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15 Common Side effects of Keto diet

Side Effects of keto diet

15 Common Side effects of Keto diet

A lot of people seem impressed over the remarkable health benefits of keto diet these days. But some medical experts still disagree with this revolutionary low-carb nutritional plan due to its potential side effects and long-term complications. So, if you’re considering keto diet as part of your eating lifestyle, it would be helpful to know the side effects before engaging in this calorie-stricken routine. Discover the 15 common side effects of keto diet to be discussed below.

1. The initial effects called keto flu

The ketogenic diet requires following an extremely high-fat, low-carb nutritional plan to put the body into ketosis. This metabolic process enables your body to become more efficient at burning fat rather than sugar as its primary fuel source. But further studies might be required to completely understand the potential health risks of this diet since ketogenic research is scarce, according to Colorado-based registered dietician Stephanie McKercher, who is also a recipe developer at The Grateful Grazer.


Stable blood sugar control is one of the most beneficial effects of ketogenic diet as your body switches from a high-carb diet to an extremely low-carb diet. A ketogenic diet helps lower the insulin levels since you only need a small amount of insulin for fat as opposed to sugars and carbohydrates during energy conversion. When low insulin levels are maintained, your liver starts converting fat into ketones, which your body can use as energy instead of relying on glucose. As a result, your body is in a metabolic state called ketosis, which teaches it to depend on fat and ketones for sustainability.


However, it may take your body organs, including your brain, some time adapting to the ketogenic lifestyle, which would possibly lead to withdrawal symptoms known as “keto flu.” The keto flu happens because of the transition stage where your body switches from burning sugar to burning fat. During the early stage of keto diet, your body will secrete more water and sodium as your insulin levels drop, causing you to urinate more often. Dr. Nancy P. Rahnama, a California-based bariatric and internal medicine specialist, said that dieters would be experiencing common symptoms of “carb withdrawal,” which may result in weight loss and potential keto flu.


Keto symptoms and side effects include:

  • Random feeling of fatigue
  • Mild headache
  • Difficulties in mental concentration
  • Irritability and various discomforts
  • Nausea and dizziness
  • Strong cravings for sugar and carbohydrates


Unfortunately, many of these common symptoms are associated with loss of sodium and water in the body. But the immediate response of any individual to keto transition varies depending on current health status and weight. Keto flu symptoms may disappear within the next few days after you start as your body gradually adjusts to the system. While adjusting, here are some suggestions that you may consider to avoid such discomforts:


Increase water and salt intake

Increasing your salt and water intake significantly reduces the symptoms of keto flu by as much as 70% according to studies. It’s recommended to drink a full glass of water with half a teaspoon salt to alleviate the symptoms within 15 to 30 minutes whenever you feel uncomfortable due to headache, nausea, or dizziness. Alternatively, you may have either chicken or beef stock stirred with grass-fed butter and salt to replace lost water. Also, drink at least three liters of fluid, including water and other beverages, about 12 glasses daily, particularly during the first 3-4 weeks of keto diet.


Increase fat intake on your diet

Though an increased intake of salt and water may be good enough to resolve these keto flu issues, eating more fat is another remedy to keto flu. A balanced ketogenic diet requires enough healthy fat (about 75%) to prevent you from getting hungry while providing you sustained energy throughout the day.


Go easy with daily physical activities

Reducing stressful activities and strenuous workouts can help fend off the keto flu symptoms, although increased stamina and endurance are some key objectives of keto. Perform light exercises such as walking and stretching during the first few weeks of keto diet until your body becomes fat-adapted. When you learn how to balance hunger, fatigue, and stamina while exercising, increase your exercise intensity to expedite the fat-burning process. However, you may consider slowing down the transition of ketogenic diet as you increase the intensity by consuming a few carbs until you learn to keep the carb intake under 50 grams.


It’s not necessary to focus your attention on macronutrients or calorie counts when you are trying to become fat-adapted. Take the whole process slowly, and once your body becomes consistent in ketosis, expect your appetite to go down naturally. Consume as many keto-friendly sources as needed until you learn to eat only when necessary.


Kristen Kizer, registered dietician, and nutritionist at Houston Methodist Medical Center pointed out that some people may encounter these symptoms of keto flu when they start ketosis. These include vomiting, lethargy, gastrointestinal discomforts, and physical fatigue at any given time. But she assures that all these keto flu signs will pass in a matter of days. Dr. Josh Axe, natural medicine expert, and clinical nutritionist explains that water and salt are more than enough to minimize the side effects while allowing your body to train itself to rely on fat.

2. Reduced body performance

Some individuals like athletes and fitness enthusiasts are far impressed with keto diet, not just only for enhanced athletic performance but also for weight loss. But keto beginners are expected to experience fatigue and lack of motivation during the first three weeks due to the effects of carb withdrawal. As mentioned earlier, the body begins to switch from burning sugar to burning fat, prompting it to feel tired while losing weight. In addition, Edward Weiss, Ph.D., associate professor of Nutrition and Dietetics at Saint Louis University, has warned that the body could be in a more “acidic” state during ketosis, which may hamper its ability to perform at its best, particularly on long-term keto dieters.

3. Diarrhea

A ketogenic diet may cause non-serious cases of diarrhea since your gall bladder seems overwhelmed over the drastic dietary changes you take from high-fat to very low-carb consumption. Since the keto diet lacks in essential fiber sources, you may also experience irregular bowel movements. This may happen when you cut back on carbs like pasta and whole grains, and you don’t supplement them with fiber-enriched sources such as low-starch vegetables. Also, some individuals aren’t able to tolerate a high intake of dairy products, organic foods, and artificial sweeteners.


An effective remedy to this concern is to replace water with electrolytes and frequent drinking of liquids. Beverages shouldn’t contain any refined sugar and food additives.

4. Leg cramps

Leg cramps are common side effects of any low-carb nutritional plans, including ketogenic diet. These symptoms happen due to lack of essential minerals, specifically magnesium, which is often secreted through frequent urination. What you need to do is to increase fluid and salt intake to reduce this bothering side effect. You may also take some magnesium supplements to replace the lost minerals.


If drinking water, adding salt, and taking magnesium tablets are not enough, consider increasing your carb intake within a specific timeline until you get used to the diet. This should resolve your problem with leg cramps.

5. Bad breath

Some people may experience having a bad breath as one of the side effects of a low-carb diet. The foul smell can be related to active ketone production, which is also a clear sign that your body is continuously burning the excess fat for energy. Though the smell only happens temporarily, it can turn up as body odor, particularly if you have active sweat glands. Unfortunately, the smell doesn’t go away for some individuals, so consider these practical solutions to reduce the bad effects of keto breath.


  • Increase the intake of fluids and salt since you will experience dryness in your mouth. You may have difficulties trying to wash away the bacteria with saliva.
  • Practice regular brushing to reduce the smell.
  • Apply mouth fresheners to cover up the smell.
  • Reduce the level of ketosis by consuming additional carbs. You can maintain 70 to 80 grams of carbs per day along with intermittent fasting.

6. Constipation

Constipation is a common side effect during the first few weeks of a low-carb diet. Your digestive system may require some time to adapt since a ketogenic diet will only allow the minimum intake of carbohydrates, especially those fiber-enriched sources. The best way to prevent this is to increase your fluid intake since constipation is usually caused by dehydration.


Another effective way is to increase the intake of healthy vegetables. Vegetables also contain healthy fibers which can help move your intestines well, thus reducing the risk of constipation.

7. Palpitations

When you’re on a ketogenic diet, you may experience a slight heart palpitation due to increased intake of salt. Other possible reasons are dehydration and constipation, which are both related to lack of fluid intake as the heart needs to pump up harder to maintain blood pressure. Random palpitation is also a result of the stress hormones released in order to maintain blood sugar levels, particularly individuals who are taking regular medications for diabetes. What you need to do is to increase water intake and take enough salt at the same time.


If symptoms still persist, consider increasing your carb intake to help your body jump out of ketosis temporarily. Mineral supplementation is also an effective solution in reducing palpitation during the initial stages of the keto diet.

8. Temporary fluctuation of blood sugar levels

A ketogenic diet has been shown to reduce insulin levels since your body will start converting fat instead of relying on carbohydrates as an energy source. But expect some blood sugar fluctuations during the first few weeks as part of your transition from being sugar-burning to a fat-burning machine. Avoiding carbohydrates definitely decrease your need for diabetes medication as time goes by. In fact, when you still take the same insulin dosage while already undergoing a strict low-carb diet, there’s a higher risk of experiencing hypoglycemic episodes, which may have resulted from low blood sugar.


To avoid this incident, you need to monitor your blood sugar regularly while slowly adopting the keto diet. Maintain constant communication with your healthcare professional whether your diabetes is treated with medication or diet alone.

9. Non-permanent hair loss

Temporary hair loss may happen when a person undergoes a drastic dietary change. This sudden change may result from restricting your calorie intake down to its lowest level as well as other approaches like meal replacement, intermittent fasting, and water therapy. Hair loss may become noticeable between three to six months after starting a low-carb diet in which you’ll notice some hairs falling out when brushing them. But you shouldn’t worry about this problem since the hair follicles will begin to grow new hair strands again in a few months.


Hair loss is commonly associated with everyday stress and other potential reasons like pregnancy, disease, nutrient deficiencies, and psychological stress, among others. But lost strands will be replaced a few months later as part of your body’s ability to adjust and recover to certain environmental or dietary changes. If you wish to minimize this potential risk, you don’t need to do anything except to maintain a healthy level of calories and fat without starving yourself. It’s also helpful to practice regular sleeping habits and to avoid strenuous exercises for the first two weeks.

10. Temporary high blood pressure

You may expect your blood pressure to elevate a bit during the first few weeks of keto diet due to the need for salt intake. But the blood pressure tends to become normalize as your body begins to adapt the low-carb diet. Once your body turns fat-adapted, it reduces the need for medication for blood pressure control. Otherwise, when you’re taking the same dosage, you might experience increased heart palpitation, so you should discuss this matter with your doctor to determine whether you can reduce or discontinue the medication.

11. Slight increase in cholesterol levels

A ketogenic diet has been shown to reduce cholesterol levels, specifically the bad ones, which strongly indicate a lower risk of cardiovascular disease. There may be a slight elevation in your cholesterol level, mainly due to the increased LDL) good cholesterol), resulted from higher intake of healthy fat. This may also contribute to lowering triglycerides, but may also contribute to extremely low total cholesterol levels, which is considered unhealthy. To avoid this potential side effect, you may reduce fat intake when you’re not feeling hungry, or you may consider intermittent fasting to alter your cholesterol levels safely.


Consuming unsaturated fats such as fatty oils and olive oil can also help lower your cholesterol. If you don’t see any changes, consider adding some carbohydrates, but only choose the unprocessed sources and not refined sugar or whole wheat.

12. Low alcohol tolerance

Individuals who are on a calorie-stricken diet may experience low alcohol tolerance as the liver is concentrating on ketone production. This could limit the liver in breaking down alcohol at a normal rate, thus making you feel intoxicated a bit faster. Medical experts also believe that sugar and alcohol contents are broken down in similar processes in the liver when taken simultaneously, partly slowing down the burning process. Consuming fewer carbohydrates could make your liver become temporarily less effective in breaking down alcohol.

13. Gout

A ketogenic diet may potentially cause gout, particularly when consuming excessive meat instead of concentrating on healthy whole food choices. Low-carb dieters should only eat meat in moderation and focus more on eating vegetables, fruits, and healthy fat. The good news is that the risk for developing gout will likely go down if you avoid eating too much meat, and this benefit can become long-term. But expect a slight gout increase over the next 2-3 weeks after starting a keto diet.

14. Weight gain

Health experts explain that jumping out of ketosis more often will eventually lead keto dieters back to their previous form. Though any low-carb diet should be followed with a sustainable diet plan, experts say that a lot of people tend to regain weight or weigh even more as soon as they start feasting on carbs again. Weight fluctuation can be attributed to eating disorder or possibly poor perspective on proper nutrition. So, the best solution for this problem is to seek professional help by means of hiring a professional counselor or lifestyle coach to monitor your acts better.

15. Muscle loss

Muscle loss is another potential consequence of keto diet since the diet will require you to consume more fat than protein. You’ll probably lose weight, but much of the changes can be attributed to the loss of muscle mass according to some medical experts. Muscles burn the calories better than fat, which may largely affect your overall metabolism.


It’s often not in the same proportion anymore, referring to muscle and fat ratio, when you decide to jump off the ketogenic diet and have regained much of your original weight. That’s because you’re likely to regain fat, instead of gaining your lean muscles back. What you can do is to increase the protein intake and reduce your fat intake intermittently to achieve proper balance.


The keto diet has become an exceptional extreme-low carb eating plan that can help drop your weight down, but the potential effects on your body might go beyond weight loss. Still, it would be helpful to become aware of the potential health dangers before deciding to try this low-carb diet to yourself.

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Maribelle is a writer, health enthusiast, and a registered nurse by profession. She broadens her knowledge more on the ketogenic diet and shares some tips based on her personal experience.

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