When to stop a keto diet: what to know

Written on February 3, 2023 by Sendra Yang, PharmD, MBA. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.

Table of contents

• What is a keto diet?
• Who should not start a keto diet?
• When is it time to stop your keto diet?
• Final thoughts on stopping your keto diet
• Related content

What is a keto diet?

A ketogenic diet, commonly referred to as a keto diet, is a high-fat and low-carbohydrate diet that induces your body to undergo ketosis [1]. Normally, your body converts carbohydrates into glucose as its primary energy source. When glucose is unavailable as an energy source, your body will utilize stored fats to produce energy. The process of generating energy from stored fat is called ketosis. The keto diet taps into this alternative energy route, resulting in weight loss. Most typical keto plans consist of a daily diet of 55%-60% fat, 30%-35% protein, and 5%-10% carbohydrates [1]. A keto diet includes beef, chicken, pork, fatty fish, leafy greens, almonds, walnuts, and olive oil. To follow the diet, you typically reduce your carbohydrate intake and increase your fat intake while eating adequate protein.

Who should not start a keto diet?

You should not start a ketogenic diet if you have: pancreatitis, liver failure, fat metabolism disorders, types of carnitine deficiencies (carnitine is a compound that has a role in energy production), porphyrias (conditions that lead to excess porphyrins in your body; porphyrins are part of red blood cells and play a role in carrying oxygen), or pyruvate kinase deficiency (an inherited red blood cell enzyme disorder causing chronic hemolysis) [1]. Before starting any diet, be sure to consult with your healthcare provider.

When is it time to stop your keto diet?

Health concerns are a reason to stop your keto diet

The ketogenic diet is often used for weight loss. It can also help manage health conditions such as diabetes and improve cardiovascular health and gut microbiome diversity when good fats are included [2]. However, it's essential to understand that not all diets are suitable for everyone, and sometimes health concerns can arise. You should consider stopping the keto diet if you are experiencing any health concerns related to the diet.

The keto diet can present some of the following health concerns [1,3-6]:

1. Liver problems: The diet has the potential to increase blood cholesterol levels and elevate liver enzymes leading to non-alcoholic fatty liver disease or hepatic steatosis [1,3].
2. Heart health: A high-fat diet can potentially lead to an increased risk for cardiovascular diseases if most of the fats in the diet are from foods with high HDL cholesterol levels [1,4].
3. Constipation: Reducing your consumption of foods with carbohydrates, particularly healthy high-fiber foods, can increase your experience of constipation [1,5]. Occasional constipation can cause abdominal pain and discomfort.
4. Keto flu: In some people, starting the keto diet may lead to lightheadedness, fatigue, headaches, and nausea in the first few weeks of the diet. These effects can make it challenging to adhere to and maintain the diet [1,6]. Other common side effects of the ketogenic diet include vomiting, dizziness, insomnia, and difficulty in exercise tolerance [1].

Other adverse effects of any diet can include severely low blood sugars, kidney stones, vitamin and mineral deficiencies, and low protein levels in the blood [1]. Before starting or stopping a diet, you should consult your healthcare provider to determine the best way to achieve your health goals.

Other reasons to consider stopping your keto diet

Maintaining a diet for long periods can have positive health benefits as well as challenges [2]. If you feel that you have achieved your overall goal with your diet, ditching the diet (keto or not) may be a good idea. Here are a few reasons why you should [1,7-9].

1. You have achieved your desired weight goal and now are focused on maintaining your weight. Talk with your healthcare provider about how you can transition off and maintain your desired weight without resorting to a keto diet [7,8,9].
2. If you don't see progress, it may be time to reevaluate the diet plan and consider strategizing other ways to achieve your weight goals with your healthcare provider [1,8,9].
3. If you feel you are having difficulty following the diet, it may be too strict for your liking. Being unable to stick to the diet will likely make it unsustainable. Consider an alternative option that better matches your goals and personality [8,9].
4. You no longer enjoy the diet. If you find that the foods or expectations of the diet plan are not what you want, you may lose motivation and progress in achieving your goals. You should consult with your healthcare provider to identify other strategies that better fit you [8,9].
5. If you feel overwhelmed or stressed, it may be time to reconsider other ways to achieve your weight goals Feeling confident and less stressed will help you sustain your dieting goals over the long haul [8,9].

Final thoughts on stopping your keto diet

The ketogenic diet, also known as the keto diet, is a high-fat and low-carbohydrate diet that induces your body to undergo ketosis. The goal of this diet is to lose weight by shifting your body's energy source from glucose to stored fat. In some people, the keto diet can cause health concerns, such as liver problems, heart health issues, constipation, and keto flu. Before starting any diet or stopping a keto diet, it's critical to consult with a healthcare provider.

Everlywell offers access to telehealth for weight loss where you can schedule an online consultation with a certified healthcare provider to discuss your weight loss concerns and goals.

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References

1. Masood W, Annamaraju P, Uppaluri KR. Ketogenic diet. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022. URL.
2. Dowis K, Banga S. the potential health benefits of the ketogenic diet: a narrative review. Nutrients. 2021;13(5):1654. doi:10.3390/nu13051654. URL.
3. Anekwe CV, Chandrasekaran P, Stanford FC. Ketogenic diet-induced elevated cholesterol, elevated liver enzymes and potential non-alcoholic fatty liver disease. Cureus. 2020;12(1):e6605. doi:10.7759/cureus.6605. URL.
4. Kosinski C, Jornayvaz FR. Effects of ketogenic diets on cardiovascular risk factors: evidence from animal and human studies. Nutrients. 2017;9(5):517. doi:10.3390/nu9050517. URL.
5. Wibisono C, Rowe N, Beavis E, et al. Ten-year single-center experience of the ketogenic diet: factors influencing efficacy, tolerability, and compliance. J Pediatr. 2015;166(4):1030-1036.e1. doi:10.1016/j.jpeds.2014.12.018. URL.
6. Bostock ECS, Kirkby KC, Taylor BV, Hawrelak JA. Consumer reports of “keto flu” associated with the ketogenic diet. Front Nutr. 2020;7:20. doi:10.3389/fnut.2020.00020. URL.
7. How to smoothly transition off the keto diet. Cleveland Clinic. URL. Published October 16, 2020. Accessed February 1, 2023.
8. Memon AN, Gowda AS, Rallabhandi B, et al. Have our attempts to curb obesity done more harm than good? Cureus. 2020;12(9):e10275. doi: 10.7759/cureus.10275. URL.
9. Batch JT, Lamsal SP, Adkins M, Sultan S, Ramirez MN. Advantages and disadvantages of the ketogenic diet: a review article. Cureus. 2020;12(8):e9639. doi: 10.7759/cureus.9639. URL.