Symptoms and side effects of the ketogenic diet
There are many symptoms and adverse effects reported by study groups on low carbohydrate diets such as the ketogenic diet.
The main ketogenic diet symptoms are:
headache, dizziness, presence of diarrhea and constipation, weakness, loss of concentration, bad breath, low blood pressure, increased heart rate, among many others.
According to Dr. Mauro DiPasquale, a respected member of the international sports community as an athlete, administrator and physician, and author of the famous book “The Anabolic Diet”, he originally created this diet for bodybuilders and athletes, but since then he has developed other versions for the general public.
This is a very interesting article about ketogenic diet from ncbi. about “Long-term effects of a ketogenic diet in obese patients”.
He says that in the first week of the ketogenic diet the body is going through the metabolic shift from being a carb and muscle-burning machine to being a fat burner, and that can be very difficult.
This is called the induction phase and people may have some symptoms including lethargy, dizziness, mental fogginess, irritability, and irregular bowels, depending on how your body reacts to the radical shift in macronutrients.
Some people will suffer few symptoms, others will be very affected. Your energy can also drop and there might be a frequent feeling of you being hungry.
That’s because the body is going through a readjustment phase.
Due to the low amount of nutrients, especially vitamins and minerals, may also occur weakening of the immune system, leaving the body more susceptible to several infections. So, the discipline and persistence during the first week of the ketogenic diet is very important to experience the benefits later.
The energy will come back and you will feel better. This will usually take 3-4 weeks.
Now, let’s see the 3 untold symptoms and side effects you probably don’t know about the ketogenic diet:
Problems with brain function (in the ketosis diet)
The brain, as well as the various parts of our body needs glucose to function properly, using around 30% of the glucose metabolism needs.
This means that when starting a ketogenic diet that has very low levels of carbohydrates and glucose, your brain will be one of the first places to not receive glucose in sufficient quantities.
In the first 2 to 3 days following a ketogenic diet, it was reported symptoms such as lethargy, reduced ability to concentrate, focus and reasoning as the the body uses fat for energy instead of glucose.
The brain begins to deplete the glucose stored rapidly, presenting these symptoms in the early days of you beginning the ketogenic diet.
After these early days, as the process of ketosis and energy production start through the use of the fat metabolism, the brain starts to receive strength and these symptoms subside.
Another issue occurring with the decrease of glucose levels in the brain is the reduction of neurotransmitter production called serotonin.
This neurotransmitter is responsible for the well-being, and reducing its levels in the brain can cause a considerable heightened sense of irritation and bad mood.
This is another symptom reported by people in the early days of the ketogenic diet.
With the reduction of serotonin, the body starts to increase the feeling and the desire to eat sweets and quick-release carbohydrates, causing an uncontrolled appetite, greatly damaging the discipline in the first 2-5 days of the diet.
To meet this demand on the brain, it is recommended to increase fat levels in the early days of the diet, accelerating the ketosis process to provide energy.
This helps in improving concentration and focus functions in the brain.
It is also recommended the practice of light exercise such as walking that help in the release of the neurotransmitter serotonin, which reduces the feeling of irritation and helps in controlling the desire for sweets.
A diet rich in fresh vegetables along with the proteins of the ketogenic diet can also help some consumption of important minerals for the release of serotonin such as iron, manganese, potassium and magnesium.
Moderate salt intake also helps in increasing of some of these minerals.
Kidney stone formation (in the ketogenic diet)
Some short-term side effects were detected in researches on the use of the ketogenic diet in the treatment of epilepsy in children, including constipation, acidosis and hypoglycemia.
In a long-term studies of the ketogenic diet in these children, it identified the formation of bone fractures and stone formation in the kidneys.
The formation of kidney stones is associated with the following dietary factors:
- Presence of excess calcium in the urine that occurs due to bone demineralization with acidosis. The bones are formed basically by calcium phosphate, which reacts with the acid present in the body and excreted by the kidneys;
- The low concentration of citrate in the urine promotes the accumulation of free calcium, as this substance is responsible for dissolving calcium;
- Increased dehydration which occurs due to the elimination of glucose stored as glycogen in the muscles and liver. With the breakdown of glycogen, all the water that binds it happens to be eliminated from the body through the kidney, increasing the concentration of calcium and the chances of forming gallstones;
Besides the problem of kidney stones due to dehydration, there is also the appearance of symptoms such as fatigue, lightheadedness, dizziness, muscle cramps and headaches that occur due to increased release of minerals such as potassium and magnesium in the urine.
For this reason, the use of salt during the ketogenic diet is very important in making these minerals replacement, since the loss of sodium in the urine causes the reduction of potassium and magnesium.
The use of vitamin and mineral supplements to reduce the problem is also recommended.
There are also many researchers trying to show that protein and ketones are not hard on the kidney and liver.
They discovered that most of the nitrogen from the protein is converted to urea in the liver and excreted by the kidneys, and that the carbons are oxidized to carbon dioxide and water.
They also realized that the renal system automatically responds to stabilize our system.
The increase of water consumption during a ketogenic diet can help prevent the formation of kidney stones, avoiding the dehydration process.
An alternative was found in a survey conducted by John Hopkins Hospital that was also a supplementation of oral potassium citrate, a substance that helps in decreasing the incidence of kidney stones in patients during the ketogenic diet.
Digestive system problems (for ketosis)
With the drastic reduction in carbohydrates during the ketogenic diet it has been observed in many studies the presence of symptoms such as diarrhea and constipation, both associated with severe reduction mainly of dietary fiber in food.
The high protein content in the ketogenic diet also promotes changing the texture of the stool, causing changes in the intestinal flora and also in the rhythm of the intestine.
Another factor is the mineral magnesium deficiency that increases the incidence of constipation in patients following the ketogenic diet.
With the changes in relation to the proportion of the nutrients in food, bacteria of the intestinal flora are affected and this promotes several changes in the processes of the digestive and intestinal system.
To avoid this problem, it is recommended the use of probiotic supplements containing beneficial bacteria for health promotion of intestinal flora.
Magnesium supplementation with the use of magnesium citrate or magnesium chloride is also recommended.
One can also add dairy food in ketogenic diet food, such as cheese, milk and yogurt without adding sugar, among others.
The low-carbohydrate diet history
Throughout human history we have seen the development of agriculture, allowing societies to remain in a stable physical location changing food habits over the years.
The hunting societies had fat and protein as the primary sources of dietary energy, on the other hand the agricultural societies had a grain-based diet.
As the science of nutrition developed in the early 20th century, many comparative studies showed the differences between all kinds of diets.
Most of these studies supported the idea that carbohydrates were a necessary nutrition for optimum human health and function.
In modern society, however, excess carbohydrates found in processed foods, especially foods high in sugar, has caused many problems dramatically increasing rates of obesity and the risk of disease.
From the 50’s and 60’s, there was a considerable increase in research on calorie restriction diets to be used in the treatment of obesity.
In the early 70’s came the diets high in protein and low in carbohydrates.
With the advent of the Internet and the media, diets restricted to the academic world became part of television programs, magazines, and newspapers widely being discussed by the digital medium.
This, unfortunately, has brought an increase in fad diets that promise miraculous results in a short time and without much effort.
These diets, in turn, may increase the risk of health problems if performed without the supervision of a health professional.
Because of this scenario, most physicians and nutrition scientists still believe that carbohydrate should be the major component of one’s daily energy intake.
Is has also been reinforced by the clinical experience of many of these physicians, whose patients followed low carbohydrate diets and frequently complained of experiencing many symptoms and side effects such as lightheadedness, weakness and fatigue.
One of the first studies about low-carbohydrate diets and the ketosis process was made by Frederick Schwatka during his expedition in April of 1879, after a prolonged experience eating meat and fat.
There was something new and interesting about the low calorie intake and the very low carbohydrate diets, such as the ketogenic diets, that showed up during the 1970’s due to the weight loss studies.
In a traditional diet, the daily recommendation is 55% to 60% of total calories from carbohydrate sources, about 15% of total calories from protein sources and around 30% of total calories from fat sources.
In the case of the ketogenic diet, these rates are changed, becoming a diet low in carbohydrates and high in protein and fat.
It works on the principle that by reducing the amount of carbohydrates, there is a process called ketosis which promotes lipid oxidation, influencing the reduction of adipose tissue, and also influencing the control of satiety and the increase of energy expenditure by your metabolism.
During the ketosis process, the body uses fat as the main source of energy, breaking it down into glycerol and free fatty acids, forming ketone compounds that are converted to energy within the cells.
The ketogenic diet had its wide dissemination with the famous diet proposed by Dr. Robert Atkins that today reaches about 20 million followers around the world.
The Atkins diet is a low calorie diet, similar to the ketogenic diet, which is based on consumption of fat, protein, and low carbohydrates.
It consists of three main phases: induction diet, diet, and permanent maintenance diet.
These three periods are different just by the amount of carbohydrates consumed, starting with a severe restriction of carbohydrates with only 15 to 20 g per day.
According to Dr. Atkins, the benefits of this diet are huge, with fast weight loss without starving, maintaining good health, and preventing cardiovascular disease.
The fastest weight loss happens mainly due to the control of the release of the hormone called insulin in the blood, promoting the regulation of short-term appetite controllers.
Insulin is a hormone that has antilipolytic action, it inhibits the activity of the enzyme lipase that is responsible for reduction of fat, resulting in the increase of adipose tissue in the body.
With the ketogenic diet, there is greater control of this hormones and the metabolism starts to seek the necessary energy in the fat stored by the body, which is why the Atkins diet promotes rapid loss of body fat by oxidation.
Satiety, promoted by the Atkins diet and the ketogenic diet, also occurs due to the increase in ketone bodies and serotonin levels in the brain.
Serotonin has a receptor in the hypothalamus, which promotes the reduction of food consumption.
However, several studies have shown that diets high in carbohydrate restriction, as it is the case of Dr. Atkins and all ketogenic diets, may cause many adverse problems and should not be followed for long periods of time.
The first identified aspect was that the ketogenic diets are more easily abandoned as time passes.
Due to carbohydrate restriction, people turn to follow a normal diet gaining weight again and promoting obesity.
This is due to the reduction of basal metabolic rate after the diet, turning the weight loss process more difficult.
Another identified effect of the ketogenic diet is the loss of muscle mass. With the reduction of insulin secretion, there is an increase of circulating fatty acids and ketone bodies in the blood, which increases the protein catabolism and, consequently, there is a reduction in lean body mass.
Some studies demonstrate effective preservation of lean body mass just by adjusting the protein intake maintaining the levels of protein intake in the range of 1.2 – 1.7g/kg in reference to your body weight.
The effects of reducing daily protein intake to below 1.2 g/kg in reference to your body weight during a ketogenic diet, it includes progressive loss of functional lean tissue.
Finally, the lack of concern of the Atkins diet and the ketogenic diet with intake of healthy foods can also cause serious health risks in the long run.
A major problem is the high consumption of saturated fat content in the diet implying increased risk of various diseases, particularly cardiovascular diseases.
Obesity is a major public health problem worldwide and is now considered an epidemic, according to the World Health Organization.
Several factors contribute to this problem, including the extra calories contained in processed foods, a sedentary lifestyle, bad habits and also stress.
An excess of body fat and being overweight can also increase levels of cardiovascular diseases, diabetes and even certain types of cancer.
For this reason, many researchers have began several studies in search for the new alternative diets in order to control weight gain and combat obesity.
Diets low in carbohydrates, such as the ketogenic diet, are among the best diets for those who wish for faster and more efficient results in weight loss.
However, the ketogenic diet may also have some symptoms and adverse effects.
In this article, we are going to show you the 3 untold symptoms and side effects you probably don’t know and how they can affect your health.
The ketogenic diet is very famous for its quick results and more efficient weight reduction, helping a lot in reducing body fat.
However, many studies show that following a ketogenic diet can cause various symptoms and side effects.
The most common ketogenic diet symptoms are lethargy, dizziness, mental fogginess, irritability, and irregular bowels, depending on how your body reacts to the radical shift in macronutrients.
In this article, we also showed you the 3 untold symptoms and side effects you probably don’t know about the ketogenic diet.
Still after studying the symptons that are produced by following a ketogenic diet there are supplements and a dietary system that you can follow in order to reduce these symptoms.
Overall this is a great a healthy diet to follow due to its amazing benefits.
Before you follow a ketogenic diet, seek the guidance of a professional health care in order to avoid possible problems.
Continue with us in the next articles and leave your comments or questions here.
If you want more information about what is ketosis.
1 – Phinney, Stephen; Ketogenic diets and physical performance; Nutrition & Metabolism 2004, 1:2;
2 – Cavallino, Stephen, M.D., Habib, Amid, M.D., Sim, David, M.D., Nemer, Robert, D.O.; The Truth About Ketones & Ketosis; Cambridge International Institute for Medical Science;
3 – Manninen, Anssi; Metabolic Effects of The Very Low-Carbohydrate Diets: Misunderstood “Villains” of Human Metabolism; Journal of the International Society of Sports Nutrition. 1(2):7-11, 2004;
4 – HM Dashti; TC Mathew; T Hussein; et al; Long-term effects of a ketogenic diet in obese patients; Exp Clin Cardiol 2004, 9(3):200-205;
5 – Westman, Eric; Phinney, Stephen; Volek, Jeff; The New Atkins for a New You: The Ultimate Diet for Shedding Weight and Feeling Great; Fireside, 2010;
6 – DiPasquale, Mauro; The Anabolic Diet; Optimum Training Systems, 1995;