Is a ketogenic diet safe?

By Dr. Stephen Phinney and the Virta Team

Nutritional ketosis, achieved by following a well-formulated ketogenic diet is a safe and beneficial metabolic state for most people. However, close physician supervision is necessary for people on medications for certain conditions, like type 2 diabetes or high blood pressure.

Because nutritional ketosis can lead to rapid improvements in blood sugar and blood pressure, prompt changes in medications for blood sugar or blood pressure are often necessary. A physician can help you safely reduce your medications to avoid rapid and dangerous reductions in your blood sugar or blood pressure. Both hypoglycemic (low blood sugar) and hypotensive (low blood pressure) episodes can be very dangerous, and potentially even fatal. So medical supervision is critical. In addition, certain conditions such as a prolonged QT-interval diagnosed by EKG can make nutritional ketosis dangerous. This condition is uncommon, potentially linked to magnesium depletion, and must be corrected before starting a ketogenic diet

Nutritional ketosis should not to be confused with diabetic ketoacidosis–the two are dramatically different, with ketone levels in ketoacidosis typically being 10-fold higher than in nutritional ketosis. Nutritional ketosis induced by dietary changes is a positive metabolic state that allows the body to effectively rely on fat and ketones for energy. Ketoacidosis, on the other hand, is a life-threatening condition that is the result of insufficient insulin to meet glucose demands, most likely to occur in someone with type 1 diabetes. It is exceedingly rare for a patient with normal pancreatic beta cell function to enter ketoacidosis.

Learn more about reversing diabetes through nutritional ketosis.

Back to Keto FAQ


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