You can have a completely smooth transition into ketosis, or…not. While your body is adapting to using ketones as your new fuel source, you may experience a range of uncomfortable short-term symptoms. These symptoms are referred to as “the keto flu.” Low-sodium levels are often to blame for symptoms keto flu, since the kidneys secrete more sodium when you’re in ketosis, says Volek. A few side effects:
For people with diabetes, rapidly rising ketone levels can signal a health crisis that requires immediate medical attention. When there is an absence or not enough of the hormone insulin (or the body is too resistant to insulin to allow it to drive glucose into the cells for energy), the body cannot use glucose for fuel. Insulin helps ferry glucose to our cells and muscles for energy. Instead, in this case, the body resorts to burning stored fat for energy through the process of ketosis, leading to a buildup of ketones in the body.

Cyclical ketogenic diet: The Bulletproof Diet falls into this category. You eat high fat, low carb (less than 50 grams of net carbs a day) five to six days of the week. On day seven, you up your carb intake to roughly 150 grams, during what’s called a carb refeed day. Carb cycling this way helps you avoid the negative effects some people experience when they restrict carbs long term, like thyroid issues, fatigue and dry eyes.[10] [11] Full ketosis isn’t for everyone, and adding carbs such as sweet potatoes, squash, and white rice one day a week keeps your body systems that need some amount of carbs functioning properly.
Now, what should you eat? There are endless combinations of food and it really depends on your personal preference. I put together a simple 3 day keto menu plan to get you started. This is what works for me, and because my body knows the drill, I can actually get back into ketosis in less than 2 days on this plan. If you are new to low carb, it may take you as long as 4 to 5 days. Don’t despair, it will happen.
Today is day one! Breakfast was delicious. So happy I found your blog and thank you for the recipes and especially the shopping list! You’ve left me with no excuses and actually a little bit excited to begin this 21 day adventure. This is huge. I’ve done Paleo before, felt good, but it didn’t last long term. My body needs to be low carb, no sugar, so again, thank you.
The Johns Hopkins Hospital protocol for initiating the ketogenic diet has been widely adopted.[42] It involves a consultation with the patient and their caregivers and, later, a short hospital admission.[18] Because of the risk of complications during ketogenic diet initiation, most centres begin the diet under close medical supervision in the hospital.[9]
Kale, mushrooms, onions, etc all have a surprising amount of carbs, but aren’t included in this three day kickstart. The weekly menu plans have specific serving sizes but it’s not necessary in this three day kickstart if you eat on plan and don’t deviate – as proven by the hundreds if not thousands of people who have had success with it. If you follow the three day kickstart as written you will get into ketosis.
I am a type 1 diabetic of 57 years. I am my doctor’s only patient that has had this disease this long with no diabetic problems. My A1C average is 7.0. My experience with eating a Keto diet is my blood glucose goes very high when eating more fat. I got no help from doctor, so I learned by trial and error to take more insulin for the among of fat I eat. I have it down to a percentage. If eating 6 carbs for breakfast and 18g of fat, I divide 30% into the 18g of fat, which will be 6. I add the 6 with the 6 carbs and I take 12 units of insulin for my breakfast. Not only do we need to take insulin for the carbs we eat, but also for the fat when eating the amount you should consume on a Keto diet. I have been using My Fitness Pal for 9 years to document everything I eat, keeping up with the total calories, carbs, fat, sodium, protein and sugar.
I too started Atkins years ago- back in the ‘80’s. I did well as long as i stuck to it. But, it’s a tough road and restaurants and snack food companies are not very low carb friendly. It’s all too easy for me to grab something quick & the donuts in the break room do me in everytime!!! I read your post this morning & It inspired me. I also am 57 and have been discouraged lately with my weight and lack of ability to stay away from carbs. But, I am going at it again – and this time with a vengeance. Thanks again for your post – very inspiring & appreciated. By the way – I found that Mellissa’s website the best for keto. Her recipes are simply delicious and not over complicated or time consuming. She also has a great sense of humor. It’s nice to know she goes through the same trials we do – and what it’s like to mess up !! !!. Thank you Mellissa for your articles, recipes, humor and your perseverance!!
The ketogenic diet—also known as "keto"—has become the latest big thing in weight-loss plans, touted recently by celebs like Jenna Jameson, Mama June, and Halle Berry. The diet involves cutting way back on carbohydrates, to 50 grams a day or less, to help the body achieve a state of ketosis, in which it has to burn fat (rather than sugar) for energy.
For any individual with diabetes, discussing dietary changes — especially those as dramatic as the ones the ketogenic diet requires — with your healthcare team is essential. Because carbohydrates are broken down into glucose in the blood, cutting carbohydrates from your diet could cause levels to crash rapidly depending on your current medication regimen. Such a change may require significant adjustments to medication and insulin to prevent dangerous side effects such as low blood sugar, called hypoglycemia. (8)
UPDATE: Hi! It’s been 4 weeks already. I am still cooking keto and enjoying many delicious dessert too! I have finally convinced my husband to totally convert to keto food. It’s only been one week since he stopped using diet package food. He is very happy with the food he get to eat and still losing weight but much slower pace this week. That’s because I have been giving him larger portions as this is the first week for him. Since he was already on low carb diet prior to this, keto flue may be not as bad but still want to keep him happy and better transition experience. Meanwhile, I get to cook keto for the whole family and really enjoying the new way of eating and cooking. I have lost total of 6 lb but that was enough to prove to my husband eating bacon and butter is ok as long as we are on keto diet. I was only doing this to convert my husband since he doesn’t have any interest in nutrition or theory behind it, so what he sees is what he believes. 6 lb may not sounds a lot for 4 weeks but I was already below average weight , so it was a lot of loss for me. I think it’s a science 5-30-65 combination works on everyone. Now I just eat more portions of everything ,so we can still eat same food. Today, he had a once a week appointment with his ideal protein dietitian. Seems like they are not convinced that he can still continue to lose weight unless he eat their packaged food. I plan to continue sending him there for once a week appointment , so he sill have something to be accountable for. Next few weeks, I’m hoping he won’t be as hungry so I can start portion control his food without his knowledge, LOL.
That’s why many health experts are concerned about people on the keto diet, especially those who try it without the guidance of a doctor or nutritionist. Doctors say that high-fat diets like this one may raise cholesterol levels, and some studies suggest that they increase the risk of diabetes. Some have even called it a “cardiologist’s nightmare.”
As a note, you do need to check the carbohydrate content of everything you eat, especially processed foods such as sausages, cheeses and sauces. There could be hidden carbs in the products used to preserve or “pad out” these foods, so make sure you are buying the lowest carb options and counting the carbs they do contain to ensure you don’t go over your daily limit.
When in the hospital, glucose levels are checked several times daily and the patient is monitored for signs of symptomatic ketosis (which can be treated with a small quantity of orange juice). Lack of energy and lethargy are common but disappear within two weeks.[17] The parents attend classes over the first three full days, which cover nutrition, managing the diet, preparing meals, avoiding sugar and handling illness.[18] The level of parental education and commitment required is higher than with medication.[43]
My husband and I started Ideal Protein last July and had lost about 60 pounds each by November. We decided to take a break for the holidays, and unfortunately, our holidays are still going. Like you mentioned, we both have 10 to 15 pounds we keep gaining and losing, and we can’t seem to get back the momentum we had last fall. I am so excited about your meal plans! I think we could actually be satisfied enough to stick to these plans and get back on track. They look really tasty, and I love how the ingredients are pretty easy to find. Thank you for your time and effort!

So, in regards to #9….(guys, look away now) I have been keto for about a month and a half now. Shark week came and went as normal….Normally if I even get cramps, it’s for the first day or two of my period and they are never that bad. About a week later I started getting really really bad cramps…to the point they were waking me up in the middle of the night. Someone suggested constipation but I didn’t think that was it because I was still going…just not as much, which is normal on a keto/paleo plan. 9 days after my normal period ended, I started again and it was just like the previous when it came to flow. After the first 5 days which is when it should have ended, it started getting heavier and has stayed that way since. I am now on day 13 of this second period with no indication of an end in sight. I have not had this experience in years and that was due to birth control that I was taking at the time. I am miserable and in more pain than I have ever experienced. I have energy thanks to the keto but I am in far too much pain to even think about working out and it sucks! I know you said you went thru some irregularity yourself but was it anything like this? Do you know people that have experienced this? I have tried searching the web but everything that pops up talks about their periods disappearing or getting 2 in one month at most, not what I am experiencing which is probably going to be closer to a month before I end.
The first signs of ketosis are known as the “keto flu” where headaches, brain fogginess, fatigue, and the like can really rile your body up. Make sure that you’re drinking plenty of waterand eating plenty of salt. The ketogenic diet is a natural diuretic and you’ll be peeing more than normal. Take into account that you’re peeing out electrolytes, and you can guess that you’ll be having a thumping headache in no time. Keeping your salt intake and water intake high enough is very important, allowing your body to re-hydrate and re-supply your electrolytes. Doing this will help with the headaches, if not get rid of them completely.
Getting control of your diet is the first and most important step towards lasting health and weight loss. Low carb recipes like these will give you a good blueprint to move forward with permanent changes to the way you eat that will improve your life and health. When filled with healthy, whole foods that are low in carbs and prepared deliciously, the keto diet is an amazing way to create a lasting, positive difference in your life!
Hi Gigi, Low carb and keto is about the balance of macronutrients eaten (fat, protein and carbs), not specifically meat or lack thereof. Most people on keto do eat meat, though some people do vegetarian keto. Fat is actually necessary for many body processes. There is no issue for the kidneys with a high fat diet, but if you eat too much protein that isn’t great for the kidneys. It’s a common misconception that keto is high protein (it isn’t). Keto is great for diabetics as it naturally helps stabilize insulin. All of this being said, please know I’m not a doctor and you should consult your doctor on any medical questions or before starting any diet. If you have more questions that aren’t medical questions, I recommend our low carb & keto support group here.
Today is day one! Breakfast was delicious. So happy I found your blog and thank you for the recipes and especially the shopping list! You’ve left me with no excuses and actually a little bit excited to begin this 21 day adventure. This is huge. I’ve done Paleo before, felt good, but it didn’t last long term. My body needs to be low carb, no sugar, so again, thank you.

Made this for the first time tonight, excellent! I read the comments before I started so I knew to beat the eggs well and drain the beef. Thank you to everyone who commented! I didn’t use pickles, instead I put a few dots of sweet relish on top of the beef/bacon layer then spread them out a bit. Not so keto friendly but there isn’t much in a portion and it’s much quicker than dealing with pickles. Hubby asked me what I thought of it as he went for seconds. I quite enjoyed this and he did too! I had much more beef than called for, I used all 3 eggs and beat them well before the whipping cream and yellow mustard went in.There was no eggy taste. I will definitely make this again!
2 years ago I cut suger out of my diet and lowered my carbs. went from 230 down to 192, then I wasn’t so good about being careful and creeped back upto 207 and wasn’t a happy camper about it, but was having problems being good with a bunch of personal & work chaos going on. so a few days ago I really started looking at keto once again, now I’m back at 199 and looking forward to working through the keto flu, god I hate headaches but the scale is telling me to keep going

The researchers agree that the diet itself isn’t inherently dangerous. But, cautions Weiss, “If you have any medical condition, if you take any medicine at all – there are lots of things that change how medicines work in our bodies, and nutrition is definitely one of them. If you’re making a real change in your nutrition, you really should talk to your doctor.”
As I understand intermittent fasting, the long period between my early dinner at 6 pm and breakfast at about 8:30 am qualifies. As a past yoga instructor, fasting was something that we were encouraged to do regularly as well as cleansing. I feel so frustrated and helpless at not being able to make any difference no matter what I’ve tried. I am very disciplined and cheating is not an option.

It’s important to remember that the goal of any dietary change is to promote a healthy lifestyle, so make sure to select a meal plan you can envision yourself following long term. If you know you will not be able to comply with such stringent carbohydrate restrictions for years to come, the ketogenic diet is most likely not the right choice for you.


There are three instances where there’s research to back up a ketogenic diet, including to help control type 2 diabetes, as part of epilepsy treatment, or for weight loss, says Mattinson. “In terms of diabetes, there is some promising research showing that the ketogenic diet may improve glycemic control. It may cause a reduction in A1C — a key test for diabetes that measures a person’s average blood sugar control over two to three months — something that may help you reduce medication use,” she says.
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