The ketogenic diet has been praised for effective weight loss, but a high-fat, low-carb lifestyle isn’t for everyone. Don’t attempt to reach ketosis if any of these six situations apply to you!
By now, you’ve probably read a book or at least a couple of articles, touting the benefits of
the ketogenic diet. While it may seem like just another fad that won’t be around for long, the truth is that the high-fat, very low-carb eating plan comes with numerous health benefits. In fact, research shows that the keto diet can aid in weight loss, obesity prevention, improvement of cognition and alertness, cardiovascular or metabolic conditions, and the treatment of seizure disorders. (1)
This is possible because, during ketosis, the body passes through different phases of hormonal and metabolic adaptations in order to utilize a new source of available energy: fat. (2)
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When glucose is no longer available as a fuel source, free fatty acids are converted into ketone bodies that pass across the blood-brain barrier and energize the brain, heart, and muscles, while, of course, minimizing the excess fat cells that we find in all the wrong places on our bodies.
That said, the keto diet is not ideal for everyone. Following are six situations in which the ketogenic diet may actually be dangerous and should, therefore, be avoided:
1. You’re Pregnant or Nursing
To date, there hasn’t been much research done to investigate the effects of the ketogenic diet during pregnancy. However, studies have found that side effects of the keto diet can include weight loss, deficiencies in important nutrients, anemia, dehydration, hormonal changes, constipation, and inadequate growth in children.
Pregnant women and women who are nursing typically need to consume more protein and extra fiber from plant foods compared to non-pregnant women. This increased fiber intake helps to support fetal growth and development (especially of the brain), provides enough essential vitamins and minerals, and can help improve digestion for mom. (3)
As a result, the keto diet is risky for pregnant women.
2. You Have Diabetes or Other Serious Blood Sugar Issues
Many people following the keto diet will deal with bouts of hypoglycemia or low blood sugar, at least initially. (4) This can become dangerous if your blood sugar is not stable to begin with and/or you’re taking medication to control diabetes.
There’s lots of evidence showing that the prevention of diabetes and/or slowed progression of the disease can be achieved through healthy diet and exercise changes. However, to be on the safe side, people with a history of hypoglycemia, diabetes, or prediabetes should not attempt the ketogenic diet without being monitored closely by their doctor. (5)
Weight loss and dietary changes might also mean that diabetes medication dosages need to be adjusted, so it’s best not to follow any restrictive diets without supervision.
3. You Have a Thyroid Disorder or Adrenal Fatigue
A moderate low-carb diet might be helpful for certain people with thyroid disorders, but a very low-carb diet (like the keto diet) may also worsen some thyroid-related symptoms, including brain fog, trouble sleeping, digestive issues, and changes in mood. (6) The same can be said for adrenal fatigue symptoms, which are usually remedied through a balanced diet and lifestyle changes.
It may still be possible to follow a moderate low-carb diet if you have a thyroid condition such as hypothyroidism, but you’ll want to keep a very close eye on your symptoms and reactions, especially if you take medications.
If you do notice that eating low-carb worsens your symptoms, it’s always best to ask your doctor for advice. You should also consider increasing your carb intake by 15 to 20 grams at a time until you find an amount that works well for you.
4. You’re Underweight or Nutrient Deficient
Despite being a very high fat diet, the ketogenic diet tends to lead to weight loss – and sometimes that weight loss occurs very rapidly. So if you’re already underweight, have any known vitamin or mineral deficiencies tied to undereating, or have a past involving disordered eating, the keto diet is not recommended.
For those who lose weight easily, a moderate diet that includes more complex carbs and plenty of healthy fats and proteins will likely be a better fit.
It’s important to note that the keto diet may also be dangerous for people who have had gastric bypass surgery, due to the increased risk for nutrient deficiencies that can occur from eating too few calories.
5. You Have a History of Kidney Stones or Kidney Disease
The increased risk of kidney stones are an unfortunate side effect attributed to the keto diet. If you’re already prone to kidney disease, going keto just isn’t worth the gamble. (7)
If you have a family history of any kind of kidney disease, I recommend that you see a doctor before starting the ketogenic diet. Have your physician check your urine calcium/creatinine ratio to be sure that you’re not putting yourself at risk for complications such as nephrolithiasis, which refers to dangerous calcium accumulation in the kidneys. (8)
6. You Have an Enzyme Defect or Deficiency
Although they are rare disorders, the two most serious contraindications to the ketogenic diet are conditions called pyruvate carboxylase deficiency and porphyria. These disorders involve a problem with lipid metabolism and the production of heme, a component of hemoglobin that has the role of carrying oxygen from the lungs to other parts of the body.
People with these disorders have deficiencies in certain enzymes, making it difficult to metabolize high amounts of free fatty acids (FFAs) and to transport them properly to the cells’ mitochondria so that they can be used to create energy. Following the ketogenic diet with these types of deficiencies – or any beta-oxidation defects – can cause dangerous complications, including nervous system deterioration, mental changes, and irregular heartbeats.
The reason this can be dangerous is that FFAs may build up but can’t be utilized for energy. People with pyruvate carboxylase deficiency and porphyria rely on glucose to supply enough energy for their organs. When no glucose is present due to following the ketogenic diet, life-threatening symptoms can occur (this is called catabolic crisis). To avoid complications, if someone has a family history of mitochondrial disorders or is suspected to have either of these conditions, they should always be screened before initiating the ketogenic diet. (9)
What Type of Diet Might be a Better Option for You?
Even if the standard keto diet is not a safe option for you, there are still ways you can modify the plan to make it more appropriate and equally beneficial. One way is to follow a “modified low carb diet,” also called a low glycemic index diet.
Reducing carbs in your diet, especially from processed foods and added sugar, is a way to achieve more stable blood glucose levels while using a much less restrictive regime than the ketogenic diet. The modified low carb diet can also help with weight loss and improvements in energy and mental health.
With this approach, you can still eat a high-fat diet with moderate protein, but you’ll add in more unrefined carbohydrates and high-fiber foods. On a moderate low-carb diet you should aim to get approximately 40-60 percent of total calories from fat, and at least 50-100 grams of carbs per day, especially from carbohydrates that have a glycemic index score less than 50.
(Read This Next: Keto Diet Foods – What to Avoid and What to Eat)