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1. If a set number ketones in the blood is an indicator that my body has transitioned to ketosis and not necessarily the cause (the cause being limited access to glycogen because of limited carb intake) then how does using exogenous ketones put me in ketosis as opposed to mimic being in ketosis (because when measuring blood ketones suddenly there are more because I put them there, I didn’t create them)?
The ketogenic diet achieved national media exposure in the US in October 1994, when NBC's Dateline television programme reported the case of Charlie Abrahams, son of Hollywood producer Jim Abrahams. The two-year-old suffered from epilepsy that had remained uncontrolled by mainstream and alternative therapies. Abrahams discovered a reference to the ketogenic diet in an epilepsy guide for parents and brought Charlie to John M. Freeman at Johns Hopkins Hospital, which had continued to offer the therapy. Under the diet, Charlie's epilepsy was rapidly controlled and his developmental progress resumed. This inspired Abrahams to create the Charlie Foundation to promote the diet and fund research.[10] A multicentre prospective study began in 1994, the results were presented to the American Epilepsy Society in 1996 and were published[17] in 1998. There followed an explosion of scientific interest in the diet. In 1997, Abrahams produced a TV movie, ...First Do No Harm, starring Meryl Streep, in which a young boy's intractable epilepsy is successfully treated by the ketogenic diet.[1]
What would your advice be to a high raw vegan who wants to try an HRV keto diet? The supps you recommended above look vegan, but aren’t the results based on those of omnis? Would they work the same way on vegans? Also I heard you mention in the recent Keto Summit that SE Asians need a little more carb and I happen to be one. I’m a petite 39-YO female and I’ve been raw for the past 11 years. I have been practicing intermittent fasting in the last 7 years and try to eat only twice a day. Up to how many grams of carbs can I consume to get into ketosis?

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]
If you have a functioning pancreas that can produce insulin – i.e. you don’t have type 1 diabetes – it would be extremely hard or, most likely, impossible to get ketoacidosis even if you tried. That’s because high ketone levels result in release of insulin, that shuts down further ketone production. In other words, the body has a safety net that normally makes it impossible for healthy people to get ketoacidosis.

What about fruits and vegetables? All fruits are rich in carbs, but you can have certain fruits (usually berries) in small portions. Vegetables (also rich in carbs) are restricted to leafy greens (such as kale, Swiss chard, spinach), cauliflower, broccoli, Brussels sprouts, asparagus, bell peppers, onions, garlic, mushrooms, cucumber, celery, and summer squashes. A cup of chopped broccoli has about six carbs.

But people who started following the keto diet noticed weight loss for a few reasons: When you eat carbs, your body retains fluid in order to store carbs for energy (you know, in case it needs it). But when you’re not having much in the carb department, you lose this water weight, says Warren. Also, it's easy to go overboard on carbohydrates—but if you're loading up on fat, it may help curb cravings since it keeps you satisfied.
Yes, they're technically a fruit, but we think olives deserve a shout-out all of their own, since they're also a great source of healthy fats and are one of a few keto-approved packaged foods. Plus, they're a great source of antioxidants, will satisfy your craving for something salty, and are blissfully low-carb. “About a palm's worth only has 3 grams of net carbs,” Sarah Jadin, RD, told Health in a previous interview.
You indicate that exogenous ketones do not shut down the ability, of your body, to oxidize fat. Is that to say it does not have an effect on your body at all? My specific question is… does my body oxidize less fat, when supplementing with exogenous ketones? I think you indicate in your article that it could. I would expect it to, in that if I supplement then my body would not “need” to oxidize the fat to provide the energy.
Meat products make up a big part of the keto diet, but experts stress the importance of choosing quality. "Since the keto diet is based a lot on animal proteins, it's important to buy organic poultry and grass-fed, organic beef," says Aimee Aristotelous, RD. "Not only do organic selections help with limiting environmental toxins, but grass-fed options of red meats even change the composition of fats." The result, she explains, is that your body is able to better absorb those healthy fats.
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]
The ketogenic diet is calculated by a dietitian for each child. Age, weight, activity levels, culture, and food preferences all affect the meal plan. First, the energy requirements are set at 80–90% of the recommended daily amounts (RDA) for the child's age (the high-fat diet requires less energy to process than a typical high-carbohydrate diet). Highly active children or those with muscle spasticity require more food energy than this; immobile children require less. The ketogenic ratio of the diet compares the weight of fat to the combined weight of carbohydrate and protein. This is typically 4:1, but children who are younger than 18 months, older than 12 years, or who are obese may be started on a 3:1 ratio. Fat is energy-rich, with 9 kcal/g (38 kJ/g) compared to 4 kcal/g (17 kJ/g) for carbohydrate or protein, so portions on the ketogenic diet are smaller than normal. The quantity of fat in the diet can be calculated from the overall energy requirements and the chosen ketogenic ratio. Next, the protein levels are set to allow for growth and body maintenance, and are around 1 g protein for each kg of body weight. Lastly, the amount of carbohydrate is set according to what allowance is left while maintaining the chosen ratio. Any carbohydrate in medications or supplements must be subtracted from this allowance. The total daily amount of fat, protein, and carbohydrate is then evenly divided across the meals.[37]

“When you start the keto diet, you lose sodium and other electrolytes in the urine due to reductions in insulin,” says Yawitz. “This is a major contributor to symptoms of keto flu.” So it’s important to replenish sodium through the diet, especially if you exercise or sweat a lot. “This can help ward off more serious side effects that are seen with long-term sodium deficiencies,” says Yawitz. These include lethargy and confusion — and in extreme cases, seizures, coma, and death, according to the Mayo Clinic.
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. 
The ketogenic diet typically reduces carbohydrate intake to less than 50 grams per day — and calls for increased protein and fat intake, according to a review published in August 2013 in the European Journal of Clinical Nutrition. Roughly speaking, on keto you’ll get 70 to 80 percent of your calories from fat, about 20 percent from protein, and as little as 5 percent from carbs.

I am not a doctor and this is not to be taken, interpreted or construed as medical advice. Please talk with a licensed medical professional about this. These are just my own personal thoughts and not a prescription or a diagnosis or any form of health care whatsoever. Your mother can avoid the "keto flu" by adding sufficient sodium to her diet and staying well hydrated, especially in the first few days of starting to reduce carbohydrates. The keto flu could also be called “carbohydrate withdrawal symptoms” because of the effects on hormonal and electrolyte balance. If you're not already using a device to measure ketones in your body, I recommend this one: https://bengreenfieldfitness.com/ketonix As far as how much to take, it all depends….you can actually do more than two servings per day if you want, and you can experiment to see how many servings your body should handle. You should know that it would be very difficult to overdose on ketones. They are water soluble, so any excess ketones will be eliminated mainly via the urine. Hope this helps!

Ketosis is a nutritional process characterised by serum concentrations of ketone bodies over 0.5 mM, with low and stable levels of insulin and blood glucose.[1][2] It is almost always generalized with hyperketonemia, that is, an elevated level of ketone bodies in the blood throughout the body. Ketone bodies are formed by ketogenesis when liver glycogen stores are depleted (or from metabolising medium-chain triglycerides[3]). Ketones can also be consumed in exogenous ketone foods and supplements.
Keto breath, on the other hand, is less of a side-effect and more of a harmless inconvenience (your breath literally smells like nail polish remover). Basically, when your body breaks down all that extra fat on the keto diet, it produces ketones—one of which is the chemical acetone, Keatley previously told WomensHealthMag.com. (Yes, the same stuff that's in nail polish remover.)
“For events longer than 60 minutes, consuming 0.7 g carbohydrates·kg-1 body weight·h-1 (approximately 30-60 g·h-1) has been shown unequivocally to extend endurance performance. Consuming carbohydrates during exercise is even more important in situations when athletes have not carbohydrate-loaded, not consumed pre-exercise meals, or restricted energy intake for weight loss. Carbohydrate intake should begin shortly after the onset of activity; [and continue] at 15- to 20-min intervals throughout the activity.”
Lots of apps and websites offer keto diet challenges—basically, a blueprint for the keto diet with a fixed starting and ending point (they typically last for a week to a month, though some may be longer). Speaking of apps, plenty of keto-centric ones are right at your fingertips (a.k.a., your smartphone), like the KetoDiet app, which can help you calculate your macros and track your keto diet effectively.
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.
C8 is the rarest MCT found in coconut oil, comprising about 6% of coconut oil. It has potent anti-microbial properties (way more potent than lauric acid) to help you maintain a healthy gut, and it is the fastest MCT to metabolize in the brain. (hence the name Brain Octane). Your liver does not need to process C8, and it only takes the steps for your body to turn it into ATP cellular energy (sugar takes 26 steps). You would need 18 tablespoons of coconut oil to get just one tablespoon of Brain Octane.
“For events longer than 60 minutes, consuming 0.7 g carbohydrates·kg-1 body weight·h-1 (approximately 30-60 g·h-1) has been shown unequivocally to extend endurance performance. Consuming carbohydrates during exercise is even more important in situations when athletes have not carbohydrate-loaded, not consumed pre-exercise meals, or restricted energy intake for weight loss. Carbohydrate intake should begin shortly after the onset of activity; [and continue] at 15- to 20-min intervals throughout the activity.”
Some clinicians[37] regard eliminating carbohydrates as unhealthy and dangerous.[38] However, it is not necessary to eliminate carbohydrates from the diet completely to achieve ketosis. Other clinicians regard ketosis as a safe biochemical process that occurs during the fat-burning state.[35] Ketosis, which is accompanied by gluconeogenesis (the creation of glucose de novo from pyruvate), is the specific state that concerns some clinicians. However, it is unlikely for a normally functioning person to reach life-threatening levels of ketosis, defined as serum beta-hydroxybutyrate (B-OHB) levels above 15 millimolar (mM) compared to ketogenic diets among non diabetics, which "rarely run serum B-OHB levels above 3 mM."[39] This is avoided with proper basal secretion of pancreatic insulin. People who are unable to secrete basal insulin, such as type 1 diabetics and long-term type II diabetics, are liable to enter an unsafe level of ketosis, eventually resulting in a coma that requires emergency medical treatment.[citation needed] The anti-ketosis conclusions have been challenged by a number of doctors and advocates of low-carbohydrate diets, who dispute assertions that the body has a preference for glucose and that there are dangers associated with ketosis.[40][41]
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.
The classic ketogenic diet is not a balanced diet and only contains tiny portions of fresh fruit and vegetables, fortified cereals, and calcium-rich foods. In particular, the B vitamins, calcium, and vitamin D must be artificially supplemented. This is achieved by taking two sugar-free supplements designed for the patient's age: a multivitamin with minerals and calcium with vitamin D.[18] A typical day of food for a child on a 4:1 ratio, 1,500 kcal (6,300 kJ) ketogenic diet comprises three small meals and three small snacks:[28]

Hey Alex, thanks for commenting and great to have you as a new listener! For this kind of thing, because it requires so going into detail, I'd suggest you book a consult with me by going to
For example, a key component of safe and lasting fat loss is your capability to tap into your body’s own storage fat for energy. This access to fat cannot happen if your body is constantly drawing on carbohydrate reserves and blood glucose for energy. In the type of moderate- to high-carbohydrate diets you’ve learned are widely recommended by prevailing nutrition science, not only does the utilization of fat for energy become far less crucial (since you’re constantly dumping readily available sugar sources into your body), but your metabolism never becomes efficient at using fat. There is a growing body of evidence proving that a high-fat, low-carbohydrate diet results in faster and more permanent weight loss than a low-fat diet. Furthermore, appetite satiety and dietary satisfaction significantly improve with a high-fat, low-carbohydrate diet that includes moderate protein.

Ben – curious about your thoughts on this. I went into ketosis (using LOTS of coconut oil) but it raised my cholesterol and doc was worried about my lp(a) level (17mg/dL on VAP) even though crp was 0.5, trigs 51 and a1c was 5.2. Advised a low fat diet. Have you seen this before with folks on a lchf/ketosis diet and is there anything to be concerned about? Off to read your coconut oil article. Thank you!
Then there’s medium chain triglycerides (MCT’s). Most dietary fat has to be converted into water soluble molecules that then need to enter the liver via your lymph system. Your liver then converts these molecules to fatty acids and ketone bodies. But unlike most other forms of dietary fats, MCT’s can enter your liver directly without having to go through your lymph system. This means that consuming MCT’s gives your body an opportunity to quickly produce ketone bodies.
You need to do a “common man’s” version of a good ketogenic nutrition program or discussion. Great article, and I leaned a few things. Those Ketone Salts and other supplements can get pricey. I eat a very low carb and high fat diet and meander in and out of ketosis during the week. A pure ketogenic diet is so restrictive that meals it can get very repetitive during the week. I’d like to learn more about cooking with oils and how temperature effects their qualities. I can only handle eating so much raw food, and I love to cook my greens and other vegetables in bacon fat and coconut oil. It will be next May before I can get my blood work performed (insurance reasons) so until then I’ll need to be careful and hold back on those after supper dark chocolate excursions! Thanks!!
Peak fat oxidation was 2.3-fold higher in the LC group (1.54 ± 0.18 vs 0.67 ± 0.14 g/min; P = 0.000) and it occurred at a higher percentage of VO2max (70.3 ± 6.3 vs 54.9 ± 7.8%; P = 0.000). Mean fat oxidation during submaximal exercise was 59% higher in the LC group (1.21 ± 0.02 vs 0.76 ± 0.11 g/min; P = 0.000) corresponding to a greater relative contribution of fat (88 ± 2 vs 56 ± 8%; P = 0.000). Despite these marked differences in fuel use between LC and HC athletes, there were no significant differences in resting muscle glycogen and the level of depletion after 180 min of running (−64% from pre-exercise) and 120 min of recovery (−36% from pre-exercise).