Anxiety actually coming back slightly on Keto


I’m a 32 year old male who has been doing intermittent fasting for about 6 months with moderate carbs. I take Lexapro for anxiety, and I noticed that later into my fast I would feel great. Not only was I dipping my toes into ketosis, I was teaching myself to deal with the cortisol of fasting and learning that it wasn’t actually anxiety and would go away upon eating a meal.

I decided to take the plunge and make my meals keto. I’m definitely past keto flu stage because I’ve felt amazing for about 2 weeks, reaping the benefits of relaxing ketosis and lots of energy. I also workout every day either weights or cardio. Well yesterday, after going several days feeling great and in ketosis, I noticed signs after having my morning coffee that my anxiety is back, but in the background. Just enough to make it hard for me to focus at work, with that uneasy feeling. Could this be my serotonin levels dropping slightly? Am I one of those people who genetically just needs a little more carbs at night to produce more serotonin? Or perhaps cortisol issues? I should mention that the anxiety is paired with waking up at 3am feeling wide awake and having to fall back asleep again. Help, I don’t want to give up on keto :slight_smile:

(mole person) #2

If I were you I’d invest in a blood ketone meter. For mental health issues you probably need to be keeping ketones a bit higher than the base “nutritional ketosis” level. Check your ketones and try modifying your diet to achieve a deeper ketotic state and see if that helps.


That sounds like a good place to start. What’s interesting though, is that the day before my anxiety came back I was deep into ketosis, probably one of the best feelings in my life. I did a quick 1.5 mile jog in the evening and ate a keto dinner with some cauliflower and spinach being the only carbs. Meaning I definitely should have stayed deep in ketosis. Yet the next day is when I noticed the irritability and background anxiety. I immediately chalked it up to low serotonin.


Naturally my first inclination is to slowly add some carbs at dinner, since I actually felt pretty good back when I was still eating them.

(Robert C) #5

Here is some advice about anxiety and meal timing…

(mole person) #6

Have both cauliflower and spinach both been thing you’ve been eating regularly since you’ve been feeling better? Could you be sensitive to one?

There are plenty of people now finding their metal health only really improved after they cut plants completely.

(mole person) #7

Jordan Peterson only eats beef and water these days, as does his daughter.


Thank you so much for the responses. Ok, based on this information it sounds like my body likes being in ketosis, but perhaps skipping breakfast and continuing with the intermittent fasting was just pushing it a little too far. I think I should get back into deep ketosis again and add breakfast back into the mix that includes protein. Maybe that was the missing piece for me. Breakfast


And yes I do eat cauliflower and spinach regularly as they are my favorite veggies. Never had any issues with them before.

(Bob M) #10

But if they are your favorite vegetables and you had anxiety while eating them before…how can you say they don’t cause problems?

If you want to know, don’t eat them for a week or more. Then reintroduce them.


Ok I should clear up a little about my history with anxiety: Before I actually took the plunge into full keto, I was doing intermittent fasting with a low carb lunch, and a moderate carb dinner. I felt great, and my anxiety was basically minimal to almost gone. I personally believe that the carbs at night is what helped my body get more tryptophan into my brain so that it could produce the serotonin. I was on the right track.

I saw moving into full keto as the final step that would help he go ahead and get off the meds altogether - that I would feel EVEN better. Perhaps it was stupid for me to go keto when I was already feeling better. It’s almost like my body and mind was thriving better doing intermittent fasting with carbs at night.

I know I can’t be the first person to experience this. Maybe I just thrive better at a slightly higher carb level?

(mole person) #12

Your coming to this conclusion after one day of feeling off when in your first post you said you’d felt amazing in ketosis for two weeks prior.


Yea naturally anyone would, considering anxiety coming back is literally the exact opposite of what is supposed to happen while in legitimate ketosis, which I still am right now. And I can still feel that anxiety in the background and struggling to focus at work.

Everyone’s body works a little different. You don’t think that’s a fair conclusion to think that maybe I should revert back to what was working really well before?


I’ll say to try some of the recommendations above.

If you think getting tryptophan to the brain is the issue, try eating your keto carbs as far away as possible from your keto proteins/fats.

So for example, eating your keto carbs (vegs) with no protein right after coming off your IF ( competing amino acids should be at their lowest then). Then eating your protein and fat 1 or more hours later.

That’s just an example, of course. The key is to eat the keto carbs at a time where tryptophan has the least competition. Of course, go up to the higher end of your keto carb limit if you feel it helps. Your body will likely adjust as time goes on to needing less carbs.

The above resolved my sleep issues when I started extended fasting in addition to my daily OMAD. I’m not in the euphoric ketosis state but I am getting sleep. Could have been inadequate tryptophan to aid melatonin creation (for me), or could have been something temporary that went away.

It’s just something to try. If it doesn’t work, tryptophan getting to the brain may not be the issue. You could always take tryptophan but I am still cautious about the reported EMS side effect from contaminated synthetic tryptophan. A prescribed version could be ok though.

(squirrel-kissing paper tamer) #15

I eat two meals a day. The first, lunch, is almost zero carbs. Dinner is later, closer to bed, and that’s when I have my carbs because I sleep better and feel better doing this. Before keto I always had heavy carbs before sleeping (and actually used to sleep eat carbs when I was a carb enthusiast). I’ve been keto for over a year and don’t need a ton of carbs before bed but I do struggle to get to sleep and stay asleep if I eat a zero carb dinner.

You’re right, everyone is different. When I went to two meals a day I increased the amount of carbs I eat as well, because I was getting a longer stretch between the evening meal and the next day’s first meal. It may be unpopular to admit we’re using carbs to help with anything, really, but the point isn’t to follow arbitrary rules, it’s to feel better and get healthy. If your main concern is mental health and it’s helping, then do what works for you.


Your advice here is exactly on point. Out of respect for everyone’s efforts here, I want to give an update on what I chose to do and what effect it had.

I decided to go ahead and have a very large calorie meal for dinner that included lots sweet potatoes and spaghetti squash. I immediately felt like a different person. So here is my conclusion:

For someone who doesn’t take Serotonin boosting meds and generally doesn’t have an issue with it, they would have cruised right through this phase because the boost in GABA associated with Keto is enough for them to actually feel better. BUT, for someone taking an SSRI or perhaps just recently stopped taking one, the slightly lower levels of serotonin associated with Keto might bring out some symptoms of their anxiety/depression, and for that person this can be absolutely devastating.

I’m still going to eat keto lunches, but I think it’s imperative for someone in my position to get a decent amount of insulin going at some point during the evening. Whether thats a carby snack right after working out, or a dinner with good carbs. I think there is a sweet spot where I can eat just the right amount of carbs, and due to heavy weight lifting sessions, still get some insulin going at night and still be back into ketosis the next day after an intermittent fast.

Thank you all <3

(Carole) #17

You may not need the drug anymore as Keto has done what the drug used to. Not a doctor just saying! Wish you the best!


Actually my experience was the opposite of that. Going deeper into ketosis exposed the weakness my body has for not producing enough serotonin. This isn’t just a “feeling off” sensation but rather some definitive symptoms of anxiety/panic coming back. It fits all the hallmarks of low serotonin. The increased GABA on keto is great but MIGHT not me enough to offset the anxiety for some people. For me it wasn’t.

Eating more carbs, still good ones like squash, fixed the problem for me. Personally, and this is really just my own opinion, but I think the slightly reduced serotonin levels associated with Keto can expose this problem in people who are on SSRIs.

(Carole) #19

Well, if that’s what helps you then you know what to do. You can still stay in ketosis with 50gms of carbs. So, have some carbs and stay calm. My best to you!


Absolutely, Carole. That is the plan. I’m trying to find that sweet spot where I can still get into ketosis the next morning. Thanks for your input!