On the ketogenic diet I feel very shaky/anxious from when I wake up til about noon. Eating doesn’t really help. It could be electrolyte related but seems possibly more related to excess cortisol/adrenaline as noon is also when I start to crash and get tired on a more normal diet, and because those 3 am awakenings that worsen simultaneously in ketosis seem to also have to do with HPA axis stuff. Does this side effect potentially also have to do with my fasting blood sugar being elevated?
Watermelon is a staple summer fruit and another low-carb way to help satisfy your sweet tooth on keto. Each ½ cup of diced watermelon has 5.4 g of net carbs. It’s also an acceptable choice when dieting because of its high water content. The ½ cup serving size of watermelon has about 23 calories and 4.7 g of sugar. This juicy fruit also offers 432 IU of vitamin A, which is 8.6 percent of the DV.
The addition of MCT powder to ketones serves the purpose of maintaining endogenous production of ketone bodies by stimulating fatty acid oxidation in the liver, which then causes the production of even more ketone bodies. In this transcript from a podcast with Dr. Dom D’Agostino it is mentioned that MCT’s cross the blood-brain barrier straight to the brain. So not only are the ketones being used by the brain as an alternative fuel but so are MCT’s.
The brain is composed of a network of neurons that transmit signals by propagating nerve impulses. The propagation of this impulse from one neuron to another is typically controlled by neurotransmitters, though there are also electrical pathways between some neurons. Neurotransmitters can inhibit impulse firing (primarily done by γ-aminobutyric acid, or GABA) or they can excite the neuron into firing (primarily done by glutamate). A neuron that releases inhibitory neurotransmitters from its terminals is called an inhibitory neuron, while one that releases excitatory neurotransmitters is an excitatory neuron. When the normal balance between inhibition and excitation is significantly disrupted in all or part of the brain, a seizure can occur. The GABA system is an important target for anticonvulsant drugs, since seizures may be discouraged by increasing GABA synthesis, decreasing its breakdown, or enhancing its effect on neurons.[7]

BHB is the primary ketone your body can most efficiently use as fuel during exercise and at rest (especially when you’re keto-adapted), it is the most stable of the ketones, and it is actually found in nature in many foods including eggs and milk. A “BHB salt” is simply a compound that consists of sodium (Na+), potassium (K+), and the ketone body beta-hydroxybutyrate.
2) I'm currently using Ketocana and in that section you state "Similar to the BHB salts and MCT’s from the KETO//OS I discuss above, powdered forms of ketones are excellent if you don’t want to completely eliminate carbohydrates or fat or eat copious amounts of fats, but want to simultaneously maintain high levels of blood ketones." – How would eating copious amounts of fat be a negative? Wouldn't that help contribute to a ketogenic state?
I see a lot of people say that ketosis is great for insulin sensitivity. BUT, in my experience ketosis causes physiological insulin resistance whereby the muscles and liver are sparing glucose for the brain. Hence, glucose tolerance actually goes down during ketosis. As such, is it possible that post workout carbs could do a lot more damage than they would on a non-ketogenic diet? Or maybe, as Kiefer suggests, glucose uptake post workout is not moderated by insulin at all i.e. muscles soak up glucose regardless of their insulin sensitivity? Or maybe cyclical ketosis doesn’t allow liver glycogen to get low enough to trigger physiological insulin resistance?
“Muscle loss on the ketogenic diet is an ongoing area of research,” says Edwina Clark, RD, a dietitian in private practice in San Francisco. “Small studies suggest that people on the ketogenic diet lose muscle even when they continue resistance training. This may be related to the fact that protein alone is less effective for muscle building than protein and carbohydrates together after exercise.” Meanwhile, according to a small study published in March 2018 in the journal Sports, people following the keto diet for three months lost about the same amount of body fat and had about the same muscle mass changes as people following normal diets. Yet the folks on keto did lose more leg muscle.
BHB is the primary ketone your body can most efficiently use as fuel during exercise and at rest (especially when you’re keto-adapted), it is the most stable of the ketones, and it is actually found in nature in many foods including eggs and milk. A “BHB salt” is simply a compound that consists of sodium (Na+), potassium (K+), and the ketone body beta-hydroxybutyrate.
Therefore, more people experiencing "keto crotch" need to visit doctors to determine what's really happening. It could be that some of the people claiming "keto crotch" are instead detecting smells that are not related to their diets. Many different smells could emanate from your crotch, some are normal, some are not. Conversely, who knows for sure what a drastic change in your diet may do to different parts of your body? There is still a lot unknown about the links between nutrition and your various bodily functions. You are a complex system with many unknowns. The keto crotch could be a real phenomenon, but more scientific evidence and studies are needed.

You state that many athletes and very active people could benefit from 100-200g of carbs a day, and be back in ketosis in a few hours. Any particulars on which kind of activities or say how long/many training sessions would benefit from this to balance hormones. I train mma 3-4 days a week and also do lots of hiit and strength training as well. Just trying to see if this is a situation where i would benefit from your suggestions. Thanks!
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.
I’ve been on and off of my Keto diet with the primary purpose of losing weight. I’m 30 years old, workout daily – I’m in decent shape but have some extra fat around the mid-section that I’d like to get rid of, I am hoping to lose ~20 pounds of fat. However, the problem is that I am an extremely picky eater with tremendous cravings for some of my favorite carb-heavy foods – I only eat a number of high-fat / low-carb foods that help me attain Ketosis, so cycling through them multiple times a week becomes excruciating. I find myself cheating on my diet every 2 – 3 weeks, which causes a 3 – 5 pound setback that takes me a few days to overcome and get back into ketosis.
Keep in mind that if your crotch begins to have a very unusual smell, whether or not you are on the keto diet, you may want to see your doctor. Don't just tell everyone on Reddit about how much your crotch smells. Regardless of your gender, an unusual smell could be a sign of an infection or some other condition that needs proper medical attention. Even if you don't have a medical problem, your doctor can tell you what kinds of smells are normal and not normal. In other words, he or she could lower your concerns about what's going on in the lower part of your body.
Meat – like grass-fed selections – and fresh veggies are more expensive than most processed or fast foods. What you spend on Keto-friendly foods will vary with your choices of protein source and quality. You can select less-expensive, leaner cuts of meat and fatten them up with some oil. Buying less-exotic, in-season veggies will help keep you within budget.
On a ketogenic diet, your entire body switches its fuel supply to run mostly on fat, burning fat 24-7. When insulin levels become very low, fat burning can increase dramatically. It becomes easier to access your fat stores to burn them off. This is great if you’re trying to lose weight, but there are also other less obvious benefits, such as less hunger and a steady supply of energy. This may help keep you alert and focused.

After increasing water intake and replacing electrolytes, it should relieve most all symptoms of Keto Flu. For an average person that is starting a ketogenic diet, eating 20-30g of net carbs a day, the entire adaptation process will take about 4-5 days. My advice is to cut your carbs to fewer than 15g to ensure that you are well on your way into ketosis within one week. If you are experiencing any more keto flu symptoms, double check your electrolyte intake and adjust.

^ Jump up to: a b c d e f g h i j k l m n o p q r s 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


Here are a few of the most common side effects that I come across when people first start keto. Frequently the issues relate to dehydration or lack of micronutrients (vitamins) in the body. Make sure that you’re drinking enough water (close to a gallon a day) and eating foods with good sources of micronutrients. To read more on micronutrients, click here >


Typically, to gain lean body mass one needs to have some degree of caloric surplus, or at the very least, not be in a significant deficit. This is especially true when looking to add muscle mass. It is certainly possible to gain muscle mass on a ketogenic diet. For most individuals this would require consuming adequate protein (while still remaining in ketosis), enough calories to support growth, sufficient electrolytes to support muscle function, as well as incorporating progressive resistance training. The type and volume of resistance exercise needed to add lean body mass will be very dependent on the individual and their age, training status, health status, etc. Therefore, the answer to this question can become quite nuanced, but in simple terms, yes, it is very possible to gain lean body mass on a ketogenic diet while still taking advantage of the health promoting effects this way of eating provides.


One more thing that I noticed is that my HR does not move Beyond a certain point. I can still perform quite at a high level and faster than most people at my box but weirdly enough it’s like there’s a block on my HR which doesn’t allow it to move beyond 160 bpm. I’m not sure if this is good or bad! Could I go even faster if my HR would pass this limit?? It is a physiological barrier created by the glycogen sparing mechanism that doesn’t allow my body to move after a certain point so it won’t have to tap into my glycogen stores or force my body to go into gluconeogenesis?? If I added some more carbs around my workouts would it be easier to get the glycolytic pathway to work more effectively since it’d be faster and easier fuel? I read about the downregulation of PDH enzymes after prolonged keto and I constantly worry that I dont use my glycolytic pathway as effective anymore. I LOVE this lifestyle but at the same time, as athletes; we’re always thinking on how to improve performance. What are your thoughts?! Thank you so much!!
What about fruits and vegetables? All fruits are rich in carbs, but you can have certain fruits (usually berries) in small portions. Vegetables (also rich in carbs) are restricted to leafy greens (such as kale, Swiss chard, spinach), cauliflower, broccoli, Brussels sprouts, asparagus, bell peppers, onions, garlic, mushrooms, cucumber, celery, and summer squashes. A cup of chopped broccoli has about six carbs.
The nerve impulse is characterised by a great influx of sodium ions through channels in the neuron's cell membrane followed by an efflux of potassium ions through other channels. The neuron is unable to fire again for a short time (known as the refractory period), which is mediated by another potassium channel. The flow through these ion channels is governed by a "gate" which is opened by either a voltage change or a chemical messenger known as a ligand (such as a neurotransmitter). These channels are another target for anticonvulsant drugs.[7]

Frankly, the results of my foray into ketosis and eventually keto-adaptation were astounding. I had the best Ironman triathlon season of my life and shocking levels of mental focus and physical ease, especially for races and workouts that lasted longer than two hours. Without experiencing muscle loss, hunger pangs or brain fog, I found I could go the entire day without eating, which was enormously helpful for business and personal productivity. My gas, bloating, fermentation and GI “issues” disappeared. My blood levels of inflammatory markers like HS-CRP and cytokines dropped to rock-bottom, while my levels of good cholesterol, vitamin D, and anti-inflammatory fatty acids skyrocketed.
I asked James Fell if he had some practical advice on sustainable dieting. “When it comes to weight loss,” he said, “the only thing that matters is caloric deficit. However, quality of diet affects quantity. A higher quality diet is more likely to be one that allows you to eat a lower quantity of calories and still be satisfied. That being said, there are many different ways to find a high-quality diet.”

Now open your eyes. Unfortunately, you still have the same amount of self-control as you before. Your roommate still wants to get margaritas and tacos next week. Butter still doesn’t taste good in coffee. Small-smilers on public transport are almost never going to say anything to you. The ketogenic diet is an empty promise, propagandized by brainwashed influencers and companies that want to profit from you. There’s no need to meditate on what being keto actually looks like -- just observe closely as the people around you, without apprehension, recreate their world based on diet blog listicles and tell you that you should, too -- until they realize the myth and quit and say nothing about it.


^ Ketogenic "eggnog" is used during induction and is a drink with the required ketogenic ratio. For example, a 4:1 ratio eggnog would contain 60 g of 36% heavy whipping cream, 25 g pasteurised raw egg, saccharin and vanilla flavour. This contains 245 kcal (1,025 kJ), 4 g protein, 2 g carbohydrate and 24 g fat (24:6 = 4:1).[17] The eggnog may also be cooked to make a custard, or frozen to make ice cream.[37]

This is an absolutely necessary function for basic survival. As the body can only store carbs for a day or two, the brain would quickly shut down after a couple of days without food. Alternatively it would quickly have to convert our muscle protein into glucose – a very inefficient process – just to keep the brain going. That would make us waste away quickly. It would also ensure that the human race could hardly have survived all those millennia before we had 24-7 food availability.
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]
A high-fat diet also trains your body to burn even more fat during exercise, even at high intensities. Fat is released faster and in greater amounts from your storage adipose tissue and transported more quickly into your muscles and mitochondria. Your muscles also store more energy as fat and use this fat-based fuel more efficiently and quickly. Even more interestingly, a high-fat diet can cause a shift in the gene expression that codes for specific proteins that increase fat metabolism – and create very similar adaptations to exercise itself. So the mere act of shifting primary fuel intake from carbohydrates to fat begins to make you more “fit”, even if you’re not exercising.

It’s also important to note there have been no long-term studies on the ketogenic diet, nor has there been research that details what may happen to the body if it’s in a constant state of ketosis itself. But given how the body needs carbs to function properly, diets that are based on fat burning may lead to nutritional deficiencies, and supplements and multivitamins are recommended because you’re cutting out entire food groups, warns Alyssa Rothschild, RDN, who is in private practice in New York City.
^ Hochachka PW, Storey KB (February 1975). "Metabolic consequences of diving in animals and man". Science. 187 (4177): 613–21. Bibcode:1975Sci...187..613H. doi:10.1126/science.163485. PMID 163485. In the terminal stages of prolonged diving, however, even these organs must tolerate anoxia for surprisingly long times, and they typically store unusually large amounts of glycogen for this purpose.
Note: Are you a vegetarian or vegan and want to go on a ketogenic diet? It’s still possible! Just keep in mind that the dietary restrictions can sometimes be a little bit intense. Make sure to plan ahead and prepare to aid your success. To help out, we’ve published articles (with 7 day meal plans included) for both the vegetarian ketogenic diet and the vegan ketogenic diet.
My question is, does the benefit to using KetoCaNa only extend to significant decreases in oxygen demand/ increases in physical performance/ heightened mental acuity/cognitive performance.? Of course, these are all great benefits, but if I were to use KetoCaNa as a pre-workout, is it going to impair my endogenous ketone production? I usually train fasted with a strong black coffee and L-Carnitine.
On a ketogenic diet, your entire body switches its fuel supply to run mostly on fat, burning fat 24-7. When insulin levels become very low, fat burning can increase dramatically. It becomes easier to access your fat stores to burn them off. This is great if you’re trying to lose weight, but there are also other less obvious benefits, such as less hunger and a steady supply of energy. This may help keep you alert and focused.
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]
The keto diet changes the way your body converts food into energy. Eating a lot of fat and very few carbs puts you in ketosis, a metabolic state where your body burns fat instead of carbs for fuel. When your body is unable to get glucose from carbs, your liver converts fatty acids from your diet into ketones, an alternative source of energy. Burning ketones in place of glucose reduces inflammation and spurs weight loss.[1]
As a matter of fact, from a pure biology perspective, lauric acid should actually be considered a LCT, because unlike C8 and C10 forms of MCT, lauric acid gets processed by your liver. This matters because your body metabolizes MCT’s differently than LCT’s: unlike LCT’s, MCT’s get very quickly converted into ketone energy to fuel your brain and body instead of requiring a pit stop in the liver for processing.
Hi Mel, Assuming that your ranch dressing doesn’t have sugar added, you don’t need to worry too much about limiting it, but within reason. This is my homemade ranch dressing recipe, which has 0.9g net carbs per 2-tbsp serving. It would be hard to find a store bought one with much less than that, even though some round anything less than 1g down to 0g, which isn’t truly accurate. Also, keep in mind that if weight loss is your goal, some people find that too much dairy can cause a stall. Finally, make sure you aren’t using all your “available” carbs on ranch dressing – have it with some low carb veggies!
On the ketogenic diet I feel very shaky/anxious from when I wake up til about noon. Eating doesn’t really help. It could be electrolyte related but seems possibly more related to excess cortisol/adrenaline as noon is also when I start to crash and get tired on a more normal diet, and because those 3 am awakenings that worsen simultaneously in ketosis seem to also have to do with HPA axis stuff. Does this side effect potentially also have to do with my fasting blood sugar being elevated?
In fact, most folks have enough stored body fat to fuel aerobic activity for days and days without running out of energy. For example, a 150 pound dude at a hot, sexy and ripped at 8% body fat still carries 12 pounds of storage fat – which at 3500 calories per pound of fat can easily liberate 42,000 calories of useable fuel for exercise. You’ve got those same thousands of calories sitting around your waist, abs, hip, butt and thighs – just sitting there, waiting to be burnt.
Physicians of ancient Greece treated diseases, including epilepsy, by altering their patients' diet. An early treatise in the Hippocratic Corpus, On the Sacred Disease, covers the disease; it dates from c. 400 BC. Its author argued against the prevailing view that epilepsy was supernatural in origin and cure, and proposed that dietary therapy had a rational and physical basis.[Note 3] In the same collection, the author of Epidemics describes the case of a man whose epilepsy is cured as quickly as it had appeared, through complete abstinence of food and drink.[Note 4] The royal physician Erasistratus declared, "One inclining to epilepsy should be made to fast without mercy and be put on short rations."[Note 5] Galen believed an "attenuating diet"[Note 6] might afford a cure in mild cases and be helpful in others.[11]
Hi Cyn, The numbers are general guidelines but will vary depending on many factors, such as activity level, insulin resistance, weight and more. There is no single magic number, just conventional recommendations that are a good starting point. I will have a macro calculator coming soon that will help determine what is best for each person, but even then it’s an approximation. The only way to know for sure is to test. If keto is your goal, it’s usually best to start lower and then see if you can stay in ketosis when increasing.
Checking your ketone level is one way to know if you’re in ketosis. This metabolic state usually kicks in after three or four days of restricting your carbohydrate intake or going through periods of intermittent fasting. You don’t have to visit a doctor to measure your level. Pick up a ketone urine test from a nearby drug store, or use a blood sugar meter that’s capable of measuring ketones.

Remember how important it is to measure ketone blood levels accurately? Same goes for food tracking. A food tracking app, like MyFitnessPal, provides insight into macronutrient intake and thus the ability to tweak the diet to achieve ketosis. Tracking diet (inputs) and measuring ketones levels (outputs) delivers the best shot at optimizing the keto diet plan.
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