Ketosis is pretty different from what your body is used to, and this onslaught of symptoms is its way of dealing with carb withdrawal—and adapting, explains Kristen Mancinelli, RD, author of The Ketogenic Diet. “It takes a while, usually a week or two, for the metabolic machinery to shift to fat-burning mode. And you’ll feel pretty crummy while the transition is happening,” she says.
After initiation, the child regularly visits the hospital outpatient clinic where they are seen by the dietitian and neurologist, and various tests and examinations are performed. These are held every three months for the first year and then every six months thereafter. Infants under one year old are seen more frequently, with the initial visit held after just two to four weeks.[9] A period of minor adjustments is necessary to ensure consistent ketosis is maintained and to better adapt the meal plans to the patient. This fine-tuning is typically done over the telephone with the hospital dietitian[19] and includes changing the number of calories, altering the ketogenic ratio, or adding some MCT or coconut oils to a classic diet.[18] Urinary ketone levels are checked daily to detect whether ketosis has been achieved and to confirm that the patient is following the diet, though the level of ketones does not correlate with an anticonvulsant effect.[19] This is performed using ketone test strips containing nitroprusside, which change colour from buff-pink to maroon in the presence of acetoacetate (one of the three ketone bodies).[45]
In 1921, Rollin Turner Woodyatt reviewed the research on diet and diabetes. He reported that three water-soluble compounds, β-hydroxybutyrate, acetoacetate, and acetone (known collectively as ketone bodies), were produced by the liver in otherwise healthy people when they were starved or if they consumed a very low-carbohydrate, high-fat diet.[10] Dr. Russell Morse Wilder, at the Mayo Clinic, built on this research and coined the term "ketogenic diet" to describe a diet that produced a high level of ketone bodies in the blood (ketonemia) through an excess of fat and lack of carbohydrate. Wilder hoped to obtain the benefits of fasting in a dietary therapy that could be maintained indefinitely. His trial on a few epilepsy patients in 1921 was the first use of the ketogenic diet as a treatment for epilepsy.[10]
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In addition, no statement on this website has been evaluated by the Food and Drug Administration, and any product mentioned or described on this website is not intended to diagnose, treat, cure, or prevent any disease. If you purchase anything through a link on this website, you should assume that we have an affiliate relationship with the company providing the product or service that you purchase, and that we will be paid in some way. We recommend that you do your own independent research before purchasing anything.
Heart disease: The diet emphasizes eating a lot of fat. If you eat too much saturated fat (the kind in foods like bacon and butter), that could raise your cholesterol, especially LDL, which is linked to heart disease. This is a special concern for people with diabetes, since the condition itself makes you more likely to get heart disease. Make sure that healthier sources are providing your fats -- the mono- and polyunsaturated kinds, such as those in foods like avocados, nuts, and olive and canola oils. If you do it right, your LDL cholesterol and triglyceride levels could go down. If you take medicine for heart problems, such as high blood pressure, check with your doctor to see if you need to make changes to your medications.
Another mineral you may want to supplement is potassium. While there is no concrete evidence that a dramatic potassium loss occurs on a low-carb regimen, Sondike says to ensure against problems he recommends patients use Morton's Light Salt -- a potassium chloride product that he says can add back any of this important mineral that's lost. Eating a few almonds is also a good way to supplement this mineral without adding carbs to your diet.
For your body to adapt to carbohydrate restriction, it must make many changes from the cellular level to the hormonal level. This process is synonymous with the adjustment period we go through after ending a relationship with someone we love very much. And just like with our first breakup, breaking up with carbohydrates can cause a laundry list of symptoms called the keto flu.

If you’re looking to get a jump start on your health and fitness goals this year, you may be thinking about trying the ketogenic diet. Maybe you’ve heard the phrase before — it’s a huge diet buzzword — but aren’t sure what it means. Here’s a primer: The ketogenic diet is an eating plan that drives your body into ketosis, a state where the body uses fat as a primary fuel source (instead of carbohydrates), says Stacey Mattinson, RDN, who is based in Austin, Texas.
For instance, working with an expert can reduce the risk for dehydration—which can make keto flu symptoms like headache, cramping, nausea, and fatigue worse. Drastically slashing carbs causes the body to excrete a higher volume of water and electrolytes, so you may need to drink more liquids and eat more salt to stay adequately hydrated, Mancinelli explains. How much more is different depending on things like your activity level and age, but a pro can help determine the right amount for you.
Although many hypotheses have been put forward to explain how the ketogenic diet works, it remains a mystery. Disproven hypotheses include systemic acidosis (high levels of acid in the blood), electrolyte changes and hypoglycaemia (low blood glucose).[19] Although many biochemical changes are known to occur in the brain of a patient on the ketogenic diet, it is not known which of these has an anticonvulsant effect. The lack of understanding in this area is similar to the situation with many anticonvulsant drugs.[56]
If you feel as if you’re starving, you’re likely to feel tired and want to give up your diet. But a ketogenic diet should not result in hunger, making it sustainable and possibly making you feel great. So eat enough protein foods and low-carb veggies, with enough added fat to feel satisfied. If you’re hungry all the time, check that you are getting adequate amounts of protein at most meals and, if so, add more fat to your meals (like more butter, more olive oil, or some delicious sauces). Our keto recipes have plenty of fat included, but you can adjust up or down, according to your own needs.
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