What is Ketosis?

What Is Ketosis?


Ketosis is a natural state for the body, when it is almost completely fueled by fat. This is normal during fasting, or when on a strict low-carb diet, also called a keto diet.

Ketosis has many potential benefits, but there are also side effects. In type 1 diabetes and certain other rare situations excessive ketosis can even become dangerous.

On this page you can learn all about how to harness the benefits of ketosis, while avoiding any problems. It all starts with understanding what ketosis is.

Choose a section, or keep reading below for all of them.
 


ketones

Ketosis Explained

The “keto” in the word ketosis comes from the fact that it makes the body produce small fuel molecules called “ketones”.1 This is an alternative fuel for the body, used when blood sugar (glucose) is in short supply.

Ketones are produced if you eat very few carbs (that are broken down into blood sugar) and only moderate amounts of protein (excess protein can be converted to blood sugar).

Ketones are produced in the liver, from fat. They are then consumed as fuel in the body, including by the brain. This is important as the brain is a hungry organ that consumes lots of energy every day,2 and it can’t run on fat directly. It can only run on glucose… or ketones.

Maximizing fat burning

On a ketogenic diet your entire body switches its fuel supply to run almost entirely on fat. Insulin levels become very low and fat burning increases dramatically. It becomes easy to access your fat stores to burn them off. This is obviously great if you’re trying to lose weight, and studies show that ketogenic diets lead to more weight loss.3 But there are also other less obvious benefits.

When the body produces ketones it’s said to be in ketosis. The fastest way to get there is by fasting – not eating anything – but obviously it’s not possible to fast forever.

A low-carb or “keto” diet, on the other hand, can be eaten indefinitely and also results in ketosis. It has many of the benefits of fasting – including weight loss – without having to fast.
 
Learn more about a ketogenic diet

Ketones are brain fuel

It’s a common misconception that the brain needs carbs. The truth is that the brain happily burns carbs when you eat them. But if you don’t eat too many carbs, the brain is happy to burn ketones instead.

Does the Brain Need Carbohydrates? – Answers to Common Questions4.7 out of 5 stars5 stars85%4 stars8%3 stars3%2 stars1%1 star1%61 ratings6105:56
This is an absolutely necessary function for basic survival. As the body can only store carbs for a day or two, the brain would quickly shut down after a couple of days without food. Alternatively it would quickly have to convert our muscle protein into glucose – a very inefficient process – just to keep the brain going. That would make us waste away quickly. It would also ensure that the human race could hardly have survived all those millennia before we had 24-7 food availability.

Fortunately our bodies has evolved to be smarter than that. Normally we have fat stores that lasts so that we can survive for many weeks (if not months) without food. Ketosis is how the body makes sure that the brain can run on those fat stores too.

Bottom line: We do not need to eat any carbs at all. The brain can happily run on fat.

Many people even feel more energized and focused when the brain gets to run on ketones, made from fat. And it certainly speeds up fat loss, if you’re trying to lose weight.
 



 

The Benefits of Ketosis

There are many benefits of ketosis. By giving your body and brain an almost unlimited supply of energy, you can increase your mental and physical endurance. It also reduces hunger, facilitating effortless weight loss.

Furthermore, as getting into ketosis requires eating very few carbs, it can effectively reverse type 2 diabetes. Finally, ketosis has been used for a long time to control epilepsy – often even without drugs.

 

 


 

How to Get Into Ketosis

To get into ketosis you need low levels of the fat-storing hormone insulin. The most important way to do that is to eat a strict low-carb diet, also called a ketogenic diet.

On top of the necessary ketogenic diet there are many ways to increase ketosis further. The most powerful is adding intermittent fasting.

Full guides

 
 


 

Symtoms & How to Know You’re In Ketosis

Symptoms of ketosis: dry mouth, thirst, frequent urination

How do you know you’re in ketosis? It’s possible to measure it by testing urine, blood or breath samples. But there are also other telltale signs, that requires no testing:

  • Dry mouth and increased thirst. Unless you drink enough and get enough electrolytes, like salt, you may feel a dry mouth. Try a cup of bouillon or two daily, plus as much water as you need.
  • Increased urination – another ketone body, acetoacetate, can end up in the urine. This makes it possible to test for ketosis using urine strips. It also – at least when starting out – can result in having to go to the bathroom more often. This is the main cause of the increased thirst (above).
  • Keto breath – this is due to a ketone body called acetone escaping via our breath.4 It can make a person’s breath smell “fruity”, or similar to nail polish remover. This smell can sometimes also be felt from sweat, when working out. It’s often temporary. Learn more

 
Other, less specific but more positive signs include:

  • Reduced hunger – many people experience a marked reduction in hunger.5 This may possibly be caused by an increased ability of the body to be fueled by its fat stores. Many people feel great while eating just once or twice a day, automatically ending up doing a form of intermittent fasting. This saves both time and money, while also speeding up weight loss.
  • Increased energy – perhaps after a few days of feeling tired (the “keto flu“) many people experience a clear increase in energy levels. This can also be experienced as clear thinking, a lack of “brain fog” or even as a sense of euphoria.

How Do You Measure Ketosis?

ketone meters
There are three ways to measure for ketones, which all come with pros and cons:

  1. Urine strips
  2. Breath ketone analyzers
  3. Blood ketone meter

 
 


 

Side Effects, Fears & Potential Dangers

 

Side effects

When starting a low-carb ketogenic diet and reaching ketosis it’s common to get some side effects during the first week. Possibilities include headache, lethargy, irritability, leg cramps, constipation and heart palpitations.

These side effects are usually relatively minor and transient, and most of them can be avoided by getting enough fluid and salt.

Learn more about low-carb side effects and how to cure them


 

Ketosis vs. ketoacidosis

Ketosis vs. ketoacidosis

There are many misconceptions about ketosis. The most common is mixing it up with ketoacidosis – a rare and dangerous medical condition that mostly happen to people with type 1 diabetes if they don’t take insulin.6 Even some health care professionals tend to mix up these two situations somewhat, perhaps due to the similar names and a lack of knowledge about the distinct differences.

Ketosis and ketoacidosis are not the same thing.

Ketosis is a 100% natural state, under full control by the body. It can be caused by a low-carb diet or by a brief period of fasting.

Ketoacidosis is a severe malfunction of the body, with excessive and unregulated production of ketones. This leads to symptoms like nausea, vomiting and stomach pain followed by confusion and finally coma. It requires urgent medical treatment, as it can potentially be fatal.7

This graph shows the vast difference in amount of ketones in the blood between ketosis and ketoacidosis:

ketone zone

Most people who eat a strict low-carb ketogenic diet never reach levels higher than 3 millimolar or so, in fact many people struggle to get it above 0.5. Long-term starvation – meaning a week or more with zero food – might bring the number up to 6 or 7. But ketoacidosis occurs at levels of 10+, most commonly 15+.

It’s like the difference between drinking a glass of water vs. drowning in an ocean. Both situations are about water – but they are not the same thing. Drinking a glass of water will not make you drown. Nor does ketosis result in ketoacidosis.

If you have a functioning pancreas that can produce insulin – i.e. you don’t have type 1 diabetes – it would be extremely hard or, most likely, impossible to get ketoacidosis even if you tried. That’s because high ketone levels result in release of insulin, that shuts down further ketone production. In other words, the body has a safety net that normally makes it impossible for healthy people to get ketoacidosis.8

 


 

 

How to Reach Optimal Ketosis

Getting into ketosis is not a black or white thing. It’s not like you’re either in ketosis, or out of ketosis. Instead, you can be in different degrees of ketosis, as this chart demonstrates.9 The numbers below refer to values when testing blood ketone levels.

 
The Ketone Zone

  • Below 0.5 mmol/L is not considered “ketosis”. Although a value of, say, 0.2 demonstrates that you’re getting close. At this level you’re still far away from maximum fat-burning.
  • Between 0.5 – 1.5 mmol/L is light nutritional ketosis. You’ll be getting a good effect on your weight, but perhaps not optimal.
  • Around 1.5 – 3 mmol/L is called optimal ketosis and is recommended for maximum mental and physical performance gains. It also maximizes fat burning, which can increase weight loss.
  • Values of over 3 mmol/L aren’t necessary. That is, they will achieve neither better nor worse results than being at the 1.5 – 3 level. Higher values can also sometimes mean that you’re not getting enough food (“starvation ketosis”). For type 1 diabetics, it can be caused by a severe lack of insulin that requires urgent attention.10
  • Values of over 8 – 10 mmol/L are usually impossible to get to just by eating a ketogenic diet. It means that something is wrong. The most common cause by far is type 1 diabetes with severe lack of insulin.11 Symptoms include feeling very sick with nausea, vomiting, abdominal pain and confusion. The end result can be a state called ketoacidosis, that may be fatal. Needless to say abnormally high ketones requires immediate medical care.

 

How to achieve ketosis

There are many things that increase your level of ketosis. Here they are, from most to least important:

  1. Restrict carbohydrates to 20 digestible grams per day or less – a strict low-carb diet. Fiber does not have to be restricted, it might even be beneficial.12
  2. Restrict protein to moderate levels. If possible stay at or below 1 gram of protein per day, per kg of body weight. So about 70 grams of protein per day if you weigh 70 kilos (154 pounds). It might be beneficial to lower protein intake even more, especially when overweight, and then aim for 1 gram of protein per kg of desired weight. The most common mistake that stops people from reaching optimal ketosis is too much protein.
  3. Eat enough fat to feel satisfied. This is the big difference between a ketogenic diet and starvation, that also results in ketosis. A ketogenic diet is sustainable, starvation is not.
  4. Avoid snacking when not hungry. Unnecessary snacking slows weight loss and reduces ketosis.
  5. If necessary add intermittent fasting, like 16:8. This is very effective at boosting ketone levels, as well as accelerating weight loss and type 2 diabetes reversal.
  6. Usually not necessary: Supplement MCT oil and/or Bulletproof coffee.
  7. Usually not necessary: Supplement exogenous ketones.13

Two stories about achieving long-term ketosis

Optimal ketosis experimentHere are the three reports from a 2-month experiment in reaching optimal ketosis:

  1. Experiment: Optimal ketosis for weight loss and increased performance
  2. Four weeks of strict LCHF and ketone monitoring
  3. Final report: Two months of strict LCHF and ketone monitoring

 
Here’s a great ten-minute presentation about self-tracking one year in nutritional ketosis:

A Year of Self-Tracking in Nutritional Ketosis – Dr. Jim McCarter4.5 out of 5 stars5 stars70%4 stars19%3 stars4%2 stars5%1 star0%119 ratings11910:20

Do I have to reach optimal ketosis to experience the benefits?

In short, no. Many of the benefits, such as weight loss, are experienced at lower levels of ketosis (at least above 0.5). There are indications that you might need to reach higher levels of ketosis for high-level physical performance.

A master class in ketosis

Here’s a great presentation by Professor Jeff Volek, about the benefits of adapting your body to run on fat and ketones for fuel:

Keto-Adaptation and Performance – Prof Volek4.7 out of 5 stars5 stars84%4 stars7%3 stars3%2 stars0%1 star3%117 ratings11758:58

Long-term ketosis

Do you want to understand what it takes to successfully and enjoyably reach and maintain long-term ketosis? Then there’s no better teacher than Professor Stephen Phinney. Get inspired here:

Low-Carb Living – Dr. Stephen Phinney4.8 out of 5 stars5 stars91%4 stars3%3 stars3%2 stars1%1 star1%94 ratings941:00:21

 

More

A Ketogenic Diet for Beginners

You can also learn a lot about ketosis from one of the world’s foremost researchers on the topic, Dr. Dominic D’Agostino:

Dominic D'Agostino – 10 Years of Ketogenic Research4.8 out of 5 stars5 stars90%4 stars3%3 stars2%2 stars2%1 star0%127 ratings12722:05Dr. Dominic D'Agostino - Nutritional Ketosis: Metabolic Regulation and Signaling4.7 out of 5 stars5 stars85%4 stars2%3 stars8%2 stars1%1 star1%71 ratings7153:13


 

Comments

Feel free to leave a comment below.

  1. There are three different ketones, or “ketone bodies” used as fuel by the body. They are:

    1. Acetone
    2. Acetoacetate
    3. Beta-hydroxybutyrate

    Ketones

    Learn far more than you’ll ever need about ketones here:

    Dr. Peter Attia: Ketosis – advantaged or misunderstood state? (Part I)

  2. The brain consumes about 20% of the body’s required energy every day, despite only representing 2% of the body’s mass.

    A good bonus for weight loss, if you can get your hungry brain to burn fat for you, 24-7.

  3. For example Shai 2008 or Bazzano 2014.

    Full list of studies with the most important findings explained

  4. This can sometimes be measured as early as during the first day on a ketogenic diet:

    AJCN: Breath acetone is a reliable indicator of ketosis in adults consuming ketogenic meals. (2002)

  5. This has been clearly demonstrated in several scientific studies:

    Obesity Reviews: Do ketogenic diets really suppress appetite? A systematic review and meta-analysis (2014)

  6. Learn more about how to safely and effectively do a low-carb diet if you have type 1 diabetes:

    Starting Low Carb with Diabetes Medications

  7. In the most common case – type 1 diabetes – the treatment mainly includes insulin infusion and fluids.

    Ketoacidosis is potentially fatal, but provided adequate and timely medical treatment it fortunately has a more than 99% survival rate.

  8. There are a few situations besides type 1 diabetes that can – in rare and extreme cases – result in ketoacidosis. These include doing a strict keto diet or fasting while breastfeeding or on a new class of diabetes medications called SGLT-2 inhibitors (e.g. Farxiga, Jardiance, Invokana).

  9. The chart is from the excellent book The Art and Science of Low-Carbohydrate Performance by Professor Stephen Phinney and Jeff Volek. Highly recommended.

    perf

  10. Take insulin, eat carbs (if your blood glucose isn’t already high), and contact medical services immediately.

  11. Other possibilities include doing a strict keto diet or fasting while breastfeeding or on a class of diabetes medications called SGLT-2 inhibitors (e.g. Farxiga, Jardiance, Invokana).

  12. Fiber is digested by bacteria in the colon, and some of it is transformed into a fat called medium-chain triglycerides. This fat can be absorbed by the body and is very effective at turning into ketones. Thus eating more fiber (but still very low carb) could result in higher ketone levels in the blood.

  13. The company Prüvit sells drinkable ketones, called KETO//OS. This drink raises blood levels of ketones and may possibly improve physical and mental performance under certain circumstances.

    However, it does not lower insulin or blood sugar, and it does not increase fat burning. Thus it hardly helps with weight loss or type 2 diabetes reversal.

    Also note that they are selling through a multi-level marketing scheme, meaning their affiliates are paid on commission. So take all endorsements with a grain of salt.

     

    Pruvitnow.com

27 Comments

  1. Dawn
    I'm using urinalysis strips right now. Should I strive for "large" numbers of ketones or is small or moderate still effective? Small = 15mg/dL, moderate is 40, large is 80+. Not sure how to do the conversion from blood test results.
    Reply: #3
  2. Maria
    I have been doing a lot of research in this area. I began the LCHF diet last spring and had been on it for about 6 weeks. (I am not diabetic but have a family history of it. If I do not watch what I eat my glucose levels are in the pre-diabetic range. I went on LCHF as a proactive measure.) My weight was on the lower end, but not extremely low, at the end of the six weeks--115 @ 5'5". I fasted for a day for religious reasons---not a total fast either. The next morning my glucose level was 57 and I felt weak. I ate some thoughout that day, but still did not feel well. By evening my stomach was hurting, I had loose bowels, and threw up. I ended up in the ER by midnight--felt jittery and had a glucose of 61. They were not concerned about the glucose levels, but through blood testing told me I had metabolic ketoacidosis. I have got a copy of my lab reports but all it says under ketones is LARGE, and another page says 3+ abnormal. My blood PH got messed up, also.

    All that I was told was that I needed not to be on the diet---by multiple people (doctors, nurses). After observing me and a couple bags of fluids, they let me go.

    A few days later I had some follow up work done which was normal except for a higher fasting glucose level (because I had been eating more sugar) that they were concerned about.

    I don't have funds to go back to the doctor, but am still confused as to why I could end up in ketoacidosis in one day of partial fasting?? Again, I am not type 1 diabetic, don't drink and generally feel great on the LCHF, which I have continued.

    Any thoughts?

    Reply: #20
  3. Jen

    I'm using urinalysis strips right now. Should I strive for "large" numbers of ketones or is small or moderate still effective? Small = 15mg/dL, moderate is 40, large is 80+. Not sure how to do the conversion from blood test results.

    I had the same question! I've been having serious brain fog, and all i have is the urinalysis strips, don't know if i'm going too far in ketosis. The blood ketone strips are expensive AND hard to come by. Wonder if anyone monitors these comments.

    Reply: #4
  4. Hi Dawn and Jen!

    Of course we monitor the comments. :) But we do not have the possibilities to answer all of them.

    I think if you are really serious about eating ketogenic then you should use blood ketone strips.

    If you want to check that you are actually eating strict/moderate LCHF then the urine strips should be good enough. If you get any kind of indication on the strips then it's OK. Darker normally means that you are eating stricter.

    I'm using urinalysis strips right now. Should I strive for "large" numbers of ketones or is small or moderate still effective? Small = 15mg/dL, moderate is 40, large is 80+. Not sure how to do the conversion from blood test results.

    I had the same question! I've been having serious brain fog, and all i have is the urinalysis strips, don't know if i'm going too far in ketosis. The blood ketone strips are expensive AND hard to come by. Wonder if anyone monitors these comments.

  5. Dawn
    Thanks! I'm madly in love with this lifestyle! I don't need the blood strips. I make sure my net carbs are right around 20mg each day. Been in ketosis for 5 weeks. I'm just very interested in the chemistry. Why some strips are lighter/darker than others. But based on research from other sites, I've come to the conclusion that anything over "none" means I'm producing ketones, and therefore in ketosis. I never suffered any real side effects so I can't help you, Jen. Best of luck!
  6. David
    Get Started

    What Is Ketosis?

    Ketosis is a natural state for the body, when it is almost completely fueled by fat. This is normal during fasting, or when on a strict low-carb diet.
    Ketosis has many potential benefits, but there are also side effects. In type 1 diabetes and certain other rare situations excessive ketosis can even become dangerous.

    On this page you can learn all about how to harness the benefits of ketosis, while avoiding any problems. It all starts with understanding what ketosis is.

    Choose a section, or keep reading below for all of them.

    Ketosis ExplainedKetosis Explained BenefitsBenefits How to Get Into KetosisHow to Get Into Ketosis Ketosis ExplainedSymptoms & How to Know You’re In Ketosis
    Side Effects, Fears & Potential DangersSide Effects, Fears & Potential Dangers How to Reach Optimal KetosisHow to Reach Optimal Ketosis

    ketones

    Ketosis Explained
    The “keto” in the word ketosis comes from the fact that it makes the body produce small fuel molecules called “ketones”.1 This is an alternative fuel for the body, used when blood sugar (glucose) is in short supply.

    Ketones are produced if you eat very few carbs (that are broken down into blood sugar) and only moderate amounts of protein (excess protein can be converted to blood sugar).

    Ketones are produced in the liver, from fat. They are then consumed as fuel in the body, including by the brain. This is important as the brain is a hungry organ that consumes lots of energy every day,2 and it can’t run on fat directly. It can only run on glucose… or ketones.

    Maximizing fat burning
    On a ketogenic diet your entire body switches its fuel supply to run almost entirely on fat. Insulin levels become very low and fat burning increases dramatically. It becomes easy to access your fat stores to burn them off. This is obviously great if you’re trying to lose weight, and studies show that ketogenic diets lead to more weight loss.3 But there are also other less obvious benefits.

    When the body produces ketones it’s said to be in ketosis. The fastest way to get there is by fasting – not eating anything – but obviously it’s not possible to fast forever.

    A low-carb or “keto” diet, on the other hand, can be eaten indefinitely and also results in ketosis. It has many of the benefits of fasting – including weight loss – without having to fast.

    Learn more about a ketogenic diet

    Ketones are brain fuel
    It’s a common misconception that the brain needs carbs. The truth is that the brain happily burns carbs when you eat them. But if you don’t eat too many carbs, the brain is happy to burn ketones instead.

    Does the Brain Need Carbohydrates? – Answers to Common Questions
    5105:56
    This is an absolutely necessary function for basic survival. As the body can only store carbs for a day or two, the brain would quickly shut down after a couple of days without food. Alternatively it would quickly have to convert our muscle protein into glucose – a very inefficient process – just to keep the brain going. That would make us waste away quickly. It would also ensure that the human race could hardly have survived all those millennia before we had 24-7 food availability.
    Fortunately our bodies has evolved to be smarter than that. Normally we have fat stores that lasts so that we can survive for many weeks (if not months) without food. Ketosis is how the body makes sure that the brain can run on those fat stores too.

    Bottom line: We do not need to eat any carbs at all. The brain can happily run on fat.

    Many people even feel more energized and focused when the brain gets to run on ketones, made from fat. And it certainly speeds up fat loss, if you’re trying to lose weight.

    The Benefits of Ketosis
    There are many benefits of ketosis. By giving your body and brain an almost unlimited supply of energy, you can increase your mental and physical endurance. It also reduces hunger, facilitating effortless weight loss.

    Furthermore, as getting into ketosis requires eating very few carbs, it can effectively reverse type 2 diabetes. Finally, ketosis has been used for a long time to control epilepsy – often even without drugs.

  7. AJ0292
    Hi,

    I tried low carb last year for 4 months and lost 8kgs, while still being active, alert and most importantly, not hungry. Unfortunately I slipped back into my old habits of eating and regained the weight and then more weight within 6 months. I have restarted the diet again to make the most of the benefits it provided me with but I have a question, once I've reached my desired physical and mental goals, is it okay to have a day or two in a month to indulge in a high carb dish (desserts or noodles)? What impact does a sudden heavy dose of refined carbs/sugars have on your blood insulin and health? The last time I'd occasionally indulge in a piece of cake or a bowl of sweet corn soup, I'd not enjoy the way my stomach would feel right after so I'd tend to avoid "cheating" most of the time. But I'm concerned about what the sudden dose of sugar does to you when you've been on low carb for a few months?

    P.S. I'm 25 years old, woman. 5.5 ft tall and I'd want to switch to low carb diet as a matter of lifestyle change considering the way I felt while I was following it.
    Thank you for sharing :)

    Reply: #9
  8. vicky
    hello, I started this diet 5 days ago and feel really sick also have bad headaches and I feel really weak,i have a young family to care for and cant afford to be faint. Any ideas ? thanks

    p.s every time I think about eating eggs and sausages with butter for breakfast I'm nearly sick, the food is so rich !

    Replies: #10, #23, #26
  9. Michael
    AJ, Cheating on a keto diet will generally take you out of ketosis... what that means depends on how hard it is for you to get back into ketosis, and how bad your keto-flu is

    for example: me and my wife have both been doing LCHF dieting for about 6 months, we both occasionally cheat the diet and come out of ketosis (me more than her, for reasons below)

    For me, 1-2 days of LCHF will put my ketone levels back in the 2+ range on the urine strip, and my keto-flu is generally just feeling tired for a day or so on the third day, then great on the 4th day.

    For my wife she generally has to do the LCHF diet for around a week to get above .5 on the urine strip, and her keto flu, according to her I'm obviously not in her body to report directly, is 2-3 days of her feeling tired, dizzy, nauseous and sometimes even vomiting.

    So it's more of an ordeal for my wife to cheat on the diet than me, so she cheats less than I do. The same would apply to you, just understand that whatever it felt like when you started the diet (either the stress of peeing on a strip and not seeing your ketones where you want them, and the nausea associated with the keto-flu) whenever you start it again.

    However, there are actually a ton of really good keto recipes that are low carb for deserts, it sucks not being able to order chocolate molten cakes at Chili's anymore, but there are lots of desserts you can make at home that are good. And there you can make reasonable noodle replacements out of many vegetables.

  10. Michael
    The important thing about this is, did this just start at the 5 day mark, because it may just be your body burning through it's supply of glucose, and beginning to produce ketones and going into Ketosis. (I realize this comment is now 4 days old, but I was just reading keto stuff today, so you've probably either come out of your keto-flu, or stopped your diet at this point)

    If you don't like eating fat/protein rich foods for breakfast you could try bulletproof coffee, which is coffee with butter in it, which sounds really weird but is actually pretty good... I'd just say to try it before you write it off because it sounds weird, now that I've started drinking it, I think it tastes better than normal coffee from Starbucks. My recipe for bulletproof coffee is as follows:

    14oz of fresh brewed coffee
    1TbS of Butter
    1TbS of MCT Oil
    Splash of Heavy Whipping Cream
    Zero Carb flavor syrups

    as soon as it's done brewing add in 1 TbS of kerrygold unsalted butter, stir well until butter fully melts,
    add a splash of heavy whipping cream, no more than a TbS... I don't generally measure it and should probably start,
    1 TbS of MCT oil,
    add in your zero carb/cal flavor syrups to taste,
    blend well with an emulsion blender or a frother if you have one.

    I find that it helps to give the drink a swirl between drinks, if I don't I always end up with some oil separated at the bottom of my cup.

    The nice thing about bulletproof coffee is that it should fill you up for a few hours to get to lunch, more so when you're actually in Ketosis when your body isn't looking for carbs to fuel you as much.

  11. Geri
    I don't understand about fiber. Says I can have it. What is it? Metamucil?
    Reply: #18
  12. ollie
    My husband needs to lose about 20 lbs. He has a fatty liver and high triglycerides is this diet feasible for him to go on.
    Reply: #13
  13. Hi ollie!

    We believe that it's a good idea! :)

    My husband needs to lose about 20 lbs. He has a fatty liver and high triglycerides is this diet feasible for him to go on.

  14. lucky
    Hi ,
    I was wondering is it ok to drink (kangen water) alkaline water (ph 9.5) on keto diet ?
    Or will it get us out of ketosis?
  15. Dev
    How long is long term Ketosis?
    Is it roughly a two month program and then go back to a normal diet.
    There also is a spelling mistake in one of your headings leading me to believe this is not a lifestyle nor a diet, just some BS money grab from advertisers.
    Reply: #16
  16. Ashley
    One typo is enough to make you think it's fake? You obviously haven't researched this. Its benefits are all over the place on the internet.
  17. Sandy2v
    Hi. I'm on third week of lfhc and been in optimal ketones level for last few days until this morning when it's gone up to 8 I think.(dark purple on urine strip but not the darkest). I'd rather be in optimal so should I slightly up carbs? And is it dangerous to have very high level. ? Want to stick with it but do the right thing. Thanks for such a great resource btw.
  18. Andrea
    They mean fiber in general. Fiber is listed on nutritional labels as a carbohydrate. So when you are counting carbs, you want to use NET carbs...Total Carbs - Fiber.
  19. Maggie
    Can you please talk about water content and advise how much water one should be drinking at optimal ketosis? I went on a shake diet where ketosis was desirable but they wanted us drinking huge amounts of water each day to flush out the ketones and also to keep the urine strips light pink as apposed to a darker pink. If someone had too dark a strip they would advise more and more water to drink. Your site seems to suggest that the darker colours on the urine strips are more advisable?
  20. happy
    Hi Maria, I don't know if you will ever read this response. I hope you will. English is not my native language, but I will do my best.

    I wonder if you have you taken enough magnesium, potassium, and salt during your diet? Those three minerals are extremely critical to maintain a healthy keto diet. Without them, you would completely lose the balance of electrolyte in the body, and yes, it can make you collapse. Without carbs holding them, those minerals just come right out of your body. While on keto diet, you must consume enough amount of those three nutrients everyday, either through a supplementary pill or as food. Google the food that has good amount of potassium and magnesium. Make sure to consume enough salt, yes salt. Given your history, I would actually carry a small bottle of salt and add extra salt into all of your food.

    Also, if you were ever following those crazy keto ratio program that suggests only 20 grams of carb consumption, just drop it. It is simply crazy, unrealistic, and even dangerous. I recommend that you try to consume at least 40 grams of carb per day (try to consume around 40 to 60). You will still be in Ketosis enjoying all the benefits, and you will never end up in the ER.

  21. Dietetic Student
    Hello, I am a dietetic student, and we are studying ketosis right now, so this was interesting to read! We are learning that even though fat provides energy during a fast, it can give give very little glucose for energy for the brain and nerves. Only the small glycerol molecule on fat can be converted to glucose--fatty acids cannot be. Therefore, the average person needs carbohydrates. There are different types of carbohydrates---whole grains and brown rice are preferable to white flour,white flour, and other processed food. The Dietary Guidelines for Americans recommends that 45-65% of the daily diet should be carbohydrates.
    Reply: #28
  22. Kim Tomkins
    New to this, can anyone tell me if I can eat total yogurt and if so why are the net carbs higher in the low fat than full fat, also can I eat soya yogurt?
  23. Lori
    I feel the same way, I'm really hoping that me starting week 2 I will start to feel better, otherwise I will have to add more carbs. I feel weak and faint as well. Im not hungry, so I believe I am eating enough fats etc. Hoping I start to feel better. How are you feeling now Vicky?
  24. Marcia Hamilton
    3/7/2017 Yesterday I was diagnosed with non-alcoholic chirrosis of the liver. I've had fatty liver for quite some time, the doctors never once telling me it could lead to the above. My liver is enlarged measuring 19.cm craniocaudal, whatever that means. I know that 7cm is normal up to 15cm, depending on where you get the facts from. If I use this diet, won't the high fat worsen the liver more than it is already or can nothing help me at this point, period? I'm 70 years old, but feel like I'm 20 years younger except for lately when I'm feeling tired, sluggish and have nausea in the morning.
  25. 1 comment removed
  26. Carl Jackson
    vicky and Lori,

    I started dieting a few months ago and experienced the same headaches and lethargy. My coach instructed me to take in more calories. Take one tablespoon of coconut oil. The oil helps regulate insulin. Since doing this I've had a decrease in the jitters. I snack on a dozen almonds between meals. A healthy sports drink (gatorade-type) is what got me past the headaches. Your brain needs the sugar (or glucose). I even drank a Dr. Pepper and it helped with my energy, but I only did this once.

    I would say that the sudden drop in these sugars or ketones to the brain cause the headaches. She also advised my to eat unflavored Greek yogurt for the protein.

    I started my weight at around 193lbs and am down to 178. I'm 6' 1" and am working on my gut. I came across this site looking for info on Ketosis after being introduced to Cowboy Coffee. Trying my coffee right now.

    Good luck everyone.

  27. manesail
    Thanks "happy" for your comment. My husband and I did a month of LC. While the extra body fat has been reduced, I never felt great. Bowels irregular, heart palpitations, etc. One night I awoke with never before over-the-top severe deep cramps in back of both thighs and calves, lasted several minutes. Next day research discovered several people had same on similar diet and based on their experiences I upped potassium, magnesium, water intake and carbs (e.g. brown rice or sweet potato) and doing much better. I'm pondering that Dr Weil's low inflammatory diet may be the most healthy all- around long-term lifestyle. Just haven't gotten to that much whole grain and won't eat that much fish :/
  28. ruby
    Dietetic Student- my research is showing that under the recommended daily allowances for Americans, we have become the fattest and most un-healthy nation in the developed world. We also have the most weight-health related diseases. Diabetes is at an all time high, with warnings of it's increase. As a student, please educate yourself and understand your teachers no do know everything, neither do your textbooks, or even medical professionals. Education of ourselves, when we look at the entire picture, is to explore new avenues when the paths we are on show negative results. To keep doing the same thing, knowing it will not give you positive results, is the opposite of smart and educated. The results show, following the recommended daily allowances are not to the benefit of most Americans, weight or health.

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