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The Reason for The Keto Flu - that no one is talking about

functional nutrition ket flu ketogenic diet nutrition Jul 28, 2023
Functional Nutrition

Year by year, there is a new diet that is unveiled as the new ‘holy grail’ to weight loss and overall health and wellness.  Currently, the ketogenic diet is getting the most press as the diet that not only promotes weight loss but provides a variety of other health benefits.  These benefits range from improvement in brain function, to healthier blood sugar levels, stabilization of diabetes, reduction in seizures, improvement in mitochondrial health, dementia prevention, and so much more.  In the history of the ketogenic diet, it was originally introduced to mimic the benefits of fasting as a way to balance brain function and decrease or eliminate seizure activity.  This was achieved by reducing carbohydrates and sugar in the diet.  Many moons ago, researchers at Johns Hopkins found that fasting and avoiding carbohydrates had positive effects on blood sugar and insulin which provided benefits to patients with neurological imbalances.  Since long-term fasting is not realistic, the ketogenic diet was born to mimic the benefits of fasting by consuming high fat and little to no carbohydrates.  When the body does not have sugar or glucose readily available, it essentially tricks the body into thinking it is fasting.  


In many scenarios, there is vast improvement to overall health by shifting the diet to becoming ketogenic but some people experience adverse reactions from the keto diet that deter them from continuing. Experts speculate that symptoms arise due to sugar withdrawal, metabolic issues, or not being fat-adapted [meaning your body does not know how to use fat as fuel for energy] but there is another piece of the puzzle that is often being overlooked.  As we shift the body into a fat-burning state, we need to consider what is being mobilized from the fat tissue that can be causing adverse symptoms.  


The rundown on Ketosis

Ketogenic diets work through the elimination of sugar, also known as glucose, in the diet and the introduction of fat. The goal is that if we eliminate glucose from the diet the body will be forced to find another source of energy. In restricting sugar and carbohydrates from the diet, we still have about 24 hours of glucose in the liver and muscle tissue.  When the glucose stores are burned up, the body shifts into this fat-burning state which produces ketone bodies and this is the state that we call ketosis


The body using fat for energy was an evolutionary survival mechanism.  Shifting the body into a state of ketosis allowed our ancestors to burn fat for energy in times of famine. Their bodies needed the ability to maintain energy on less food so they could go longer periods of time between meals


Shifting into a fat-burning state to get the body into ketosis can promote weight loss, decrease inflammation, and improve brain health but it can also have less-than-desirable effects.  In the early stages of embarking on the ketogenic diet, some people may develop an array of symptoms that resemble the onset of a flu also known as the ‘keto flu’.  


What is the Keto Flu

The most common symptoms of the keto flu include fever, nausea, headache, body aches, chills, literally flu-like symptoms.  A complete list of symptoms can include:

  • Fatigue
  • Cravings for carbs and sugar
  • Dehydration
  • Loss of appetite
  • Constipation
  • Diarrhea
  • Heartburn or other symptoms of indigestion
  • Low motivation to exercise and poor recovery from workouts
  • Brain fog
  • Dizziness
  • Trouble sleeping
  • Moodiness or irritability

Many experts are exclaiming that the reason for the ketogenic flu is unknown and others report that the symptoms are often due to sugar withdrawal or a metabolic reset.  Sugar is a considerable part of the American diet.  Not only is sugar in pastries, bread, and fruit but it is also hidden in almost every pre-packaged product including ketchup, cereals, milk, milk alternatives, spaghetti sauce, coffee creamers, protein powders, sports drinks, and granola bars. In fact, studies have found that sugar actually causes neurochemical changes in the brain similar to those caused by addictive drugs such as cocaine.  It is probable that kicking the habit of sugar can induce withdrawal symptoms that cause symptoms similar to the keto flu.  In some scenarios, people are developing these symptoms in the absence of high amounts of sugar in their diet, so the question stands, what else could be the contributing factor?


The cause of the keto flu that no one is talking about  

If you recall, the foundation of the ketogenic diet is to shift the body from a sugar [glucose] burning state to a fat-burning state. As you enter this fat-burning state, you can begin to mobilize toxins out of the fat tissue, especially in someone who is overweight or obese.  Most of our toxic burden from environmental chemicals lives in the fat tissue which is why many people complain of cellulite [no it’s not genetic], inflammation, and inability to lose weight.  For those of you that are new to the idea of environmental toxins, these are things that we are exposed to on a daily basis from food, water, damaged buildings, personal products, perfumes, cosmetics, and just plain ol’ air.  If you don’t believe me, check out scorecard.org and type in your zip code to reveal the pollutants in the air and water of your town. 


So where do these toxins come from


  1. Heavy metals like mercury which come from fish consumption [including your beloved sushi] and silver amalgam fillings in your teeth [even if they have been removed, you could still have had their mercury saturate into your tissues].  As well as aluminum which many of us apply to our armpits every day since it is the active ingredient in antiperspirants.
  2. Pesticides, Herbicides, and Insecticides are regularly used in farming so they are on our produce, in our wine, and on our coffee beans. 
  3. Prescription drug additives.  Many of us take prescriptions but do not consider the additives in many of the drugs.  You can look up the ingredients of your medication and you may be surprised to see dyes, heavy metals, and other preservatives. 
  4. Water-damaged buildings expose us to mold and mycotoxins which can trigger frequent urination, headaches, sinus issues, allergies, and a variety of hormonal issues.  
  5. Plastics contain a variety of chemicals that leach into our water and foods, especially with heat ie.  heating your food up in the microwave while in plastic Tupperware or leaving your water bottle in the car on a hot sunny day
  6. Our personal products include makeup, hair products, lotions, and other skin regimens.  Most of our commercial products contain up to 10 harmful chemicals.  Using an app like Think Dirty is extremely helpful to gain clarity about what you are using.  
  7. Xenobiotics (man-made environmental toxins): such as dioxin [in your tampons], formaldehyde [in your keratin treatment and hair dye], PCBs [in your fish], methyl and propylparaben [in your makeup]
  8. Food Preservatives such as aspartame (diet sweeteners), MSG, many spices, and food colorings. 


An important note, our bodies are designed to detox naturally but over time our inborn ‘filtration’ systems become overloaded which can make the detoxification process more difficult.  The example that I give to many of my patients is in reference to how a vacuum works.  If you have a new vacuum that you use every day for a month, without ever dumping the filter, you will find that at the end of the month, your vacuum doesn't really work anymore.  But if you dump the filter, you can continue to use your vacuum and it will function like new.  So over a lifetime, our bodies are bombarded with different chemicals and toxins that it is constantly filtering out.  It then comes to a point when our detox organs like our liver, gut, kidneys, and lymphatic system can not filter like they used to.  This is what causes us to trap more toxins are start to feel increasingly worse.  These are not always extreme symptoms, it is the symptoms that we ALL complain about.  It is fatigue, not waking up refreshed, feeling foggy, and forgetful than our younger selves.


A great example of our increasingly congested filtration system over time is in reference to alcohol tolerance. In our younger days, many of us could tolerate alcohol and/or staying up late. In our older years, we can have a glass of wine or stay up late and feel poorly for days after. We call this aging but it really is the body’s inability to detox like it used to. Despite this being a funny example, many of us can relate to some capacity. On a positive note, your body is extremely resilient and with the right tools you can get these detox pathways working again which can eliminate an array of symptoms that many of us are plagued with like brain fog, fatigue, sleep troubles, abnormal digestion, and poor memory. 


Signs that you have toxins trapped in your fat cells

There are many signs and symptoms that many of us experience that are connected to toxic burdens.  In particular, if you have toxins in your fat cells you may experience some of the following:  

  1. Cellulite
  2. Inability to sweat or you only glisten after a workout
  3. Water retention or swelling [especially after plane rides]
  4. Dense Breasts or fibrocystic breasts
  5. circulation issues like Raynaud's disease [cold hands and feet] or you are just generally always cold
  6. Distended belly.  This also applies to people that are generally skinny but say they have belly fat
  7. Skin disorders including acne
  8. Varicose veins
  9. Swollen lymph nodes/glands
  10. Brain fog or Memory loss 


How to overcome the keto flu

If you have many of the symptoms listed you may have a toxic burden. If so, before switching to a ketogenic diet you may want to consider how you can support your body’s ability to detox.  There are a few things to consider when choosing what are your best therapies. Use the symptoms scenario to allow you to choose which supportive therapies are best for you. 


Disclaimer:  All content and suggestions are for informational purposes only. It is not intended to be a substitute for professional medical advice and is not intended to serve as a substitute for the consultation, diagnosis, and/or medical treatment of your physician or healthcare provider.


You don't sweat, you have swelling, water retention, skin issues, cellulite.  This is an indicator that you have toxins trapped in your lymphatic system and your fat cells.   Some strategies to support your lymphatic system include:

  1. Dry Brushing: Use a special brush to brush your skin towards the heart to get your lymph moving.  You also get a nice exfoliation as you do it.  
  2. Rebounding:  jumping on a mini-trampoline has tons of benefits on lymphatic drainage 
  3. Infrared Sauna:  infrared heat will heat you from the inside out to mobilize toxins for elimination
  4. Ionized Foot Bath: ions act as magnets for different toxins to help your body to eliminate them over the course of a few days [through urine and stool]


You are sensitive to alcohol, medications, or caffeine.  You also have food intolerances [especially fatty foods] and/or constipation.   This is a sign that you have toxins trapped in your liver and gut.   

  1. Support your liver with celery juice and cruciferous veggies. 
  2. Ease up on the saturated fats from animal products like cheese, milk, and butter.  Opt for more plant-based fats like avocado, coconut, and olive oil.
  3. Consume soluble fiber from steel-cut oats to make sure everything is bound and moving.  Soluble fiber has many benefits for detoxification.
  4. Use Chlorella to bind toxins and eliminate them through your bowel movements


You have a history of urinary tract infections, bladder infections, frequent urination, or you have discolored urine or urine with odor.  This is a sign that you have toxins stressing your kidneys and urinary system.  

  1. Make sure to stay hydrated and include electrolytes in your regimen.  
  2. Drink dark tart cherry juice to cleanse the kidneys 
  3. Be cautious with your protein selection by decreasing pork products. 


One Keto diet does NOT Fit all [blood types]

Another important consideration with the ketogenic diet is reviewing different versions of the diet.  There is no “one size fits all” keto diet because every person is unique and each person’s needs are different.  This can also be reflective of someone's blood type.  As an example, an O Blood type will need more animal protein but less fat from cow dairy.  The AB and B Blood Types will need more red meat while avoiding chicken and less fat from avocado and coconut.  An A Blood Type will want to consume more fish protein or follow a more Mediterranean keto diet.  The Mediterranean keto mainly focuses on consuming fish, seafood, olives, low-carb vegetables, salads, and olive oil.  Some people also have food allergies.  For these reasons, there are a variety of eating versions within the ketogenic diet. I often advise my patients to be cautious with the overconsumption of cow dairy.  In these cases, I might suggest opting for goat or sheep dairy which is usually better digested by the body.  I also express the importance of clean protein. Not all protein is created equal due to the rise of industrial and factory farming. We need to be conscious of factory-farmed meats that contain more additives that can actually promote more toxicity.  Gravitating toward pasture-raised organic meats is key. When shopping for red meat, look for grass-fed and grass-finished which assures that the animal ate grass its whole life. 

Final Thoughts

When embarking on the ketogenic diet, symptoms can arise as the body shifts into a fat-burning state. These symptoms include headache, fatigue, irritability, and achiness which can be better known as the ‘keto flu’. These symptoms can arise due to sugar withdrawal but can also be due to the mobilization of toxins in fat tissue.  There are different strategies to support the body with detoxification, depending on your body, that can prevent the keto flu symptoms.  You also want to consider your body, your food allergies, and even your blood type when deciding on your ketogenic diet.  

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