What is keto-adaptation?

By Dr. Stephen Phinney and the Virta Team

When maintained for several consecutive weeks, nutritional ketosis fundamentally changes the way cells work. This includes switching the mix of fuels they use, as well as awakening genes that are silenced by high-carb diets. Over time the body refines its metabolism to run on fat and ketones, ultimately manifested by two-fold higher rates of whole body fatty acid oxidation. Meanwhile glycolysis, insulin concentrations, constituitive inflammation, and oxidative stress are all decreased. As a result, keto-adaptation can have prompt and potent therapeutic effects; most notable reversal of clinical signs of metabolic syndrome and type-2 diabetes. Many other disorders/diseases may be amenable to keto-adaptation. This is an early-stage but burgeoning area of scientific investigation.

Read more in our deep dive on ketone basics here: https://blog.virtahealth.com/ketone-ketosis-basics/

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  1. Avatar

    Would you please add some info to the site about how to plan for a hospitalization if you are keto adapted. Is it ok to ask your doctor to not use an IV that is sugar based? How should this be handled (I’m thinking of any unplanned hospitalization or ER visit)


    1. Virta Health

      There isn’t a standard plan of care for individuals that are keto-adapted. In patients with epilepsy or other neurological/metabolic conditions, it is typical to notify medical staff that the patient is on a ketogenic diet and should only receive non-carbohydrate containing fluids and medications. You may want to start by having that conversation with your medical provider prior to an emergency in order to gain their input and develop a plan.


  2. Avatar
    silvio fontana June 10, 2019 at 7:26 am

    I am reactive to almost all LCHF vegetables, so find it easier to eat a Carnivore diet of fatty meats, fish.
    I am also intolerant to Dairy, which includes butter and coconut oil.

    This limits my fat intake to a point.

    As Carnivore significantly reduces my Bm’s, I consume 50grams of oats daily about 25grams of carbs, and no other carbs other than the conversion of my protein consumption to glucose.

    With the addition of oats, my Bm’s are regular, my colon pain is almost non existent as opposed to constant pain and gas on a LCHF diet.

    I eat until full with each meal and seldom feel hungry, however, I cannot get going in the mornings until I have my eggs/steak and oats for breakfast.

    As I keep my carbs at <30grams/day? am I likely to be in a level of Ketosis?


    1. Virta Health

      Great question, Silvio. It is going to depend on your response to oats and if you eat it at one time or divide it throughout the day. If you eat all of the oats at one time, this is likely to disrupt ketosis and raise your blood sugar. If you consume 5-10 grams of carbs at different times across the day, you’re more likely to be able to maintain ketosis


  3. Avatar

    Once fully keto-adapted (i.e. months in), how long does it take to reverse the process? I.e. will a week of eating high carbs undo the months of adaptation?


    1. Virta Health

      Great question! Dr. Phinney has previously written, “In our clinical experience with human patients, however, we typically find that more than a few days of ‘falling off course’ can reverse keto-adaptation and take from several days to up to a week or more to fully recover. The timeline for this likely depends on one’s level of insulin resistance and the amounts of carbohydrate consumed.”


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