Why You May Want to Think Twice About Keto

People with metabolic insulin resistance or neurodegenerative conditions like Alzheimer’s and Parkinson’s can benefit enormously from a ketogenic diet.  Others just want to have better focus, improve their game or stop eating processed foods.

Many of these people thrive with the shift but others don’t.  So who doesn’t and why not?

Adrenal Fatigue

Perhaps you have a friend who has tried a keto diet and done everything by the book but it hasn’t worked.  This person may be feeling worse even after the initial adaptive phase.

When the HPA axis is stressed keto can make things worse. The body interprets this low carb diet as just another added stress to deal with.  This’ll happen if cortisol, our primary stress hormone, is out of whack.

Symptoms of constant overwhelm, afternoon crashes, insomnia and poor waking energy indicate ‘adrenal fatigue’.  The cause is chronic or acute stress that is more than the body can handle.  Learning to regulate cortisol and recover from the stress has to come first.  Otherwise switching to a ketogenic diet is unlikely to work.  It may even make things worse.

Thyroid Health

It’s similar with thyroid health. Nearly every tissue in the body requires thyroid hormone. If you have a low body temperature, are losing hair and have thinning eyebrows you may want to have your thyroid checked. In fact, I screen all my patients for thyroid levels.  This is because I see it so commonly missed and is essential to metabolism.

When it comes to keto or low carb diets caution make sense. Thyroid function requires consistent fuel. This fuel is most accessible through carbohydrate.  Although the body can adapt it makes more sense to stabilize the thyroid first.  The endocrine system as a whole has this check and balance system of negative feedback loops. The benefits of keto won’t roll out if thyroid health is not at a certain level of stability.

Simple Solutions

Often in clinic there is a dual presentation.This is why medicine is personal and individualized.  As a practitioner I tease out what is possible.  For example, a patient with a cortisol imbalance who has a family history of diabetes may benefit from keto if stress management is taken seriously.  If this person’s life doesn’t allow space for meditation or good sleep hygiene then keto should be avoided.

Many people with adrenal or thyroid require specific nutrients.  If symptoms flare on keto then electrolytes become even more important.  Not enough electrolytes can cause cortisol to rise which interferes with the conversion of T4 to T3 which is the active form.  Stay tuned because my next article is all about electrolytes.

Getting enough sleep, sunlight, movement and social contact optimizes our health in ways that diet doesn’t.  Ignoring these aspects of health is common especially for anyone who likes to fixate. Experiment and keep a curious mind.  For those with a history of disordered eating or addiction its important to notice if you are becoming neurotic about the details.  After an initial phase switching to keto shouldn’t take too much thought.

Keep in mind that overeating is another stressor.  It’s easier to eat less with keto because fat and protein is much more satiating than carbs are.  You may have noticed feeling hungry if you have just a piece of fruit.  If you add some nuts or cheese your snack last longer.  This is a really simple example but it works.  On keto cutting carbs down to less than 25% of your caloric intake means your body begins using fat as fuel.  And we know healthy fats have benefits throughout the body from nourishing the joints, brain and gut.