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There are a few ways of pushing your body into ketosis, including sustained periods of fasting and following a ketogenic diet (as the name so obviously suggests).  Dr. D’Agostino also suggests spending some time in the sun and heat.  Getting out in the sun lowers glucose and raises ketones, and can push you into ketosis, especially if you’ve been fasting.


Short-term results for the LGIT indicate that at one month approximately half of the patients experience a greater than 50% reduction in seizure frequency, with overall figures approaching that of the ketogenic diet. The data (coming from one centre's experience with 76 children up to the year 2009) also indicate fewer side effects than the ketogenic diet and that it is better tolerated, with more palatable meals.[18][50]
Early studies reported high success rates; in one study in 1925, 60% of patients became seizure-free, and another 35% of patients had a 50% reduction in seizure frequency. These studies generally examined a cohort of patients recently treated by the physician (a retrospective study) and selected patients who had successfully maintained the dietary restrictions. However, these studies are difficult to compare to modern trials. One reason is that these older trials suffered from selection bias, as they excluded patients who were unable to start or maintain the diet and thereby selected from patients who would generate better results. In an attempt to control for this bias, modern study design prefers a prospective cohort (the patients in the study are chosen before therapy begins) in which the results are presented for all patients regardless of whether they started or completed the treatment (known as intent-to-treat analysis).[19]
The ketogenic diet is a mainstream dietary therapy that was developed to reproduce the success and remove the limitations of the non-mainstream use of fasting to treat epilepsy.[Note 2] Although popular in the 1920s and '30s, it was largely abandoned in favour of new anticonvulsant drugs.[1] Most individuals with epilepsy can successfully control their seizures with medication. However, 20–30% fail to achieve such control despite trying a number of different drugs.[9] For this group, and for children in particular, the diet has once again found a role in epilepsy management.[1][10]
It also means that if you’re a very active athlete or exercise enthusiast and you’re following “trickle-down” advice from the sedentary or less active ketosis experts to eat less than 40g of carbs per day, you’re making a big mistake when it comes to your hormonal balance, and you need to up your carbohydrate intake to 100-200g of carbs per day. You’d be surprised at how easy it is (if you’re a very active person) to stay in ketosis on this level of carbohydrate intake. Go ahead. Do Ketonix breath testing to prove me wrong. You can eat boatloads of carbohydrates at night and be back in ketosis within just two to three hours. When you combine that with the cutting-edge tricks you’re about to learn, you’ll find that you can toss hormonal issues out the window, get into ketosis, have your cake, and eat it too. Literally.
It’s also important to note there have been no long-term studies on the ketogenic diet, nor has there been research that details what may happen to the body if it’s in a constant state of ketosis itself. But given how the body needs carbs to function properly, diets that are based on fat burning may lead to nutritional deficiencies, and supplements and multivitamins are recommended because you’re cutting out entire food groups, warns Alyssa Rothschild, RDN, who is in private practice in New York City.
I started a ketogenic diet about 5 weeks ago and have experimented with KetoCaNa and KetoForce along with Now Foods MCT oil (which is made of caprylic and capric acid) in the hopes of easing the transition into ketosis. I don’t use it every day, but often before an aerobic based workout. I was wondering if taking these exogenous ketones at the beginning of a ketogenic diet helps you become keto adapted by up regulating the body’s handling of ketones. And conversely, does taking exogenous ketones down regulate or affect lypolysis since BHB is readily available? My main priority at this point is fat loss.

I'm at 240 now and actually weigh less than I did in high school. Have a decent amount of excess skin that skews my actual weight. Thankfully the government of Canada pays for plastic surgery in my case because it could lead to health problems in the future. Surgery is in about 8 or so months and I'm quite excited to start a completely new chapter of my life once it's done.
A study in the Journal of Applied Physiology showed that people who do twice-a-day workouts, but defy standard nutrition recommendations by not eating for two hours after the first session (thus depleting carbohydrate stores with the first session) experienced a better ability to burn fat (with no loss in performance) compared with a group that trained only once a day and ate carbohydrates afterward.
Hi Ben – Great article. I had trouble at the end figuring out if you were now eating high fat (60-80% of calories), or if you went back to something closer to 50% fat calories and higher carbs and are using exogenous ketones to get int ketosis when needed. Are you doing any carbs at night or a refeed, or just having higher carbs on most days? Thanks
Thanks so much for the reply! One more question about the LivingFuel SuperGreens…I had very bad GI issues with VEGA Protein in 2011 when I tried it (quit after half a container), which scared me away from the vegetarian proteins with greens in them. Is this drastically different from VEGA? Or seeing that pea is the primary source of protein should I look towards something else? Thanks again!

In many developing countries, the ketogenic diet is expensive because dairy fats and meat are more expensive than grain, fruit and vegetables. The modified Atkins diet has been proposed as a lower-cost alternative for those countries; the slightly more expensive food bill can be offset by a reduction in pharmaceutical costs if the diet is successful. The modified Atkins diet is less complex to explain and prepare and requires less support from a dietitian.[55]

After initiation, the child regularly visits the hospital outpatient clinic where they are seen by the dietitian and neurologist, and various tests and examinations are performed. These are held every three months for the first year and then every six months thereafter. Infants under one year old are seen more frequently, with the initial visit held after just two to four weeks.[9] A period of minor adjustments is necessary to ensure consistent ketosis is maintained and to better adapt the meal plans to the patient. This fine-tuning is typically done over the telephone with the hospital dietitian[19] and includes changing the number of calories, altering the ketogenic ratio, or adding some MCT or coconut oils to a classic diet.[18] Urinary ketone levels are checked daily to detect whether ketosis has been achieved and to confirm that the patient is following the diet, though the level of ketones does not correlate with an anticonvulsant effect.[19] This is performed using ketone test strips containing nitroprusside, which change colour from buff-pink to maroon in the presence of acetoacetate (one of the three ketone bodies).[45]


If you’re following the keto diet, you will need protein, but you should limit your intake to about 20 percent of your total daily calories. (1) This is important because when you consume more protein than you need, your body converts the excess protein into carbs through a process called gluconeogenesis. This process pushes your body out of ketosis.
I've been on the diet for about a month and a half now and I've noticed that my vaginal odors have gotten MUCH stronger... (It smells like a mix between urine and discharge... I'm not exactly sure how vaginas are 'supposed' to smell like. Many say 'musky' but I feel like that's too mild of a word... It's much stronger than 'musk' for me :/ ). My discharge is white in color and it doesn't smell fishy. Sometimes when it dries on my underwear it's a light yellow? Has this happened to anyone before? Is it because of my change in diet (if so, can anybody explain why?), or could it be something else?
Hi Ben great science & sound advice. May I share with the group? I’m 42, in australia, have been an alcoholic for 10 yrs. In April 2016 I gave up drinking & started living strictly ketogenic. In 3 months I dropped 25 kilos. I have cheated on weekends but I go through a fast of sorts on Mondays to get back into ketosis by Tues. I work afternoon / evenings so I wake at 10.30am take a pre workout drink with raspberry ketones & a splash of mct oil & all my vitamins as well. I then do weights for an hr then get ready to go to work. I take 2 800ml protein shakes consisting of 20 ml mct & 30grm amino enhanced protein. I work in warehousing so I walk anywhere between 10 km & 5 km a nite. I feel great all the time, thanks largely to your research & advice. If have any thoughts or opinions I’d love hear them.
Putting — and then keeping — your body in ketosis isn’t exactly easy. You’ll need to severely minimize your intake of carbohydrates, eating no more than 20 to 50 grams (g) of carbs per day to get there and stay there. A single medium pear, for example, contains 26 g of carbs, and even foods that aren’t generally considered high in carbs — such as nuts and nonstarchy veggies — contain a small amount of carbohydrates, and so will need to be limited or avoided on this plan.
After reading the article I shopped around and I noticed there are types of MCT oil that are derived from Palm Oil and are considerably less expensive. (http://prototypenutrition.com/keto8.html ) There is a litany of research that says that Palm Oil is on the same level a High Fructose Corn Syrup when it comes to your body. Is this true for MCT oil made from Palm Oil? Is Coconut derived superior to Palm Oil or a blend of the two?
The addition of MCT powder to ketones serves the purpose of maintaining endogenous production of ketone bodies by stimulating fatty acid oxidation in the liver, which then causes the production of even more ketone bodies. In this transcript from a podcast with Dr. Dom D’Agostino it is mentioned that MCT’s cross the blood-brain barrier straight to the brain. So not only are the ketones being used by the brain as an alternative fuel but so are MCT’s.
“To achieve the relatively high rates of intake (up to 90 grams/hour) needed to optimize results in events lasting longer than three hours, athletes should practice consuming carbohydrates during training to develop an individual strategy, and should make use of sport foods and drinks containing carbohydrate combinations that will maximize absorption from the gut and minimize gastrointestinal disturbances.”
Net carbs are what we track when following a ketogenic diet. This calculation is pretty straightforward. Net Carbs = Total Carbs – Fiber. For example, one cup of broccoli has 6g of total carbs and 2.4g of fiber. That would mean one cup of broccoli has 3.6g of net carbs. We count Net Carbs  because dietary fiber does not have a significant metabolic effect. 

^ Lawrie 2014, pp. 92-. "A much delayed onset of rigor mortis has been observed in the muscle of the whale (Marsh, 1952b). The ATP level and the pH may remain at their high in vivo values for as much as 24h at 37ºC. No adequate explanation of this phenomenon has yet been given; but the low basal metabolic rate of whale muscle (Benedict, 1958), in combination with the high content of oxymyoglobin in vivo (cf 4.3.1), may permit aerobic metabolism to continue slowly for some time after the death of the animal, whereby ATP levels can be maintained sufficiently to delay the union of actin and myosin in rigor mortis."


I'm constantly on the lookout for low-carb diet and ketosis friendly option that allow hard charging athletes, especially athletes who have glycolytic, high-intensity demands during sport, to get a “slow bleed” of carbohydrate into their body. For example, “UCAN Superstarch” is one such option, but, unfortunately, I've found that many athletes and exercise enthusiasts tend to get gastric distress or excessive fermentation from that slow-release starch.
“Given that there is no known detriment to consumption of a high-carbohydrate diet (other than body weight gain due to water retention) and some research reports a benefit, it is recommended that all athletes consume a high-carbohydrate training diet, i.e., at least 60-70% of energy as carbohydrate (7-10 g/kg), and increase this to 65-85% for the few days before competition. Use of a carbohydrate supplement before and during exercise will likely improve performance of intermittent, high-intensity sprints.”
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 presence of abnormally high levels of KETONES in the blood. These are produced when fats are used as fuel in the absence of carbohydrate or available protein as in DIABETES or starvation. Ketosis is dangerous because high levels make the blood abnormally acid and there is loss of water, sodium and potassium and a major biochemical upset with nausea, vomiting, abdominal pain, confusion, and, if the condition is not rapidly treated, coma and death. Mild ketosis also occurs in cases of excessive morning sickness in pregnancy.
I will begin a medically supervised weight loss program on Tuesday, that is intended to put me into ketosis via a very low calorie, high protein diet of shakes for two meals per day and one (controlled) regular meal. The overview of the program says to expect up to 2 weeks of foggyness and crankiness while getting in to ketosis. Will taking KetoCaNa 3 times a day for two days in advance of starting the diet (and during the introduction to the diet) help move me more quickly through the foggy, cranky phase? And should I also be eating (a ketogenic diet) during those two days or only drinking the KetoCaNa? My thanks in advance for any light you can shed on this!

The first modern study of fasting as a treatment for epilepsy was in France in 1911.[12] 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.[13]

You said you saw Dr. Jeff Volek at UCONN. I am interested in ketosis to help me with my M.S. I still have questions related to M.S. and not so much as it effects on athletes. I do live in CT, but was unable to locate Dr. Volek at either the Storres or Farmington campus. Would you be able to give me either his e-mail address or telephone number so that I can contact him directly? Your help would be greatly appreciated.


^ Freeman JM, Vining EP, Pillas DJ, Pyzik PL, Casey JC, Kelly LM. The efficacy of the ketogenic diet—1998: a prospective evaluation of intervention in 150 children. Pediatrics. 1998 Dec;102(6):1358–63. doi:10.1542/peds.102.6.1358. PMID 9832569. https://web.archive.org/web/20040629224858/http://www.hopkinsmedicine.org/press/1998/DECEMBER/981207.HTM Lay summary]—JHMI Office of Communications and Public Affairs. Updated 7 December 1998. Cited 6 March 2008.
Putting — and then keeping — your body in ketosis isn’t exactly easy. You’ll need to severely minimize your intake of carbohydrates, eating no more than 20 to 50 grams (g) of carbs per day to get there and stay there. A single medium pear, for example, contains 26 g of carbs, and even foods that aren’t generally considered high in carbs — such as nuts and nonstarchy veggies — contain a small amount of carbohydrates, and so will need to be limited or avoided on this plan.
No-sugar diet plan: What you need to know Eliminating sugar from the diet can help prevent weight gain, diabetes, heart disease, and other problems. Whether cutting sugar out of the diet completely or simply cutting back, we have eight important tips for following a no-sugar diet, and some advice about fruits and other natural foods that contain sugar. Read now
You also get incredible gains in metabolic efficiency when you use fat as a primary source of fuel – especially when doing high-intensity interval training – with this one-two combo causing potent 3–5 percent decreases in the oxygen cost of exercise, which is extremely significant. Translated into real- world numbers, this increased fat utilization from carbohydrate restriction and high-intensity interval training would allow you to pedal a bicycle at a threshold of 315 watts, whereas a high-carbohydrate, aerobic-only program (the way most people train) would allow for only 300 watts. Talk to any cyclist and you’ll find out that an 15 extra watts of power is huge in a sport like cycling, and something most cyclists train years and years to achieve.
This article really bothers me in that if you do a few incorrect things with this diet, it will actually do more harm than a full carb diet. I have been in ketosis for a month or so but to what detriment? Based on the “ketosis darkside” list you highlighted, i could be doing any or all of these without realising. Could i share with you my meal plans and see if in your opinion they are beneficial and healthy or if im digging myself an early grave?

Look into cold showers and ice baths for relief from depression along with all the other benefits it provides. If you’re willing to push your comfort zone, you’ll find that cold showers/baths provide a monumental difference. There’s some research out there that identifies the benefits of combining specific ketogenic diets and ice baths. And I used this to increase gains in the gym, reduce inflammation, feel better in general, builds patience and raises tolerance levels. It’s impressive stuff. Cold and heat thermogenesis for the win (heat would be sauna/steam room, but cold is what helps you sleep better and will help you with depression). Good luck mate!


Ken, not 100% sure I understand your question but if you're asking if you should take any more supplements through out the week, it's hard to know without getting some blood testing done. If you want to go into detail, book a consult at bengreenfieldfitness.com/coaching and choose 20 or 60 mins and we'll get you scheduled. If you want to know specifically about fueling for your runs, have a read through this: https://bengreenfieldfitness.com/2013/07/what-…
To understand exogenous ketones, you should know that there are three types of ketones: beta-hydroxybutyrate (BHB), acetoacetate (ACA) and acetone, and all three are the normal by-products of fat breakdown by your body. In much the same way as glucose, ketones can be used by your tissues, especially your brain, diaphragm and heart and are actually a far more efficient fuel source than glucose.
My question is: what if I want to be in ketosis for all the reasons mentioned in the Life Extension article and because I don't feel a strong urge to eat in between meals when I go lower carb and if I up carb intake I get hungrier more frequently and get urges . . . BUT on the flip side, I don't seem to digest fat all that well(dairy in particular is a no-no) and constipation is an issue and starchy carbs seem to help with that. It's a bit of a catch-22.
Fuels and feeds your brain: Ketones provide an immediate hit of energy for your brain, and up to 70% of your brain’s energy needs when you limit carbs.[6] Fat also feeds your brain and keeps it strong. Your brain is at least 60% fat, so it needs loads of good fats to keep it running.[7] Essential fatty acids such as omega-3s help grow and develop the brain, while saturated fat keeps myelin — the layer of insulation around the brain — strong so your neurons can communicate with each other.
A lot of changes are happening in your body and you’re going to feel it! The first five to seven days can be pretty rough, but your body is getting over its dependency on sugar. During this time of transition it is essential that you supplement electrolytes. Your body is flushing out lots of water, and with that goes electrolytes. The Keto Flu can be greatly reduced if you add sodium, potassium and magnesium to your diet. Check out our supplements page for a list of electrolyte supplements we recommend. Stay on course and you’ll start feeling better in no time!
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