Keep in mind that if your crotch begins to have a very unusual smell, whether or not you are on the keto diet, you may want to see your doctor. Don't just tell everyone on Reddit about how much your crotch smells. Regardless of your gender, an unusual smell could be a sign of an infection or some other condition that needs proper medical attention. Even if you don't have a medical problem, your doctor can tell you what kinds of smells are normal and not normal. In other words, he or she could lower your concerns about what's going on in the lower part of your body.
Moreover, recent studies show that the Inuit have evolved a number of rare genetic adaptations that make them especially well suited to eat large amounts of omega-3 fat. And earlier studies showed that the Inuit have a very high frequency—68% to 81% in certain arctic coastal populations—of an extremely rare autosomal recessive mutation of the CPT1A gene—a key regulator of mitochondrial long-chain fatty-acid oxidation—which results in a rare metabolic disorder known as carnitine palmitoyltransferase 1A (CPT1A) deficiency and promotes hypoketotic hypoglycemia—low levels of ketones and low blood sugar. The condition presents symptoms of a fatty acid and ketogenesis disorder. However, it appears highly beneficial to the Inuit as it shunts free fatty acids away from liver cells to brown fat, for thermogenesis. Thus the mutation may help the Inuit stay warm by preferentially burning fatty acids for heat in brown fat cells. In addition to promoting low ketone levels, this disorder also typically results in hepatic encephalopathy (altered mental state due to improper liver function), enlarged liver and high infant mortality. Inuit have been observed to have enlarged livers with an increased capacity for gluconeogenesis, and have greater capacity for excreting urea to remove ammonia, a toxic byproduct of protein breakdown. Ethnographic texts have documented the Inuit's customary habit of snacking frequently  and this may well be a direct consequence of their high prevalence of the CPT1A mutation as fasting, even for several hours, can be deleterious for individuals with that allele, particularly during strenuous exercise. The high frequency of the CPT1A mutation in the Inuit therefore suggests that it is an important adaptation to their low carbohydrate diet and their extreme environment.
Children who discontinue the diet after achieving seizure freedom have about a 20% risk of seizures returning. The length of time until recurrence is highly variable, but averages two years. This risk of recurrence compares with 10% for resective surgery (where part of the brain is removed) and 30–50% for anticonvulsant therapy. Of those who have a recurrence, just over half can regain freedom from seizures either with anticonvulsants or by returning to the ketogenic diet. Recurrence is more likely if, despite seizure freedom, an electroencephalogram shows epileptiform spikes, which indicate epileptic activity in the brain but are below the level that will cause a seizure. Recurrence is also likely if an MRI scan shows focal abnormalities (for example, as in children with tuberous sclerosis). Such children may remain on the diet longer than average, and children with tuberous sclerosis who achieve seizure freedom could remain on the ketogenic diet indefinitely.
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. 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. 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.
The bottom line is that there have not been enough scientific studies, especially longer term ones, to really determine all the potential risks and benefits of the keto diet. Many of the claims out there on the Internet, social media, or television in either direction are anecdotal, meaning that they are individuals telling stories about what has supposedly been their experiences. Take everything you hear that is not supported by scientific evidence with a grain of salt (but not too much salt because too much can be bad for you.)
I just discovered your site and have been thoroughly enjoying many of the articles and appreciate that you get so in depth in your explanations. I’m in my late 40’s and, while not an extreme endurance athlete, I am moderately active with 18-20 mile rides 3x a week as well as some boxing and body weight resistance (push up, pull up, etc) mixed in. I’ve generally been paleo and stick to quality macros for the most part (grass fed meats/dairy, organic veg and oils) and zero supplements. I recently started following keto (after reading this article) about 10 days ago and things seem good thus far. I do, however, want to avoid any of the negative side effects you mention and also not lose any lean muscle. I’m currently about 174 lbs, 5’8″ and about 19% bodyfat – I’m taking in about 95g protein, 130g fat and <20g net carbs. I'm eating all quality – wild salmon, grass fed beef, pastured eggs, coconut oil, Brain Octane and Grass fed butter in coffee, sardines, etc. With a smattering of organic veg, but it seems real easy to bust through the carb barrier. *I'M ALSO TAKING KETOCANA PRE-WORKOUT* and I notice this is keeping me going throughout a ride or the gym.
The ketogenic diet is indicated as an adjunctive (additional) treatment in children and young people with drug-resistant epilepsy. It is approved by national clinical guidelines in Scotland, England, and Wales and reimbursed by nearly all US insurance companies. Children with a focal lesion (a single point of brain abnormality causing the epilepsy) who would make suitable candidates for surgery are more likely to become seizure-free with surgery than with the ketogenic diet. About a third of epilepsy centres that offer the ketogenic diet also offer a dietary therapy to adults. Some clinicians consider the two less restrictive dietary variants—the low glycaemic index treatment and the modified Atkins diet—to be more appropriate for adolescents and adults. A liquid form of the ketogenic diet is particularly easy to prepare for, and well tolerated by, infants on formula and children who are tube-fed.
The ketogenic diet doesn’t put a cap on saturated fat or even trans fats. The latter are fats you should always avoid. Read ingredient labels and avoid any food with partially hydrogenated oils, aka trans fats. These fats heighten your LDL (“bad”) cholesterol levels and lower your HDL (“good”) cholesterol levels. They also raise your risk of heart disease and stroke, according to the American Heart Association.
The DNA test does not necessarily take into account your goals (e.g. breathholding, Ironman, cognition, etc.) and if your goals would benefit from ketosis, then you may want to choose it as a dietary strategy even though it could indeed be true that for FAT LOSS a higher carb intake may suit you. So it all depends on your goals. Or you could just us the supplements like ketones AND eat more carbs and get "best of both worlds".
I am not a doctor and this is not to be taken, interpreted or construed as medical advice. If you have poor liver or gallbladder function, it can be a good idea to take care of that prior to a high fat diet, yes. But a healthy high fat diet would not cause liver issues per se. These are just my own personal thoughts and not a prescription or a diagnosis or any form of health care whatsoever.
The first modern study of fasting as a treatment for epilepsy was in France in 1911. Twenty epilepsy patients of all ages were "detoxified" by consuming a low-calorie vegetarian diet, combined with periods of fasting and purging. Two benefited enormously, but most failed to maintain compliance with the imposed restrictions. The diet improved the patients' mental capabilities, in contrast to their medication, potassium bromide, which dulled the mind.