Ketogenic Diet Supplements

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The Ketogenic Diet does not typically provide a complete intake of all required nutrients, so supplementation is recommended, especially salt, selenium, fiber, and vitamins.

1 Sodium (Salt)

Some authorities recommend increased salt intake because low carbohydrate diets cause of the kidneys to excrete sodium. This "natriuresis of starvation" may be due to low insulin[1], increased dopamine excretion[2], or elevated Glucagon[3]. If both carbohydrate and sodium intakes are limited then the body will secrete aldosterone[4] which will cause the kidneys to excrete potassium and conserve sodium[5]. This loss of potassium can cause Muscle Cramps and heart arrhythmias, as well has the loss of Muscle Tissue. Personally I found higher salt intake to be critical during the Ketogenic Diet or my blood pressure would drop too low.

2 Selenium

Insufficient intake of selenium can result in a weakening of the heart muscles (cardiomyopathy), and the ketogenic diet may not provide a sufficient intake[6]. Good sources of Selenium that could be used on a ketogenic diet include are Brazil nuts, tuna, beef, chicken and turkey, but supplementation is normally recommended.

3 Fiber and Constipation Supplements

Constipation is a common issue with low carbohydrate diets as they can be low in fiber. Recommended approaches to reducing constipation include MCT oil, avocadoes, prunes, exercise and good hydration, or even a mild laxative such as Miralax[7]. Personally, I've found the ketogenic diet to produce a change in stool consistency even with a comparable fiber intake, which may be due to the way that non-fiber carbohydrates pass through the digestive system and are metabolized by the intestinal flora.

4 Vitamins

For children using the Ketogenic diet for seizure control, daily supplementation with calcium, vitamin D, zinc, selenium and multivitamin/mineral is required[8] [9]. There are anecdotal reports of scurvy (Vitamin C deficiency) while on ketogenic diets.

5 Omega-3

For children on the Ketogenic diet for epilepsy, the recommended range of Omega-3 is 0.6-1.2% of their total fat intake[10]. The FDA recommends the Omega-3 intake from fish not exceed 3 grams/day.

6 MCT

MCT can be added to a ketogenic diet to improve the ketone levels by adding 5-25 grams per meal or per day[11]. (Coconut oil is normally 60-70% MCT[11].)

7 Carnitine

Carnitine is critical for the metabolism of fat, and generally the body will make enough, but there may be cases where supplementation is required[12]. It is possible to test for carnitine deficiency, which, if used, should be repeated every 3-6 months[13]. If carnitine levels are <15, then extra carnitine is often given, especially if combined with symptoms of sleepiness or sluggishness[14].

8 Oral Citrates

Taking Potassium citrate (Polycitra K) can reduce the risk of kidney stones by 7x[15], probably by reducing urine acidity.

9 See Also

10 References

  1. P. Stenvinkel, A. Ottosson-Seeberger, A. Alvestrand, J. Bolinder, Effect of insulin on renal sodium handling and renal haemodynamics in insulin-dependent (type 1) diabetes mellitus patients., Acta Diabetol, volume 32, issue 4, pages 230-4, Dec 1995, PMID 8750761
  2. R. Swaminathan, G. Cope, M. Sheltawy, MR. Lee, JK. Wales, Dopamine excretion during natriuresis of starvation., Int J Obes, volume 7, issue 1, pages 31-5, 1983, PMID 6840964
  3. C. D. Saudek, P. R. Boulter, R. A. Arky, The Natriuretic Effect of Glucagon and Its Role in Starvation, Journal of Clinical Endocrinology & Metabolism, volume 36, issue 4, 1973, pages 761–765, ISSN 0021-972X, doi 10.1210/jcem-36-4-761
  4. Phd Stephen D. Phinney MD, Rd Jeff S. Volek Phd, The Art and Science of Low Carbohydrate Living: An Expert Guide to Making the Life-saving Benefits of Carbohydrate Restriction Sustainable and Enjoyable, 2011, publisher Beyond Obesity LLC, isbn 978-0-9834907-0-8, Page 312
  5. Christopher J. Lote http://www.amazon.com/Principles-Renal-Physiology-Christopher-Lote/dp/0792360745 Principles of Renal Physiology, 22 June 2012, Springer, ISBN 978-1-4614-3785-7
  6. Eric. Kossoff, Ketogenic diets : treatments for epilepsy and other disorders, date 2011, publisher Demos Health, location New York, isbn 1-936303-10-8, Kindle Offset 1826
  7. Eric. Kossoff, Ketogenic diets : treatments for epilepsy and other disorders, date 2011, publisher Demos Health, location New York, isbn 1-936303-10-8, Kindle Offset 1790
  8. Eric. Kossoff, Ketogenic diets : treatments for epilepsy and other disorders, date 2011, publisher Demos Health, location New York, isbn 1-936303-10-8, Kindle Offset 1338
  9. Eric. Kossoff, Ketogenic diets : treatments for epilepsy and other disorders, date 2011, publisher Demos Health, location New York, isbn 1-936303-10-8, Kindle Offset 2490
  10. Eric. Kossoff, Ketogenic diets : treatments for epilepsy and other disorders, date 2011, publisher Demos Health, location New York, isbn 1-936303-10-8, Kindle Offset 1820
  11. 11.0 11.1 Eric. Kossoff, Ketogenic diets : treatments for epilepsy and other disorders, date 2011, publisher Demos Health, location New York, isbn 1-936303-10-8, Kindle Offset 1812
  12. Eric. Kossoff, Ketogenic diets : treatments for epilepsy and other disorders, date 2011, publisher Demos Health, location New York, isbn 1-936303-10-8, Kindle Offset 1793
  13. Eric. Kossoff, Ketogenic diets : treatments for epilepsy and other disorders, date 2011, publisher Demos Health, location New York, isbn 1-936303-10-8, Kindle Offset 1799
  14. Eric. Kossoff, Ketogenic diets : treatments for epilepsy and other disorders, date 2011, publisher Demos Health, location New York, isbn 1-936303-10-8, Kindle Offset 2258
  15. Eric. Kossoff, Ketogenic diets : treatments for epilepsy and other disorders, date 2011, publisher Demos Health, location New York, isbn 1-936303-10-8, Kindle Offset 1778