Mil­lions of peo­ple around the world were switch­ing to an eat­ing plan that involved almost com­plete­ly elim­i­nat­ing car­bo­hy­drates in favor of pro­tein and fat. Doc­tors warn: this diet is not as safe as it might seem.

And while it is effec­tive in weight loss and has proven ben­e­fits for peo­ple with type 2 dia­betes, it can have health risks. What can hap­pen to our body if we go on a keto diet with­out a doc­tor’s rec­om­men­da­tion?
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Keto flu

Car­bo­hy­drates are the main source of ener­gy for our cells. When we abrupt­ly deprive the body of its usu­al fuel, try­ing to force it to work on fat, in the first days and even weeks it can “pun­ish” us with a whole bunch of unpleas­ant sen­sa­tions. Headache, mood swings, irri­tabil­i­ty, insom­nia — these are the most com­mon symp­toms of keto flu that most adher­ents of this diet encounter in the first week: it can be eas­i­ly con­fused with a reg­u­lar ARVI. The peri­od of adap­ta­tion of the body to a new diet takes from sev­er­al days to two weeks.

If you are deter­mined to con­tin­ue with your new eat­ing plan, eat more salt and potas­si­um-rich foods, and drink more water to restore elec­trolyte bal­ance.

Muscle spasms

Dur­ing ketosis—a state in which the body switch­es to fat as its main source of energy—sodium is active­ly removed from the liv­er. How­ev­er, lack of sodi­um and potas­si­um often leads to mus­cle cramps, which can be quite painful. To com­bat them, take potas­si­um and increase the amount of salt in your diet.

Andrey Shom­polov, trau­ma­tol­o­gist-ortho­pe­dist:

“Diets are often accom­pa­nied by train­ing, dur­ing which the body los­es water and sodi­um chlo­ride along with sweat. Sodi­um is the main elec­trolyte, the loss of which dur­ing intense exer­cise leads to so-called “heat” cramps in ath­letes. The prob­lem is solved by using spe­cial saline solu­tions to replen­ish the defi­cien­cy of flu­id and elec­trolytes.

Anoth­er cause of seizures may be a defi­cien­cy of B vit­a­mins (B1, B12) — with a reduc­tion in the con­sump­tion of meat and plant foods, as well as sar­cope­nia — the process of mus­cle tis­sue break­down due to a lack of ener­gy sources against the back­ground of an inad­e­quate­ly select­ed diet.

In addi­tion, an incor­rect­ly com­posed diet can pro­voke an exac­er­ba­tion of chron­ic dis­eases or serve as a start­ing point for the devel­op­ment of new ones, the first man­i­fes­ta­tions of which may be mus­cle cramps. In this regard, if such symp­toms appear, it is nec­es­sary not to delay con­tact­ing a spe­cial­ist who will help deter­mine the cause of the con­di­tion and draw up a recov­ery plan.”

Muscle cramps occur due to lack of sodium and potassium

Bad breath

To under­stand the cause of keto breath­ing, it is impor­tant to under­stand how metab­o­lism works. The body gets ener­gy from a vari­ety of food sources, includ­ing car­bo­hy­drates, fats and pro­teins — first break­ing down car­bo­hy­drates or glu­cose for ener­gy, then fat. Because the keto­genic diet and oth­er low-carb diets inten­tion­al­ly lim­it car­bo­hy­drate intake, the body is forced to use fat stores for ener­gy once glu­cose stores are deplet­ed. Keto­sis occurs when the body breaks down fat for ener­gy. The fat­ty acids are then con­vert­ed into ketones, which are nat­ur­al chem­i­cals the body pro­duces when you burn fat for ener­gy. These include beta-hydrox­y­bu­tyrate, ace­toac­etate and ace­tone.

This is why so-called “ace­tone breath­ing” is a sign of keto­sis. In addi­tion to an unpleas­ant odor, this process is accom­pa­nied by the appear­ance of a metal­lic taste in the mouth. Ketones are usu­al­ly harm­less and are elim­i­nat­ed from the body through exha­la­tion and uri­na­tion. Since ace­tone is an ingre­di­ent in some nail pol­ish­es, breath that smells like nail pol­ish remover may indi­cate a state of keto­sis.

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Skin rash

This is not as com­mon a symp­tom as keto­sis flu or bad breath. Small rash­es on the skin appear against the back­ground of vit­a­min defi­cien­cy, which many adher­ents of the keto diet face, and also due to the bio­chem­istry of ketones — ace­tone is released with sweat, which pro­vokes irri­ta­tion. The rash may be brown or light pink, and may be accom­pa­nied by itch­ing or increased sen­si­tiv­i­ty of the skin, but in any case, this is a sign that you need to con­sult a doc­tor.

This is prob­a­bly a tem­po­rary prob­lem. Foods con­tain­ing sat­u­rat­ed fats will help reduce inflam­ma­tion: fat­ty beef, fish, nuts, cheese, eggs, coconut. For exam­ple, make bone broth reg­u­lar­ly.

Skin rashes may appear on the keto diet

Changes in urine

Ketones are nat­ur­al diuret­ics, that is, they increase the removal of water and salts from the body and at the same time reduce the flu­id con­tent in the tis­sues. Ketones cause insulin lev­els in the blood to decrease and the body to lose more water. There­fore, after switch­ing to a keto diet, the fre­quen­cy of uri­na­tion may change (they will become more fre­quent). Also, the col­or, smell and con­sis­ten­cy of urine will become dif­fer­ent — this is due to the process of burn­ing glyco­gens: they are formed by the break­down of car­bo­hy­drates into glu­cose and are stored in the liv­er.

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Bowel problems

Because the keto diet lim­its car­bo­hy­drates, it’s not easy to meet your dai­ly fiber needs. Some of the rich­est sources of fiber, such as high-carb fruits, starchy veg­eta­bles, whole grains and legumes, are elim­i­nat­ed from the diet. As a result, the keto diet can lead to diges­tive dis­com­fort and con­sti­pa­tion. A low-carb, low-fiber diet, such as keto, may neg­a­tive­ly impact gut bac­te­ria, although cur­rent research on this top­ic is mixed. Con­sume flax seeds, chia seeds, coconut, broc­coli and greens — they are high in fiber and are allowed on the keto diet.

Flax seeds will help improve bowel function

Who is the keto diet contraindicated for?

Before start­ing a keto diet, be sure to get test­ed for total pro­tein and albu­min, glu­cose, gly­cat­ed hemo­glo­bin, insulin and lipid pro­file. The keto diet is con­traindi­cat­ed for peo­ple with Gilbert’s syn­drome (increased indi­rect biliru­bin), dia­betes mel­li­tus, kid­ney, liv­er, gas­troin­testi­nal and endocrine sys­tem dis­eases, as well as preg­nant women.

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