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5 of the worst keto diet side effects

The keto diet can help with weight loss, but at what cost?

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  • In addition to weight loss, there are a few well-known side effects of the keto diet, some of which can be unpleasant.
  • Some side effects of the keto diet are bound to occur, though others only happen when the diet is implemented poorly.
  • The keto diet doesn't have to lead to a host of negative side effects, but anyone considering undertaking the diet over the long term should be especially careful.

The keto diet is often called a fad diet. Make no mistake: it is. But unlike other trendy diets, the keto diet is unique because it actually pushes the body into an alternate, natural metabolic state called ketosis. When this happens, you can reliably expect a few negative side effects, notably those that come with the "keto flu." But other side effects emerge only when people implement the keto diet poorly, typically by failing to eat balanced, nutrient-rich foods as a part of a high-fat, low-carb diet.

Here are a few of the worst side effects of the keto diet, most of which can be avoided with some careful planning.

​Constipation

What's likely to happen when you cut out common sources of fiber from your diet? Constipation. A 2015 study involving children on the keto diet showed that regular constipation was extremely common among participants, affecting about 65 percent of them.

"Many of the richest sources of fiber, like beans, fruit, and whole grains are restricted on the ketogenic diet," registered dietician Edwina Clark told Everyday Health. "As a result, ketogenic eaters miss out on the benefits of fiber-rich diet such as regular laxation and microbiome support. The microbiome has been implicated in everything from immune function to mental health."

Still, the keto diet doesn't need to lead to fiber deficiency: avocados, flaxseed, almonds, pecans and chia seeds can all provide fiber while still keeping you in ketosis — when consumed in the right amounts.

Vitamin deficiency

Any diet that prohibits you from eating many types of fruits, vegetables and other foods is bound to leave you vulnerable to vitamin and mineral deficiencies, and it's for this reason many doctors only advise going on the keto diet over the short term.

"Keto is not a great long-term diet, as it is not a balanced diet," Nancy Rahnama, M.D., M.S., an internal medicine and bariatric specialist, told Reader's Digest. "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 is under medical supervision."

On the keto diet, your body begins to shed fat, water and glycogen, and as this happens you lose key electrolytes, such as sodium, potassium and magnesium. When you're running low on these electrolytes, you might experience headaches or extreme fatigue. These losses are most pronounced during the first few weeks after you enter ketosis, so if you're going to start the keto diet it's best to plan ahead to make sure you get healthy amounts of these electrolytes — and other vitamins and minerals — either through supplements or a thoughtfully-designed meal plan.

​Muscle loss

Some research suggests that the keto diet can lead to the loss of lean body mass, which includes muscle protein.

"Muscle loss on the ketogenic diet is an ongoing area of research," Clark told Everyday Health. "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."

The website sci-fit, which compiled a survey of the research on the keto diet, found:

"We generally see greater lean body mass (LBM) loss in ketogenic diet groups. Note that lean body mass contains water, glycogen, and muscle protein, by definition. It is hard to say with certainty that LBM loss implies greater "dry" muscle protein loss. "Wet" LBM can come and go quickly because it consists of water and glycogen."

In terms of gaining muscle, it seems protein alone doesn't do as well as it does when paired with complex carbs. These carbs don't become part of the muscle fiber, but they do help speed up the process, in part by helping cells regain glycogen — a key source of fuel during exercise.

The 'keto flu'

One of the most immediate side effects of the keto diet is the "keto flu," a suite of symptoms that many experience in the first couple weeks after entering ketosis. Similar to the flu, these symptoms can include fatigue, brain fog, dizziness, vomiting, nausea and stomach pain.

"The keto flu is definitely real," registered dietician Scott Keatley told Everyday Health. "Your body functions really well on carbohydrates — that's what it was designed for. When it switches to fat burning, it becomes less efficient at making energy."

The keto flu — and the accompanying sugar cravings – often leads people to give up the diet and begin scarfing down carbs, but those who stick it out usually report that the symptoms clear up after a few days or a couple weeks.

Kidney damage

Some people inflict damage on their kidneys when they switch to the kidney diet because they eat too much meat and don't drink enough water. This can lead to an increase in uric acid, which is known to cause kidney stones.

"If you're going to do keto, there's a better and a worse way to do it," registered dietician Kim Yawitz told Everyday Health. "Loading your plate with meats, and especially processed meats, may increase your risk for kidney stones and gout... High intake of animal proteins makes your urine more acidic and increases calcium and uric acid levels. This combination makes you more susceptible to kidney stones, while high uric acid can increase your risk for gout."

Of course, a responsible keto diet plan need not result in damage to the kidneys. In addition to monitoring meat consumption, a 2007 study on kidney stone development within young participants on the keto diet found that taking oral potassium citrate tablets seemed to be effective at preventing kidney stones.

Hints of the 4th dimension have been detected by physicists

What would it be like to experience the 4th dimension?

Two different experiments show hints of a 4th spatial dimension. Credit: Zilberberg Group / ETH Zürich
Technology & Innovation

Physicists have understood at least theoretically, that there may be higher dimensions, besides our normal three. The first clue came in 1905 when Einstein developed his theory of special relativity. Of course, by dimensions we’re talking about length, width, and height. Generally speaking, when we talk about a fourth dimension, it’s considered space-time. But here, physicists mean a spatial dimension beyond the normal three, not a parallel universe, as such dimensions are mistaken for in popular sci-fi shows.

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A new hydrogel might be strong enough for knee replacements

Duke University researchers might have solved a half-century old problem.

Lee Jae-Sung of Korea Republic lies on the pitch holding his knee during the 2018 FIFA World Cup Russia group F match between Korea Republic and Germany at Kazan Arena on June 27, 2018 in Kazan, Russia.

Photo by Alexander Hassenstein/Getty Images
Technology & Innovation
  • Duke University researchers created a hydrogel that appears to be as strong and flexible as human cartilage.
  • The blend of three polymers provides enough flexibility and durability to mimic the knee.
  • The next step is to test this hydrogel in sheep; human use can take at least three years.
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Predicting PTSD symptoms becomes possible with a new test

An algorithm may allow doctors to assess PTSD candidates for early intervention after traumatic ER visits.

Image source: camillo jimenez/Unsplash
Technology & Innovation
  • 10-15% of people visiting emergency rooms eventually develop symptoms of long-lasting PTSD.
  • Early treatment is available but there's been no way to tell who needs it.
  • Using clinical data already being collected, machine learning can identify who's at risk.

The psychological scars a traumatic experience can leave behind may have a more profound effect on a person than the original traumatic experience. Long after an acute emergency is resolved, victims of post-traumatic stress disorder (PTSD) continue to suffer its consequences.

In the U.S. some 30 million patients are annually treated in emergency departments (EDs) for a range of traumatic injuries. Add to that urgent admissions to the ED with the onset of COVID-19 symptoms. Health experts predict that some 10 percent to 15 percent of these people will develop long-lasting PTSD within a year of the initial incident. While there are interventions that can help individuals avoid PTSD, there's been no reliable way to identify those most likely to need it.

That may now have changed. A multi-disciplinary team of researchers has developed a method for predicting who is most likely to develop PTSD after a traumatic emergency-room experience. Their study is published in the journal Nature Medicine.

70 data points and machine learning

nurse wrapping patient's arm

Image source: Creators Collective/Unsplash

Study lead author Katharina Schultebraucks of Columbia University's Department Vagelos College of Physicians and Surgeons says:

"For many trauma patients, the ED visit is often their sole contact with the health care system. The time immediately after a traumatic injury is a critical window for identifying people at risk for PTSD and arranging appropriate follow-up treatment. The earlier we can treat those at risk, the better the likely outcomes."

The new PTSD test uses machine learning and 70 clinical data points plus a clinical stress-level assessment to develop a PTSD score for an individual that identifies their risk of acquiring the condition.

Among the 70 data points are stress hormone levels, inflammatory signals, high blood pressure, and an anxiety-level assessment. Says Schultebraucks, "We selected measures that are routinely collected in the ED and logged in the electronic medical record, plus answers to a few short questions about the psychological stress response. The idea was to create a tool that would be universally available and would add little burden to ED personnel."

Researchers used data from adult trauma survivors in Atlanta, Georgia (377 individuals) and New York City (221 individuals) to test their system.

Of this cohort, 90 percent of those predicted to be at high risk developed long-lasting PTSD symptoms within a year of the initial traumatic event — just 5 percent of people who never developed PTSD symptoms had been erroneously identified as being at risk.

On the other side of the coin, 29 percent of individuals were 'false negatives," tagged by the algorithm as not being at risk of PTSD, but then developing symptoms.

Going forward

person leaning their head on another's shoulder

Image source: Külli Kittus/Unsplash

Schultebraucks looks forward to more testing as the researchers continue to refine their algorithm and to instill confidence in the approach among ED clinicians: "Because previous models for predicting PTSD risk have not been validated in independent samples like our model, they haven't been adopted in clinical practice." She expects that, "Testing and validation of our model in larger samples will be necessary for the algorithm to be ready-to-use in the general population."

"Currently only 7% of level-1 trauma centers routinely screen for PTSD," notes Schultebraucks. "We hope that the algorithm will provide ED clinicians with a rapid, automatic readout that they could use for discharge planning and the prevention of PTSD." She envisions the algorithm being implemented in the future as a feature of electronic medical records.

The researchers also plan to test their algorithm at predicting PTSD in people whose traumatic experiences come in the form of health events such as heart attacks and strokes, as opposed to visits to the emergency department.

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