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There are many physical benefits to the keto diet.

The keto diet has been used for decades as treatment for seizure disorders in children.

It is now being used as an effective method of weight loss through the suppression of insulin secretion and the rapid metabolism of fats. The benefits of the keto diet arise as a direct result in relation to the benefits from weight loss. The effective weight loss through the keto diet result in improved heart health, decrease in inflammatory conditions such as asthma and arthritis, and improved insulin sensitivity. This enhanced insulin sensitivity can result in the reversal of type II diabetes.

Keto Diet and Insulin

When adhering to the keto diet an individual is on a strict low carbohydrate diet, which results in a drop in insulin levels. Insulin is the hormone that tells your body to store fat and retain water.

When there is a drop in insulin, water retention drops and fat metabolism accelerates. As a result, there is an improvement in blood pressure, blood sugar levels, and cholesterol. There is also a drop in total body inflammation as a result of fat loss. With the drop in insulin levels, the keto diet is a very effective method of weight loss, as fat metabolism accelerates and water retention decreases.

Downsides of the Keto Diet

With the start of the keto diet, the body switches from using sugar as a source of energy to using the body’s stored fat.

With the start of this low carbohydrate diet, most suffer from the “keto-flu”. In the process of breaking down fat, the body produces ketones, which are then removed by the body through frequent and increased urination. This may lead to dehydration and flu-like symptoms, such as fatigue, dizziness, irritability, nausea and muscle soreness. With frequent urination, there is also the inevitable loss of electrolytes, which can exacerbate these symptoms. In addition, as carbohydrates are a source of energy and stimulation, removal of this source of energy will result in increased sugar cravings, brain fog, and difficulty concentrating, much like most other withdrawal symptoms.

Risk Factors

Since the keto diet is an elimination of carbohydrates, this also includes fiber, which will often result in constipation.

A more serious risk factor associated with the keto diet is dehydration, which can result in acute kidney injury. Increased urination will also lead to a loss of electrolytes such as sodium, magnesium and potassium. This may put the dieter at risk of cardiac arrhythmias, as electrolytes are necessary for the normal beating of the heart.  Electrolyte deficiencies are serious and may result in an irregular heartbeat, which can be deadly.

Should Everyone Do It?

Not all patients are appropriate candidates for the keto diet, especially those with chronic conditions such as high blood pressure, diabetes or other conditions that may be the result of their previous diet.

Since one’s diet will be drastically changed with the start of a keto diet, medications may also need to be changed. Patients need to be evaluated and closely monitored by a physician when on this level of dietary restriction, in addition to close monitoring of their laboratory results to continuously assess potential changes that may need to be made (i.e. electrolyte supplementation and/or change daily medication dosage…etc.).

Should Keto be a Long-Term Diet?

The keto diet is a very successful way for rapid weight loss as long as it is done safely, as you do not want to cause bigger problems in order to solve a smaller one.

Keto is not a great long-term diet, as it is not a balanced diet. A diet that is devoid of fruit and vegetables will result in long-term micronutrient deficiencies that can have other consequences. The keto diet can be used for short-term fat loss as long as it under medical supervision.


Patients starting a ketogenic diet will need to increase their water intake before they start.

Some patients may need to supplement with sodium, as long as they do not have blood pressure issues. Some may even need prescription potassium supplementation. I start all of my keto diet patients on magnesium supplementation, as it is an electrolyte that can be taken with low risk of overdose. If the dieter continues to have symptoms despite hydration, they should increase their carbohydrate intake with the addition of vegetables/fruit and contact their physician.

Further Resources

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