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The keto diet isn’t new, and it’s been around for nearly a century. It was originally developed to treat people with epilepsy. In the 1920s, researchers found that raised levels of ketones in the blood led to fewer epileptic seizures in patients. The keto diet is still used today to treat children with epilepsy who don’t respond well to anti-epileptic drugs.[2]
It seems like everyone is talking about the keto diet — the high-fat, low-carb eating plan that promises to turn your body into a fat-burning machine. For that reason, keto has surged in popularity over the past year as a lose-weight-fast strategy. Thank Hollywood A-listers and professional athletes like Halle Berry, Adriana Lima, and Tim Tebow who’ve publicly touted the diet’s benefits, from shedding weight to slowing down aging. Here’s everything you need to know about going keto.
Endogenous ketone production denotes ketones produced naturally by the body. It's the body’s natural adjustment to the absence or restriction of carbohydrate in the diet. Without enough glucose from carbs to fuel its cells, the body turns to fat to replace glucose as its primary source of energy. In the liver, fat that is not burned for energy directly is converted to ketones. This means that you are in a ketogenic state. Ketone levels increase in the bloodstream and provide an alternate and efficient fuel source for the body and brain. As a result, muscle protein is spared from being converted to glucose for energy.
Before starting, ask yourself what is really realistic for you, Mattinson suggests. Then get your doctor’s okay. You may also work with a local registered dietitian nutritionist to limit potential nutrient deficiencies and talk about vitamin supplementation, as you won’t be eating whole grains, dairy, or fruit, and will eliminate many veggies. “A diet that eliminates entire food groups is a red flag to me. This isn’t something to take lightly or dive into headfirst with no medical supervision,” she says.

"Muscle loss on the ketogenic diet is an ongoing area of research," Clark told Everyday Health. "Small studies suggest that people on the ketogenic diet lose muscle even when they continue resistance training. This may be related to the fact that protein alone is less effective for muscle building than protein and carbohydrates together after exercise."

Thanks so much for the reply! One more question about the LivingFuel SuperGreens…I had very bad GI issues with VEGA Protein in 2011 when I tried it (quit after half a container), which scared me away from the vegetarian proteins with greens in them. Is this drastically different from VEGA? Or seeing that pea is the primary source of protein should I look towards something else? Thanks again!
What would your advice be to a high raw vegan who wants to try an HRV keto diet? The supps you recommended above look vegan, but aren’t the results based on those of omnis? Would they work the same way on vegans? Also I heard you mention in the recent Keto Summit that SE Asians need a little more carb and I happen to be one. I’m a petite 39-YO female and I’ve been raw for the past 11 years. I have been practicing intermittent fasting in the last 7 years and try to eat only twice a day. Up to how many grams of carbs can I consume to get into ketosis?
On the ketogenic diet, carbohydrates are restricted and so cannot provide for all the metabolic needs of the body. Instead, fatty acids are used as the major source of fuel. These are used through fatty-acid oxidation in the cell's mitochondria (the energy-producing parts of the cell). Humans can convert some amino acids into glucose by a process called gluconeogenesis, but cannot do this by using fatty acids.[57] Since amino acids are needed to make proteins, which are essential for growth and repair of body tissues, these cannot be used only to produce glucose. This could pose a problem for the brain, since it is normally fuelled solely by glucose, and most fatty acids do not cross the blood–brain barrier. However, the liver can use long-chain fatty acids to synthesise the three ketone bodies β-hydroxybutyrate, acetoacetate and acetone. These ketone bodies enter the brain and partially substitute for blood glucose as a source of energy.[56]

Therefore, more people experiencing "keto crotch" need to visit doctors to determine what's really happening. It could be that some of the people claiming "keto crotch" are instead detecting smells that are not related to their diets. Many different smells could emanate from your crotch, some are normal, some are not. Conversely, who knows for sure what a drastic change in your diet may do to different parts of your body? There is still a lot unknown about the links between nutrition and your various bodily functions. You are a complex system with many unknowns. The keto crotch could be a real phenomenon, but more scientific evidence and studies are needed.


In the first week, many people report headaches, mental fogginess, dizziness, and aggravation. Most of the time, this is the result of your electrolytes being flushed out, as ketosis has a diuretic effect. Make sure you drink plenty of water and keep your sodium intake up.6One of the fathers of keto, Dr. Phinney, shows that electrolyte levels (especially sodium) can become unbalanced with low carb intake.

“Suddenly and drastically reducing carbohydrates sets your body up for a double whammy of sorts,” says Yawitz. “The brain’s favorite fuel is glucose, which is most easily created from carbohydrates. In very-low-carb diets, the brain has to adjust to using ketones from digested fats for energy. To add to this discomfort, your kidneys release more electrolytes as insulin levels fall.” Additionally, your total body water decreases as carbohydrates become depleted on a keto diet, notes Clark. The result? What’s known as the keto flu, which could cause constipation, nausea, headache, fatigue, irritability, cramps, and other symptoms. Don’t fret, though: Many of these symptoms are short term and should last only a few days to weeks. Make sure to drink plenty of water to help your body cope with these symptoms. And call your doctor if symptoms — especially nausea — are prolonged, advises Yawitz.
There are many ways in which epilepsy occurs. Examples of pathological physiology include: unusual excitatory connections within the neuronal network of the brain; abnormal neuron structure leading to altered current flow; decreased inhibitory neurotransmitter synthesis; ineffective receptors for inhibitory neurotransmitters; insufficient breakdown of excitatory neurotransmitters leading to excess; immature synapse development; and impaired function of ionic channels.[7]
^ Greenberg CR, Dilling LA, Thompson GR, Seargeant LE, Haworth JC, Phillips S, Chan A, Vallance HD, Waters PJ, Sinclair G, Lillquist Y, Wanders RJ, Olpin SE (April 2009). "The paradox of the carnitine palmitoyltransferase type Ia P479L variant in Canadian Aboriginal populations". Molecular Genetics and Metabolism. 96 (4): 201–7. doi:10.1016/j.ymgme.2008.12.018. PMID 19217814.

Awesome info. I’ve been LCHF moderate protein (about 1 g per lean lbs/mass) and 50-100g of carbs for about a year. I’d consume around 2500 cals. I’m active 4-5 days a week (60-90 min cycling sessions) I started using MCT/Butter coffee. It surpressd my appetite and I would only eat whole food at lunch/dinner…still LCHF, but since my appetite was lower I was only takin in about 1800 cals. After about 2 weeks I started to gain body fat. Do you think the reduced caloric intake is the culprit? Should I “force” myself to eat…maybe up the MCT intake to make up the difference?
Hi, I am a parent of son with epilepsy. On our last EEG we found out he is having 10 absence seizures per hour as well as bimonthly grandmal seizures . People have been using the ketogenic diet for seizure control for years. Our neurologist mentioned that seizure control is effected by blood insulin as well as ketones. I know the original Keto esters came from DR. D’Augustino’s work with Navy Seals who were having seizures due oxygen toxicity. The main reason we have not been using the Keto diet is lack of compliance and it so easy for kids to get out of ketosis. I am wondering if we could get seizure control with a zonish/adkins diet with keto os, brain octain supplementation. Even an educated guess would be appreciated. Thanks, Mike
I have never been able to fix the electrolyte loss symptoms I get on the ketogenic diet (heart palpitations, dry mouth, air hunger) by supplementing with electrolytes. Blogosphere says that is just the transition, but mine seem to only get worse over time. I’ve tried about 2 grams of extra potassium, 800 mg extra magnesium, and 3 grams extra salt (in addition to my already liberally salted foods) spread throughout the day. This did not help. Also does eating salt alone cause you to retain water and therefore retain the rest of the electrolytes without supplementing them?

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.


Great article! As someone who just started a “ketogenic diet” two weeks ago, I am opting to hold off on using ketone supplements for the following reason. You state how “Keto-adaptation occurs when you have shifted your metabolism to relying on fat-based sources, instead of glucose (sugar) sources, as your primary source of fuel.” If the goal is to “switch” our body’s energy supply to ketones and one uses supplemental ketones, how do they really ever know if their body has successfully accomplished this goal if they are using supplemental ketones? Aren’t they getting a false sense of ketosis if their blood or breath tests show them above 0.5 millimolar through the use of the supplements? I understand that it may take me longer to reach ketosis naturally but I guess I see it was worth it to truly reap all of the benefits that you outline in your article.
After about two to seven days of following the keto diet, you go into something called ketosis, or the state your body enters when it doesn't have enough carbs for your cells to use for energy. That's when you start making ketones, or organic compounds that your bod then uses in place of those missing carbs. At this point, your body also starts burning fat for more energy, says Beth Warren, R.D., founder of Beth Warren Nutrition and author of Living A Real Life With Real Food.
In addition to the seaweed and glycogen carbohydrates mentioned above, the Inuit can access many plant sources. The stomach contents of caribou contain a large quantity of partially digested lichens and plants, which the Inuit once considered a delicacy. They also harvested reindeer moss and other lichens directly. The extended daylight of the arctic summer led to a profusion of plant life, and they harvested plant parts including berries, roots and stems, as well as mushrooms. They preserved some gathered plant life to eat during winter, often by dipping it in seal fat.[71]
Meat – like grass-fed selections – and fresh veggies are more expensive than most processed or fast foods. What you spend on Keto-friendly foods will vary with your choices of protein source and quality. You can select less-expensive, leaner cuts of meat and fatten them up with some oil. Buying less-exotic, in-season veggies will help keep you within budget.
In its 2016 report “Healthy Eating Guidelines & Weight Loss Advice,” the Public Health Collaboration, a U.K. nonprofit, evaluated evidence on low-carbohydrate, high-fat diets. (The Keto diet falls under the LCHF umbrella.) Among 53 randomized clinical trials comparing LCHF diets to calorie-counting, low-fat diets, a majority of studies showed greater weight loss for the Keto-type diets, along with more beneficial health outcomes. The collaboration recommends weight-loss guidelines that include a low-carbohydrate, high-fat diet of real (rather than processed) foods as an acceptable, effective and safe approach.
In addition to the seaweed and glycogen carbohydrates mentioned above, the Inuit can access many plant sources. The stomach contents of caribou contain a large quantity of partially digested lichens and plants, which the Inuit once considered a delicacy. They also harvested reindeer moss and other lichens directly. The extended daylight of the arctic summer led to a profusion of plant life, and they harvested plant parts including berries, roots and stems, as well as mushrooms. They preserved some gathered plant life to eat during winter, often by dipping it in seal fat.[71]
A systematic review in 2018 looked at 16 studies on the ketogenic diet in adults. It concluded that the treatment was becoming more popular for that group of patients, that the efficacy in adults was similar to children, the side effects relatively mild. However, many patients gave up with the diet, for various reasons, and the quality of evidence inferior to studies on children. Health issues include high levels of low-density lipoprotein, high total cholesterol, and weight loss.[24]
Ketosis is a metabolic state where most of the body's energy supply comes from ketone bodies in the blood, in contrast to a state of glycolysis where blood glucose provides most of the energy. Ketosis is characterized by serum blood concentrations of ketone bodies over 0.5 millimolar with low and stable levels of insulin and blood glucose. However, with ketone supplementation (as you’ll learn about later in this article) ketosis can actually be induced even when there are high levels of blood glucose.

Jalali says people following the diet have the best chance of keeping the weight off if they stay on it long term. And that’s not always easy to accomplish. The weight may come back if you go back to your regular eating habits. And regaining weight may lead to other negative effects. “Chronic yo-yo dieting appears to increase abdominal fat accumulation and diabetes risk,” notes Clark.
Before starting, ask yourself what is really realistic for you, Mattinson suggests. Then get your doctor’s okay. You may also work with a local registered dietitian nutritionist to limit potential nutrient deficiencies and talk about vitamin supplementation, as you won’t be eating whole grains, dairy, or fruit, and will eliminate many veggies. “A diet that eliminates entire food groups is a red flag to me. This isn’t something to take lightly or dive into headfirst with no medical supervision,” she says.

This is the second shortest form of MCT, also rare and comprising about 8% of coconut oil. It is slower to turn into energy but less expensive than C8. XCT Oil is triple-distilled in a non-oxygen atmosphere with no solvents, and it contains C10 and C8, because these are the only two MCT oils that turn into ATP quickly without the liver. You would need 6 tablespoons of coconut oil to get one tablespoon of XCT oil.
I was thinking of buying exogenous ketones for my mother. She plays golf daily but gained some weight as of late. My mother does not want to do the diet but I was thinking this might help her with energy and losing weight. Another person told me it would help her. But then I got to thinking, if she went into Ketosis, then wouldn’t she get the keto flu rather than get energy and mental clarity? Would I need to tell her to take it everyday?
C12 is about 50+% of coconut oil, and it requires a pit stop in the liver rather than getting immediately converted into energy like the other MCT’s listed above. This is why it is more accurately described as an LCT, not an MCT like marketers claim. It raises cholesterol more than any other fatty acid. It is also commonly cited as having antimicrobial benefits, which is does – except the shorter chain MCT oils are more effective against candida yeast infections, and even gonorrhea and chlamydia.
Frankly, the results of my foray into ketosis and eventually keto-adaptation were astounding. I had the best Ironman triathlon season of my life and shocking levels of mental focus and physical ease, especially for races and workouts that lasted longer than two hours. Without experiencing muscle loss, hunger pangs or brain fog, I found I could go the entire day without eating, which was enormously helpful for business and personal productivity. My gas, bloating, fermentation and GI “issues” disappeared. My blood levels of inflammatory markers like HS-CRP and cytokines dropped to rock-bottom, while my levels of good cholesterol, vitamin D, and anti-inflammatory fatty acids skyrocketed.
In sheep, ketosis, evidenced by hyperketonemia with beta-hydroxybutyrate in blood over 0.7 mmol/L, occurs in pregnancy toxemia.[78][79] This may develop in late pregnancy in ewes bearing multiple fetuses,[78][79] and is associated with the considerable glucose demands of the conceptuses.[80][81] In ruminants, because most glucose in the digestive tract is metabolized by rumen organisms, glucose must be supplied by gluconeogenesis,[82] for which propionate (produced by rumen bacteria and absorbed across the rumen wall) is normally the principal substrate in sheep, with other gluconeogenic substrates increasing in importance when glucose demand is high or propionate is limited.[83][84] Pregnancy toxemia is most likely to occur in late pregnancy because most fetal growth (and hence most glucose demand) occurs in the final weeks of gestation; it may be triggered by insufficient feed energy intake (anorexia due to weather conditions, stress or other causes),[79] necessitating reliance on hydrolysis of stored triglyceride, with the glycerol moiety being used in gluconeogenesis and the fatty acid moieties being subject to oxidation, producing ketone bodies.[78] Among ewes with pregnancy toxemia, beta-hydroxybutyrate in blood tends to be higher in those that die than in survivors.[85] Prompt recovery may occur with natural parturition, Caesarean section or induced abortion. Prevention (through appropriate feeding and other management) is more effective than treatment of advanced stages of ovine ketosis.[86]

Physical or mental fatigue during workouts (or while you’re sitting at your office) is caused by the low blood glucose that occurs as your carbohydrate fuel tank approaches empty (also known as the infamous “bonk”, which is awesomely demonstrated in this funniest running cartoon I’ve ever seen). Because it is generally (and sadly) accepted as orthodox knowledge that the human body can’t burn fat as a reliable fuel source – especially when you’re exercising for long periods of time or at high intensities – nearly every shred of nutrition science is simply looking for ways to somehow increase the size of your carbohydrate fuel tank and hack the body to allow it to store more carbs or absorb carbs more quickly.
"Many of the richest sources of fiber, like beans, fruit, and whole grains are restricted on the ketogenic diet," registered dietician Edwina Clark told Everyday Health. "As a result, ketogenic eaters miss out on the benefits of fiber-rich diet such as regular laxation and microbiome support. The microbiome has been implicated in everything from immune function to mental health."
Hey Alex, thanks for commenting and great to have you as a new listener! For this kind of thing, because it requires so going into detail, I'd suggest you book a consult with me by going to