Ben – curious about your thoughts on this. I went into ketosis (using LOTS of coconut oil) but it raised my cholesterol and doc was worried about my lp(a) level (17mg/dL on VAP) even though crp was 0.5, trigs 51 and a1c was 5.2. Advised a low fat diet. Have you seen this before with folks on a lchf/ketosis diet and is there anything to be concerned about? Off to read your coconut oil article. Thank you!
I am not a doctor and this is not to be taken, interpreted or construed as medical advice. Please talk with a licensed medical professional about this. These are just my own personal thoughts and not a prescription or a diagnosis or any form of health care whatsoever. Your mother can avoid the "keto flu" by adding sufficient sodium to her diet and staying well hydrated, especially in the first few days of starting to reduce carbohydrates. The keto flu could also be called “carbohydrate withdrawal symptoms” because of the effects on hormonal and electrolyte balance. If you're not already using a device to measure ketones in your body, I recommend this one: https://bengreenfieldfitness.com/ketonix As far as how much to take, it all depends….you can actually do more than two servings per day if you want, and you can experiment to see how many servings your body should handle. You should know that it would be very difficult to overdose on ketones. They are water soluble, so any excess ketones will be eliminated mainly via the urine. Hope this helps!

How it’s done: Warm up the LEVL or Ketonix meter by plugging it in. Blow into it and wait for the flashing light indicating it’s reading your acetone levels. The software or the color and speed of the flashing light would tell your reading: green for least acetone, red for most acetone, less flashing for less acetone per color, more flashing for more acetone per color.
Moreover, in the above study of Sumithran et al. (2013), ketosis maintains post-prandial secretion of CCK as previously demonstrated by other researchers (Chearskul et al., 2008). Note that the orexigenic effect of BHB is blocked by transection of the common hepatic branch of the vagus nerve (Langhans et al., 1985). The hepatic branch contains fibers from the proximal small intestine, stomach and pancreas, and is sensitive to CCK (Horn and Friedman, 2004); ghrelin signals to brain are also transmitted via vagus nerve (Habara et al., 2014). Thus, the effects of ketosis on these two appetite-related hormones could be one of the many factors related to the effects of such nutritional regimen on food control.
I am curious if someone takes any or too much MCT oil (5-10 tablespoons/day) or Exogenous Ketones will the liver slow/stall or shut off endogenous ketone production as you are providing the ketones exogenously and thereby you may NEED to supplement ketones to maintain ketone levels or you may suffer a short term ketone deficit while the liver adjusts to making them on its own again. A parallel I am thinking of is exogenous testosterone supplementation and the hypothalamus/endocrine system slowing/stopping endogenous testosterone production (seen in bodybuilders).
Thank you for sharing, my husband and i have switched to the keto diet and we love it, we don’t feel restricted at all when it comes to meal planning, i actually feel like we eat more adventurous because we’re always looking for more receipts on how to prepare food. I’ve always done the same dinners, meat, veggies and a rice or pasta side, but with this diet we get to experiment, each night is something new to try. The Ketogenic diet is not about cutting all carbs, just cutting way back on carbs. We have gone and had regular check ups at the doctor with no negative results. I for one have always had an issue with poor digestion but since switching to the keto diet that has drastically changed. The hardest part for me was to cut pasta but i found great joy and fun in finding alternatives to pasta so i can still enjoy the same dish minus the carbs. There are so many different diets out there and so many different types of people so you have to find the right one for you, the keto diet is not for everyone but for us, so far it seems beyond perfect. Thank you again for sharing!
Also, take special note of sugar alcohols like sorbitol, mannitol, xylitol, and isomalt. Sugar alcohols are derived from plant products (ie., fruits and berries), though their carbs are uniquely altered through chemical processing. While sugar alcohols provide fewer calories than table sugar, people often overeat them because they are labeled as “sugar-free” or “no sugar added” foods. This is problematic because they can still spike blood glucose levels due to their carb content. You still need to account for them in your diet plan.[2] Your best bet is to go with erythritol because it doesn’t cause blood sugar or insulin spikes.
Plus, it's not like I couldn't feed my body anything until noon. Low-carb keto drinks such as tea, water, and coffee were all options, and Dr. Axe suggested adding protein (such as his bone broth or collagen protein powders) to my liquids to help fend off hunger. So, throughout my two weeks, I experimented with Dr. Axe's bone broth protein and collagen protein, as well as unsweetened nondairy milks such as almond and oat milk. I'll cut to the chase on this one: While expert opinion is mixed on the bioavailability of collagen powder and its potential health benefits, through trial and error, I landed on coffee with oat milk and collagen peptides as my go-to morning brew. I also took some of Dr. Axe's Keto Fire supplements in the morning. They contain exogenous ketones, which is a fancy way of saying bonus ketones my body doesn't produce on its own.
Recent studies indicate that mood disorders such as depression and anxiety can be linked to a range of physical changes in the brain, such as inflammation or change in gene expression71. Early results from animal studies have shown that ketosis could improve mood disorders, although the mechanism is still unclear. Rats fed exogenous ketones for several weeks showed reduced anxiety behaviours72. Similarly, endogenous and exogenous BHB alleviated depressive behaviour in mice subjected to stress73. This was found to be linked to altered epigenetic markers (modifications to DNA that affect the degree of gene expression) and an increased amount of brain derived neurotrophic factor (BDNF) in the brain. At this time, there are no trials investigating the effects of ketosis in human patients with mood disorders. 

But comprehensive transcriptional profiling of glucose-sensing neurons is challenging, as glucokinase (Gck) and other key proteins that transduce glucose signals are expressed at low levels. Glucose also exerts a hormonal-like action on neurons; electrophysiological recordings demonstrated, for example, that hypoglycemia activates growth hormone-releasing hormone (GHRH) neurons, suggesting a mechanistic link between low blood glucose levels and growth hormone release (Stanley et al., 2013).
“Instead of engaging in the next popular diet that would last only a few weeks to months (for most people that includes a ketogenic diet), try to embrace change that is sustainable over the long term. A balanced, unprocessed diet, rich in very colorful fruits and vegetables, lean meats, fish, whole grains, nuts, seeds, olive oil, and lots of water seems to have the best evidence for a long, healthier, vibrant life."
Experts are split on whether the keto diet is a good idea. On the one hand, Lori Chang, registered dietitian and a supervisor at the Center for Healthy Living at Kaiser Permanente West Los Angeles, says using a “cleaner” source of energy—ketones rather than quick-burning carbohydrates—can improve mood and energy levels. When you eat refined carbohydrates or just too many carbs in general, the blood is flooded with excess insulin, Chang says. "This can lead to a blood sugar rollercoaster that stresses the body and negatively impacts energy levels and mood. When you’re in a state of ketosis, however, ketone bodies don’t require insulin to cross the blood-brain barrier, which wards off unfavorable blood sugar levels."
Those issues are 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 the diarrhea and 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.

Eating right on the keto diet can be a bit tricky, as you'll want to focus on the right food choices that will keep you in ketosis all day long. And of course, that means avoiding sugary and processed foods as much as possible, as these foods can jeopardize all that fat-burning action you worked so very hard to achieve. To keep you fuller longer, registered dietitian Abbey Sharp, RD, recommended focusing on high-fiber and high-fat food sources that are also low in carbs. This keeps you satiated fast, she said, since both fat and fiber are very satiating.
Type I diabetes is usually treated by insulin injections, that replace the body’s own insulin production. In Type I diabetics, lowering dietary carbohydrate consumption can reduce the need to inject insulin to lower blood sugar101. However, because they do not release any insulin Type I diabetics can be at risk of developing a complication called “Diabetic Ketoacidosis” (DKA). DKA occurs because, alongside its effects on glucose, insulin has other effects in the body. Insulin normally inhibits the release of fat (lipolysis) from adipose tissue. In Type I diabetics, the lack of insulin can lead to high levels of lypolysis, high levels of fatty acids in the blood, this then drives rapid and uncontrolled liver ketone production. The symptoms of DKA are weakness, confusion and deep gasping breathing. In order to avoid developing DKA while following a ketogenic diet, Type I diabetics should seek medical supervision and closely monitor their glucose and ketone levels if reducing their dietary carbohydrate intake. 
Carbohydrates are necessary for the conversion of inactive thyroid hormone to active thyroid hormone, and if you’re on an extremely strict low carbohydrate diet, then you may actually be limiting this conversion. Your TSH is what tells your thyroid gland to “release more hormone,” so your TSH rises when your thyroid gland is underactive, or conversion of inactive to active thyroid hormone is inadequate. A high TSH means that the pituitary gland is releasing its hormone to try to get the thyroid to respond and produce more thyroid hormone. Because of inadequate carbohydrates, TSH will often elevate in a high-fat, low-carber – indicating potential for long-term thyroid and metabolic damage.
The ketogenic diet is indicated as an adjunctive (additional) treatment in children and young people with drug-resistant epilepsy.[25][26] It is approved by national clinical guidelines in Scotland,[26] England and Wales[25] and reimbursed by nearly all US insurance companies.[27] Children with a focal lesion (a single point of brain abnormality causing the epilepsy) who would make suitable candidates for surgery are more likely to become seizure-free with surgery than with the ketogenic diet.[9][28] About a third of epilepsy centres that offer the ketogenic diet also offer a dietary therapy to adults. Some clinicians consider the two less restrictive dietary variants—the low glycaemic index treatment and the modified Atkins diet—to be more appropriate for adolescents and adults.[9] A liquid form of the ketogenic diet is particularly easy to prepare for, and well tolerated by, infants on formula and children who are tube-fed.[5][29]
Many people may look at my side-by-side before and after pics and think, "She was fit before and she looks the same now." (Isn't it strange how differently other people see you versus how you see yourself?) But eating and exercise should always be about more than the aesthetics. How do your diet and fitness habits make you feel? Food is fuel (and recovery) for the activities you like to do most. If eating well means you gain some perspective, then ending up with a better butt is just icing on the cake. BTW, I can have cake now. 
Thanks for your comment. First off, I’m not influencing anyone to not try something. What I’m doing is giving people a safe space to say, “hey, this didn’t work for me, and that’s okay!” You have to remember, I’m writing this from MY perspective and how keto turned my eating into a disordered eating pattern. Yes, there are resources out there people can find to support keto, but there are also resources out there that show that keto isn’t for the average person. We can’t just look at one side, and that’s the conversation I’m trying to have.
Ketone urine-testing strips, also called Ketostix or just ketone sticks ... are small plastic strips that have a little absorptive pad on the end. This contains a special chemical that will change colour in the presence of ketones in the urine. The strips may change varying shades of pink to purple, or may not change color at all. The container will have a scale on the label, with blocks of colour for you to compare the strip after a certain time lapse, usually 15 seconds. Most folks simply hold a strip in the flow of urine. Other folks argue that the force of the flow can "wash" some of the chemical away, and advise that a sample of urine be obtained in a cup or other container, then the strip dipped into it.
In the beginning of the study, all participants were instructed to consume either ≤20 g of fat (if in the low-fat group) or ≤20 g of carbs (if in the low-carb group) for the first two months, after which they could increase either their fat or carb intake to levels they felt they could sustain indefinitely. By the end of the trial, the vast majority had not been able to maintain such low levels. The final dietary recalls reported an average daily fat intake of ≈57 g (low-fat group) and an average daily carb intake of ≈132 g (low-carb group).
Peak fat oxidation was 2.3-fold higher in the LC group (1.54 ± 0.18 vs 0.67 ± 0.14 g/min; P = 0.000) and it occurred at a higher percentage of VO2max (70.3 ± 6.3 vs 54.9 ± 7.8%; P = 0.000). Mean fat oxidation during submaximal exercise was 59% higher in the LC group (1.21 ± 0.02 vs 0.76 ± 0.11 g/min; P = 0.000) corresponding to a greater relative contribution of fat (88 ± 2 vs 56 ± 8%; P = 0.000). Despite these marked differences in fuel use between LC and HC athletes, there were no significant differences in resting muscle glycogen and the level of depletion after 180 min of running (−64% from pre-exercise) and 120 min of recovery (−36% from pre-exercise).
After investigating 20 controlled feeding studies, Hall and Guo found that both low-carb and high-carb diets had similar effects on body fatness and energy expenditure. The results of this meta-analysis provide us with high-quality evidence that supports the widely-believed theory that calories matter much more than the fat or carbohydrate content of the diet when it comes to weight loss. [24]
It feels 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 — and how to do it the Bulletproof way.
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
If you are already in ketosis and accustomed to high-fat, low-carb diets, you can take one heaping scoop in about eight ounces of water fifteen minutes prior to working out. It stays in your system and will provide your body with elevated ketone levels for about three hours. When taken as a pre-workout, KetoCaNa has also been shown to decrease the amount of oxygen consumed at a given power output.
^ Jump up to: a b c Taboulet P, Deconinck N, Thurel A, Haas L, Manamani J, Porcher R, Schmit C, Fontaine JP, Gautier JF (April 2007). "Correlation between urine ketones (acetoacetate) and capillary blood ketones (3-beta-hydroxybutyrate) in hyperglycaemic patients". Diabetes & Metabolism. 33 (2): 135–9. doi:10.1016/j.diabet.2006.11.006. PMID 17320448.
I've been researching the ketogenic diet for quite awhile so when I started this book, I was a little skeptical that there was anything else I could learn. I was wrong. Craig and Maria have done a wonderful job breaking down the science in a way that's easy to understand. Their knowledge and experience show you how to be successful on keto and how to break through plateaus so you can achieve your health goals. This isn't a "this is how keto works for me and my body so it should work for you too" book, it's a "this is how the human body works, how keto affects the human body, and how you can be successful with keto all based on science". There are also chapters dedicated to discussing the benefits of keto and how to heal your body - it's not all about weight loss. I knew keto was a good way to eat, but I had no idea how many syndromes, diseases, and even cancers that can be reversed through a clean keto diet.
We can say that no species, including humans, could have survived for millions of years without the ability to withstand brief periods of hunger or starvation (Amen-Ra, 2006). These periods of fasting are themselves ketogenic (McCue, 2010) during which the concentrations of insulin and glucose decrease while that of glucagon increases in the attempt to maintain normal blood glucose levels. When the body passes from a condition of food abundance to one of deprivation (or else via VLCKD simulated deprivation), there is, with a slight delay, an increase in the concentration of free FAs as well as KB in the blood. Thus, from this point of view KD could be compared to caloric restriction for fasting. These manipulations of nutrients, both in quantity and quality, seem to not only act on blood glucose/KB level but also to promote changes in metabolic pathways and cellular signaling. How this kind of metabolic condition (ketosis) can affect satiety and hunger mechanisms is still a matter of debate.
So how does our body make ketones out of the stored fat?  First blood sugar and insulin have to be low enough to allow access to stored fat.  If they are, stored fat (in the form of triglyceride) can be mobilized as a fuel source. A substance called hormone sensitive lipase (HSL) breaks the triglyceride compound down into one glycerol molecule and 3 fatty acid molecules. These fatty acid molecules come in various lengths of carbon based chains.
A: The most common ways to track your carbs is through MyFitnessPal and their mobile app. You cannot track net carbs on the app, although you can track your total carb intake and your total fiber intake. To get your net carbs, just subtract your total fiber intake from your total carb intake. I have written an article on How to Track Carbs on MyFitnessPal.
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^ Jump up to: a b c Clemente FJ, Cardona A, Inchley CE, Peter BM, Jacobs G, Pagani L, Lawson DJ, Antão T, Vicente M, Mitt M, DeGiorgio M, Faltyskova Z, Xue Y, Ayub Q, Szpak M, Mägi R, Eriksson A, Manica A, Raghavan M, Rasmussen M, Rasmussen S, Willerslev E, Vidal-Puig A, Tyler-Smith C, Villems R, Nielsen R, Metspalu M, Malyarchuk B, Derenko M, Kivisild T (October 2014). "A Selective Sweep on a Deleterious Mutation in CPT1A in Arctic Populations". American Journal of Human Genetics. 95 (5): 584–589. doi:10.1016/j.ajhg.2014.09.016. PMC 4225582. PMID 25449608.
I started my journey on April’s Fools this year and it’s been a hell of a six months! Was a mix of lazy and strict Keto - tailored my meals to strictly fish, chicken, eggs, and cauliflowers/broccoli. On the days I could not prepare my meals, I went with rotisserie chicken. One whole chicken and my food intake was done for the day. Yes it’s does not meet my daily requirements but I try my best on such days. I cut beer out completely and rarely ate out. I was a sugar addict and I would drink a couple of iced coffee with sugar and milk before - it was the hardest change to make. I still buy it weekly - one sip and I throw the rest away. Just to sort out my urges haha!
In the mid-1990s, Hollywood producer Jim Abrahams, whose son's severe epilepsy was effectively controlled by the diet, created the Charlie Foundation to promote it. Publicity included an appearance on NBC's Dateline programme and ...First Do No Harm (1997), a made-for-television film starring Meryl Streep. The foundation sponsored a multicentre research study, the results of which—announced in 1996—marked the beginning of renewed scientific interest in the diet.[1]
Lately anecdotal evidence has been building that a ketogenic diet can yield transformative results with respect to weight loss: with people taking to social media to share ‘before and after keto’ photos and to stories of ‘how keto changed my life.’ Despite this, concrete clinical evidence confirming that a ketogenic diet is superior to any other diet that creates a calorie deficit is lacking. At the moment the most accurate statement is that ‘the best diet for you is one you can stick to,” a pattern of eating that maintains a small calorie deficit should, over time, lead to weight loss. 
Amazing article – gonna have to print it and read it again. To much to break down in one sitting. Thanks Ben – you’ve pulled together so much insight and references that’s given me greater confidence and conviction. I’m 50 and use to be super active and a seasoned athlete but after a few ‘mid life surgical interventions’ I had to find a better way… Ketogenics has been that for me… no more inflammation… I can’t tell you how great it’s been to be pain free! Keep leading from the front.

There’s not enough of it to matter in coconut oil, it tastes bad, and it often results in stomach/gastric upset, but it does get converted quickly into ketones. If your MCT oil brand of choice makes your throat burn or has a weird flavor, one reason may be that the distillation did not remove enough of the C6. There are other reasons this can happen too, discussed below.


If you do try the diet outside of medical supervision, Kizer says it’s important to test your urine with urinalysis ketone test strips to ensure your ketone levels don’t become dangerously high. Ketone urine test strips are also used by people with diabetes to determine if they’re at risk for ketoacidosis (DKA), a life-threatening complication that occurs when an individual doesn’t have enough insulin in their body. (Healthy ketosis is considered 0.5 to 3.0 mM blood ketones.)
I started with completely cutting sugar. This was after B.Cancer. Also estrogen caused I decided to cut carbs to loose body fat which produces estrogen. I kept carbs to 15-20 grams. I researched and learned alot about research, nutrition and health. Primarily it gave me some semblance of control over the Russian Roulette that is cancer, chemo and radiation which all take a mighty toll on your body and mind. It has been 2 years of low carb and intermittent fasting. I have introduced a few seasonal foods, I eat chocolate, and the occasional celebratory cake. Just a bite or 2 not a huge serving. There are several alternative treats that are yummy and satisfying. Not a struggle. I am 67, lost specific fat that I could never shed even on the best eating plan. Belly fat especially. I am 3 years post and hope to live many more years.
Over 8–10 mmol/l: It’s normally impossible to get to this level just by eating a keto diet. It means that something is wrong. The most common cause by far is type 1 diabetes, with severe lack of insulin. Symptoms include feeling very sick with nausea, vomiting, abdominal pain and confusion. The possible end result, ketoacidosis, may be fatal and requires immediate medical care. Learn more

If you need to eat more or fewer calories per day, you can adjust accordingly by simply taking out or adding a bit more of the ingredients already included in a recipe. For example, adding/removing a tablespoon of olive oil or butter will add/remove about 100 calories. If you like or dislike certain recipes, feel free to shift things around. Make sure to keep an eye on the calories so you’re still falling within an acceptable range of your daily goal.
Great article, thanks for the info. My question would be this: Is there any benefit for weight loss by taking the Keto/OS and not making any dietary changes (eating standard American diet) In other words, will the Keto/OS help me to lose weight without going on a special diet? Do I have to work out in order to benefit (weight loss) from using this product?

"I was on Reddit one day when I saw a weight loss transformation of a guy who had lost 140 pounds in a year using the keto diet. I started reading the keto subReddit and began researching the science behind it. After years of using upcoming events as excuses not to diet, I chose to start keto in January when the holidays were over and there weren’t any weddings or parties for the next few months. 
^ Jump up to: a b c d e f g h i j k l m n o p q r Kossoff EH, Zupec-Kania BA, Amark PE, Ballaban-Gil KR, Bergqvist AG, Blackford R, et al. Optimal clinical management of children receiving the ketogenic diet: recommendations of the International Ketogenic Diet Study Group. Epilepsia. 2009 Feb;50(2):304–17. doi:10.1111/j.1528-1167.2008.01765.x. PMID 18823325
Ditto! I have an autoimmune disorder which includes rumathoid arthritis. Since I have been on Keto I suffer less pain and my blood pressure is now normal. Is it a cure all? Nope, it is a easy to follow life style change I recently turned 62 and I almost feel like a teenager again. Dang it, I’ve lost so much weight and now I’m going to have a neck lift to cut off the excess loose skin. I hate when that happens! 🙂
Eat the right amount of protein. Too much protein can increase insulin levels and decrease ketone levels, while not consuming enough protein can cause you to burn muscle rather than fat. If you exercise, protein levels should be hovering around 0.8g – 1.0g protein per lean pound of body mass a day. This helps with muscle mass retention and growth. However, if you are not exercising – your protein intake doesn’t need to be as high. A protein intake of 0.6g – 0.8g of protein per lean pound of body mass is going to be fine for sedentary individuals.
It has recently been proposed that the ARC is required for the coordination of homeostatic circadian systems including temperature and activity. Authors tested this hypothesis by injecting saporin toxin conjugated to leptin into the ARC of rats. Wiater et al. showed that the leptin-sensitive network is required for entrainment of activity by photic cues and entrainment of temperature by food but is not required for entrainment of activity by food or temperature by photic cues (Wiater et al., 2013).
These two meta-analyses (and the other research you’ll find in this article on keto & weight loss) provide us with a look at the real world significance of low-fat and low-carb diets. When you put people on a low-carb ketogenic type diet, they tend to lose more weight than people who are on a low-fat diet. The ketogenic diet also provides us with clear rules to follow, which makes it is easier for us to keep ourselves from overeating.

An increase in fat burning ability could improve endurance capacity: as body fat represents a larger store of energy (150,000 kCal) compared to carbohydrate (2000 kCal), a greater ability to burn fat during exercise could prolong endurance performance. Whilst the theory appears sound, there is only one study showing an IMPROVEMENT in performance with a low carbohydrate diet18, with many showing no clear benefit of a low carbohydrate diet 19 ,20.    

"I start my day with coffee and heavy whipping cream. My first meal of the day is in the afternoon and is usually something small like leftovers or some eggs. It’s about getting in protein and making sure whatever I eat is quality and tastes delicious. For dinner, I have a bigger meal which is always an animal protein with a side of something green like spinach or broccoli."
This article is excellent and I’ve actually read it a few times just to make sure I’m absorbing as much as possible. With that said can we talk a bit about protein? Why does it seem like protein is taking a back seat? What about the athlete who needs to maintain and/or increase muscle mass. I don’t want to make any assumptions and with all the research I’ve done along with personal testing into Keto it just seems to me that protein and its benefits are not a discussion point in this diet. Why?

Obesity means that someone has an excess amount of fat to the extent that it harms your health. Oftentimes, doctors, nurses, and other professionals will put your weight in terms of your height and gender in a figure called body mass index (BMI). According to the World Health Organization, a BMI from 25-30 usually indicates someone is overweight, BMI in the 30-35 range puts someone in the range of being obese and 35 and over morbidly obese. [1]
Under these circumstances, as soon as the body’s limited reserves of glucose starts to run out, your entire body switches its fuel supply to run almost completely on fat. The levels of the fat-storing hormone insulin levels become very low, and fat burning increases dramatically. You thus get easy access your fat stores, and can burn them off. This is great for losing excess weight. Studies prove that keto diets result in more weight loss, faster. There are also more potential benefits.
"I work in a really corporate environment where there's often donuts and cupcakes around. My coworkers say, 'Nobody will know if you just a have a cupcake,' but I will know! It’s not about beating the system or sneaking in cheat meals. I know the food is going to make me feel bad all day and it's not worth it to me. There’s always a line of people at the coffee machine at 2 o’clock in the afternoon because they’re all so tired after lunch."
“When the body is in ketosis, it lowers the blood pH level, causing the blood to become acidic. To counter this, the body takes calcium away from the bones,” she says. “The increased acidity in the body also increases uric acid, which can lead to the formation of kidney stones.” Therefore, it goes without saying that due to the stress an extremely low-carb diet can have on the body, those with kidney damage shouldn’t try to achieve ketosis or attempt the ketogenic diet. (10)

This article really bothers me in that if you do a few incorrect things with this diet, it will actually do more harm than a full carb diet. I have been in ketosis for a month or so but to what detriment? Based on the “ketosis darkside” list you highlighted, i could be doing any or all of these without realising. Could i share with you my meal plans and see if in your opinion they are beneficial and healthy or if im digging myself an early grave?


Also, take special note of sugar alcohols like sorbitol, mannitol, xylitol, and isomalt. Sugar alcohols are derived from plant products (ie., fruits and berries), though their carbs are uniquely altered through chemical processing. While sugar alcohols provide fewer calories than table sugar, people often overeat them because they are labeled as “sugar-free” or “no sugar added” foods. This is problematic because they can still spike blood glucose levels due to their carb content. You still need to account for them in your diet plan.[2] Your best bet is to go with erythritol because it doesn’t cause blood sugar or insulin spikes.
Type II diabetics can reduce their risk of developing these complications by keeping blood glucose levels within a healthy range (4.5 - 6.5 mM). This can be achieved using insulin injections, but using insulin is not without side effects (i.e hypoglycemia requiring assistance and weight gain)101. Therefore dietary carbohydrate restriction is likely to be a good lifestyle change to help with diabetes management,. Companies such as Virta Health are popularising this approach to diabetes management and pioneering the use of technology to improve compliance. The benefits of carbohydrate restriction include:
In the 1960s, it was discovered that medium-chain triglycerides (MCTs) produce more ketone bodies per unit of energy than normal dietary fats (which are mostly long-chain triglycerides).[15] MCTs are more efficiently absorbed and are rapidly transported to the liver via the hepatic portal system rather than the lymphatic system.[16] The severe carbohydrate restrictions of the classic ketogenic diet made it difficult for parents to produce palatable meals that their children would tolerate. In 1971, Peter Huttenlocher devised a ketogenic diet where about 60% of the calories came from the MCT oil, and this allowed more protein and up to three times as much carbohydrate as the classic ketogenic diet. The oil was mixed with at least twice its volume of skimmed milk, chilled, and sipped during the meal or incorporated into food. He tested it on twelve children and adolescents with intractable seizures. Most children improved in both seizure control and alertness, results that were similar to the classic ketogenic diet. Gastrointestinal upset was a problem, which led one patient to abandon the diet, but meals were easier to prepare and better accepted by the children.[15] The MCT diet replaced the classic ketogenic diet in many hospitals, though some devised diets that were a combination of the two.[10]
Infants and patients fed via a gastrostomy tube can also be given a ketogenic diet. Parents make up a prescribed powdered formula, such as KetoCal, into a liquid feed.[18] Gastrostomy feeding avoids any issues with palatability, and bottle-fed infants readily accept the ketogenic formula.[30] Some studies have found this liquid feed to be more efficacious and associated with lower total cholesterol than a solid ketogenic diet.[3] KetoCal is a nutritionally complete food containing milk protein and is supplemented with amino acids, fat, carbohydrate, vitamins, minerals and trace elements. It is used to administer the 4:1 ratio classic ketogenic diet in children over one year. The formula is available in both 3:1 and 4:1 ratios, either unflavoured or in an artificially sweetened vanilla flavour and is suitable for tube or oral feeding.[50] Other formula products include KetoVolve[51] and Ketonia.[52] Alternatively, a liquid ketogenic diet may be produced by combining Ross Carbohydrate Free soy formula with Microlipid and Polycose.[52]
Ideally, you combine supplemental ketones with a relatively low carb diet, especially if metabolic efficeincy is important to you. HOWEVER, you can achieve most of the benefits of ketosis aside from the fat burning efficiency by using exogenous ketones. So it all depends on how lean you are, what's important to you from a performance vs. fat loss standpoint, etc.
Oh my god! This is one of those ‘Too-good-to-be-free’ comprehensive resources. I’ve been following your content and I wonder why you give away so much well researched info for free. Anyway, that’s a pretty damn good job you’ve done here. Until I read this, I was floundering with so much bit sized confusing information out there. You’ve literally dumbed it down for me. I’m off to take my measurements before I start the diet! Thanks a ton!!!
You likely heard that a high-fat, low-carb keto diet can melt fat. Because it contains virtually no carbs, a ketogenic diet forces your body to burn fat instead of glucose for fuel. Ketosis is the state your body enters when your liver effectively breaks down fats into ketones to use as energy. Without glucose, your body doesn’t have all the highs and lows that lead to hunger pangs, energy crashes, and cravings. Instead, your blood sugar levels stay stable. Your body also sheds excess weight — fast.

KETO//OS contains a specifically engineered ratio of ketone mineral salts blended with a high fiber based medium chain triglyceride (MCT) formulation, so you get a potent delivery of both exogenous ketones and medium chain triglycerides.  It is simply a powder that you mix with 8-10 oz of water. Within 15-30 minutes it puts your body into a full and deep state of ketosis.


The longer cholesterol circulates in your bloodstream, the higher the likelihood that it will dig its way into an endothelial wall and potentially contribute to atherosclerosis or plaque formation. This is why it’s so dangerous to eat a high-fat diet, but to also have your nightly dark chocolate bar, overdo it on the red wine, or have weekly “cheat days” with pizza, pasta, or sugar-laden ice cream.
In order to obtain the most comparable measures, it is useful to measure blood ketones at the same time each day. Measuring immediately on waking means that there are fewer potential variables that could alter the measurement, such as exercise, or different food intake. However, it can also be useful to check ketone levels around 60-90 minutes after an intervention such after eating a fat rich meal or consuming exogenous ketones.      

1. If a set number ketones in the blood is an indicator that my body has transitioned to ketosis and not necessarily the cause (the cause being limited access to glycogen because of limited carb intake) then how does using exogenous ketones put me in ketosis as opposed to mimic being in ketosis (because when measuring blood ketones suddenly there are more because I put them there, I didn’t create them)?
Rami co-founded Tasteaholics with Vicky at the start of 2015 to master the art of creating extremely delicious food while researching the truth behind nutrition, dieting and overall health. You can usually find him marketing, coding or coming up with the next crazy idea because he can’t sit still for too long. His favorite book is The 4-Hour Workweek and artist is Infected Mushroom.
The diet gets billed as a miraculously enjoyable diet—eat all the fat you want, just cut out the carbs. But the ketogenic diet (also called keto) was never supposed to be fun. It was supposed to treat severe epilepsy. And as a medical treatment, it was only intended to be administered under the supervision of trained nutritionists and physicians. The professionals would be able to monitor patients for potential problems and ensure that their diet was actually keeping them in ketosis—a metabolic state where your body switches from using glucose as energy to using ketone bodies, which come from body fat. They needed those checkpoints because staying in true ketosis is exceptionally challenging for adults.
The current hypothesis is that the brain functions differently on ketones than on glucose, and this is what causes certain brains to reduce epileptic seizures. I would then also hypothesize that certain people who feel that “brain fog” lifted on ketosis is due to either placebo effect OR their brain actually functioning differently on ketones vs glucose.
The BBB, largely formed by the brain capillary endothelial cells, provides a protective barrier between the systemic blood and the extracellular environment of the CNS. Passage of FAs from the blood to the brain may occur either by diffusion or by proteins that facilitate their transport. Studies indicate that FATP-1 and FATP-4 are the predominant FA transport proteins expressed in the BBB based on human and mouse expression studies (Mitchell et al., 2011).
This was a great read , Steve, thanks! I’m 19 days in but forever educating myself. Wish I’d been more prepared for the keto flu cos’ that hit me HARD! Out the other side now though and hoping to see some improvements in my cycling endurance and less reliance on the gels and goos! I’ll also be doing lots of HIIT for some racing that I’ll be doing this winter (in the UK) so looking forward to experimenting with that! As a former (and maybe still current) sugar lover, the dessert tips were especially useful. Thanks again!
Ketone salts did not improve performance 35 ,36. There are two recent published studies of ketone salts on athletes.. Performance was compared between ketone salts vs. carbohydrate in a 4 minute cycling time trial and a 150 kJ ( ~10 mins) cycling time trial. In the 4 minute trial there was no change in performance, and in the 150 kJ test, performance was decreased by 7%. Reasons for the difference in findings could be: Lower levels of blood BHB levels (which peaked at 0.6 mM and 0.8 mM in these studies) meaning far less BHB was present than in the ketone ester study. The ketone salt was given without carbohydrate and so there was no additive effect of ketones + carbohydrate as seen in the ketone ester study. The tests used were short and highly reliant on anaerobic (glycolytic) metabolism, therefore ketones did not offer an advantage. 

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