Adverse Reactions to Ketogenic Diets: Caution Advised

Adverse Reactions to Ketogenic Diets

As the list of health conditions that may be at least partially alleviated by ketogenic diets increase (and which currently includes epilepsy, Alzheimer’s, Parkinson’s, Autism, traumatic brain injury, bipolar disease, PCOS, cancer, obesity, and diabetes), so too does a body of literature pointing to common side effects and potential adverse reactions.

Adverse reactions to a ketogenic diet have been reported in the scientific literature. Yes, even including well-designed clinical trials performed and published very recently.  In fact, the intolerability of side effects and adverse reactions is the primary reason for trial participants to drop out of clinical trials (other reasons for trial drop-outs include ineffectiveness of the diet, and that the diet is too hard to follow).

Adverse reactions are not the same thing as side effects.  An adverse reaction is an, unwanted/unexpected and dangerous reaction to a therapeutic agent.  In contrast, a side effect is a secondary, typically undesirable effect of a therapeutic agent.  More simplistically, side effects are minor and adverse reactions are not. Side effects are typically what are reported in shorter-term studies, where as both side effects and adverse reactions are reported in the long-term ketogenic dietstudies (typically 6 months to 2 years, but any study that allows for keto-adaptation, which takes up to a month, can be considered long-term).  This article is not a discussion regarding side effects, the list of which has some overlap with the list of adverse reactions (for example common side effects include minor gastrointestinal symptoms).  This article is to draw attention to the documented adverse reactions, which include:

  • Gastrointestinal disturbances (diarrhea, vomiting, nausea, constipation, GER)
  • Inflammation risk
  • Thinning hair/hair loss

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