The Dangers Of Eating A Ketogenic Diet Long-Term (And How To Heal From It)
We have shined a light (and our thoughts) on the ketogenic diet in a previous blog post, Is a Ketogenic Diet Good or Bad for You?, but today we are taking a more in-depth look at the effects of this popular diet and how it can be supportive or detrimental to your health.
The diet is similar to the very low-carb diet referred to as the Atkins diet in the 1990s, promising quick weight-loss through a high-fat, no carbohydrate approach.
While individuals are getting results, this type of diet acts as a diuretic in your body, meaning it sucks the water from your muscles, allowing you to drop weight fast. It is common for those starting on a ketogenic diet to lose weight fast within the first few weeks, mostly due to water weight.
The History Behind The Ketogenic Diet
The overall premise of the diet (high-fat with little to no carbohydrates), has been shown in research to be supportive to those with epilepsy. This goes back in history to 400 BCE, where doctors recommended fasting for those having epileptic seizures.
Fast forward to today, there is evidence showing the connection between epilepsy and our diet. While long-term fasting is not always a viable option, doctors continued to search to see how fasting could best be mimicked. The answer they came to was the Ketogenic diet—a high-fat, low-carbohydrate meal plan.
While shown to be beneficial for those with epilepsy, Parkinson's, Alzheimer's, or metabolic syndrome, there is little to no research on the long-term effects of this diet in healthy people or even athletes.
We have repeatedly seen participants in our Adrenal ReCode program who have been on a highly restrictive high-fat (70-80% of calories from fat), low-carbohydrate diet have fat malabsorption, vitamin and mineral deficiencies, and hormones that are way off balance.
They can’t sleep. Their hair is falling out. They’re anxious.
The diet is no longer working to provide them energy and mental clarity, so they are exhausted. And now, they can’t lose the “spare tire” around their belly no matter how much they restrict carbs.
What Exactly Is Ketosis?
Ketosis is a state where the body is receiving a low intake of carbohydrate sources and a high intake of fat—often 70-80% of calories come from fat.
The body learns to burn fat for energy by way of producing ketones, which circulate the bloodstream to serve as energy. This process is ultimately mimicking the effects of fasting.
When starting a ketogenic diet, the body begins by going through a process called gluconeogenesis where it uses stored glucose (called glycogen) from your muscles and liver to supply the body with energy. After these stores are used up, the body starts to utilize ketones from fat for energy.
Here’s What’s Happening With A Body In Ketosis
When you blow through your glucose reserves and start burning fat, the next thing to go is muscle (unless you are super diligent about staying in ketosis). The body then has no choice but to go into muscle-wasting-mode, burning protein for fuel. This is what happens when we are dying.
The body prefers to use carbohydrates as fuel and forcing it to burn fat (or protein) gives it no choice but to go into high stress, survival mode forcing the overproduction of stress hormones in the breakdown process—you cannot have healthy stress hormones and be on a long-term ketogenic diet—it's scientifically impossible.
Over time, because you have willingly chosen to take away your precious reserves of energy—energy that provides you with both physiological and emotional stability under times of stress (I’m even talking about skipping a snack or encountering heavy traffic as stress).
It’s like burning out the generator so you have nothing to rely on when the power goes out.
When we are under high amounts of stress (either psychologically or due to illness), we need to use stored glucose as fuel. If we do not have any stores of glycogen, the body has no choice but to secrete cortisol, a stress hormone, which means the body is running off of stress hormones instead of fuel. This is a way to compromise long-term health for short-term benefits (like fast weight loss or “energy” or “brain power” that is being inappropriately powered by stress hormones).
It’s kind of like putting diesel in a car that requires gasoline.
A healthy human body should have 1,400-2,000 calories (or 350-500 grams) of glycogen stored in the muscles and about 400 calories or 100 grams of glycogen in the liver.
Having that backup supply creates stability and resilience in the nervous system and gives you a greater ability to tolerate and rebound from stress because it keeps the body from overproducing or inappropriately producing stress hormones (cortisol and adrenaline) that, in excess, are toxic to your adrenals, thyroid, gut, and immune system.
If we stay on a ketogenic diet long-term, it becomes a detriment to our sleep, energy levels, and mental or emotional health, not to mention our adrenals get burned out from overworking and the thyroid continues to take a hit (losing its ability to convert inactive thyroid hormone to active thyroid hormone or to even make thyroid hormone = hair falling out).
Furthermore, and worse – this creates a gateway to autoimmunity or stress-induced autoimmune diseases.
Those of us who build up our reserves and learn how to burn healthy carbohydrates (watch our show on healthy carbs if you haven’t already) as fuel get the freedom, self-reliance, and strength to live “off the grid” so to speak.
We are not nearly as weakened by external events or significant life stressors the way other people's lives literally stop when high-stress enters their life.
The Research Behind The Keto Diet
As previously mentioned, there can be a therapeutic purpose to a ketogenic diet, including for those with Type 2 diabetes, metabolic syndrome, epileptic seizures, cancer, and neurological diseases.
There have been positive studies looking at ketogenic diets for a period of 4 to 24 weeks (6 months), the results have been mixed. One has shown the benefits of a ketogenic diet in reducing hemoglobin A1C levels in those with type two diabetes.
Surrounding weight management, the results have been mixed; there have been a few studies showing improvements in weight while others show no improvement when compared to participants with the same caloric intake but a high-carbohydrate diet.
From working with tens of thousands of people, I would not recommend anyone stay on a ketogenic diet longer than 8-10 weeks. There is not enough definitive research to speak to the six-month period of time as mentioned above.
The Dangers Of The Ketogenic Diet
The ketogenic diet acts as a diuretic, so naturally, weight loss occurs quickly (and unnaturally) as carbohydrates hold onto fluid in the body.
This means that the glycogen molecules in your body hold onto the water while they are being removed or burned off.
While we love healthy fat, too much of it and with an unbalanced source of carbohydrates (and protein) can be dangerous because it overloads the liver and gallbladder, leading to fat malabsorption, poor digestion, and poor cholesterol output which means poor sex hormone production.
This highly-restrictive diet can make food choices very limited, and we have seen, for some, that it can become the gateway to developing an eating disorder.
Women And The Ketogenic Diet
Hundreds of women in our Adrenal ReCode program have come from a ketogenic background and came to us experiencing mood swings, unbalanced or absent menstrual cycles, fertility issues, hair loss, low energy, and vitamin deficiencies.
They thought they were eating healthy and doing the right things. They thought it was just their schedules, their kids, or their age that must be making them feel overwhelmed, exhausted, and out of control until they realized what was really happening.
Fight-or-Flight Mode: The ketogenic diet especially puts a woman's body in persistent fight-or-flight mode, creating high cortisol leading to stubborn belly fat, sleep issues, and anxiety.
Hormones: Long-term this can lead to a drop in progesterone, often leading to estrogen dominance and premature menopause/perimenopause, and infertility. This is very important for women of all ages; fertility issues can be common, often losing a menstrual cycle entirely, due to the body being in survival mode. For some, especially women over the age of 40, estrogen can also take a drop which can put us at risk for osteoporosis and other bone-related health problems.
Neurotransmitters: These chemical messengers in our brain are often depleted due to not receiving the right amounts of amino acids and cofactors which are found abundantly in healthy carbohydrate sources. This affects our mood, cognition, memory, and sleep.
Thyroid: Thyroid hormone production drops with both low-calorie diets and ketosis, especially T3 – the thyroid hormone that gives you energy and affects your weight, digestion, and metabolism. On lab tests, a thyroid hormone called reverse T3 is often increased due to the high amounts of stress and cortisol. Reverse T3 stores away thyroid hormone and makes it inactive, blocking active T3.
Men And The Ketogenic Diet
For men, the thyroid and neurotransmitters take a hit as well.
Some studies showing how a high-fat diet reduces sperm count, by 43% when compared to those consuming a moderate to low-fat diet.
When carbohydrates are reduced drastically, testosterone production is often decreased which triggers muscle catabolism (the opposite of muscle building).
This is why, long-term, we are seeing muscle-loss and weight-gain in those following a ketogenic diet.
Healing From A Ketogenic Diet
If you have been eating a ketogenic diet for a long time, it can often feel overwhelming trying to come off of it. It can be common that this is coupled with fear and anxiety of the unknown and questioning how your body will react when adding new foods back into your diet.
When starting off, the key is to take it slow and to have patience.
If we go too quickly when adding back in (healthy) carbohydrates, rapid weight gain can be possible. This is due to the fact that your body has not been using carbohydrates for fuel, so it does not know how to utilize them correctly meaning it looks at them as a foreign food it cannot metabolize and puts them aside to be stored as fat.
Similar to the fact that you do not go to the gym and start deadlifting 200lbs, we must retrain your body and start slow.
Try small amounts of healthy carbs (root vegetables and fruit and don't be afraid of tropical fruit)—2 tablespoons to a ⅛ cup depending on how many you're currently eating—to train your body to use them as fuel once again instead of storing them as fat.
If your digestion isn't great, you might want to eat cooked fruits—start with peeled and cooked apples and pears with a little bit of Ceylon cinnamon. While we love the pectin and insoluble fiber in the skin, it can't be digested and is better to leave out when digestion is already compromised.
Treat yourself as if you are healing, because you are and give your body foods that are easy to digest and foods that do not cause inflammation.
Make sure to have protein, carbs, and fat with each meal, but just downwardly adjust your fat and play with your carbohydrates until your body can tolerate and use them again.
When you eat muscle meat (chicken, beef, turkey, etc.) combine it with a little bit of collagen or bone broth to make the muscle meat easier to digest and less inflammatory.
The combination of these three things will calm and soothe your system and allow for a more graceful transition to normal, healthy eating that powers your cells and therefore your body and your brain.
What To Do Instead Of Eating The Ketogenic Diet Long-Term
The bottom line is that eating “keto” unnecessarily creates a starving state of emergency for the body, and yet millions of people are willingly choosing to eat this way because we live in a quick fix society that wants to trick or force the body into doing what they want it to do.
Many often spend years, if not decades, chasing trendy diets and quick fixes. To the contrary, we can find peace in just a few months through healing the nervous system and a broken metabolism and balancing hormones.
Every human being that eats food needs to understand that glucose is the preferred source of energy for the body—the body feels starvation when there is not enough glucose in the bloodstream and therefore releases stress hormones that give you negative symptoms both physically and emotionally.
If you want to find out more about this approach, take our free mini-course or just jump into the full Adrenal ReCode program and join the revolution of giving your body what it needs to support you in having the best and fullest experience of life.
Now, we want to hear from you. We know this is a controversial topic and that it might bring up some questions or concerns, so please feel free to comment or inquire below.
Dangers Of The Ketogenic Diet & How To Heal From It
References:
- A Novel Intervention Including Individualized Nutritional Recommendations Reduces Hemoglobin A1c Level, Medication Use, and Weight in Type 2 Diabetes.
- Beyond weight loss: a review of the therapeutic uses of very-low-carbohydrate (ketogenic) diets
- The Effects of Ketogenic Dieting on Body Composition, Strength, Power, and Hormonal Profiles in Resistance Training Males
Along with some other autoimmune symptoms, lately I enjoyed this article. While not strictly KETO, my diet has been pretty low carb.
I’m now experiencing fatigue that shuts me down. I think it’s the price I’m paying for religiously starting my day for the past 4-5 years with Bullet proof coffee ( MCT oil, coconut oil and butter combination) and intermittent fasting. The fat-filled coffee has given me lots of energy and I don’t feel like eating until about 3 o’clock in the afternoon so my weight stays down.
But now I’m so tired all the time. I don’t get my work done and I don’t feel like socializing. My body aches and I feel like I’m falling apart.
My doctor put me on a diet to give my liver and pancreas a break from fat. I’ve only been doing it for a few days hope it will undo the damage than I may have done so I can get back to bring me again..
HI Tami- So very sorry to hear what you have been go through energy wise. I would encourage you to check out our Free mini-course, all about healing your nervous system, adrenals and thyroid. This can be super important for those with autoimmune conditions. You may check it out here: https://theadrenalrecode.com/minicourse/
This debunks the idea that ketogenic diets are stressful: https://nutrita.app/article/keto-diet-and-stress-hormones/
Only three references that have not been replicated. “Energy that provides you with both physiological and emotional stability under times of stress (I’m even talking about skipping a snack or encountering heavy traffic as stress).” Well, a bit of stress is actually great for mitochondrial function! That is the whole point of authophagy (you should read about it).
I have T2D and am in a FB group focused on reversing diabetes. The group highly promotes a lifelong ketogenic diet to reverse diabetes. This blog ever so briefly mentions a ketogenic diet for diabetes but does not discuss the benefits or dangers or a ketogenic diet for this disease. Currently I use more of a paleo diet along with medication and exercise to manage my diabetes, Can you speak to the wisdom of a ketogenic diet for T2D? Thank you.
Hello, the blog mentions something about fasting but I’m wondering your stance on fasting. I’ve read a lot of research lately supporting IF so I was curious. Thanks!
Hi Haley- Thanks for watching the episode! We think short-term fasting can be great for metabolic health and neurodegenerative diseases. For most of us living off stress hormones, fasting can further exacerbate this stress cycle and increase cortisol even further.
In a high carb diet what shoud be the ratio of carbs, fat and protein? Had this already been determined or still is an enigma?
Hi Valery- great question, this can be very individual but on a higher carb diet the macros can look something like 40% carbs, 30% protein and 30% fats.
I know there is a lot controversy over the Keto diet but that was the only thing that helped me shed a few pounds where nothing else has. I’m not on it anymore but have not been able to lose anything just being on low carb. What is one to do? There is something about that way of eating that works for me.
Hi Vianna- Great question, I know how frustrating it can be trying everything and not finding a solution. We have found when balancing our hormones we can achieve a natural balance and rhythm in the body. If the lower carb (or even Keto) works for you, Great! I would just keep a check on your hormones and your cycle as well as your temperature and pulse, these are great indicators of whether it is working or not. 🙂 All the best to you on your journey to health! You can find out more about our approach here: https://thewholejourney.com/adrenal-recode-mini-course/
It is hard to choose between doing a ketogenic diet or not as so much information coming from reliable doctors agree that the ketogenic diet is good. Some doctors even say that it balance hormones. I respect you so much, that’s why I follow you and agree with you but I feel confused when listening to good doctors like Dr.Axe or Dr. Permutter or Dr. Hyman talking positive about ketogenic diet…
HI Claudine – The thing to keep in mind is individuality. The keto diet IS helpful for certain situations in the short term. It likely becomes unhealthy when people are on it for long periods of time and/or those who are already adrenal and thyroid compromised. Feel free to email us at [email protected] if you’d like some support figuring out what is best for you and your body!
Could you cite the studies that support your position that the keto approach is dangerous, I read over the article a couple of times and didn’t see anything. Does your position include the other LCHF approaches? I’ve noticed that in those ‘communities’ there is not a consensus regarding ratios of macronutrients vs just eating protein to satiety and adding some veggies in but not a lot of extra fat. Would be good to have all the info!
HI Moyb – you can find those at the bottom of the article.
References:
A Novel Intervention Including Individualized Nutritional Recommendations Reduces Hemoglobin A1c Level, Medication Use, and Weight in Type 2 Diabetes.
Beyond weight loss: a review of the therapeutic uses of very-low-carbohydrate (ketogenic) diets
The Effects of Ketogenic Dieting on Body Composition, Strength, Power, and Hormonal Profiles in Resistance Training Males
Your references completely support the Keto diet. Good job trying to confuse people into thinking that this way of eating is bad for you. Eating whole, unprocessed low carb food has shown, even by your references to help not only with weight loss but improve health.
It’s about time someone came out with the real “common Sense” about the keto diet. I watched all the renowned foodies (doctors, podcasters, clinicians) jump on the keto bandwagon and so tried it myself. It didn’t really make sense to me because I had a hard time believing that our paleo ancestors could have found so much fat to live on. Keto didn’t work for me (I think I am a lean mass hyper responder). I went back to low carb paleo and feel (and look) great. Thanks Christa for making sense of this latest fad.
Hi Glenn- So glad that you listened to your body to help navigate your food choices! Thanks for tuning in and being a member of our tribe.
I am so glad I got to watch this video . I have been told to go on the keto diet because I have a very difficult time loosing weight but I have been reluctant to do this and after watching your video I am so glad I haven’t. I am hypothyroid. Thank you I love your videos.
Hi Susan- Stay tuned for some upcoming blog posts on that very topic 🙂 We appreciate your support if you have not already please check out theadrenalrecode.com for the free mini course. It has helped many with balancing their hormones and weight naturally coming into balance.
The best thing you can do for your body/brain is to adopt Vinnie Tortorich’s #NSNG- no sugar, no grain way of eating. Simply eliminating these dangerous things from your menu will do wonders. Other than this, I have found that eating an animal based diet is best especially fatty red meat and organs along with fatty fish like wild salmon, mackerel, sardine etc. I also find that staying in ketosis or near ketosis is easy and provides me great energy as well as great sleep.
Hi Trevor- Great to hear that this type of plan is working for you, we completely agree that eliminating processed grains and foods is the way to go. Thanks for watching!
I just celebrate you, Christa! Always a front-running source of TRUTH when it comes to our health! Love love love what you so eloquently, unapologetically, and yet, humbly and honorably said in this video – yes, the Adrenal ReCode IS aka: KetoRecovery! That was me! I can’t recommend The Adrenal ReCode more than to shout it from the mountaintops how it has impacted my life in such a dramatic and defining way – and I KNOW it has and will continue to do so for so many others, if they allow themselves to open up to the TRUTH of how our bodies actually work! Truth: after doing the AR, I lost belly fat I didn’t even know I had to lose! At 1-month shy of 50, my abs look like a fitness model’s – not kidding! And(!) that’s with eating sweet potato pancakes, butternut squash pancakes, raw honey in my morning elixir, and consciously keeping it Carbs>Proteins>Fat! You and TWJ team with AR partnered with my mind/body/spirit to come together and respect one another – and LOVE one another! Without meaning to sound OTT, I can’t say it any other way than I completely ADORE YOU and celebrate your willingness to be bold, step up and out in this Keto-focused society, and speak truth to help us help ourselves! Mad love to you!
Nancy- We are all so excited for you and you inspire us to continue to spread the message! 🙂
I adore you right back, Nancy!! Woohoo for your fitness model abs and happy mood with eating carbs and living freely! xo
I am menopausal finally at 56. I have been doing the keto diet since Feb. and did not experience any of the things mentioned above. Instead, I had a very slow weight loss of maybe one pound a week until I lost 13 pounds and have stayed there and feel great. I tracked my carbs and calories on a free app called Senza and tried to stay at about 20-30 carbs a day. I now eat a few more and sometimes drink some wine on the weekend but I will bounce up a pound or two and then balance back down in weight without alcohol. Tracking was the only way I could lose that last 10 lbs that would not come off. I eat lots of veggies and some fruit, like blueberries and 1/4 banana, a beet and two handfuls of spinach and frozen green spirulina in a smoothie everyday with kefir milk I make myself. I cycle 50 miles a week and I know I am not losing muscle mass as I am building muscle the last two years. I am sure there are problems with Keto but if you make sure to get lost of fresh and cooked veggies, healthy organic olive oil, avocado oil and coconut oil with grass fed meats, curbing the grains sure helps to drop excess pounds. I occasionally eat rice. It seems to agree with me but not corn or wheat flour. I ate Paleo for years but Keto is what really helped me to get the where I wanted to be. I feel fit and strong. I am a grandmother of 12 and can run circles around them.
Sonii- We are happy to hear that you have found a sense of renewed health and that the lifestyle is working for you. Great to hear that you are including fruits and some rice as well into your plan! 🙂
My experience is similar to Sonii. I am 59, post menopausal and have experienced exactly the same outcome as her. I never dieted (or needed to) until the last 6-7 years – as the process of menopause changes a woman so much. I was not myself at all. I was never one to fluctuate in weight but had slowly added about 12 pounds over my ideal weight. I was sleepless, anxious and bloated. I had developed weird sugar & carb cravings. I did regain a much needed balance when I did Christa’s Kick Candida program about 5 years ago. (I had never done a cleanse before.) This program really kicked the brain fog, the bizarre sweet cravings I had acquired etc. I even dropped a few pounds down. Overall it got me feeling like me again. I have always eaten very nutritious foods and never the SAD way. Yet still that 10-12 pounds remained. I liked being “sugar free” from the candida cleanse, so I gradually worked to back off the carbs more and more. Yet barely any move on the scale. Eventually I landed on the Keto diet last year, which I followed strictly for 6 months. I too lost 1 pound per week effortlessly and best of all, began to sleep really well. (When a menopausal woman goes to bed, then the next time she wakes up, it’s light outside it is cause for celebration! ). I loved this diet. Now a year later, I have added more complex carbs into my diet now, but I just have to keep them low – about 40-50 total carbs per day seems to work. I just spent 8 days in Japan…and those carbs are hard to filter out of the food. We walked 10-12 miles every day and I came back 6 pounds heavier. Ugh…not fair! It’s been 3 weeks back and those pound seem stuck, so I just started logging into my carb app – Carb Manager. 1 down 5 to go.
After one year though, the keto diet works very well for me. Just be smart, eat clean and keep a variety of nutritious snacks around. I do love and appreciate Christa’s in-depth knowledge and passion for healthy eating and will remain cautious and careful.
🌳Thank you! That was such a breath of fresh air!!!
Thank you, Kristen 🙂 Thanks for being a member of our tribe!
The blog says that gluconeogenesis is the use of stored glycogen. This is grossly incorrect. It is the production of glucose by the body from protein.
Hi Claire – thanks for your comment. Technically it’s is a metabolic pathway that results in the generation of glucose from certain non-carbohydrate carbon substrates, but we explained it this way to help more people understand it easier.
WellnessWiz Jack here … having lived through the American Revolution (just kidding) … having lived through the high protein diets of the 1970’s and the high complex carb diets of the 1980’s as well as the low carb weight loss diet, the fit for life low protein diet, and the low fat diets, it only makes sense that the next one is the high fat diet. So here’s a note of historical insight. If it’s HIGH this or LOW that, then it’s already off the mark. If you have to weigh out portions and restrict all the time, then it’s off the mark. Let’s first draw our strength from nature … whole foods, in the season thereof. This is the holistic basis of food. The new governing principle is genetics and epigenetics — that we eat according to what works. Thus we can gently modify our foods regarding histamine responses, lectin responses, and ratios of fat-protein-carbs. Milk is often held up as Nature’s perfect food. Basically, milk is equal parts fat, protein, carbohydrate. So the message here is BALANCE in all things. There are three important macronutrients–fat, protein, carbohydrate. While ratios differ for each person individually, the three are the hub around which other nutrients revolve–minerals, trace minerals, herbs (botanical compounds), spices, vitamins, nutriments. Thank you, Christa, for being an independent voice of insight. People can get off the witch hunts for foods to exclude and embrace Nature’s bounty. That’s exactly what the gut microbiome is seeking for it’s food supply which in turn, is processed and passes into the body as cell-ready nutrients for health and longevity.
Amen, Jack. Thank you for that. Always enjoy and appreciate your valuable insight!
Most of my friends who have gone keto, lost weight…but then hair! All if them had thyroid issues and eventually had to add more protein.
Ive been low carb forever and need to rethink this. Thanks Christa!
Glad it was helpful for you, Sandra. 🙂