When to Choose the Keto Diet (and When Not to)

The ketogenic diet has gained a lot of popularity lately because of its rapid weight loss results, improved mental clarity, energy and so forth. The ketogenic diet essentially mimics starvation; it deprives the body of carbohydrates and forces it into ketosis. With this info in mind, it becomes obvious the keto diet isn’t for everyone. Those with the following conditions should think twice before considering the ketogenic diet:

1. Diabetes Type 1:

      This population is at a much higher risk of ketoacidosis, which occurs when blood sugar drops too low for too long and ketones become too high. Ketones are acidic, which causes the blood to become too acidic and that can be life-threatening. If you have Type 1 Diabetes you should consult with your doctor before considering the keto diet.

2. Absence of Gallbladder

Gallbladder stores bile and releases it to aid with fat digestion. Those who had their gallbladder surgically removed will likely have a hard time digesting all that fat on a keto diet. These people may notice more digestive concerns, such as flatulence, pain, bloating, diarrhea, etc.

3. Adrenal dysfunction:

The goal of the keto diet is to achieve ketosis, a state when your body burns fat instead of glucose. However, ketosis can be a major strain on the body and on the adrenal glands, especially if you already have adrenal fatigue and are feeling depleted. Cortisol, produced by our adrenals, helps to stabilize blood glucose levels. If you haven’t eaten for a few hours, cortisol breaks down glycogen stores from the liver and raises blood glucose to normal level. However, if you have low glycogen stores because of low carbohydrate consumption, then cortisol will break down muscle in order to regulate blood glucose levels.

4. Hypothyroidism

With any low carb diet, there is a risk of thyroid suppression, and poor conversion of free T4 to free T3. This is because the hypothalamus and the pituitary gland require glucose to function. In fact, the main thyroid hormone produced by the pituitary gland is TSH (Thyroid Stimulating Hormone), which is partly made up of glucose molecules. The most common symptoms of poor thyroid function are; hair loss, constipation, cold intolerance and dry skin. The good news is that this hypothyroid state is reversible once you go back to eating a balanced diet, although it may take a few months.

     5. Cardiovascular disease

A high fat diet, especially one high in saturated fats can increase the risk of cardiovascular disease. It is particularly concerning for those who have cardiovascular disease in the family. Genetically, these people may not be able to metabolize fat appropriately, which increases risk of atherosclerosis. Keto diet is quite restrictive and not sustainable long term, which often leads to yo-yo dieting, which puts stress on the heart and has been associated with increased mortality.  

6. Interaction with medications:

Specifically, medications or supplements that lower your blood sugar levels, such as Metformin, can be concerning.  Your blood sugar levels may drop too low while on a ketogenic diet, which can lead to hypoglycemia, such as shakiness, weakness, extreme hunger, nausea, dizziness, headaches, sweating and poor concentration.

Medications that affect your liver function may also cause issues on a Keto diet. Your liver is responsible for converting fat into ketones and if it’s not able to do so effective, ketosis may not occur and the body will not be able to create fuel for itself. If you are taking medications, you should consult with your healthcare provider before starting the Ketogenic diet.

The ketogenic diet is not for everyone, and it is not sustainable long-term. This is just another diet, which means that when you rapidly lose weight, you are also more likely to rapidly gain it all back once you are off the diet. I work with my patients to create an individualized dietary program, which is more of a lifestyle change, rather than a diet. It is relatively easy to follow and is sustainable long-term.  

Read more about the Keto Diet from Dr. Tatiana.

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