Three years ago, I’d never even heard of the ketogenic diet, despite being one of the most health-conscious people in my circle. Now, almost everyone has heard of it, and for good reason. The ketogenic diet is the most popular diet in America (as of this writing), and it shows great promise for health, cognition, longevity, fitness, and weight-loss. However, some think keto might be dangerous.
While I don’t agree that the ketogenic diet is outright dangerous, you can definitely make mistakes that will make it so.
For this reason, I am here to show you how to do the ketogenic diet the right way, as well as to dispel some common myths that may be preventing you from trying it.
The ketogenic diet has been important to me personally. My mental and physical health improved, my focus improved, and even my sleep improved. I’ll share more of those details at the end of this article.
We’ll start by defining exactly what the ketogenic diet is, as well as outlining the basics about how to go about doing it. Then we’ll move into the myths that surround keto, and we’ll address the real dangers that come with a keto diet performed poorly, as well as solutions to avoid these dangers completely. Lastly, we’ll go in-depth on how to perform the ketogenic diet perfectly, complete with the necessary toolkit and habits to optimize your experience.
Defining the Ketogenic DietFasting & The History of the Ketogenic Diet
Ancel Keys & the demonization of fat
Don’t call it a comebackMyths & Misconceptions
Myth #1: You will lose muscle on a ketogenic diet (and can’t gain muscle on it)
Myth #2: Keto slows down your metabolism
Myth 3: Ketosis is bad for your thyroidCommon Mistakes on the Ketogenic Diet & How To Avoid Them
Mistake #1: Being too concerned about eating excess protein
Mistake #2: Not eating enough (read: any) carbs
Mistake #3: Eating too many omega-6 fats & dairyPutting It All Together: How To Do the Ketogenic Diet
The Keto Flu
Measure your macros
Measure your ketones
Quality over quantityConclusion and My Experience With KetoStudies and Resources for Further Reading
Defining the Ketogenic Diet
Here are the basics: The ketogenic diet is designed to make your body enter a metabolic state known as ketosis. Ketosis occurs when your body switches from burning glucose as its primary fuel source to burning fats instead. When this happens, your body produces ketones as a bi-product of fat-burning, which are then used as fuel throughout the body and brain.
Why is this a good thing? Well, many people in modern society have been eating too much sugar and carbs for most of their lives. Diabetes is literally a disease born of overburdening the body with sugar.
In a natural environment, humans entered ketosis while fasting or due to a higher dietary supply of fats and a lower supply of glucose. I mean, think about it — half the food we eat has extra sugar added to it. Take that out of the equation and we’re already doing a lot better.
To make a long story short: due to a lack of fasting, and an unnatural, sugar-laden diet, most people are not efficient at burning fat for fuel, and they never enter ketosis.
The ketogenic diet attacks this problem directly. You switch to consuming 70% or more of your calories in the form of fats, with 10–25% coming from protein, and 5% or less coming from carbohydrates. By sticking to this regimen, your body will enter ketosis and you will become better at using fats for fuel.
Now, that’s all fine and dandy, but what are the actual benefits? Well, current research supports the use of a ketogenic diet for:
- Weight loss
- Blood sugar balance and enhanced insulin sensitivity
- Improved energy levels, oxygen capacity, & athletic performance
- Migraine treatment
- Neuroprotective benefits in seizure disorders; ADHD; Alzheimer’s disease, memory, and cognitive function; Parkinson’s disease and Multiple Sclerosis
- Autism, and improved behavior and social impacts
- Mood stabilization in bipolar disorder
- Ischemic stroke prevention
- Inflammation management & Alzheimer’s treatment
This is not medical advice, and I’m not saying that you should go use the ketogenic diet to treat a medical condition. I’m just letting you know there is promising research supporting the positive benefits of this diet, especially for the metabolism and the brain.
Aren’t fats bad for us, though? To put it simply: no, they are not. Contrary to popular belief — as well as decades of dietary advice — fats can actually be pretty healthy, and cholesterol is the building block by which our bodies create hormones.
So, why haven’t we heard about it sooner? Let’s take a look at the past 100 years of nutrition history to get a clearer view.
Fasting & The History of the Ketogenic Diet
Keto is inextricably linked to fasting, for fasting is the state which the ketogenic diet was created to mimic.
Fasting is an old concept in human nutrition, and even today, many religious cultures practice fasting as a spiritual event. I am not religious in a strict sense, but with that said, the suggestion to partake in fasting by most religious texts might be the greatest evidence of divine wisdom I know of. I’m kidding, mostly, but it is true that fasting is an incredible and important tool.
In the words of Hippocrates: “To eat when you are sick is to fuel your sickness,” and it is no wonder that lack of appetite is a common symptom of a bad flu or a cold.
This isn’t all just conjecture either. Fasting has been used in medicine for real health problems since 500 B.C. Hippocrates discovered that fasting was effective for treating seizures, and almost 2500 years later, this would lead to the creation of the ketogenic diet.
In the early 1900s, physicians at the Mayo Clinic discovered that a high-fat, low-carb diet mimicked the effects of fasting in treating epilepsy. Ketosis is so effective at treating epilepsy that it is being considered as a treatment for a myriad of other neurological diseases.
Then a researcher named Ancel Keys appeared, and everything changed.
Ancel Keys & the demonization of fat
Despite these discoveries, the ketogenic diet and low-carb diets would be all but wiped off the map starting in the 1950s. It starts with a researcher named Ancel Keys, creator of the “Diet-Heart” hypothesis and a major influence on the high-carb dietary guidelines that would be adopted by the U.S. henceforth.
Ancel Keys believed that saturated fat and dietary cholesterol were major contributors to heart disease, and his famous “Seven Countries Study” pointed to this conclusion. Regardless of the accuracy or inaccuracy of these findings, the issue would be that all fat, not just saturated fat, would come under fire.
The reality is that The Seven Countries Study had some significant flaws. Keys selected the 6 out of 22 countries which showed the greatest relationship between fat consumption and increased heart disease for his study results. However, when you look at all the data available, the results were vaguer.
Furthermore, the deeper data of the study implies that animal fat consumption and heart disease is much more direct than saturated fat or fat in general. For a great analysis of Keys’ study, check out this article by Dr. Harcombe.
I have my own theories for why this might be, and I am no vegan, but I do suggest that when it comes to keto, you should get as much of your fat from plant sources as possible and stick with lean cuts of meat for your protein (with the exception of fish).
I also find this whole story interesting because Ancel Keys himself ate a Mediterranean diet, which often has a higher amount of fat and lower amounts of grain-based carbs. I don’t know the specifics of his version of the diet, but between olive oil, olives, and fish, I’m sure Keys was benefiting from healthy fats himself.
I don’t blame Keys. After all, he was just one researcher, and I’d guess he really wanted to help people. However, in the following years, the country would run with new dialogue that high-carb grain based diets were the solution, and fats the enemy.
If Keys’ data was the first domino, a presidential heart attack was the second. President Eisenhower switched to a high-carb, low-fat diet after his first heart attack in 1955, and he became a major advocate of this high-grain, anti-fat way of eating.
Most people don’t realize that Eisenhower’s health became rapidly worse on this diet. He would go on to have much higher cholesterol, experience 5 more heart attacks, and a stroke, and ultimately died of a heart attack in 1969.
In 1977, the USDA Dietary Goals for Americans recommended a decrease in dietary fat and suggested a diet based primarily on grains and cereals. Since then, obesity, and diabetes have only increased. The rest, as they say, is history.
Don’t call it a comeback
As high-carb diets became more popular, keto and low-carb fell by the wayside. Still, some remained fervent proponents — and none more famous (or infamous) than Dr. Robert Atkins.
Dr. Atkins brought his own version of keto to the public with his book, Dr. Atkins’ Diet Revolution, which he published in 1972. After his death in 2003, a team of studied the diet formally, and discovered that the Atkins diet outperformed a diet based on the 1977 USDA guidelines with respect to several coronary risk factors.
Steadily, others began to go against the high-carb grain (pun intended) and throughout the 2000s, low-carb diets have increased in popularity. A recent meta-analysis of data from 18 countries links increases in carbohydrate intake with increased mortality.
These days, low-carb diets and keto are more common than ever, and you can find advice on how to do these diets anywhere you look. However, like anything popular, there is a lot of misinformation out there, and the ketogenic diet is not immune to myths and falsehoods.
Myths & Misconceptions
We’ve covered some benefits of keto, defined it, and covered the history of keto, and now we’re going to cover some common myths about the diet.
We could go right into the how-to stuff, but I want to build your foundation. This way you can go into the ketogenic diet feeling educated and empowered.
For those of you who are new to keto, this will prepare you for when people bring up these myths to discourage you, and will also show you that if you hear about other concerns regarding keto, that you can find good, accurate information out there to help you make your own judgment.
In short, addressing the myths and misconceptions before actually showing you how to do the diet gives us a better foundation of understanding so we can focus on some of the real problems of a keto diet done wrong.
Myth #1: You will lose muscle on a ketogenic diet (and can’t gain muscle on it)
This one is especially for athletes, and I’ll just nip it in the bud here in the first few sentences. You are actually more likely to gain muscle on a ketogenic diet than to lose it.
The worry that you can lose muscle on keto is based on a misunderstanding of a process called gluconeogenesis, whereby the liver converts protein into glucose. Our body cannot break down fats into glucose. There are certain processes in our body that require glucose and cannot run on fats.
Because of this, some think that your body is just going to break down its muscle tissue to provide glucose for these processes.
It’s an understandable misconception. If you aren’t consuming carbs, and you can’t turn fat into glucose, your body will surely convert protein into glucose instead, right?
Many of the processes in your body can run on both ketones and glucose, or on ketones entirely. When you enter ketosis, though your kidney cells (for example) can only use glucose, your brain can use both. Your body will send ketones to your brain, and then glucose in the brain is sent to the kidney and other processes that can only use glucose.
You see, the body is efficient, and the process of gluconeogenesis (using protein to make glucose) is slow. Entering ketosis doesn’t cause your body to just run out of glucose — ketones will displace glucose where possible, and send it elsewhere.
What little protein the body does need to break down for glucose will come from your dietary intake, which, even on a ketogenic diet, should be 15% to 25% of your calories, and there are also the 5% of your diet in carbs you’re still eating.
If all this weren’t enough to maintain your glucose needs, there is also The Cori Cycle.
The Cori Cycle is a metabolic process for producing energy. As your body displaces glucose to other parts of your body, it creates lactic acid, which is also a byproduct of exercise. This lactic acid goes to your liver, where it is then turned into — you guessed it — more glucose.
This is particularly cool for an advanced ketogenic athlete because it means that their body is using the by-product of lactic acid from exercise to create fuel. We’ll get into this more in a later section about keto for active individuals.
That’s the science. People also believe they are losing muscle because, in the initial days of keto, you deplete the glycogen in the muscles and dump water weight, making you look smaller. For every gram of glycogen in the muscles, your body carries 3–7g of water. That can cause pretty significant appearance changes when looking in a mirror. (Heck, I dropped 5lbs in the first two days on keto despite being a very fit, low body fat individual.)
Combine that with many people feeling somewhat “spent” during their first few days of keto, due to the body trying to continue using sugar for fuel despite lowering glycogen stores, and it’s easy to understand why someone would think they are simply “losing their gains.”
It’s all just water-weight. It takes a lot, and I mean a LOT, for the body to catabolize (break down) muscle. As long as you are not eating at an extreme calorie deficit for long periods of time, you should be fine.
On the contrary, the ketogenic diet is actually muscle-sparing, meaning that your body can retain and create muscle more easily on keto than many other diets.
Beta-Hydroxy Buterate (BHB), which is the main ketone created from fats during ketosis, preserves protein, as well as promoting protein synthesis. If that weren’t all, BHB prevents the oxidization of leucine, which is one of the main amino acids used in muscle building.
Ketosis preserves muscle, promotes the ability to gain muscle, and preserves leucine.
A study in the Journal of the International Society of Sports Medicine observed the effect of weight training while on a very low-carb ketogenic diet, vs. a standard American diet.
Those that were on the ketogenic diet had an average increase in muscle mass of 9.5 lbs, whereas the traditional diet group gained 2.2 lbs on the same weight training program. Furthermore, the keto group had gained greater muscle density as well, meaning that they gained less fat than the traditional diet group.
I think we’ve got that one just about covered. Keto = good (read: great) for muscle, not bad for muscle.
Myth #2: Keto slows down your metabolism
Keto is popular for weight loss, but some people think that the ketogenic diet will cause your metabolism to slow down in the long run, which is a common problem for other weight loss diets.
Here’s the thing: any diet that involves restricting your calories can result in a slower metabolism. If you maintain a calorie deficit for 3+ weeks, you’ll have to worry about your metabolism slowing down regardless of whether you’re eating low-carb or not.
That said, it’s a good practice to include a refeed day once a week while on a ketogenic diet. Either increase your calorie intake 500–1000 kCal, and/or include carbs.
Yes, if you include carbs this will knock you out of ketosis, but as you continue to do a ketogenic diet, your body will become more and more efficient at getting back into ketosis, so much so that an active athlete can eat up to 200g of carbs at night and be back in ketosis when they wake up in the morning.
Just like the myth about losing muscle on keto, this diet actually appears to do the opposite compared to other diets. Eating a ketogenic diet actually appears to help you maintain a higher metabolism while losing weight than other diets.
We all have something known as a Basal Metabolic Rate (BMR), which simply refers to the amount of calories we burn per day — regardless of our activity level. Typically, someone’s BMR represents 75% of their energy expenditure.
Well, your BMR is tied to your weight, and a larger person will have a higher BMR due to greater energy demands simply carrying their body weight. It’s harder to carry a 50-lb backpack than a 20-lb backpack, and this is true of being overweight as well.
Normally when people lose weight quickly, their BMR drops, too, due to their lower weight. This makes them susceptible to a rebound where they will gain all the weight they lost as soon as they stop exercising or start eating more.
However, the ketogenic diet pulls off something pretty amazing. As you lose weight on keto, your metabolism stays the same.
A recent study performed in London observed the changes in resting metabolic rate of 20 men as they proceeded to lose weight over the course of 4 months on a ketogenic diet. Despite dropping 45 lbs, the men in the study displayed almost no change in metabolic rate, and this was not related to an increase in sympathetic tone, thyroid hormones, or other factors.
The most common hypothesis is that the metabolic rates of these men were maintained by lean body mass, which ketones help preserve as mentioned in the last section. Basically, because ketosis preserves muscle, which helps maintain metabolism, you‘ll maintain your metabolism as you lose body fat.
Myth 3: Ketosis is bad for your thyroid
This myth is a favorite among keto-diet opposition. Your thyroid is a gland in your neck which helps control your metabolism, and when it isn’t working right you can feel pretty crummy.
When in ketosis, many people display lower levels of the thyroid hormone T3, and because of this, some claim that keto must be bad for the thyroid. However, what they don’t know is that some of your T3 is dedicated to metabolizing glucose.
Knowing this, it really doesn’t cause much concern that T3 would be lower on a diet that involves far less glucose metabolism. Further, the symptoms of hypothyroid — a condition brought on by poor thyroid function — are contraindicated by many effects of a ketogenic diet.
For one thing, ketosis preserves metabolism, whereas hypothyroidism is associated with impaired metabolism.
Now, I’m not suggesting that you can’t get thyroid problems on a ketogenic diet. Thyroid problems can appear as a result of all sorts of things, especially when you put the body under stress.
Add in genetic factors and other risks, and someone could get thyroid issues while on keto, but not necessarily at higher risk than any other diet or major change.
In fact, current research implies that even multi-day fasting shows no negative effect on the thyroid. Similar to the ketogenic diet, multi-day fasting slightly lowered T3, which is likely due to less glucose metabolism — then once you stop fasting, it returns to normal.
Now, I will admit there is not a ton of research on this topic. However, that goes both ways. While there is little evidence to imply that keto is bad for the thyroid, there is little supporting the idea that it is dangerous either.
If you get thyroid issues, you’ll know it. Many people go into the diet worried their thyroid is getting messed up, but they feel fine.
If your thyroid starts misbehaving, you‘ll know it right away. Symptoms of thyroid problems include sudden and rapid weight gain, sensitivity to both hot and cold environments, poor mood and concentration, and even anxiety and depression, not to mention straight up fatigue.
That said, I’d be surprised if the ketogenic diet caused you thyroid problems without other factors, such as excessive job stress or overtraining in the gym.
The biggest danger to your thyroid on the keto diet is if you maintain a calorie deficit for too long, which (as we mentioned earlier) slows your metabolism on any diet. This is why a higher calorie re-feed at least once a week is a good idea on a keto protocol.
Common Mistakes on the Ketogenic Diet & How To Avoid Them
As the title implies, here is where we step from myth into reality, and the ketogenic diet does have a few common mistakes that can make this otherwise amazing diet less effective.
Mistake #1: Being too concerned about eating excess protein
This mistake occurs because people give the process of gluconeogenesis too much credit. If you’ll recall the earlier section on building muscle on keto, gluconeogenesis is when the liver converts protein into blood glucose.
The existence of this process leads many to believe that consuming too much protein on a ketogenic diet will kick them out of ketosis. However, gluconeogenesis operates based on demand, not availability.
What I mean by this is that your body will not convert protein into glucose just because you ate more than you intended today. It only converts protein to glucose if your body needs glucose, so it’s going to happen based on that rather than whether you ate 25% of your calories from protein today or 35%.
The body always has some glucose demands, so if you decide to seriously restrict your protein and carb intake, gluconeogenesis will use existing tissue to create glucose. This is why it’s best to have adequate protein, and why it’s actually good to introduce more carbs occasionally to supply glucose demands.
Mistake #2: Not eating enough (read: any) carbs
But carbs are the enemy, right? Not necessarily. The biggest enemy of health isn’t that people eat carbs, it’s that we’ve eaten such high amounts of carbs for so long that for many of us have impaired metabolic function (particularly insulin sensitivity) and we can no longer easily use fats for fuel.
Issues with ketosis tend to come up when people do the diet for long periods of time. There are a few reasons this can happen, but one of them may be simply not leaving ketosis often enough.
Here’s the thing: when you leave ketosis, it doesn’t reset all your progress. Every time you enter ketosis, it gets easier and easier for your body to do so, until eventually, you can literally eat carbs in the evening, leaving ketosis, and be back in by the time you wake up in the morning. More on that later.
Including weekly re-feeds where you eat some high-quality carbs can help prevent problems with long-term ketosis.
Having a day of the week when you consume higher calories, and don’t restrict carbs, can let your body replenish glycogen stores to support high-intensity training, get fiber and starch to support your gut-biome, and replenish minerals that you may be lacking if you restrict carbs for too long.
Now, that doesn’t mean to binge on pizza and grains. Typically, my carb “re-feeds” are comprised primarily of vegetables and sweet potatoes.
Re-feeds are not “cheat days” and are not an excuse to eat poor quality food. We’ll get into food quality later, but eating real, good quality food is probably more important for most people than being in ketosis.
Another note: keto is great for athletes, but high-intensity exercise needs some sugar to provide energy. This is why many CrossFit athletes do not do keto.
When you get fat-adapted and are really efficient at entering ketosis, you can actually replenish your body’s glycogen stores with refeeds and night carbs. This allows for an ultimate state where you have full glycogen stores and are also efficiently burning fats for fuel.
I recommend that athletes who perform at a high activity level — either training more than an hour a day or participating in high-intensity anaerobic training like CrossFit — eat more carbs with their evening meals.
This will kick you out of ketosis, but if you stick with a ketogenic diet otherwise, you can get to the point when you are eating carbs at night, leaving ketosis, and getting back into ketosis by the following morning.
Ben Greenfield, an extreme endurance athlete and a biohacker, eats up to 200g of carbs a night and is back in ketosis the next morning.
This strategy is best implemented after you are already well adapted to ketosis. If you try eating big amounts of carbs at night when you are first starting keto, even if you are a hard-charging super-athlete, you may simply be sabotaging any chance of entering ketosis. Still, it’s a great strategy once you’re used to the diet if you train often.
In short, everyone should re-feed at least once a week, where you eat more calories than your daily energy needs. Athletes should have some carbs at night — up to 200g if you’re very active and several weeks or month into keto already.
Refeeds can also be a great way to maintain social obligations such as weekend get-togethers. You can obviously hang out with friends while maintaining keto, but it’s a lot easier if you don’t have to worry about your keto macros.
Mistake #3: Eating too many omega-6 fats & dairy
The ketogenic diet is popular, heck, it was the most popular diet in America in 2018. I love that, and I commend anyone who is trying to improve their health. However, it is not necessarily enough to just be in keto. The quality of the foods you eat matters, especially the fats you eat.
For one, the ketogenic diet doesn’t explicitly set a standard of quality — it just asks that you get 70%+ calories from fat, 15% to 25% from protein, and 5% or so from carbohydrates. How you go about that is left up to you, and you will enter ketosis on that plan no matter what you eat.
However, that doesn’t give you a free pass from all the health problems that come with low-quality eating, and poor food choices in the keto diet can lead to problems down the road.
Many of the foods available to us are high in omega-6 fatty acids. For optimal health, our bodies need a ratio of 4:1 to 1:1 omega-6 to omega-3 fats. Many people have a ratio closer to 20:1 omega-6 to omega-3, due to added vegetable oils and high consumption of dairy.
Then, we start keto and need to up our fat intake to 70% of our calories. Suddenly we’re eating a lot more of the fats we’ve always eaten, and our omega ratio becomes even more imbalanced.
At first, people still feel great, due to the anti-inflammatory effect of being in ketosis, but around the 3-month mark, many people hit something called the keto wall. They still show results and continue to lose weight, but they just feel crummy, and many people complain of joint pain at this point.
Here’s how you can avoid this: prioritize your dietary intake of omega-3 and omega-9 fatty acids. You should still consume some omega-6, but not excessively. A few ways to do this are:
- Use lean meat for your protein, and get your fats from plant and trusted sources.
Meat can be a great source of good fats, but it can also have too high omega-6 amounts. In particular, beef from grain-fed cows has a less optimal lipid profile compared to beef from grass-fed, grass-finished animals.
Unless you have access to grass-fed, grass-finished meat, stick to lean cuts and focus on getting your dietary fat elsewhere. The exception to this is small, oily fish. Oily fish such as salmon and sardines are both a phenomenal source of omega-3, and also usually contain less heavy metals than large, lean fish like tuna or swordfish.
2. Cut the cheese
Cut out dairy. I know, milk and cheese are a very common and convenient source of fat, but they are high in omega-6 fats. Furthermore, cow dairy in the U.S. contains an A-1 casein protein, which is highly inflammatory for most people. This protein strongly resembles the gluten protein, and can even influence thyroid disorders.
How so? A-1 casein is similar in structure to thyroid proteins. When your body is constantly inflamed by casein, it can eventually make the mistake of thinking your thyroid is causing inflammation, and you could develop problems.
As long as you are paying attention to your omega-6 intake, goat dairy or A-2 dairy products are a great alternative that does not cause inflammation in most people.
3. Use a high-quality fish oil or algal oil supplement
This is one of the best ways to get extra omega-3 fat into your diet. Quality fish oil or algal oil is pure omega-3 and can work wonders to help assuage an imbalanced omega fat ratio.
I personally recommend algal oil over fish oil, as it has much higher amounts of DHA which is a powerful brain enhancer. Either way, though, do not skimp on quality. Quality standards for fish oil products are low, to say the least, and companies can release sketchy products with ease.
Lots of fish oil products on the market are rancid and will do more harm than good. Make sure the product you go with is reputable. I am not affiliated with either of these, but I strongly recommend the KetoBalance product by PuraThrive, which is a blend of algal oil, collagen, and MCT oil wrapped in a liposomal delivery layer, or living fuel essentials fish oil.
Both of these are also available on Amazon, but they have better descriptions on their home sites, which I do recommend reading.
Another awesome source of omega-3 is fish eggs! Salmon roe, in particular, is a phenomenal source of DHA omega-3 from a food source.
Putting It All Together: How To Do the Ketogenic Diet
If you’ve stuck with me and read this guide so far, then you already have a great foundation for doing a ketogenic diet yourself. You know about some of the false myths of doing keto, so you won’t shy away from it just because you lose water weight or are worried about slowing your metabolism. You also know about common mistakes people make, such as consuming poor quality fats or never eating carbs.
Now we’re going to learn how to actually perform a ketogenic diet and make variations based on your personal goals.
First things first, let’s discuss a few things to help you go into the diet with a good mindset and feel prepared to go through with the keto diet.
The Keto Flu
When you start the ketogenic diet, you may not feel very good during the first week. However, this doesn’t mean you should quit. Many people experience something known as the keto flu, which as the name implies can feel like flu-like symptoms. You will likely feel lower energy, possibly fatigue, and maybe headaches. However, the reasons behind keto flu can be used to help make things more manageable.
Your body is dumping glycogen as it switches over to using fats for fuel. This causes you to deplete water faster as well, and many of the symptoms of keto flu are the result of simple dehydration. It’s pretty simple: just drink more water.
Grab a few big Nalgene or Liberty water bottles, and drink 3 to 5 a day based on your thirst level.
2. Supplement with sodium, magnesium, and potassium.
Because your body is depleting water, it is also depleting sodium. Now, your body isn’t depleting potassium directly, but the relationship between potassium and sodium is so tight-knit that your body will use up potassium in response to lower levels of sodium. Simultaneously, most people are deficient in magnesium, and it helps regulate the other electrolytes.
Magnesium, in particular, offers a host of other benefits, but during ketosis, it can help prevent mood problems and also help regulate your other electrolytes.
I increase my sodium by adding 1/4 teaspoon to 1/2 teaspoon of pink Himalayan salt to my water throughout the day. Try to spread it out or use a large water bottle, as too much sodium at once can cause your body to expel it in the form of diarrhea.
You should consult a doctor before supplementing with potassium, and I cannot give you a specific recommendation for how much to take. Typically people do well to supplement 99 to 200mg per day, with sodium and magnesium. Eating avocados is a great natural way to increase your potassium, and I personally use this method. Bring on the guacamole!
For magnesium, the best thing to do is get an RBC magnesium blood test through your doctor or through a company like Direct Labs. The ideal result would be 4.2 to 6.8, though if you are at the lower end of that range you could supplement some magnesium.
Daily values of magnesium involve supplementing 240 to 500mg daily, but on keto, you can do 400 to 800mg spread throughout the day. I recommend using magnesium glycinate or magnesium malate. These have much greater absorbability than other forms and are less likely to have a laxative effect. Like sodium, spread your magnesium supplementation throughout the day.
Furthermore, magnesium often has an anti-anxiety effect for some people, and can be great for using to get better sleep or facing challenges.
3. Supplement with KetoPure by Purathrive or use a quality fish oil to supplement your omega-3 fats.
We already mentioned this earlier in the mistakes section, but using a good omega-3, especially one high in DHA, benefits the brain and can completely prevent mental fatigue as a result of keto.
Even if you initially experience lower physical strength, you can get the cognitive benefits of keto pretty quickly by using DHA.
4. If you feel weaker during workouts, don’t worry about it.
Your body is switching fuel sources and dumping the glycogen it normally uses to power your muscles. For this reason, you may feel weaker during workouts, especially regarding strength exercises. On the flip side, your body will also be using your lactic acid to create glucose as necessary, so you will probably also get less sore.
This is normal, and as you do keto longer your body will not only regain its old strength but you should be able to perform at even higher levels.
High-intensity interval training may be the most difficult on keto, but you can definitely do this training when you become fat-adapted. When you’ve gone a few weeks on keto, your body can start storing glycogen again through your refeed days or carbs at night.
An active ketogenic athlete can eat up to 200g of carbs a night to restore muscle glycogen and be back in ketosis by the morning. Furthermore, doing re-feed days with no limit on carbs once a week is recommended for everyone and helps restore glycogen.
Measure your macros
A common nutrition logging technique is to measure your macros. This simply means to keep track of how much protein, fat, and carbs you eat on a daily basis.
For the ketogenic diet, you should eat 70% to 80% of your calories in the form of fat, 15% to 25% from protein, and 5% or less from carbs, initially (once you have been doing keto for a while, especially if you are active, you can increase your carbs as long as you eat them at night.)
So, basically, if you are going to attempt keto you should measure your food precisely. Sure, you can try to just wing it, but you’ll be constantly guessing whether you’re getting enough fat, eating too many carbs, etc.
It’s do-able, but it’s far easier to just measure the dang stuff.
It’s also cheap, and easy. All you need is a food scale from Amazon ($10) and an app or database to get the nutritional info for the food you eat. There are a few good apps out there, but I recommend My Macros + for the simple reason that it calculates your macros for you.
The reason you need to do this with keto is that your body will only enter ketosis and begin producing ketones when you are eating enough fats, and eating very few carbs. Guesswork here will simply lead to a much more complicated and difficult process.
Furthermore, if you’re not measuring your ketones (and you should be) your only hope of truly attempting keto is to measure your macros. There are a few signs your body will give you to let you know you might be in ketosis, but I am telling you, do not try to just wing it. It will be more difficult, and even if you do enter into ketosis, you’ll never know for sure that you did the diet right.
Which leads to our next point…
Measure your ketones
Entering ketosis is defined by your body creating ketones from burning fat for fuel. Therefore, you only know if you’re doing the ketogenic diet correctly if you enter ketosis.
So, we measure.
You are in a state of ketosis when your blood ketone level is higher than .5mmol, and many feel the benefits of ketosis above 1.0 mmol.
There are 3 main ways to test whether you are in ketosis:
- Blood ketone levels
This is far-and-away the most accurate way to measure your ketones. However, it is also far-and-away the most expensive (though not excessively expensive).
As the name implies, measuring your blood ketones involves using a device that measures the ketones in your blood.
Most of these devices work by pricking your finger and measuring on a blood ketone strip. The trouble is that ketone strips are fairly expensive, so measuring often can become impractical.
Thankfully, the kit by Keto Mojo offers much more affordable ketone strips than any competition, and they have spearheaded the campaign to make accurate ketone measurement easily affordable for all.
If you want the Ferrari of ketone monitoring, then you should get the Dexcom G6 continuous blood ketone monitor. This device is about $350 and allows you to continuously monitor your ketones and blood glucose. No finger pricks necessary, and you can see what your ketone and glucose levels are at all times.
Activity and the hormone cycle can affect how our ketones and glucose change throughout the day, so a continuous monitor is how you read and use that information.
2. Ketone urine strips
If you don’t want to shell out the money for a blood ketone monitor or prick your finger, keto urine strips are the next on the list.
These are by far the most affordable way to measure your ketones but are also the least accurate.
When you first get into ketosis, your body is very inefficient at using ketones for fuel. Because of this, your body dumps a lot of excess ketones in your urine and sweat. So, when you are new to ketosis, you can use keto urine strips to measure these excess ketones.
If you are producing excess ketones, then your body is burning fat to create ketones. You won’t know your blood ketone levels, but you will know you are producing ketones.
The only problem is that after your body adapts to a ketogenic diet, it will stop dumping ketones in the urine, and urinary ketone strips will no longer work. You might be in deep ketosis but show no ketones in your urine.
However, this is still a good tool for first getting into ketosis. You can use urine strips when you begin keto to make sure you’re doing it right and can invest in a blood ketone monitor at a later time.
I’ve personally used Keto 22 urine strips. Others are probably just as good, but I can vouch for these, and they are only $8 for a bottle.
3. Ketone breath monitor
This is the sweet spot between blood and urine testing. Blood testing is accurate but expensive. Urine testing is cheap but inaccurate. Well, breath testing is both accurate and affordable.
Research has found that acetone levels in the lungs are very accurate to measure the levels of ketones in your blood, and because of this, you can test your acetone levels using a breath monitor to determine your level of ketosis.
There’s really not much more to it than that. Yes, blood monitors are the most accurate, but you’ll either need to deal with scabs on your fingers from constantly pricking them, or shelling out a few hundred dollars for a continuous monitor.
I think that breath ketone monitors are the perfect happy medium. They’re very accurate, don’t prick your finger, and are much more affordable than continuous blood ketone monitors.
The best breath ketone monitor I know of is the Keyto. At $129, it’s an investment but is far more affordable than a continuous blood ketone monitor. It also doesn’t involve replacement strips like a standard blood ketone monitor.
Quality over quantity
I think the biggest mistake people make with nutrition in general is that they don’t prioritize eating high-quality food. Heck, I think it’s better to just start eating organic whole foods than to do most “diets” in the first place, and it’s not that difficult to figure out:
“Eat real food,
not too much,
This mantra, made popular by the food author Michael Pollan, is the best, simple diet advice I have ever heard, and we’ll apply it to the ketogenic diet as well.
- Eat real, whole foods
Eat food that you could either grow in a garden or get directly from an animal.
When consuming dairy, stick to goat dairy and avoid inflammatory A1 cow dairy. Yes, dairy comes from an animal, but the dairy at a store is in a much more processed state than if you worked at the farm. The long and short of this phrase is basically: eat meat and plants, which have been minimally processed, if at all.
Go organic when possible to avoid pesticides, wash your food thoroughly before eating.
When it comes to meat, stick with grass-fed and grass-finished beef, pasture raised chicken, etc. when possible, and exclusively for fatty cuts of meat. This is important — you need to eat a high amount of fat on a keto diet. However, grain fed cows have higher amounts of omega-6 fat in their meat.
If you are not going to eat grass-fed, which is perfectly understandable, then stick with lean cuts of meat and get your daily fat intake from plant-based or other trustworthy sources.
Fish are a great source of healthy omega-3 fats, but many have heavy metals in their flesh due to ocean pollution. Stick with smaller, oily fish like sardines, and salmon that is wild-caught not farm raised.
Avoid large fish such as tuna, mackerel, and swordfish, all of which tend to contain higher amounts of metal in their meat.
2. Not too much: Restrict your calories, most of the time
The second part of our mantra refers to the benefits of caloric restriction, which simply means eating LESS calories than you burn. This is not only necessary for weight loss but is well linked to increased longevity.
When doing a ketogenic diet, either for weight loss or for improved health, you should endeavor to eat a daily calorie deficit (meaning less than you burn,) on most days of the week.
Then, to avoid negatively impacting your metabolism, include high calorie feast days once a week and/or before days of high activity. You can find out your estimated daily calorie needs by using a calculator such as TDEE.
Whatever your TDEE comes out to be, aim to eat 200 to 300 calories lower on a daily basis. If you feel hungry all the time, you can increase it.
We’re not trying to have an extreme calorie deficit, but just trying to have one. A ketogenic diet combined with even a small calorie deficit will lead to weight loss and improved health.
On your weekly re-feed day (I like to save Saturday for this), you can aim to eat 500 to 1000 calories over your TDEE depending on your size. A good way to do it is to just not count your calories at all, and eat how you like.
This is also a good time to eat carbs. Yes, it will kick you out of ketosis, but every time you get back into ketosis in the coming days, your body will do it faster and faster.
Eventually, this lets you restore your muscle glycogen with the carbs from your re-feed day, while maintaining ketosis the rest of the time. Your metabolism never slows down from a long-term calorie deficit, and you have fuel for hard workouts that rely heavily on glucose.
I also like to use this part of our mantra (not too much) as a reminder to participate in the practice of fasting.
The ketogenic diet is also known as “the fasting mimicking diet” for a reason. The state of ketosis is reached during periods of fasting, especially if you eat low-carb most of the time outside of this.
Fasting is being studied heavily these days for many a good reason, including hormone balancing, losing weight, improving insulin sensitivity, and even shows promise for preventing cancer (this is not medical advice nor should be construed as such — see a doctor before using fasting for a medical condition).
For our purposes with keto, the most beneficial fasting tool is intermittent fasting, which is an easy way to enter a fasted state on a daily basis without lowering calories or fasting for days on end.
There are benefits to longer fasts, and I do recommend them, but for now, simply consider the habit of skipping breakfast. When your body goes 12 hours or more without food, you enter a fasted state. Keto already lends itself to efficiency in this state, so to boost benefits and support ketosis, simply begin skipping breakfast and increasing the size of your meals later in the day.
It’s not about eating less, but about eating less often. You should still aim to hit whatever calorie goals you have, just do so during the lunch to dinner window of your day.
3. Mainly fats from vegetables
I think the third part of this mantra (eat mainly vegetables) comes from research which implies that higher consumption of animal products reduces lifespan.
I do not personally think this is the case, as many of these studies have at-best vague results, or they imply that processed meats like hot dogs or bacon with nitrates increase your risk of early death, but steak and “clean” meats do not. A review of the scientific literature points this out well.
However, I definitely think that on a ketogenic diet, you should get most of your fats from plant sources or trustworthy sources (low heavy-metal fish).
Like we said earlier, unless you have a trusted source of grass-fed, grass-finished meat, stick to lean cuts of meat and get your fat intake from plant-based sources.
Furthermore, try to eat a Mediterranean-like ketogenic diet, relying more heavily on unsaturated fats than saturated fats.
Why? Because even though coconut oil, a saturated vegetable fat, is healthy for most people, your genetics can make it unhealthy for you.
If you have the APOE4 genetic variation, saturated fats can cause inflammation in your body.
You can definitely get your genetics tested, and companies like 23andme will let you do so for $100 or so. But otherwise, just be moderate with your saturated fats, and avoid them entirely if you feel inflamed after eating them.
I personally have the APOE2 gene, which means I don’t need to worry about saturated fats whatsoever. I can, and do, consume copious amounts of coconut manna, but I still use mainly unsaturated fats for convenience.
For most people, this will mean olive oil, so I’ll add a quick section here.
Most forms of olive oil are cut with other, unhealthy oils. For this reason, you should be careful about where you get your olive oil. The best brand I know of is Vervana, by the heart doctor Stephen Sinatra.
Vervana is like the Ferrari of olive oils and is a little pricey. For this reason, I use it primarily as a small dressing for my food rather than as a cooking oil. For the rest of my needs, I’ll use coconut oil or Braggs’ Extra Virgin Olive Oil, which is great quality and available at many grocery stores, such as Whole Foods.
Conclusion and My Experience With Keto
I won’t get too in-depth about it, but I started my journey into health and fitness expertise when I developed a condition known as HPA-axis dysregulation in 2017.
I suffered panic attacks, mental problems, chronic fatigue, neuropathy, hot flashes, and for the better part of a year I was house-bound and could not work a job.
During this time, partially because I already believed in natural health, and partially due to a lack of income for expensive treatments, I became an expert on biohacking, diet, movement, and anything that could help me get better.
Despite this, it was not until relatively recently that I decided to officially try keto, and I regret that I did not participate sooner.
For one thing, maintaining keto is a lot easier than I ever expected. It just takes an app and some measuring devices. I didn’t even realize I’d been eating an almost-keto diet for months, but sabotaging it with unhealthy carbs I’d eat at night, usually because of cravings.
The second reason I started so late is because of all the myths I’d heard. My issues were a result of overtraining in CrossFit and crashing my adrenals. Half the people I listened to thought keto would help. The other half said it would damage my thyroid and hurt me more.
However, I always felt worse when eating too much sugar and carbs, and all the evidence my body was telling me implied that I needed to cut them out.
Anyway, my personal experience with keto is that I can focus for long periods of time without feeling distracted.
My mood is stable, and I have been able to tolerate coffee for the first time in two years.
I did notice weakness when doing strength exercises during my first week of keto, and I lost 5 lbs of water weight in the first 3 days. However, by using the right supplements and quality foods, I avoided any mental negatives of the keto flu and was immediately working better when writing articles and getting things done.
Then, around week 3 I gained all that weight back and then some, while still maintaining great muscle definition. I’ve been combining keto with a muscle-building cycle, so it is likely this is primarily muscle.
Another major benefit I’ve had since starting keto is sleep quality.
Before keto, I typically went to bed at 11 pm or 12 am and woke around 9 am. I fell asleep easily, but if I tried to go to bed any earlier it just didn’t work. I was also slow to rise in the morning, spending up to an hour laying in bed in a state of half-wakefulness.
Since getting on keto, I can go to sleep with ease as early as 8pm, and get up as early as 6am without issue. I get up quickly, and feel ready for the day. Even when tired, I don’t feel mentally hazy or distracted.
I have been waking up in the middle of the night occasionally, usually because I need to pee, but I fall back asleep quickly and don’t notice negative effects the next morning.
To me this means that I’m more easily awoken, but simultaneously capable of easily going back to sleep and getting good quality rest. This, in particular, is a favorite benefit of mine, as optimal sleep is one of the most important aspects of healthy living. Furthermore, the control to go to sleep earlier is invaluable for getting ahead on the day and maintaining discipline in my life.
I don’t know what you will experience on keto, but based on everything I’ve read, heard, learned, or experienced, I think that by following this guide and doing the ketogenic diet correctly, you will feel get profound benefits and may feel better than ever before.
Thank you for sticking with me through this guide, and I wish you the best of luck with your keto journey.
Studies and Resources for Further Reading
- Long Term 24 Week Study of The Ketogenic Diet Effect on Weight, Blood Sugar, and Cholesterol in Obese Men With High Blood Sugar & Cholesterol. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2716748/
- Low Carb Diet Improved Insulin Sensitivity in Obese Women https://www.ncbi.nlm.nih.gov/pubmed/15047685
- Study of Metabolic Conditioning in Low-Carb Endurance Athletes vs. High Carb https://www.metabolismjournal.com/article/S0026-0495(15)00334-0/fulltext
- Ketogenic Diet & Migraine https://www.ncbi.nlm.nih.gov/pubmed/25156013
- Ketogenic Diet Neuroprotective Benefits https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2367001/
- Ketogenic Diet Positive Benefits For Children on Autism Spectrum https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5863039/
- Ketogenic Diet Potential as Mood Stabilizer in Bipolar https://www.sciencedirect.com/science/article/pii/S030698770191446X
- Ketogenic Diet Stroke Prevention https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4312394/
- Keto & Inflammation, Alzheimer’s Potential Treatment https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5981249/
- History of The Ketogenic Diet Chapter 2 https://link.springer.com/chapter/10.1007/978-1-59259-808-3_2
- Analysis of Ancel Keys’ Seven Countries Study http://www.zoeharcombe.com/2017/08/the-seven-countries-study-part-2/
- Atkins Diet Outperforms 1977 USDA Guidelines Diet With Respect to Coronary Risk Factors https://www.ncbi.nlm.nih.gov/pubmed/18046594
- High-carb Diet Dangers Meta-analysis https://www.ncbi.nlm.nih.gov/pubmed/28864143
- Very Low Carb & Preservation of Muscle Mass https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1373635/#B6
- Beta-Hydroxy Buterate Effect on Leucine https://www.ncbi.nlm.nih.gov/pmc/articles/PMC303494/
- Study In Journal of International Sports Medicine of Muscle Gain on Keto vs. Standard Diet during Weight Training https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4271639/
- Multi-day fasting effect on thyroid. http://www.drsarasolomon.com/fasting-and-thyroid/
- Benefits of DHA for the brain https://www.ncbi.nlm.nih.gov/pubmed/10479465
- Caloric Restriction Anti-Aging https://www.scientificamerican.com/article/the-hunger-gains-extreme-calorie-restriction-diet-shows-anti-aging-results/
- Fasting Increases HGH https://www.ncbi.nlm.nih.gov/pmc/articles/PMC329619/
- Review of Literature About Meat Consumption & Disease https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5474906/
- Comparison of Lipid Profiles of Grass Fed vs. Grain Fed Beef https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2846864/