February 15, 2018©
Proclaim the truth and do not be silent through fear.
St. Catherine Of Siena
Should a so called health diet cause unhealthy side effects?
Below are a few side effects as reported by those on keto diets both short term and long term, so much so that they now have to be repeatedly addressed by proponents of keto diets.
I’ll let you be the judge but generally no, those are not symptoms associated with a healthy eating plan but more closely identified with various states of malnourishment and malabsorptive syndrome going along with the territory of gut disease for which ironically the remedy is more often than not vitamins and minerals that would be supplied by healthy microbiota and just a few minor but better food and eating plan choices.
Choices like consuming whole fat mammal milk daily or 1 tbsp. of a combination of healthy oils including grass fed butter. Or one cup of yogurt or kefir in place of a refined food meal. Or even adding nutritional yeast with natural vitamins supplied by organisms to an already healthy eating plan but really, choosing to engage in more malnourishment when one is already suffering the effects of severe acute malnutrition makes no sense. More chronic malnourishment does not correct malnourishment and much like other extreme diets, you’ll need dozens of supplements to replace the nutrition you aren’t getting from a well balanced diet.
- muscle cramps
- heart palpitations
- bad breath
- not satisfied
- right shoulder pain
- low back pain
- abdominal pain
If autophagy is the goal at least choose the substances that are responsible for it (lactose=lactase=galactose as in milk sugar (milk is proven to digest dead cells that is, increase phagocytosis, especially in the elderly), acid whey as in yogurt to phage CNS, undenatured whey as in colostrum (intracellular autophagy) and of course beneficial microbes that create enzymes).
They used a few things throughout history to prevent starvation in both war and famine and those were:
- whole fat mammal milk (lactose and oleic acid)
- grass fed butter (oleic acid)
- cod liver oil (oleic acid)
- and later discovered acid whey was a suitable replacement for whole fat mammal milk in the prevention of starvation (lactose)
- the process of fermentation
The truth is most people with chronic malnourishment were already experiencing most of those symptoms before starting any so called healthy cult diet like keto or the many other diet extremes with severe restrictions on either fat, carbs, vegetables, fruits, dairy or various combined food groups. In those with SAM (severe acute malnutrition), SIBO, IBS, IBD or other chronic gut conditions, no benefit was obtained from more starvation, far from it. Children who must be on keto diet as a last resort for seizures require excessive maintenance to assure malnourishment does not occur because it goes with the territory of a strict keto diet. You can not starve your way out of any gut/immune deficiency condition. Keto diet was never a first choice treatment plan for either seizures or schizophrenia because the risks outweighed the benefits. Combined with a lack of sleep, chronic malnourishment due to poor microbiota is a recipe for cancer and other deadly diseases.
Breastfeeding, food and water security are major protective factors against malnutrition and critical factors in the maturation of healthy gut microbiota, characterized by a transient bifidobacterial bloom before a global rise in anaerobes. Early depletion in gut Bifidobacterium longum, a typical maternal probiotic, known to inhibit pathogens, represents the first step in gut microbiota alteration associated with severe acute malnutrition (SAM). Later, the absence of the Healthy Mature Anaerobic Gut Microbiota (HMAGM) leads to deficient energy harvest, vitamin biosynthesis and immune protection, and is associated with diarrhea, malabsorption and systemic invasion by microbial pathogens.
A therapeutic diet and infection treatment may be unable to restore bifidobacteria and HMAGM.
Besides re-feeding and antibiotics, future trials including non-toxic missing microbes and nutrients necessary to restore bifidobacteria and HMAGM, including prebiotics and antioxidants, are warranted in children with severe or refractory disease.
I like Dr. Berg a lot but if one has to come out and prescribe something else to treat your initial prescription something is surely amiss and keto diet is no prescription for health in the treatment for chronic malnourishment SAM. At times he verges on ‘kitchen sink’ approach with his never-ending supplements, not prudent in those with severe metabolic issues (the less you have to metabolize the better to avoid more liver stress).
Keto diet is almost always used only in extreme circumstances in patients with dire conditions under strict supervision. It is not a diet for the average person, especially the unknowingly already malnourished due to poor microbiota person (also almost always improperly diagnosed or undiagnosed).
SAM is first cause with first factors and first principles, with poor microbiota establishment being first principle leading to all others thereafter including severe acute malnutrition, and until you get first principles, nothing will solve your chronic malnourishment or gut/immune problems.
In this case one simply does not put the cart before the horse.
“I am including a little card to print out and carry with you to remember all the symptoms from ‘malnourishment, malabsoprtive and metabolic syndrome’ on keto diet.”
You might want to keep that little card handy for the ER doctors as they struggle to figure out why you are collapsing in the ER.
The public weighs in
As with other cult diets, it was only a matter of time before the public began weighing in on their own experiences with keto diet. Those types of extreme diets are just not sustainable long term in the majority. Keto diet will go the way of all other cult diets including:
- Gluten Free
- Dairy Free
- Low carb
- South Beach
- Road Kill
and once again Cedars Sinai is correct in advising a moderate approach to diet while healing chronic gut conditions. Cedars was also among the first to advocate intermittent fasting for optimal gut health, formerly known as normal eating patterns in previous centuries.
Unfortunately the side effects of keto diets can often go from bad to worse.
Reversing obesity and metabolic syndrome is extremely important but as keto diets become more popular there are increasing reports of dangerous outcomes associated with such diets including:
- severe malnutrition (symptomatic hair loss)
- dehydration (for every gram of carbs not eaten, 3 grams of water are lost)
- severely altered blood sugar states leading to ER
- electrolyte imbalances
- coma and death
You can induce ketosis for a few hours per day, lose weight and stay safe without the maniacal and complicated guesswork and constant regimen of ketone testing or protein, fat and carb management which can lead to amino acid deficits, an increase in ammonia levels, and other negative outcomes.
It has been shown with cross population studies there is no sustainable weight loss in the long term via low carb dieting.
In fact, gut microbes and not ketones may account for the anti-seizure effects of the Ketogenic Diet according to a 2019 report.
The microbiota of seizure prone children is severely imbalanced as compared to controls. It has also been shown in more recent studies that keto diets do not enhance athletic performance.
It is all about the healthy gut and little else matters beyond that.
With a modest 20% calorie restriction and a moderate daily fast all the benefits of keto diet can be obtained. According to recent research a modest calorie restriction long term outperformed keto diet.
The only problem?
It takes more time.
It has been my experience that with a reasonable diet approach and focusing almost exclusively on my gut and immune health that I only felt better, not worse and all of my starvation symptoms from SAM (severe acute malnutrition) went away one by one including eventually metabolic syndrome and deranged autophagy syndrome associated with IBD. By that time I abandoned all cult diets and over the course of my natural oral immune therapy treatment, lost 30 lbs. I deliberately eliminated all diets in order to prove their gut/immune health theories to myself, and I did by losing 30 lbs. with no diet.
Once again the truth about SAM and cult diet extremism. Do what is moderate and you will achieve a better outcome. It is impossible for the average person to monitor such important systems as electrolyte balance, mineral balance (especially calcium/magnesium/potassium), and insulin, not to mention the all important acid/alkaline base. In those with already dysregulated metabolism it becomes even more of a challenge, the tip in the wrong direction could prove very dangerous as you can well see for yourself in those who “mistakenly applied?” keto diet via a quick search on youtube.
As a general weight-loss plan, keto is controversial. Some health experts warn against it entirely, citing unpleasant side effects, health risks, and the diet’s unsustainable nature. Even many keto proponents admit that, if the diet’s not done “the right way,” it can be the opposite of healthy.
All you will get by attempting to stay in constant ketosis is the equivalent of a burnt out engine. Your ancestors were never in constant ketosis, it was not a desirable state but an adaptive state due to food scarcity.
If you have type 1 or type 2 diabetes, you shouldn’t follow the keto diet unless you have close supervision.
That’s because, for people with diabetes, ketosis can trigger a dangerous condition called ketoacidosis. This occurs when the body stores up too many ketones—acids produced as a byproduct of burning fat—and the blood becomes too acidic, which can damage the liver, kidneys, and brain. Left untreated, it can be fatal.
Ketoacidosis has also been reported in people without diabetes who were following low-carb diets. Symptoms of ketoacidosis include:
- dry mouth,
- frequent urination,
- bad breath,
- breathing difficulties
If you experience these while following the keto diet, check in with a doctor right away.
If you find yourself running to the bathroom more often while on a ketogenic diet, you are not alone and this is termed ‘keto diarrhea’ . This may be due to the gallbladder—the organ that produces bile to help break down fat in the diet—feeling overwhelmed.
Diarrhea can also be due to a lack of fiber in the diet, which can happen when someone cuts way back on carbs (like whole-grain bread and pasta) and doesn’t supplement with other fiber-rich foods, like vegetables. It can also be caused by an unknown lactose intolerance to dairy or artificial sweeteners—things you might be eating more of since switching to a high-fat, low-carb lifestyle.
Recent studies on low carb diets
A 25,000-person study presented at the European Society of Cardiology Congress in Munich suggested that people on the lowest-carb diets had the highest risk of dying from cancer, cardiovascular conditions, and all other causes. Another study also found that people who followed diets that were low in carbs and high in animal proteins had a higher risk of early death compared to those who consumed carbs in moderation.
Combining keto with fasting can produce even more dire effects
Short term fasts of 12-16-18-20 hours are usually fine because you don’t stop eating and generally there are no food restrictions or food group restrictions but some already malnourished people often combine keto with 24 hour or days long fasting. It is even a blanket recommendation to combine the two by some doctors and that can be dangerous if not outright deadly in the already malnourished due to poor microbiota.
Refeeding problems can happen once food is given, particularly carbohydrate-containing foods. During the refeeding period, insulin and other hormones are activated. This causes the movement of the major intracellular ions (phosphorus, potassium, calcium and magnesium) into the cells. However, due to overall depletion of body stores, this becomes excessive and too little of these ions are left in the blood. This is what causes the major symptoms of the refeeding syndrome.
The main risk factor for re-feeding syndrome is prolonged malnutrition. When we use fasting as a therapeutic tool, most people have never missed a single meal, however, it is important to understand that patients that are malnourished should not fast.
Refeeding syndrome has been defined as the “potentially fatal shifts in fluids and electrolytes that may occur in malnourished patients”. The most important note here is ‘malnourished’. The clinical marker of this is hypophosphatemia – very low phosphorus levels in the blood. However, lowered potassium, calcium, and magnesium in the blood may also play a role. Calcium, phosphorus and magnesium are all primarily intra-cellular ions – that is, they are kept inside the cells and blood levels (which are outside of cells) tend to be quite low compared with concentrations inside cells.
Adults store 500-800 grams of phosphorus in the body. Approximately 80% of the phosphorus in our bodies is held within the skeleton and the rest in soft tissues. Almost all of the phosphorus is inside the cell, rather than outside, in the blood. The blood level of phosphorus is very tightly controlled and if it goes too high or low, can cause real problems. Average daily intake of phosphorus is 1 g/day, meaning that it often requires many months of undernutrition to produce these syndromes. Protein-rich foods, as well as grains and nuts, are good sources of phosphorus. 60-70% of the phosphorus is absorbed, mostly in the small intestine.
*Note with SIBO malabsorption in the small intestine is both common and severe.
Much of the calcium, phosphorus and magnesium in our bodies is stored in the bones. If the body needs more of these intracellular ions, it will take it from the bone ‘stores’.
During prolonged malnutrition, blood levels of phosphorus remain normal and the deficit is taken from the bones. This can last for a very long time. Since the daily intake of phosphorus is 1 gm/day, it would take hundreds of days of zero phosphorus intake to produce a significant body deficit. Since almost all foods contain phosphorus of some kind, refeeding syndrome almost always occurs on a background of malnutrition (underweight, anorexia nervosa, alcoholism).
Patients with high risk of refeeding syndrome include:
- patients with anorexia
- patients with chronic alcoholism or drug use
- oncology patients
- postoperative patients
- elderly patients
- patients with uncontrolled diabetes, electrolyte depletion or diuresis
- patients with chronic malnutrition
- prolonged fasting or low energy diet
- morbid obesity with profound weight loss
- high stress patients
- malabsorptive syndrome (inflammatory bowel disease, chronic pancreatitis, cystic fibrosis, short bowel syndrome) SIBO is also a malabsorptive syndrome
- long term use of antacids
- long term use of diuretics
Vitamin deficiencies have also been described, again mostly with prolonged malnutrition. The most important is thiamine, which is an essential coenzyme in carbohydrate metabolism. Typically, this has been described in alcoholics with the syndromes of Wernicke’s encephalopathy (ataxia, confusion, visual disturbances) and Korsakoff’s syndrome (memory loss and confabulation). Confabulation is a symptom whereby people have a complete lack of short-term memory. They therefore ‘make up’ everything when they are talking because they have no memory. There is no intent to deceive.
If there is any concern about malnutrition, then again, fasting is not recommended.
Dr. Jason Fung
The problem is the general public doesn’t realize how malnourished they are due to gut dysbiosis because malnourishment is always exclusively associated with diet but almost never associated with poor gut health!
Since insulin resistance testing is almost non existent, most people don’t even know if they are insulin resistant or steroid resistant for that matter. If you have type 1 or type 2 diabetes, you shouldn’t follow the keto diet unless you have close supervision and that includes pre-diabetic, gestational diabetes, metabolic syndrome or borderline.
I would also invite you to judge for your self the results of other diet extremes as listed above and you will most likely reach the understanding of Cedars Sinai, WHO, The Father Of The Microbiome and other gut immune health experts (along with millions of patients who eventually abandoned them in frustration) in understanding the truth about choosing extreme diets as singular treatment approach for chronic gut and immune conditions.
They don’t work.
I don’t think the necessity of a Ph.D is a reasonable approach in hoping to maintain a healthful diet, especially while underestimating the importance of healthy microbiota in that equation (first cause). It does however sell a lot of books for those who continue to maintain diet as first cause.
Slow and steady wins the race.
As you can see in the video above on autophagy a moderate approach to correct metabolic syndrome can take up to two years. Achieving gut homeostasis alone with oral natural immune therapy products like gcmaf or bovine colostrum can take 4-6 months average.
Those who insist on immediate gratification often end up with more frustration due to not being able to understand or control unpredictable responses or unpredictable results. The pendulum paradox is real, that is when bodily functions shift widely from one extreme to another in an effort to maintain homeostasis. It also can occur mentally when a person haphazardly swings from one extreme to the other in an effort to force a result because they don’t seem to notice progress. This can include adding too many supplements or drugs at once but it can also include too many diet extremes in a body that isn’t capable of shifting so fast due to a poor metabolism. This produces stress which adds to more metabolic problems. Sometimes the effects of a diet extreme don’t show up for months and that can lead to even more confusion when the person equates it with a recent change instead of a problem that had been steadily growing worse until it reaches an acute stage.
A moderate but slower approach can help you achieve greater long term success by taking the time to choose, experiment within reason, and then practice until perfect a healthier way of living and thinking that is both safe and tailored to your lifestyle.
* I generally choose and use videos to teach important general concepts in nutritional, gut and immune health in ways that are easier for viewers to grasp but do not necessarily endorse all of the practices or viewpoints as described in them. When I abandoned health extremes via gurus, the kitchen sink approach, fad chasing, and focused on balance in all things, including diet, I got healthy. I continue to enjoy all food groups with zero intolerance and only practice a 12-13 hour per day fast for moderate ketosis, which I might add had been my common practice (or even longer hours per day) since my teen years due to severe pain upon eating any and eventually all types of foods, (diet is NOT the cause)… focusing on diet/s neither prevented nor reversed anything…. and it certainly did not prevent metabolic syndrome, gestational diabetes, insulin resistance, steroid resistance, pre-diabetes, SAM, IBS, SIBO, IBD, immune tolerance issues or future autoimmune conditions (MS). It was not until I focused primarily on gut health and healthy microbiota via natural oral immune therapy and later with gut health restored, balanced nutrition, that my metabolic syndrome condition improved. It took 4-6 months to reverse all gut issues, about 18-24 months to reverse chronic lifetime metabolic syndrome. I no longer have any of the symptoms as mentioned in the beginning of this article due to SAM (severe acute malnutrition).