Ketosis Questions & Answers
Ketosis and ketogenic diets can be difficult to manage, especially for those new to the concept. Although we have a FAQ for enhancing ketosis, we wanted to include a questions and answers section for those with keto specific questions.
If you would like to ask a question, please send an email to Q&A@herbaladjunct.com. We will try to address as many questions as we can.
Below are the short answers to the most common questions we receive.
Most are followed by links to a full article in the blog section with much greater detail on the subject.
- What is dietary ketosis?
- What is a ketogenic diet?
- What are the rules for ketogenic diets?
- What are the types of ketogenic diets?
- What happens to your body during ketosis?
- How do you get into ketosis?
- How do you stay in ketosis?
- What can you eat on a ketogenic diet?
- What are Net Carbs and why do they matter?
- How do sugar alcohols affect ketosis?
- What is a keto cheat day?
- How does cheating affect ketosis?
- How to get back into ketosis quickly after cheating.
- Can I eat low carb and low fat?
- Are packaged keto diet foods really ketosis friendly?
- When should I check my ketones?
- Can you be on a keto diet and not check ketones?
- Why should I use a ketone meter instead of urine test strips?
- Why am I not in ketosis in the morning?
- What is a no carb diet and is it safe?
- What are ketosis pills and are keto pills safe for weight loss?
- Do keto pills work?
- Should I take exogenous ketones?
- I’m in ketosis. Why am I not losing weight?
- What is Keto Flu?
- When does keto flu hit?
- Can you have a cheat day on keto?
What is dietary ketosis?
At a basic level, ketosis is just a switch in the fuel source your body uses. Without enough carbohydrates coming from your diet, and once you’ve burned through your body’s storage, your body starts making ketones from the fats you eat. Ketones become the new fuel source for the body.
Without enough fat in your diet to meet all your caloric needs, your body starts burning through its fat stores. That is why ketogenic diets are famous for fat / weight loss.
For more information, see the full article “What is dietary ketosis?“.
What is a ketogenic diet?
Simply put, a ketogenic diet is any diet that is very low in carbohydrates and high in fat. Ideally, you would get the vast majority of your calories from fat, have enough protein to maintain your lean body mass, and ingest as few digestible carbohydrates as possible. We will discuss some of the relevant types of diets below, but we do not endorse any particular “brand” of ketogenic diet.
Although complicated at the biochemistry level, at a basic level, ketosis is just a switch in the fuel source your body uses. Without enough carbohydrates coming from your diet, and once you’ve burned through your body’s storage, your body starts making ketones from the fats you eat.
Ketones become the new fuel source for the body. Without enough fat in your diet to meet all your caloric needs, your body starts burning through its fat stores. That is why ketogenic diets are famous for fat / weight loss.
For more information, see the full article “What is a ketogenic diet?“.
What are the rules for being on a ketogenic diet?
There are a lot of different ketogenic diets out there, but at the core they are all about limiting carbohydrates.
You can eat 20 grams of carbohydrates a day during induction and upwards of 50 without breaking ketosis if spread out over the day (non-dieting maintenance phase).
Protein is the most straight-forward macro when it comes to ketogenic diets. It is absolutely needed for bodily repairs and many amino acids (what makes up proteins) are only available through diet. Your body cannot produce them on their own. These are called Essential Amino Acids, so you need to make sure your protein sources contain them.
The recommended range of protein intake is between 0.8 g/kg and 1.8 g/kg of body weight, dependent on many factors (see the article for a link to a calculator).
One of the hardest parts of using ketogenic diets for weight loss is getting enough fat into the diet. Even with a loose interpretation of keto rules, fat should account for a minimum of 65% of your calories.
As we discussed in “What are the types of ketogenic diets” in the high-protein diet, 65% of calories coming from fat is barely ketogenic, if at all.
The higher the fat intake, the better. Shoot for 70-90% of your calories from fat, depending on how strict you want to be.
For much more information, including formulas, see the full article “What are the rules for ketogenic diets?“
What are the types of ketogenic diets?
- Classic Keto Diet and Modified Keto Diet (both medical ketogenic diets)
- Standard Keto Diet
- Targeted Keto Diet
- Cyclical Keto Diet
- High-Protein Keto Diet
There are two main medical-based keto diets and two main non-medical diets. Non-medical ketogenic diets are what the general public think of as keto diets. There are a lot of different versions out there right now, but we will focus on the main four: Standard, Targeted, Cyclical and High-Protein.
Standard is the basic ketogenic diet, Targeted is for more active people, Cyclical is for extremely active people and bodybuilders and High-Protein is basically the Standard diet with a little less fat and a little more protein and is for those that are not wanting rapid weight loss and want a more moderate diet.
Standard Keto Diet
The Standard Keto Diet is easier to maintain that either of the medical ketogenic diets and is best for new dieters. Typically, the Standard diet macros would be 75% fat calories, 20% protein calories and 5% carbohydrate calories. Please note that we are now looking at % CALORIES, not grams.
Targeted Keto Diet
The Targeted Keto Diet is very similar to the Standard, but when you eat carbs is important. The same macros apply, but instead of spreading your carbohydrates out over the course of the day, you eat them all at once about 30 minutes prior to exercising.
This gives you both a boost of energy as well as fuel for the workout. It should be noted that this diet is for strenuous workouts or activities requiring long bouts of endurance, like long distance running.
Cyclical Keto Diet
The Cyclical Keto Diet is unique in that it requires you to break ketosis. It should only be done by dieters experienced in ketogenic diets and even then, with caution (assuming you are trying to lose weight).
Typically, one follows a Standard Keto Diet 5 or 6 days a week and then increases carbs (while decreasing fat intake) 1 or 2 days.
High-Protein Keto Diet
The High-Protein Keto Diet is a little controversial because of gluconeogenesis, the process the liver uses to make glucose from excess amino acids. The concern is that any protein not used for muscle repair/growth or for other bodily needs can be used by the liver to make glucose.
Unfortunately, there isn’t scientific research on the subject. The diet is easier to follow for most people, so it is a popular choice.
Typically, the macros are 65% of calories from fat, 30% of calories from protein and 5% of calories from carbohydrates.
I know this was a lot of information, but that is what informed choice is all about. Whichever keto diet you choose, make sure if fits your lifestyle for as long as you plan to be on it.
The very real problem with keto diets is that you are eating a lot of fat calories and if you don’t stay in ketosis, you may actually gain weight. Please see “What are the rules for ketogenic diets?” and “How do you stay in ketosis”
For much more information, including examples and calculations, see the full article “What are the types of ketogenic diets?“
What happens to your body during ketosis?
*The numbers used below are for blood ketone testing. Urine ketone testing results are usually listed as milligrams per deciliter. To convert, just move the decimal place to the right. 0.5 mmol/L for blood results would equal roughly 5 mg/dL on urine test strips.
Ketogenic diets have different phases as your body first adapts to and then optimizes the ability to utilize fat as an energy source replacement for carbohydrates. Many of the things you experience while on the diet are directly related to what is happening to your body as it makes the conversion.
Although complicated at the biochemistry level, at a basic level, ketosis is just a switch in the fuel source your body uses. Without enough carbohydrates coming from your diet, and once you’ve burned through your body’s storage, your body starts making ketones from the fats you eat.
Ketones become the new fuel source for the body. Without enough fat in your diet to meet all your caloric needs, your body starts burning through its fat stores, which of course is the whole point of the diet.
The first phase of ketogenic diets is called the Induction Phase. It starts as soon as you dramatically decrease your carbohydrate intake. Typically, it lasts around 4 days, but some people get into ketosis faster than others, while others take longer. Additionally, the number of carbs you eat during the Induction Phase helps determine how fast you get through it and start the Transitional Phase.
At the start of the Induction Phase, your blood ketone levels will be 0.1 mmol/L (see * quote at beginning of the post). This is because your body does not normally produce ketones when you are eating enough carbohydrates.
Once you start cutting the number of carbs to a level too low to supply your body with the needed energy, it starts breaking down and using stored carbohydrates for energy.
During this phase, your body is going through a major change. It is completely changing from a carbohydrate based metabolism to a fat based metabolism. As a result, many people start having symptoms of what is commonly called “keto flu”. Although there are multiple causes for the symptoms, by far the largest is dehydration.
When glycogen is broken down to glucose, water is released. For every gram of glycogen burned, 2 grams of water are released and then excreted as urine. The average person stores around 500 grams of glycogen in the muscles and around 100 grams in the liver. That comes out to around 600 grams total to be burned, which will eventually yield around 1200 grams of water. That is a little over 2 and a half pounds of water weight lost just from the burning of glycogen.
As the body eliminates the water, salt and other electrolytes follow, which can lead to headaches, fatigue, muscle cramps, etc. See “What is keto flu?” for additional symptoms and why they occur. In order to overcome these symptoms, it is best to drink a lot of water during the Induction week as well as using salt liberally and possibly taking electrolyte replacements.
Most people reach ketosis in the first five days of the diet. Some in as few as a couple of days, typically due to active lifestyles, very low carbohydrate intake and high resting metabolism. The majority, however, take 3-5 days just to reach ketosis. This level of ketosis is very unstable and is easily broken by relatively few carbs. But once the switch from carbs to fats is complete, a different process starts.
The second phase of ketogenic diets is called the Transition Phase. The main thing that happens in this phase is the optimization of the fat burning process. Various biochemical processes are triggered by the switch to ketosis, including the up-regulation of genes that code for fat metabolism.
Basically, the main purpose of the Transitional Phase is for the body to complete the conversion to a fat-based energy system by becoming more efficient at both the production of free fatty acids from body fat and utilization of fat as an energy source. As this is happening, your body produces more ketones from the fat you eat and from the fat already in your body.
Typical blood ketone levels during this phase start around 0.5 mmol/L and reach around 1.5 mmol/L by the end of the transition. For most people this occurs in a couple of weeks. At this point, your body is fully capable of living off of fat instead of carbohydrates and carbohydrates are no longer needed in the diet at all.
The final phase of the ketogenic diet is the Maintenance Phase. Your body in now optimized to burn fat for fuel (although some processes may get even stronger with more time), it has completely adapted to the lack of dietary carbohydrates.
As a result, this phase is where the body fat really starts to come off. That is because any amount of fat that the body needs to burn, but doesn’t come directly from your diet, is taken from body fat.
The normal blood ketone range that is optimized for weight loss is ~1.5 mmol/L to 3.6 mmol/L. Although it is possible for your ketones to go above 3.6 mmol/L, no research has currently shown greater benefit by going above this concentration (for non-medical, strictly dietary purposes).
One of the main issues with stopping a ketogenic diet is that your body has to revert back to a carbohydrate based energy source. You can quit cold-turkey and leave the diet completely, but there are some consequences that come with that. The most noticeable one is that once you switch back to carbs, your body starts re-storing carbs as glycogen. Although unavoidable, it is still quite a shock to gain the 3.5 pounds or so weight back as a result.
Additionally, the changes the body made during the Transition Phase have to be reversed. That means that the body won’t be used to dealing with normal carb levels and will over-respond to the higher blood glucose with excess insulin. This is a transient form of insulin resistance, quite similar to what Type II diabetics deal with, only it is short-term and resolves as your body compensates and converts back to using carbs for fuel.
Unfortunately, during the time it is occurring, you are more likely to store excess energy as fat. Simply put, when you decide to quit a ketogenic diet, be prepared to gain back some weight. It may be inevitable, but if you expect it, it won’t be as disheartening.
The other option is to remain in ketosis, but increase your carbohydrates to a level that keeps you around 1.0 mmol/L to 1.5 mmol/L. This will keep you in ketosis (somewhat), but the fluctuation will keep you from losing weight. Which is still better than gaining, right?
For much more information, including the processes that cause these changes, see the full article “What Happens to Your Body during ketosis?”
How do you get into ketosis?
There is still a lot of debate about how best to get into ketosis when you first start the diet. You can read about how to get BACK into ketosis after a cheat day in “How to get back into ketosis quickly after cheating”. There are three main ways to get into ketosis and each have good and bad points. Of course, many people choose to do a combination of the different strategies.
The first and simplest way (although arguably the hardest) is by fasting. After not eating for 2-4 days, you will be in ketosis and can start eating a normal keto diet. Fasting is not for everyone, and considering the time involved, it would be very difficult for most people.
This strategy burns through your carbohydrate reserves quickly, as it is the primary energy source. However, one of the reasons it is debated is that many people starting ketogenic diets using the next strategy still get into ketosis in around the same amount of time, so it is questionable as to how much fasting helped decrease the time to ketosis.
The second strategy is to just start the diet. Jump immediately into the high-fat diet keeping net carbs <20 per day. This is obviously easier for most people than to not eat at all for 2-4 days. That is the upside. However, for those first 2-4 days, you will be eating a lot of fat that isn’t converted to ketones until you are actively in ketosis.
During this time period, you are most likely storing the excess fat as body fat. Chances are, you won’t notice the increase for reasons discussed in the water weight section of “What happens to the body during keto?”, but it is good to be aware.
The third strategy is a slow induction into ketosis. Over the course of couple of days (or weeks), someone using this strategy will gradually increase the amount of fat while decreasing the amount of net carbs they eat. Supposedly, this decreases cravings and makes the transition to ketosis easier. On the other hand, it takes quite a bit longer to reach full ketosis.
Once you reach a certain point, usually when your main glycogen stores are almost gone, you will start to fluctuate in and out of ketosis. At this point, you should switch to a completely ketogenic diet.
There are multiple ways to combine the two strategies as well. The two most popular would be a short 12-24 hour fast followed by the Standard Keto Diet (or another ketogenic diet). Theoretically, this would help you burn through your carb stores quicker and get you eating food again earlier by not having to fast as long.
The second popular combination would be to start with a low carb, low fat diet, moderate protein diet for the first 2-3 days and then start increasing the amount of fat you eat over the next couple of days.
The thought behind this is that you get your body use to low carbs (without the added fat calories) and when your body starts running low on carbohydrate stores, you have started to increase the fat available for energy.
Until there is more research done in this area, we won’t know which strategy is most effective in reaching ketosis the shortest amount of time. You need to choose what will be best for you and go that route.
I personally can’t wean myself off carbs (third strategy), I have to go cold turkey. I’m either all-in with keto, having a cheat day (or two), or not on keto at all. Going back and forth is more stressful to me than just staying on the diet. Of course, I have the unfair advantage of a fourth strategy too; KetoSavior™.
How do you stay in ketosis?
Control Carb Intake
First and foremost, to stay in ketosis, you have to limit or cut carbs. That includes paying very close attention to labels and finding hidden carbs, especially in processed food. One example of this is maltodextrin. It isn’t considered a sugar, but it has a greater impact on blood sugar than the sugar you use on your cereal. You’ll find it in a lot of things you wouldn’t expect, even if in small amounts.
The golden rule to stay in ketosis is to keep your daily net carbohydrate intake to <20 grams per day. If you are unsure what net carbs are, see “What are Net Carbs and why do they matter?”.
Watch Protein Intake
It is thought by some that if you eat more protein than you need, it will be converted to glucose via gluconeogenesis (the process the liver uses to make glucose). There are probably just as many that think the glucose produced because of elevated protein intake would not have an impact on ketosis. What little research there is, is inconclusive, but we fall into category of believing you should eat enough protein for dietary needs, but not more. We believe excess protein will hurt your ketosis more than help it.
Utilize Carbohydrates Better
One way to help stay in ketosis is to utilize carbohydrates better. Insulin is the enemy of ketosis (see the Enhancing Ketosis page for more information) and is produced / released when there is a high level of glucose in the blood. There are various ways to decrease circulating glucose, (again, see Enhancing Ketosis), but the easiest way by far is to use it.
After you eat a meal with carbs in it, get up and move. You don’t have to have a sweat inducing workout, but even walking around helps get the additional glucose out of your system by using it as food for your muscles. The faster it gets used up, the faster your insulin levels return to normal and the faster your body starts making ketones again.
Cheat the System
The final thing you can do to stay in ketosis is to cheat the system. OK, this one is a plug for Herbal Adjunct, as we manufacture the only supplements that are specifically designed to enhance ketosis. By using KetoGuardian™ or KetoSavior™, you are able to increase your carbohydrate intake without breaking ketosis. See Enhancing Ketosis, The Science, as well as the KetoGuardian™ or KetoSavior™ pages.
What can you eat on a ketogenic diet?
There are so many different sites that answer this question that I almost didn’t write this article. However, I get the question anyway, so here are the basics. Please see the full article which gives examples in each category (or click a category below to go to that section of the full article).
- Meat (beef, chicken, seafood, fish)
- Specific fruits (berries, avocado, and olives)
- Specific dairy (cheese, cream, sour cream, and cream cheese)
- Fats and oils
- Non-starchy vegetables
- Nuts and seeds
- Unsweetened / diet drinks
- Fiber based foods like Shirataki (glucomannan) noodles / rice
In addition to the types of foods, it is also important to be able to calculate how those foods impact ketosis. For this, we use the Ketogenic Index developed for medical ketogenic diets.
The formula to make sure any particular meal is ketogenic is as follows:
FAT GRAMS ÷ (PROTEIN GRAMS + NET CARBS GRAMS)
Add the number of protein grams and the number of net carbs (see “What are Net Carbs and why do they matter?”). Divide the number of fat grams by this number and you will get the ketogenic index.
Any answer greater than 1 is good. Anything less than 1 is questionable, with it getting worse as the number gets lower. This way of looking at food may be a little advanced for keto beginners, but if you stay on the diet, this will be the best way to make sure you are getting enough fat for optimal weight loss.
Also, remember that a lot of diet food manufacturers use labels as a marketing ploy, so statements like “sugar-free” and “no sugar added” should be assumed to be marketing statements, and you have to read the label to verify they didn’t sneak carbs into the product.
In fact, some of the larger keto food brands that make meals and snacks specifically for ketogenic diets are not ketogenically friendly at all. See “What are Net Carbs and why do they matter?” for a further discussion of this, sugar alcohols and glycemic index.
You need to be informed or you may eat something supposedly “keto-friendly” that kicks you out of ketosis.
For much more information, including examples of foods in the different categories, see the full article “What can you eat on a ketogenic diet?”
What are Net Carbs and why do they matter?
In reference to ketogenic diets, “Net Carbs” are the carbohydrates that will affect your ability to maintain ketosis. Be wary though, as “Net Carbs” is defined by the people who market diet foods.
Previously, “Net Carbs” referred only to the total carbohydrates in a product minus the fiber. Now some things are not considered a “Net Carb”, but can still kick you out of ketosis. Sugar alcohols are a prime example. But first, let’s define a couple of things.
There are multiple types of carbohydrates found in food. Some are digested and affect your insulin levels, while others don’t. Simple sugars and starches are the most common carbohydrates in our diet and both substantially affect blood glucose and insulin levels.
Please see the Enhancing Ketosis FAQ page for information on how insulin is tied to ketosis. Fiber, while still a carbohydrate, isn’t digested, so it doesn’t have any effect on insulin.
Here is where it gets sketchy. Sugar alcohols are also excluded from “Net Carbs”, but some of them DO have a substantial impact on insulin. Please see the full article which includes a discussion on Glycemic Index (GI) and its importance in evaluating sugar alcohols as well as examples of good and bad alcohols with recommendations.
The worst sugar alcohol in relation to ketosis is Maltitol. Maltitol is the sugar alcohol most likely to kick you out of ketosis. It has a high GI of around 52 (depending on the preparation, ie syrup) and has a large laxative effect. Want to guess which sugar alcohol is used the most in sugar-free candy? Yep, maltitol.
That is one of the reasons we can’t say sugar alcohols are all keto friendly. This sugar alcohol (along with the rarer hydrogenated starch hydrolysates, or HSHs like polyglycitol) should be avoided on keto. It is nearly as bad as table sugar in regards to breaking ketosis.
As you can see, it isn’t appropriate to completely remove sugar alcohols from the carb count. This is especially the case for maltitol and polyglycitol, which should be counted as full carbs in my opinion. I personally only remove sugar alcohols with a GI <10 from my Net Carbs count.
Another thing of note is allulose. This is a rare sugar found in figs, raisins and other fruits in small amounts. The part that is interesting (besides being a zero calorie, zero carb, 0 GI sweetener) is that it is not required to be on the nutrition facts label as a carbohydrate.
So far, it is the only sweetener in this category. It is keto safe and should be subtracted from Net Carbs as well. As a result, we can see the Net Carb formula is as follows:
Total Carbohydrate – Dietary fiber – Sugar Alcohols (<10 GI) – allulose = Net Carbs
One thing related to Net Carbs and GI that needs to be pointed out are carbohydrates that are commonly ignored by diet food producers.
The worst offender is maltodextrin. It is used extensively and is one of the reasons a lot of processed foods are not keto friendly. The GI of maltodextrin is between 85 and 110 (depending on the study), meaning it affects your blood sugar and insulin levels (thus breaking ketosis) more than table sugar and close, if not more so than pure glucose.
Be careful reading nutrition labels because many companies make their serving size small enough to keep the total carbohydrate per serving low. This allows a legal “low carb” label, even if there is a large insulin response to the food. My best advice it to read labels like someone is trying to hide carbs and never assume “sugar-free” means keto safe.
I hope this gives you a good answer to your question.
For much more information, including the GI of common sugar alcohols and which ones are good for ketogenic diets, see the full article “What are Net Carbs and why do they matter?”
How do sugar alcohols affect ketosis?
Although mainstream keto diets (like Atkins) say to remove sugar alcohol carbs from the “net carb” amount, I don’t feel that is always appropriate. Some sugar alcohols do not affect blood glucose and insulin levels, so they can be safely subtracted, but others can break ketosis.
Maltitol is the sugar alcohol most likely to kick you out of ketosis. It has a GI of around 52 (depending on the preparation, ie syrup) and has a large laxative effect. Want to guess which sugar alcohol is used the most in sugar-free candy? Yep, maltitol.
That is one of the reasons we can’t say sugar alcohols are all keto friendly. This is one sugar alcohol (along with the rarer hydrogenated starch hydrolysates, or HSHs like polyglycitol) that should be avoided on keto. It is nearly as bad as table sugar in regards to breaking ketosis
For a more in-depth review of which sugar alcohols are good, please see the article “What are Net Carbs and why do they matter“. It also discusses the Glycemic Index (or GI) and how you can use it to evaluated sugar substitutes, like sugar alcohols. GI is also very useful when evaluating food to see what its impact will be on your ketosis levels.
Although most sugar alcohols don’t affect ketosis, that isn’t the case for all of them. However, that doesn’t mean they are a “free” food, as they can have some unpleasant side effects.
For example, google “sugar-free gummy bears review”. The stories may be funny, but there is a reason there are a lot of YouTube “challenges” involving the sugar-free gummies…
What is a keto cheat day?
A keto “cheat day” is an intentional break in ketosis by eating more carbs than the diet allows. Although called a cheat day, it may be as short as just one meal.
Regardless of the duration, it is a break in ketosis, typically for pleasure or to resolve cravings, but is not part of a dietary process, like the Targeted Keto Diet or Cyclical Keto Diet. See: “What are the types of ketogenic diets?” for other diet types.
That being said, some people call days with higher carb counts while on the Cyclical Keto Diet as cheat days, even though they are part of the diet itself.
Ketogenic diets are difficult to maintain because carbohydrates are so pervasive in Western Culture. Carbohydrates are added to almost everything pre-made and most restaurants do not have low carb options.
As a result, most keto dieters end up craving foods that have higher carbohydrate counts than they can eat on the keto diet. Although most people have a decreased appetite while on keto, the psychological cravings tend not to go away.
As a result, some people choose to break ketosis long enough to overcome the cravings by eating the foods they miss. Please see “How does cheating affect ketosis?” and “How to get back into ketosis quickly after cheating.” for further discussion.
How does cheating affect ketosis?
The biggest problem with using any of the ketogenic diets is that they are very unforgiving if you eat too much of things you shouldn’t. Most diets have calorie-based rules, so when you cheat on your diet, you don’t lose as much weight as you would like.
When you cheat while on a ketogenic diet, it changes your metabolic process and all ketone production stops until the process recovers, if it does at all. See: “What are the rules for ketogenic diets?” and “What happens to the body during keto?” for more information. This has a huge impact on the ability to lose weight on a keto diet.
As an evolutionary safety net, ketosis is the metabolic process that our body switches to when there aren’t enough carbohydrates available to us. See: “What is dietary ketosis” for a brief discussion of ketosis.
The body doesn’t know WHY the carbohydrates aren’t available, only that there are not enough available, so it switches to ketones (derived from fat) for fuel. Ketogenic diets take advantage of this to burn our own fat for fuel.
Every single gram of carbohydrate ingested decreases the body’s need for ketosis. If you ingest enough carbohydrates, the entire process stops and reverts back to a carbohydrate-based metabolism.
Everyone’s metabolism is different, but the general consensus is that <20 grams of net carbohydrates per day will keep you in ketosis enough of the time to burn your own fat stores almost continuously.
When you get to around 50 grams per day, your body fluctuates in and out of ketosis allowing you to maintain your current weight, but not burning much body fat.
100 grams of carbohydrates a day will almost definitely kick you out of ketosis altogether, although there is a little leeway if carbs are evenly distributed throughout the day and you are very active.
If you cheat before you have completed the Transition Phase (see “What happens to the body during keto?”), you may have to start the Induction Phase all over. In fact, some people who think they are doing a ketogenic diet never actually reach optimized ketosis.
That is the main reason for not achieving weight loss while on the diet. See “I’m in ketosis. Why am I not losing weight?” for further discussion.
Yo-yo dieting is not possible while on a ketogenic diet. You can’t be on it one day, off the next and then back on it again. The back and forth will keep you out of optimal ketosis and the amount of fat you eat will be stored as body fat since it isn’t being burned for fuel.
Under these conditions, you are likely to not only gain weight, but mess up your blood cholesterol levels, blood lipid (fat) levels, and increase your risk for conditions related to high-fat diets. Ketogenic diets are more of an all-or-nothing proposition than any other diets for this reason.
However, it is possible to have a cheat day and not completely throw away all of the progress you’ve made. This assumes that you are already in optimal ketosis (after Transition Phase) and that your cheat is limited in the amount of carbs or number of cheat meals consumed.
In effect, if you have a cheat meal or even a cheat day, you can recover from it. For information on how to get back into ketosis after a cheat day, see “How to get back into ketosis quickly after cheating”.
In summary, cheating on a ketogenic diet can be an emotionally gratifying way of attacking cravings, but if not correctly done, it can ruin your diet and possibly lead to health risks due to elevated blood cholesterol and blood lipids.
How to get back into ketosis quickly after cheating.
Getting back into ketosis after cheating with a cheat day (or a few), depends on a couple of different things. The level of ketosis prior to cheating, the amount of carbs consumed, the duration of how long carbs were consumed, your underlying metabolic status, physical activity and the foods you eat during re-induction, all play a role in how long it takes to get back into ketosis.
The short answer is: stop eating carbs and you will get back into ketosis. The long answer is: how long it takes to get back into ketosis depends on multiple factors. Below are the factors and a brief description of each. For much more information, see the entire article “How to get back into ketosis quickly after cheating.“
- Pre-cheat ketosis status
- Amount of carbs consumed
- How long carbs were consumed
- Underlying metabolic state
- Activity Levels
Pre-cheat ketosis status
During Induction, the body is getting into ketosis. During Transition, your body is in ketosis, but it is still adapting to using fat as fuel instead of carbs. During Maintenance, your body is fully adapted to using fat as fuel.
Basically, the less adapted your body is to ketosis, the more cheating will damage your diet. Obviously, there are other factors as well, but your pre-cheat ketosis phase will make a difference.
During the Induction phase, even small amounts of carbs can keep you from reaching ketosis. Your body is still in carb burning mode, so your body will quickly revert back to using carbs for energy. This can completely reverse any progress you’ve made already.
If you cheat during the Transition Phase, your body is still adapting and that adaptation will stop. You may even find yourself starting the Transition Phase over again.
During the Maintenance Phase, a single cheat day shouldn’t derail your diet too much, assuming you don’t overdo it on carbs. Just keep in mind that if you eat more carbs than you burn, the left overs will be converted into glycogen for storage.
As long as you burn off the glycogen before your next carb intake, you should be back in ketosis in no time. If you don’t, you will stay out of ketosis until you can burn it all back off.
If this happens in one day (thus cheat day), you probably won’t lose the fat adaptation you have already gained, so you will only “lose” the time you were out of ketosis.
Amount of carbs consumed
The amount of carbs you eat also matters. If your cheat day consists of 100 grams of carbs, you will be back in ketosis quickly, assuming you were already fat adapted (after Transition) and you go back to a regular keto diet.
If you use KetoSavior™ before your cheat meal, this becomes much easier. KetoSavior™ and KetoGuardian™ both work by inhibiting sugar absorption (among other things), so the amount of carbs ingested will have a much lower level of impact on your ketosis. In fact, if you use the products and maintain a reasonable intake of carbs, you won’t even break your ketosis.
If your cheat meal includes a pizza, a couple Mt. Dews and a bunch of gummy bears, it will be much longer until you are back in ketosis, as there are a lot more carbs being stored that you will have to burn through before you are back in ketosis.
How long carbs were consumed
Duration of carb intake matters too. Remember, the longer you are out of ketosis, the more carbohydrates are stored and the longer it will take to get back into ketosis. If you are out of ketosis for more than a day or two, you might as well plan on losing at least some of your fat adaptation.
After 3 days or more, be prepared to be completely out of ketosis and need Induction again. Cheat days are one thing… a cheat week will make you start over from scratch.
Underlying metabolic state
Your underlying metabolic rate does play a role in getting back into ketosis, albeit a lessor role than phase, amount or duration of carb intake. If you are a fit person and have a high metabolism, you will also burn through whatever carbs you store much more quickly than a sedentary person might.
This is because of how fast and how easily your body utilized stored energy. If you find it difficult to lose weight on a low-calorie diet with moderate activity, your metabolism will probably make it more difficult to rebound from a cheat day. Again, the number of times we say “probably” is due to lack of scientific research on the subject.
Activity is another influencer on how long it will take to get back into ketosis. Activity in general and activity around meal time are both important.
In general, activity helping or hurting ketosis is more about your metabolism than anything, although exercising can definitely help get you back into ketosis.
More importantly though is the timing. As we discuss extensively on the Enhancing Ketosis page, the biochemistry of ketosis is tied very closely to circulating insulin levels (regardless of diabetic status).
The longer you have high levels of circulating insulin, the longer your body is out of ketogenesis (where your liver makes ketones from fatty acids).
However, you can use this to your advantage. If you are active (take a walk, doing housework, really anything that keeps you moving muscles) immediately after eating carbs, insulin will help move the sugar into your muscle cells and use the sugar for energy.
If your body uses them, it can’t store them. Plus, if your body uses the sugar, it comes out of circulation and your insulin needs decrease, so you will spend less time with elevated insulin levels and, therefore re-enter ketosis faster.
The more active you are right after eating, the better off your ketosis is. There is an effect here and it does make a difference, but it isn’t significant enough to use as a control device to maintain ketosis.
Basically, don’t expect to drink a 20 oz Mt. Dew and stay in ketosis because you walked around the block a couple of times.
For much more information, including how to optimize re-induction, see the full article “How to get back into ketosis quickly after cheating.”
Can I eat low carb and low fat?
Although you can eat a low carb and low fat diet and lose weight, it will most likely be due to calorie restriction and not ketosis.
Unfortunately, this is a common misconception with new keto dieters by thinking it would be healthier to eat low fat as well as low carb.
However, for ketosis to work for weight loss, the body must be primed to use fat for energy. This isn’t accomplished without adequate fat intake.
There is a high likelihood that your body would not generate enough ketones from fat stores alone to keep you active and healthy. That being said, there are multiple low-fat, low-carb diets that are effective for weight loss, they just aren’t ketogenic diets.
I hope this answers your question.
Are packaged keto diet foods really ketosis friendly?
This is a tricky question. Some of the largest keto food producers sell products we wouldn’t recommend, despite the “keto friendly” label.
This is generally due to either sugar-free additives, such as sugar alcohols that have a high glycemic index (see “What are Net Carbs and why do they matter?”) or “carb hiding” by adjusting a serving size to hide the carbohydrates.
The first one is very prevalent and is a little disheartening. In fact, we recommend that no one use any “sugar free” products without carefully reading the label.
The three worse offending “sugar free” ingredients:
- hydrogenated starch hydrolysates, or HSHs like polyglycitol
- non-sugars like maltodextrin
Avoid all of these as much as you can. Not only do these have a negative effect on ketosis, they can cause gastric discomfort and diarrhea (most sugar alcohols have this side effect, for that matter).
Maltodextrin, on the other hand, has a high glycemic index (approaching, if not higher than, that of table sugar). Even though it isn’t a sugar, it will kick you out of ketosis as easily as sugar would.
Never assume anything “sugar free” or “low carb” is actually keto friendly. Keto dieters are a large market, and there are unscrupulous players trying to cash in on the ketogenic lifestyle by selling foods that don’t help, and may actually hinder, ketosis. As always, buyer beware.
When should I check my ketones?
The best time to check your blood ketone levels to verify you are in optimal ketosis is first thing in the AM prior to eating. Although you haven’t been actively fasting, being asleep keeps you from eating, so in essence, you are checking a fasting blood level.
This assumes you are using a ketone testing meter. If you are checking urine ketones using test strips, you should urinate as soon as you get up and then test the next time you urinate. Preferably, this would be before eating, as eating will change your ketone level.
For more information on when to test, what values are appropriate and optimal for ketosis and a further comparison between blood and urine testing, see the full article “When should I check my ketones?”
Can you be on a keto diet and not check ketones?
Absolutely. However, it isn’t recommended. For a ketogenic diet to be effective, you HAVE to be in full ketosis and it is almost impossible to tell if you are without testing.
In fact, you may be in sub-optimal ketosis and still shows signs of ketosis, like keto breath (sweet “fruity” smell), without being in fat burning mode. Being in partial ketosis but eating a high-fat diet is a recipe for disaster. In all likelihood, you will actually gain weight under that scenario.
Ketogenic diets are very good at helping you lose weight by burning fat, but they are also very difficult to maintain without monitoring, and worse yet, they can actually cause problems and weight gain if done incorrectly.
This is especially important for people new to the diet as they don’t know how they respond to different foods and can never really know if they are following the diet correctly.
The fact of the matter is, if you don’t follow the keto dietary rules, you are more likely to gain weight than lose it. See: “What are the rules for ketogenic diets?” for more on keto rules.
Regularly checking your ketone levels reassures you that you are doing things correctly, but it can also help you identify there is a problem with what you are eating (or in the case of fats, not eating enough).
This makes troubleshooting the diet easier. Without testing, you are just hoping things are going OK. It is a much better feeling to KNOW you are doing it correctly.
Why should I use a ketone meter instead of urine test strips?
- Blood ketone testing is not affected by water intake as much as urine strips and are more accurate as a result
- Blood ketone testing is accurate at the time taken whereas urine strips test the amount of ketones that the body has previously excreted, possibly some time ago
- Blood ketone testing is more exact than urine testing
- Blood ketone testing can help you Enhance Ketosis via experimentation
When I first saw the prices for blood ketone testing meters (and worse yet, the testing strips), I didn’t think they would catch on. Urine test strips are cheap and easily portable for testing wherever you are, so there would have to be a really good reason for testing blood instead.
I was getting inconsistent results from my diet and didn’t really know why. Granted, I wasn’t doing a 3:1 or even a 2:1 diet (see “What are the types of ketogenic diets?” for an explanation), but I should have been able to lose more weight on a 1:1 diet. I was using urine test strips daily and was always in ketosis, although not always in optimal ketosis.
Because I was serious about the diet (I had lost weight before starting keto, but wanted to lose a lot more), I decided to get a meter so I would better understand exactly how well I was doing.
I drink a lot of water and I know that urine test strips’ accuracy can vary quite a bit depending on your urine output. This is because your body tries to keep a steady blood volume and when you increase how much you drink, you increase how much you urinate.
However, your kidneys filter out more or less the same amount of other chemicals no matter what your water intake is (including ketones), so if there is more water, the numbers are diluted and if less water, those chemicals are more concentrated. This has no impact on your day to day living, but when measuring the amount of something (think ketones) in urine, the amount of water makes a difference.
If you were to do a blood test, drink a gallon of water, and retest an hour later, your ketone results would be similar, possibly a little lower, but similar. If you were to do the same with urine test strips, the results would vary greatly. For that reason, at any given time, the blood test strips are more accurate than urine test strips.
Timing of testing matters
Blood ketone testing measures the amount of ketones circulating through your bloodstream at the time the testing is done. It is as close to a “live” view of your ketosis status as we can currently get.
Urine ketone testing measures the amount of ketones found in the urine at the time of testing. Because urine is stored in the bladder and fills up over time, urine testing measures the total amount of ketones in the urine that has accumulated since the last urination.
If you test your urine four hours after the last time you urinated, the ketone level measured is really an average of the ketone levels over the past four hours. Although this level of accuracy may be beyond what a casual keto dieter cares about, it is still an accuracy issue.
Blood ketone testing is more exact
Urine ketone test strips are based on a visual scale from tan (negative for ketones) to pink (~5 mg/dL) and getting darker to purple as the concentration increases. Additionally, there is, depending on the manufacturer, a scale of five different colors that each represent a different level.
The largest manufacturer of urine test strips has a scale labeled at 5 mg/dL, 15 mg/dL, 40 mg/dL, 80 mg/dLa nd 160 mg/dL, of which only the first three (and negative) are really relevant for monitoring ketogenic diets. You look at the color of the test strip and compare to the scale and your level is whatever color is closest on the scale.
If the color is tan, you are not in ketosis. If it is light pink, you are “barely in ketosis” or trace ketosis. If it is as dark as the 15 mg/dL, you are at the low end of optimal ketosis. If it is as dark as the 40 mg/dL, you are at the high end of optimal. There is no advantage to having levels higher than 40.
So urine test strips can only tell you whether you are in ketosis or not and whether you are in optimal ketosis or not. Even that is a guess though, as the scale is visual and you are comparing two colors. Trying to figure out exactly how far into ketosis you are is impossible.
Considering the previous four reasons that blood ketone testing is better than urine testing, you can probably see how limited the information is that urine testing gives you. Are you in ketosis, yes or no? If yes, are you in optimal ketosis? That is about it.
If you are trying to enhance your ketosis through experimentation, the only real option is with a meter. If you want to see what the effect of eating at 10 PM has on your ketosis, you’ll need a meter. Want to see how many carbs it takes to kick you out of ketosis, you’ll need a meter.
If you want to lose a lot of weight quickly, but safely, you should get a meter. You will have more control over testing, be able to check if tweaks have helped or hurt, and know where you stand at any given moment. You will not have that option with urine testing.
Why am I not in ketosis in the morning?
There are three main reasons why you may be in ketosis before going to sleep but not in ketosis when you wake up.
Taking exogenous ketones
One of the most common reasons for being in ketosis at night, but not being in ketosis in the morning is the use of exogenous ketone salts during the day. The fact of the matter is that exogenous ketones, although they MAY be useful in some situations (see “Should I take exogenous ketones?”), most of the time, exogenous ketones only make you APPEAR to be in ketosis.
They affect both urine and blood ketone testing by making the tests positive, despite research showing they are not ketogenic and do not help your body reach or maintain ketosis. In fact, research shows that they inhibit ketogenesis (the creation of ketones by the liver) which is the whole point of ketogenic diets (for non-medical reasons).
Basically, if your body has enough ketones for its fuel requirements by taking exogenous ketones, it has no reason to break down body fat for fuel. You may appear to be in ketosis when you go to sleep, but as the pills wear off, your true ketosis status in the morning is tested. Exogenous ketones ultimately give you a false sense of security by making you think you are in ketosis when your body really isn’t.
Late-night eating can also cause you to be in ketosis at night, but not in the morning. Typically, this happens when you eat carbs late in the day and then go to sleep.
As your body’s metabolism slows down while sleeping, the carbs are not burned as quickly and they kick you out of ketosis. Something that doesn’t kick you out of ketosis when eaten for lunch, may not have the same effect if you eat it as a midnight snack.
All of this is assuming your carb intake doesn’t increase before going to bed. If you do eat more carbs at night than during the day, it can wreak havoc on your ketosis.
Checking ketones at the wrong time
Similar to the previous reason, checking ketones after you eat, but before the food has a chance to digest can give you a false positive as well. You will test positive for ketones, but once the food is digested and the carbohydrates enter your system, they kick you out of ketosis while you are sleeping.
This can be even worse with urine testing than blood testing due to the fact that blood tests are real-time indicators of ketosis status and urine testing indicates ketosis status from a while before.
Personally, my blood glucose rises (and ketones drop) starting around two hours after eating carbs. If I eat something at 9 PM and then test myself at 10:30 before going to sleep, I may still get positive testing results on my blood ketone test and yet, an hour later, be out of ketosis. There is even a greater lag for urine testing.
Using the same scenario, if I ate carbs at 9 PM, I would still be out of ketosis by 11:00 (same as before), but then it takes time for the ketone levels to drop in the urine. It may be hours before the average level of ketones in the bladder drop enough to even show you are out of ketosis.
See: “Should I use a ketone meter instead of urine test strips?” for a discussion about ketone test timing and accuracy. You may very well still show that you are in ketosis at midnight (in this case), even though you got kicked out from the 9 PM meal.
If you find yourself not in ketosis in the morning despite being in ketosis before going to sleep, these are the primary things to consider. Unless there is a good reason you are taking exogenous ketones, don’t use them (see the appropriate reasons to use them in “Should I take exogenous ketones?“).
They will give you a false sense of security. As for the last two reasons, be mindful about what you eat before bed as well as when you eat and when you test.
You will also need to take what type of testing you do into consideration. The best recommendation is to not eat late and use a blood ketone test meter instead of urine strips until you can identify which of these issues you have.
What is a no carb diet and is it safe?
A Zero-Carb Diet or No Carb Diet is a misnomer. The goal is to get as close to no carbs as possible while on a ketogenic diet, not to never eat a carb. This is a very difficult diet because everything you eat has to be monitored and virtually everything has to be homemade.
In my opinion, this is a fad / competitive diet just for the novelty of saying you are on a “Zero/No Carb diet”. Anyone that is trying to lose weight via a keto diet should strive to eat the lowest number of carbs they can every day. Technically, the diet is considered as safe as regular keto diets because your body does not need carbohydrates to survive.
Theoretically, you could eat zero carbs every day and not have any negative consequences. I chose those words specifically, because the reality of a zero-carb diet is not really possible outside of a medically supervised study (which I doubt will ever be done).
The reason is pretty simple. In order to eat absolutely no carbs, you would have to give up almost all food with nutritional value. Yes, you would still be able to eat meats and simple proteins along with fats and oils, but these don’t have all of the nutrients you would need to stay healthy.
Vitamin C, flavonoids and dietary fibers are some of the nutrients you can’t get through proteins or fats. While it may be possible to supplement these without adding carbs, it would take a LOT more effort than it would be worth. In order to burn off 10 grams of carbs, it only takes 40 calories and that is way too low to risk your health over.
What are ketosis pills and are keto pills safe for weight loss?
There are currently three categories of ketosis pills. Exogenous ketones, starch blockers, and ketosis enhancers. The latter is a new category of supplements that uses botanicals and ethnopharmaceutical extracts to enhance ketosis and help maintain ketosis and ketogenesis for people already on a ketogenic diet. The purpose of these supplements is to affect how carbohydrates are broken down and absorbed by the body as well as how they are utilized, stored or otherwise affect the user. Additionally, they affect how fat is broken down and utilized for energy, which enhances ketosis as well.
Unfortunately, due to the marketing of these and the scams like the “Shark Tank Keto Pill”, ketosis pills have gotten a bad name. The term “keto pill” is a red flag to almost everyone who has heard of them. However this is only relevant for the first two categories. It is not the case for ketosis enhancers.
Prior to KetoSavior™ and KetoGuardian™, there were only two types of keto supplements: exogenous ketones and starch blockers. Exogenous ketones may have a place during the Induction Phase of ketogenic diets (see “Should I take exogenous ketones?”), which typically lasts until around day 4 of the diet, but should not be used to enhance ketosis, despite being marketed as such.
Starch blockers can enhance ketosis during “cheat days” and meals containing large amounts of starch, but most people on ketogenic diets don’t have much use for them. Blocking the breakdown of starch into smaller digestible sugars would be beneficial to reducing blood glucose and insulin secretion, but starchy vegetables are considered “bad” carbohydrate sources, so aren’t consumed in large quantities on the diet anyway.
At best, starch blockers can have an effect on only part of one of the four processes used to enhance ketosis. It will suppress starch breakdown which will suppress SOME of the carbohydrates absorbed by the intestines, however, these only help with starch and have no effect on simple sugars or starch breakdown products, or any other target for enhanced ketosis.
New Keto Pill Category
Until now, there was nothing on the market that could target the other three biological processes that can be utilized to enhance ketosis (see the Enhancing Ketosis FAQ page). However, there is plenty of research in the scientific literature that describes botanical extracts and how they impact these processes.
In fact, there are many botanical choices that will impact these. However, there are also a lot of botanicals that both help and hurt ketosis at the same time. This is especially important when looking at diabetic botanical extracts. For example, berberine is a supplement that many diabetics take.
It does a good job lowering post-prandial glucose and fasting blood glucose. However, some of the ways it does that is by increasing the number of β-cells in the pancreas (more cells to make insulin) and directly increases the insulin released due to glucose in the blood.
Additionally, it can stimulate free fatty acids (fat broken down) into inducing the secretion of insulin. This is the exact opposite of what we are trying to achieve with enhancing ketosis.
In order to truly enhance ketosis, any keto supplement should focus on all four processes. These processes are:
- Enhancing the ability of glucose to enter muscle cells without increasing fat storage
- Suppressing the production of glucose by the liver
- Suppressing carbohydrate absorption in the intestines
- Suppressing glucose reabsorption by the kidneys
The main focus has to be on limiting the impact of insulin by eliminating as much glucose in the blood as safely possible. For full discussion on each of the processes, click above to be taken to that section of the Enhancing Ketosis FAQ.
Are Keto Pills Safe for Weight Loss?
All three categories of keto pills are safe in general (some brands may be sketchy though). They are made with natural ingredients and are typically safe to use at the recommended dosages.
However, while they may be SAFE for weight loss, that does not mean they are EFFECTIVE for weight loss. Exogenous ketones will NOT help the user lose weight. In fact, using exogenous ketones decreased the body’s need to burn fat and will not result in the weight loss expected from a ketogenic diet.
Starch blockers can have some effect on weight loss, especially when used before a starch-heavy meal. These work by blocking the breakdown of some of the starch ingested into simple sugars. However they don’t block all starch, nor do they block the resulting sugars from entering the blood stream or any other sugars eaten along with the starch.
The ketosis enhancing supplements are not only safe, they increased the effectiveness of ketosis so you burn more fat. Additionally, they protect ketosis by affecting how carbohydrates are digested, absorbed, utilized, stored and excreted. This helps the users stay in ketosis despite eating carbohydrates. Both of these greatly affect weight loss for those on ketogenic diets.
Do keto pills work?
Until now, there have only been two types of keto supplements on the market. Although both have some impact on ketosis, neither is sufficient to adequately enhance ketosis. Please see “What are ketosis pills and are keto pills safe for weight loss?” for information on supplements designed for enhancing ketosis.
The first type of supplement is based on adding exogenous ketones to the diet. Basically, the ketones that your body produces during ketosis are taken in pill form (or other route) to raise your blood ketone levels.
These might be helpful during the Induction Phase by giving your body adequate fuel during the period that your body has stopped relying on carbohydrates, but isn’t yet producing enough ketones on its own. However, if you are using keto for weight loss, these supplements are counter-productive.
The whole point of dietary ketosis for weight loss is to burn your own fat to produce the ketones you need for energy. If you take them as a supplement, your body will burn less of your own fat for energy.
Another problem with these supplements is that they artificially increase your ketone blood levels, which will show up in urine, blood and exhalation ketone testing. So, even if you are not in active ketosis, your tests may tell you that you are. False positives like this can make you think you are burning fat, but you may not be. See: “Should I take exogenous ketones?” for a full discussion.
The second type of supplement is based on one of the targets previously discussed on the Enhancing Ketosis FAQ page. The term Carb Blocker is used for these supplements (although technically, they are Starch Blockers, not Carb Blockers). Although these can be helpful, most people on ketogenic diets don’t have much use for them.
Blocking the breakdown of starch into smaller digestible sugars would be beneficial to reducing blood glucose and insulin secretion, but starchy vegetables are considered “bad” carbohydrate sources, so aren’t consumed in large quantities on the diet.
That being said, there is a place for these supplements during “cheat days” when a dieter intentionally breaks ketosis. Remember, any additional carb will be stored as glycogen, so blocking starch on a cheat day will shorten the time needed to get back into ketosis.
However, these only help with starch and have no effect on simple sugars or starch breakdown products, or any other target for enhanced ketosis.
Should I take exogenous ketones?
There are two very specific times when exogenous ketone supplementation might be helpful.
Beyond these, exogenous ketones will more likely hurt your ketogenic diet than help it. The two appropriate reasons are:
- Ease the transition from carbohydrate based energy to ketone based energy
- Supplemental ketone source for extended or strenuous exercise
Transition from carbs to keto
During the Induction Phase of ketogenic diets, primarily day 2 and 3, you may experience symptoms of low blood sugar due to the fact that you aren’t getting enough dietary carbohydrates to supply the energy needed to function, but your liver isn’t yet capable of producing enough ketones to supply the energy either.
During these two days, you may feel tired, fatigued, light-headed, and all around blah. The people who don’t quit the diet at this point usually recover on day 4 as your glucose levels stabilize.
Anecdotal evidence from limited studies suggest that exogenous ketone salts (the same ketones your body makes, but supplied via a pill / supplement) may help you by supplying the ketones you need for energy when your body can’t make enough yet.
However, this is still debated because scientific research has shown that exogenous ketones keep the body from making enough new ketones due to the fact there are enough ketones already circulating in your blood stream.
Although skeptical ourselves, there is a possibility that short-term (2 days or so) use wouldn’t stunt the liver’s ability to produce adequate ketones during that transition. However, after day 4, we do not recommend anyone use exogenous ketone salts.
Beyond just wasting money, they will impede the liver from producing ketones from your own fat stores, which totally defeats the entire reason people are on non-medical ketogenic diets.
Supplement for strenuous exercise
As a supplemental energy source for extended or strenuous exercise, ketone ESTERS (not the ketone salts available in pill form) have been shown to be very helpful, especially in regards to endurance and exercise recovery.
In short, the research showed that supplemental ketone esters controlled the physical effects of overtraining, which decreases one’s performance more than improving performance directly.
It has to be noted here that the research was only relevant to those who train for extensive periods of time with short recovery periods. Basically, professional athletes (the study was done over a three-week intensive cycling program) may benefit when pushing their limitations beyond what they normally do.
The authors of the study did not recommend use for recreational cyclists as the training was less frequent and not as vigorous.
Again, it should be noted that we are talking about ketone ESTERS, not ketone salts like those sold as supplements.
Ketone esters are liquid, highly concentrated and still quite expensive, however, some companies that sell ketone salts as exercise enhancers don’t want the clarification made.
Unfortunately, this makes other sellers of legitimate ketosis supplements look bad.
I’m in ketosis. Why am I not losing weight?
The major difference between normal diets and ketogenic diets is that the former is focused on calorie reduction and the latter is based on macro reduction (in this case, carbohydrates).
By limiting the number of calories you ingest to an amount less than the amount you burn every day, you will lose weight. Although there is some focus on macros, primarily limiting fat and simple carbs, the primary focus is reducing caloric intake.
Ketogenic diets are different because they focus on a metabolic hack; if you remove carbohydrates from the diet, the body burns fat for energy, including body fat. This means, on a ketogenic, you lose weight because you burn more fat everyday than you eat.
Although not typically discussed in these terms, keto diets are also calorie reduction diets. Knowing this is the key to answering the question of why you may be in ketosis, but not losing weight.
Before we get into the details though, it must be said here that you may THINK you are in ketosis and not losing weight, but you may very well NOT be in ketosis at all, or at least at the level needed to burn body fat.
Your ketosis isn’t optimized yet
In fact, most people that think they are doing a ketogenic diet but not losing weight are actually eating too many carbs to be in stable ketosis, fluctuating in and out of ketosis but never transitioning to optimized ketosis.
See “What happens to the body during keto?” and “What are the rules for ketogenic diets?” for further discussion. If your blood ketone levels are less than 1 mmol/L (or <10 mg/dL using urine test strips), your body isn’t optimized for burning fat.
Eating too many calories
Assuming you are in optimal ketosis, there may be another reason you aren’t losing weight… calorie intake. Despite that the focus of ketogenic diets on decreasing carbohydrates and increasing fats, it is possible to eat too much.
As the keto diets get stricter (see “What are the types of ketogenic diets?”) there is more and more focus on fat being the primary source of calories. It is easy to focus entirely on carb reduction and forget that the number of calories you ingest still matters.
I will give you a personal example here. Before I go to bed, I almost always crave something salty. My go-to keto snack for salty is pork rinds, typically with ranch dressing to increase the fat to protein ratio. If I don’t pay attention, I can easily eat half a bag of pork rinds and a small cup of ranch (say three tablespoons) without blinking. For the brands I eat, that comes out to around 400 calories from pork rinds and around 220 calories from the ranch.
620 calories right before bed is not a good way to lose weight, even if the food is ketogenic (the fat to carb/protein ratio is almost exactly 1:1 and the Standard Keto Diet ratio is around 1.33:1 – so even pork rinds and ranch dressing combined don’t have enough fat to be highly ketogenic).
I use this example for a reason. You would think that pork rinds and ranch dressing would be more than enough fat, but in reality it isn’t ketogenic enough to even qualify as Standard Keto Diet, let alone one of the stricter diets.
So even if I think I am eating a good keto snack, I am still ingesting 620 calories before sleep; the time of the day you need the fewest calories to function.
Do you think I am burning body fat overnight after eating this snack? That would be very doubtful.
While sleeping, the body is basically in fasting mode. Any calories needed for functioning are typically derived by breaking down body fat for energy. Burning fat while asleep is a great thing.
In fact, if you don’t eat late, you will probably burn more body fat overnight than you will during the day (due to eating meals and using that fat as an energy source instead of body fat). This is a great reason to limit food intake prior to bed.
Regardless, this post is more about calorie intake than about caloric timing. That being the case, we can’t look at the keto diet as being only about carb reduction. You can be in full-blown ketosis, but if you eat more calories than you burn, you will not lose weight. It won’t kick you out of ketosis either, which make monitoring it with keto testing impossible.
So long story short, yes, you have to count calories on keto too, even though you can be laxer about it than with traditional diets.
Using exogenous ketones
Exogenous ketone supplements are pills that contain ketone salts virtually identical to the ketones produced by the body during ketosis. Unfortunately, they are also the same as the ketones that urine test strips and ketone blood meters test for. You can be completely out of ketosis, but test positive for ketones by taking exogenous ketones.
While that makes the supplements look like they are helping you obtain or remain in ketosis, they are only masking the fact that you are not.
What is Keto Flu?
In simple terms, Keto Flu is the group of symptoms usually encountered during the Induction Phase of ketogenic diets, although some may occur until through the Transition Phase. Typical symptoms include:
- Muscle cramps
- Generalized weakness
In the full article, “What is Keto Flu?” we discuss these symptoms in much greater detail, why they occur, and how to deal with them if you experience them. For a brief answer on keto flu symptoms, please continue to read.
Headaches can be caused by dehydration, drops in blood glucose during induction, and electrolyte disturbances.
Constipation is another symptom of dehydration, lack of fiber, or a decrease in overall food intake.
Muscle cramps are typically related to electrolyte depletion due to dehydration.
Diarrhea can occur because of the changes in your digestive tract as well as from the increase in fat intake. Both resolve with time.
Generalized weakness also has a combination of causes. Electrolyte, dehydration, variations in blood glucose levels and not enough calories are all possible causes of generalized weakness.
Keto flu isn’t a long-term concern and is typically over in the first week or two. If symptoms continue after two weeks into ketosis, it may be something other than the diet and should be looked into further.
For much more information and greater detail on the symptoms, causes and treatments of keto flu, see the full article “What is Keto Flu”
When does keto flu hit?
For a full discussion on keto flu, see “What is Keto Flu“. In brief, it is a set of symptoms that mimic aspects of the common flu, such as headache, constipation, muscle cramps, diarrhea, generalized weakness, light-headedness, and brain fog. Keto flu is very common, but it can be avoided to some extent. But to understand how to avoid it, we have to know why it happens.
For a more detailed discussion around the physiology changes that occur during the different phases, see: “What happens to the body during keto?”. In short, as your body burns through its carbohydrate stores (glycogen), a lot of water is released and eliminated. This is why people tend to lose a lot of weight in the first week on keto… most of it is water.
In fact, for every gram of glycogen burned, two to four grams of water will be released and eliminated! This also depletes your sodium levels and can impact potassium and magnesium levels as well. In essence, keto flu is a combination of dehydration and electrolyte imbalance. That being said, there is some carbohydrate influence as well.
During induction and transition, your body is try to adjust to not having enough energy. It had been functioning on carbohydrates and it is not yet efficient at living off fat. Part of the fat adaptation process is the upregulation of genes make the body more efficient at using fat as a fuel source.
However, until that occurs, your body is trying to run off of two fuel sources. This doesn’t work well, so your body, especially your brain, can become foggy and fatigued.
For futher information including how to overcome keto flu, please see the full article “When does keto flu hit“.
*These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease.