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August 2022

Keto Concerns on the Rise

The Ketogenic diet, or “keto diet,” has been increasingly popular for the past several years. A strict version of the diet has been studied fairly extensively as a treatment for drug-resistant epilepsy in children. But there are less strict variations that are often tried for weight loss, including the modified Atkins diet and low glycemic index diet. As it becomes more trendy and new data emerge, new side effects and safety concerns are popping up. Here’s the latest from our recent monograph update.

Reports of prurigo pigmentosa, commonly referred to as “keto rash,” are on the rise. While it isn’t necessarily a serious side effect, it can be uncomfortable and might require treatment with antibiotics, as well as increased carb intake. Rarely, but more seriously, there have also been reports of pancreatitis. It’s believed that the keto diet might result in hypertriglyceridemia in some people, which could potentially cause pancreatitis. There have also been reports of kidney stones in about 8% of adults on the keto diet. Staying well-hydrated and potentially taking an oral citrate product might be necessary for some patients.

Despite these recent reports, the keto diet appears to be generally well-tolerated when followed for up to one year. But like all diets, one of the main issues is adherence. Depending on the keto diet variation, carb intake is usually limited to 20-50 grams daily, which forces the body to break down fat into ketone bodies for energy. Just loosely following the diet won’t trigger this breakdown, nor will taking “keto diet pills.” And most research that identified an improvement in weight loss utilized a diet with a carb restriction of less than 20 grams daily. It’s also not clear if the keto diet works any better than other diets that limit calorie intake.

Check out our recently updated monograph to learn more. We recommend reviewing the latest data on its use in people with diabetes - there’s evidence that it can lower HbA1c, but also some concern about diabetic ketoacidosis (DKA). Also, see the drug interactions section to learn about why some antidiabetes drug regimens might need to be altered before use.

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The information in this brief report is intended for informational purposes only, and is meant to help users better understand health concerns. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions. Copyright © 2024 NatMed. Commercial distribution or reproduction prohibited. NatMed is the leading provider of high-quality, evidence-based, clinically-relevant information on natural medicine, dietary supplements, herbs, vitamins, minerals, functional foods, diets, complementary practices, CAM modalities, exercises and medical conditions. Monograph sections include interactions with herbs, drugs, foods and labs, contraindications, depletions, dosing, toxicology, adverse effects, pregnancy and lactation data, synonyms, safety and effectiveness.