"Plenty of people jump right in, thinking all they have to do is cut carbs and increase fat. All of a sudden, they hit a wall and get 'keto flu.' They feel tired, lethargic, and experience headaches," Wittrock says. "The primary reason they get these symptoms is lack of the three primary electrolytes: sodium, potassium, and magnesium. If you're deficient in any of these, you'll suffer mentally and physically. This is the single biggest reason people fail on the keto diet."
Implementing the diet can present difficulties for caregivers and the patient due to the time commitment involved in measuring and planning meals. Since any unplanned eating can potentially break the nutritional balance required, some people find the discipline needed to maintain the diet challenging and unpleasant. Some people terminate the diet or switch to a less demanding diet, like the modified Atkins diet (MAD) or the low-glycaemic index treatment (LGIT) diet, because they find the difficulties too great.[41]
It is possible to combine the results of several small studies to produce evidence that is stronger than that available from each study alone—a statistical method known as meta-analysis. One of four such analyses, conducted in 2006, looked at 19 studies on a total of 1,084 patients.[22] It concluded that a third achieved an excellent reduction in seizure frequency and half the patients achieved a good reduction.[3]
In addition to burning fat reserves and super charging weight loss, ketosis produces a clean burning metabolic fuel that has many benefits. Ketones lower production of reactive oxygen species (ROS),1 enhance mitochondrial biogenesis,2 3 and induce positive epigenetic expression.4 Because of its neurological benefits, I went on a Keto Diet in 2014, and it has been helpful in moderating my MS symptoms.
Thanks for the prompt reply! I’ve successfully conquered day two and looking forward to seeing if the keto stix work in my favor on. Monday. I lost a fair amount doing ideal protein but the thought of going back to powdered foods is completely unappealing. I’m so happy to have a plan in place! We had the buffalo wings tonight and oh my gosh (!!!) they were delicious!! My husband wants me to make them again. The recipe couldn’t be more simple. Thank you for sharing your wonderful knowledge and amazing recipes!!!
There are theoretically no restrictions on where the ketogenic diet might be used, and it can cost less than modern anticonvulsants. However, fasting and dietary changes are affected by religious and cultural issues. A culture where food is often prepared by grandparents or hired help means more people must be educated about the diet. When families dine together, sharing the same meal, it can be difficult to separate the child's meal. In many countries, food labelling is not mandatory so calculating the proportions of fat, protein and carbohydrate is difficult. In some countries, it may be hard to find sugar-free forms of medicines and supplements, to purchase an accurate electronic scale, or to afford MCT oils.[53]
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!
The ketogenic diet is a high-fat, adequate-protein, low-carbohydrate diet that in medicine is used primarily to treat difficult-to-control (refractory) epilepsy in children. The diet forces the body to burn fats rather than carbohydrates. Normally, the carbohydrates contained in food are converted into glucose, which is then transported around the body and is particularly important in fueling brain function. However, if there is little carbohydrate in the diet, the liver converts fat into fatty acids and ketone bodies. The ketone bodies pass into the brain and replace glucose as an energy source. An elevated level of ketone bodies in the blood, a state known as ketosis, leads to a reduction in the frequency of epileptic seizures.[1] Almost half of children and young people with epilepsy who have tried some form of this diet saw the number of seizures drop by at least half, and the effect persists even after discontinuing the diet.[2] There is some evidence that adults with epilepsy may benefit from the diet, and that a less strict regimen, such as a modified Atkins diet, is similarly effective.[1] The most common adverse effect is constipation, affecting about 30% of patients—this was due to fluid restriction, which was once a feature of the diet, but this led to increased risk of kidney stones and is no longer considered beneficial.[2][3]
Thank you Mira for your quick reply. I didn’t make it that same day but I just made a batch now and they are excellent! I really enjoyed them. I made the recipe times 10 for 12 large muffin slots in the muffin tin. I’m thinking of shaping a larger round of batter on a parchment lined pan next time and after baking, carefully cutting in half to make 2 rounds to make a pizza crust. Thank you so much!!!
The remaining calories in the keto diet come from protein — about 1 gram (g) per kilogram of body weight, so a 140-pound woman would need about 64 g of protein total. As for carbs: “Every body is different, but most people maintain ketosis with between 20 and 50 g of net carbs per day,” says Mattinson. Total carbohydrates minus fiber equals net carbs, she explains.
There are vegetables that are high in carbs and others low in carbs. The keto diet recommends sticking to the ones low on carbs but encourages you to eat a lot of them. Best vegetables are all green ones to make it easy. And vegetables that grow above the ground (e.g. lettuce) are always better than the ones that grow below the ground (e.g. potatoes)

Following a diet that drastically restricts carbohydrates requires carefully monitoring your food choices to ensure you are meeting your nutritional needs. Working together with a registered dietitian can make sure you follow this diet in a healthy manner without increasing your risk for complications or negative side effects. You can find a registered dietitian at EatRight.org.
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.
But generally speaking, if you plan to follow a ketogenic diet, you should aim to consume less than 10 percent of your total calories from carbohydrates per day. The remaining calories should come from 20 to 30 percent protein and 60 to 80 percent fat. That means if you follow a daily 2,000-calorie diet, no more than 200 of your calories (or 50 grams) should come from carbs, while 400 to 600 calories should come from protein and 1,200 to 1,600 should come from fat. (There’s a reason this plan is also called a high-fat, low-carb diet!)

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.
So excited that after 24hours I’m in Keto, Yea!! I need to know if I can have Chicken salad instead of Tuna salad? I’m allergic to Tuna. I bought Bumble Bee Chicken breast in water. I’m going to continue with your 12 week plan when I’m finished with this 3 day plan. So far everything is so yummy and that makes a huge difference. I’m certain I will like some things more than others but so far I am super happy. I have a fatty liver and am 60lbs overweight but the good news is no damage has started so if I lose the weight I’m sure the liver will get better and I will look and feel better too!
Although many hypotheses have been put forward to explain how the ketogenic diet works, it remains a mystery. Disproven hypotheses include systemic acidosis (high levels of acid in the blood), electrolyte changes and hypoglycaemia (low blood glucose).[18] Although many biochemical changes are known to occur in the brain of a patient on the ketogenic diet, it is not known which of these has an anticonvulsant effect. The lack of understanding in this area is similar to the situation with many anticonvulsant drugs.[55]
Long-term use of the ketogenic diet in children increases the risk of slowed or stunted growth, bone fractures and kidney stones.[3] The diet reduces levels of insulin-like growth factor 1, which is important for childhood growth. Like many anticonvulsant drugs, the ketogenic diet has an adverse effect on bone health. Many factors may be involved such as acidosis and suppressed growth hormone.[37] About 1 in 20 children on the ketogenic diet will develop kidney stones (compared with one in several thousand for the general population). A class of anticonvulsants known as carbonic anhydrase inhibitors (topiramate, zonisamide) are known to increase the risk of kidney stones, but the combination of these anticonvulsants and the ketogenic diet does not appear to elevate the risk above that of the diet alone.[38] The stones are treatable and do not justify discontinuation of the diet.[38] Johns Hopkins Hospital now gives oral potassium citrate supplements to all ketogenic diet patients, resulting in a sevenfold decrease in the incidence of kidney stones.[39] However, this empiric usage has not been tested in a prospective controlled trial.[9] Kidney stone formation (nephrolithiasis) is associated with the diet for four reasons:[38]
Forget the heavy casserole recipes and try this low-carb pot pie tonight! Nothing says comfort food like a chicken pot pie. This low-carb pot pie recipe skips the traditional gluten-filled dough of chicken pot pies and replaces it with cauliflower for a more low-carb option. I simply suggest switching out the cornstarch with arrowroot or tapioca starch.

About 20% of children on the ketogenic diet achieve freedom from seizures, and many are able to reduce the use of anticonvulsant drugs or eliminate them altogether.[3] Commonly, at around two years on the diet, or after six months of being seizure-free, the diet may be gradually discontinued over two or three months. This is done by lowering the ketogenic ratio until urinary ketosis is no longer detected, and then lifting all calorie restrictions.[45] This timing and method of discontinuation mimics that of anticonvulsant drug therapy in children, where the child has become seizure free. When the diet is required to treat certain metabolic diseases, the duration will be longer. The total diet duration is up to the treating ketogenic diet team and parents; durations up to 12 years have been studied and found beneficial.[9]

Question 2: Half of my family, including me, cannot do spicy. Now when I say spicy, Mild Rotel is spicy to us. So, can you suggest a comparable substitute? For instance, your Classic Buffalo Wings sound absolutely delicious but Frank’s Hot Sauce is way too spicy. When we make wings we usually make them sweet and not spicy. But also in other recipes, spicy spices are utilized so I wondered if there is a comparable spice to use? Again, if you have already addressed this topic, please just point me in the right direction and I will educate myself.

Anticonvulsants suppress epileptic seizures, but they neither cure nor prevent the development of seizure susceptibility. The development of epilepsy (epileptogenesis) is a process that is poorly understood. A few anticonvulsants (valproate, levetiracetam and benzodiazepines) have shown antiepileptogenic properties in animal models of epileptogenesis. However, no anticonvulsant has ever achieved this in a clinical trial in humans. The ketogenic diet has been found to have antiepileptogenic properties in rats.[55]
Patty, Atkins puts in suggestions, like their own products, which are processed foods. The main plan is great and you can easily do it without processed foods! They emphasize fresh veggies and whole fat foods. Easy to use both these plans in conjunction. It’s what I’m doing. I eat almost all organic, whole foods. I’m going to try this ketogenic kick to see if I can break my stall.
This was delicious! It will be my new go to easy dinner from now on. I did make a couple of changes though. I swapped the pickles out for jalapenos, doubled the bacon, and added a dollop of Primal Kitchens chipotle lime mayo on top of my serving along with some hot sauce and it was perfect! It reminded me a lot of In-n-Outs animal style cheeseburger.
Because the ketogenic diet alters the body's metabolism, it is a first-line therapy in children with certain congenital metabolic diseases such as pyruvate dehydrogenase (E1) deficiency and glucose transporter 1 deficiency syndrome,[34] which prevent the body from using carbohydrates as fuel, leading to a dependency on ketone bodies. The ketogenic diet is beneficial in treating the seizures and some other symptoms in these diseases and is an absolute indication.[35] On the other hand, it is absolutely contraindicated in the treatment of other diseases such as pyruvate carboxylase deficiency, porphyria and other rare genetic disorders of fat metabolism.[9] A person with a disorder of fatty acid oxidation is unable to metabolise fatty acids, which replace carbohydrates as the major energy source on the diet. On the ketogenic diet, their body would consume its own protein stores for fuel, leading to ketoacidosis, and eventually coma and death.[36]
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.
"Plenty of people jump right in, thinking all they have to do is cut carbs and increase fat. All of a sudden, they hit a wall and get 'keto flu.' They feel tired, lethargic, and experience headaches," Wittrock says. "The primary reason they get these symptoms is lack of the three primary electrolytes: sodium, potassium, and magnesium. If you're deficient in any of these, you'll suffer mentally and physically. This is the single biggest reason people fail on the keto diet."
Here are a few of the most common side effects that I come across when people first start keto. Frequently the issues relate to dehydration or lack of micronutrients (vitamins) in the body. Make sure that you’re drinking enough water (close to a gallon a day) and eating foods with good sources of micronutrients. To read more on micronutrients, click here >
You’ll need to eat plenty of avocado, coconut, olive oil, beef, chicken, low starch veggies, etc. Strict Paleo avoids both dairy and soy products – I’d start there and eliminate some of the carbs they allow and you should find plenty of recipes you can use for ketosis. Also try the Whole 30 which isn’t keto but eliminates dairy, soy and a few other common allergens and I lose weight on it every time even when I’m not in ketosis. Hope that helps and that you find something that works for you!
Mellissa, I didn’t read through all the comments … just half :) Wondering if this will work for someone who’s a diet controlled diabetic? The nutritionist said I should have 45 carb meals and 20 carb snacks … I’ve been gaining weight steadily BUT my blood sugars are awesome! I’m working with a double edge sword here. My biggest issue (other than always feeling bloated) is I have to have a good, hefty snack at midnight each night to keep my blood sugars within range in the morning. Needless to say my waistline no longer exists … buy hey … my blood sugars are good. *rolling eyes*
Someone posted Dr. Wortman’s interview on facebook. Very good, especially b/c I was on the right track without knowledge of Dr. Wortman or of the ketogenic diet. However, I was still eating a small amount of bread. My diabetes has improved since eating healthier, as he recommends. I’ve been at it now for 8 months (diagnosed w/type 2 Dec 8, 2011). For the past 3 days I have had no bread. We will see how much that helps. All I can say is ‘bravo’ to the ketogenic diet!
You’ll need to eat plenty of avocado, coconut, olive oil, beef, chicken, low starch veggies, etc. Strict Paleo avoids both dairy and soy products – I’d start there and eliminate some of the carbs they allow and you should find plenty of recipes you can use for ketosis. Also try the Whole 30 which isn’t keto but eliminates dairy, soy and a few other common allergens and I lose weight on it every time even when I’m not in ketosis. Hope that helps and that you find something that works for you!
The ketogenic diet is usually initiated in combination with the patient's existing anticonvulsant regimen, though patients may be weaned off anticonvulsants if the diet is successful. There is some evidence of synergistic benefits when the diet is combined with the vagus nerve stimulator or with the drug zonisamide, and that the diet may be less successful in children receiving phenobarbital.[3]

Thank you! Yea, no bread/pasta for me, by all accounts I was eating a (what I thought and what everyone would tell me, even a dietician I went to!) ‘healthy’ diet of whole grains, rice, fruit, vegetables, low fat, etc. and couldn’t understand why I was steadily gaining weight. That’s what led me here, as I was getting so frustrated and the more I read up on low carb/ketosis and how the body processes even conventionally healthy foods, it made sense to me, but I don’t think I can give up oatmeal and fruit forever! So I will definitely just make sure I only eat those in small amounts, but that is much farther down the road anyway.. I’m on to Week 1 and I’ll post an update at the end of the week. Thanks again!
I’m so excited to have come across your site!! You’ve seriously done so much work and I appreciate it! I’m researching this keto life and plan to jump in once we are back from vacation for a lifestyle change for myself and my husband too! Looking forward to learning more and loving your meal plans! Glad to see 12 weeks! I know I won’t get bored! Thanks so much!

Option 3: "Make your own keto 'lunchable' with cubes of grilled chicken, a slice of nitrate-free ham, cheese cubes, pickle slices, a hard-boiled egg, a few raw grape tomatoes, raw veggies like cauliflower or broccoli, a few almonds or walnuts, guacamole, and ranch dressing," says Stefanski. (Looking for something meat-free? Here are 29 Vegetarian Keto Recipes for Plant-Based Eaters.)
Forget the heavy casserole recipes and try this low-carb pot pie tonight! Nothing says comfort food like a chicken pot pie. This low-carb pot pie recipe skips the traditional gluten-filled dough of chicken pot pies and replaces it with cauliflower for a more low-carb option. I simply suggest switching out the cornstarch with arrowroot or tapioca starch.
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.”
First off I just want to say thank you for the 3 day meal plan to get started. I stumbled across Keto about a week ago and I have been reading and reading and reading and then essentially got super confused and though that this was not for me! But then I came across your website and my my you break it down for people like me who are just looking for guidance to get started. I am hoping to start soon as I do go on a business trip begging of next week and I am afraid to start and then boom off the band wagon. My goal is to start next Thursday…..(fingers crossed this works) everything else has failed and dieting has been a struggle since I had a hysterectomy due to cancer. Now my weight is out of control and I am the biggest I have ever been! 251 pounds and I am 5′ 2″ and none of my clothes fit!! Makes it hard to get excited in the morning when getting ready to endure the day!
The brain is composed of a network of neurons that transmit signals by propagating nerve impulses. The propagation of this impulse from one neuron to another is typically controlled by neurotransmitters, though there are also electrical pathways between some neurons. Neurotransmitters can inhibit impulse firing (primarily done by γ-aminobutyric acid, or GABA) or they can excite the neuron into firing (primarily done by glutamate). A neuron that releases inhibitory neurotransmitters from its terminals is called an inhibitory neuron, while one that releases excitatory neurotransmitters is an excitatory neuron. When the normal balance between inhibition and excitation is significantly disrupted in all or part of the brain, a seizure can occur. The GABA system is an important target for anticonvulsant drugs, since seizures may be discouraged by increasing GABA synthesis, decreasing its breakdown, or enhancing its effect on neurons.[7]
Hi Cyn, The numbers are general guidelines but will vary depending on many factors, such as activity level, insulin resistance, weight and more. There is no single magic number, just conventional recommendations that are a good starting point. I will have a macro calculator coming soon that will help determine what is best for each person, but even then it’s an approximation. The only way to know for sure is to test. If keto is your goal, it’s usually best to start lower and then see if you can stay in ketosis when increasing.
Yancy WS Jr, Westman EC, McDuffie JR, Grambow SC, Jeffreys AS, Bolton J, Chalecki A, Oddone EZ, “A randomized trial of a low-carbohydrate diet vs orlistat plus a lowfat diet for weight loss,” Arch Intern Med. 2010 Jan 25;170(2):136-45. http://www.ncbi.nlm.nih.gov/pubmed/20101008?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum&ordinalpos=2.
Hi Mellissa. I am starting your 3 day kick start menu today (again) and was wondering, how do you calculate the carbs in sugar free syrup (with the LC pancakes)? Do you subtract the sugar alcohols the same as you do fiber? I’ve added about 1 Tbsp. to the pancakes but if I don’t subtract the sugar alcohols, it would be around 14 carbs! Help? Thank you!
Inducing ketosis – a natural state for the body, when it is almost completely fuelled by fat – in therapeutic diets is a skill that needs the close supervision of a dietitian in a specialist clinic. This is because the diet is not balanced and can easily lead to nutrient deficiencies, nausea, vomiting, headache, tiredness, dizziness, insomnia, poor exercise tolerance and constipation – sometimes referred to as keto flu.
Because people with type 2 diabetes are at an increased risk for cardiovascular disease, there’s a specific concern that the saturated fat in the diet may drive up LDL, or “bad,” cholesterol levels, and further increase the odds of heart problems. If you have type 2 diabetes, talk to your doctor before attempting a ketogenic diet. They may recommend a different weight-loss diet for you, like a reduced-calorie diet, to manage diabetes. Those with epilepsy should also consult their doctor before using this as part of their treatment plan.
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