an exciting phase for your health. But before coming up with an actual ketogenic diet food list, it's important to first take a look at what you're eating now and take out anything that's unhealthy. This means that you have to remove sugars, grains, starches and packaged and processed foods from your diet. Basically, anything that won't add to your new eating regimen has to go. This is what I call a "pantry sweep."

Thanks for the very informative article. This was the push I needed to at least try it. Starting next weekend, my partner and I will be trying keto for 30 days. I’m all for small changes, in theory, but what I sometimes discover is that sweeping changes can have their place, too, if they produce positive results. Often, what will work for me is trying a big change, and even if I then throw out 80% of it, at least the remaining 20% sticks. By contrast, any backsliding from a small change can often mean just throwing it out entirely.

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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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