Hi, I have being doing keto with IF for 3 mounts; I lost 25+ kg, skin acne gone. Unfortunately I did not do blood and urine tests at the start. I did them after 3 mounts in.
I went with the results to my doctor and I had a scene with her. Basically my glucose in blood, cholesterol and all were perfect, but my particule cetonice (ketone bodys) were 40 mg/dl (aprox 2.2 mmol/l) and on that result paper the control range was between o and 5 mg/dl. So I had 8 times more than what the lab considered normal. I attempted to explain to my doctor about my keto diet and that I am not scared and do not consider this dangerous. But she dismissed me, told me that she dose not want to be lectured by me and that I sould shut up, that I am destroying my liver in no time and I need further investigations to see what is wrong with meā¦ I did not want to be rudeā¦ but I did not expect a doctor to have zero knowledge of ketone metabolism, I ascked her why am I destroyng my liver, she told me because I have high ketones, I asked how dose that affect the liverā¦ she refused to answer. Do I really destroy my liver ?
Blood and urine test/ angry doctor
oh dearā¦
Ketosis is a normal metabolic state for human beings. Itās not a common state in most populations, but itās physiologically normal. If you look at our history - less access to food, more activity, fewer carbs - it was likely the default metabolic state.
You need a new doctor!
Congratulations! great results for only three months in!
Agree you need a new doctor. Darn, some people with power are totally ignorant. My liver tests are improving and a little fatty liver disease is now gone.
To Omar alpha: She has been my family doc since I was a small child. I live in a former communist country, maybe she did med school during that period
Anyway I am scheduled to do more liver investigations and an abdominal ultrasound testā¦ There is also a cultural/social thingā¦ I mean my love ones are happy for me, but they pushed me to make the test to be sure that everything is okā¦ And now basically I am challenging authority. And they are shocked that I doubt the doctorā¦ I am in a true mess with her. Every person has a state doctor responsible, the birocracy to change your state doctor is nasty.
Funy thing is my high school colleague is doing med school and he is also on the keto dietā¦ and he actually knows this stuff from bio chemistry books not like me from the internetā¦
If you canāt get a new doctor, perhaps you can change her mind? Virta Health is an organization in the US that is using the ketogenic diet in the context of patients with Type 2 diabetes. They have published a number of studies indicating the benefits (and detriments) of their protocol. See here:
If you look at safety, they show liver improvement (alt and ast are liver enzymes), serum creatinine is a measure of kidney function, etc. (Iām not a doctor, I just typed āalt, astā and āserum creatinineā into a search engine. You could do the same for all of these).
That link provides a nice synopsis of what happened, but they also have links to āofficialā papers published in peer-reviewed journals.
My suggestion is to take a printout of this link and a copy of this:
Which explains their results after one year. These are real patients and real results by a group of doctors. The patients were on a ketogenic diet for a year. (Unfortunately, there was no true ācontrolā group; they just compared patients who essentially volunteered for the keto diet with patients who followed standard medical care. But the results are still valid. Note also that the average ketone level at the end of the year was 0.4, which is relatively low. Note that the protocol required them to take their ketone levels and record them.)
I personally would say something like: I shared your concerns, I mean, how could eating a lot of meat and no grains be good for me? However, I did a lot of research and found information like this. [Explain Virta Health in 1-2 sentences: A group of physicians put T2 diabetics on a ketogenic diet for a year and experienced remarkable results with very few detriments.] I personally have experienced similar resultsā¦
@Yogy I love this ^ approach in general, but another way to go if the conflict with the doctor just gets too rough is to downplay your changes. You can say youāre not doing keto anymore, but that you felt so great from cutting back on starches for a few months that youāve kind of lost the taste for them, and that you think itās time to just focus on āfresh vegetables and good meatsā (or āwhole foodsā or whatever description of your food intake is actually accurate but sounds less dramatic). And then just eat how you want to eat.
This feels like great advice! Youāll run across a number of posts that suggest the first rule of keto or fasting is Donāt Tell Anyone~ I hate having to be āin the closetā about my choices, but it does save me often. Share your excitement here and in the safety of those (like your med student friend) who support you. How often do you see this doctor? Sheāll move on to other patients and see you in a year and go Wow!
I went to my doctor today just for refill on some meds I take regularlyā¦ anyway, I told her I started Keto and she was happy about it!! I was a tad worried but she says lots of her patients have had success etcā¦ she even asked me if I was doing intermittent fasting!! we did blood work today, I am 5 weeks inā¦ only down 5 pounds unfortunatelyā¦ but I am feeling better and keeping on. The medication I had to refill was lexapro and I swear it impedes any attempt to lose weight!! I wish I had NEVER got on this crapā¦
Go buy Keto Clarity and first read it yourself, then gift it to her. She got super defensive because she had no clue and her patient clearly knew something she didnāt and because SHE didnāt know about it, felt it was a quack hack. You know, because patients are always trying these crazy diets that are dangerous. 
I went to the dr today for my blood test as well. I told her what I was doing and I asked her if she knew what it was. Mind you my dr and I are friends also. She said no. She said but whatever it is you are doing great. I asked her would you please learn about it, I truly believe it will help me if you do. She was all in. Again this is a person I am friends with due to our medical office relationships. I know my results will be different than she is use to but between now and the reading I am going to invagate what and why they will be different so she knows I am serious. Then maybe she will look more into keto. I also dropped the Sead on her assistant.
I would be a little cautious and listen too the points she is making because it might be a little more complex than ketosis that is very specific too your circumstances or condition i.e. liver, because it might be a misunderstanding on your part. Just be careful before you assume sheās wrong?..
Marius, your doctor is no doubt concerned about a condition known as ādiabetic ketoacidosis,ā which is a dangerous and possibly even fatal condition, but you can reassure her on two counts: first, diabetic ketoacidosis doesnāt even begin until ketones reach 10 mmol/dL, and second, the presence of insulin in the blood preserves the pH balance, so ketoacidosis is pretty much impossible in anyone whose pancreas is producing any insulin at all (with certain extremely rare exceptions). The state you are in is called ānutritional ketosis,ā which is defined to begin at 0.5 mmol/dL, and is a state in which people very rarely achieve a ketone level above 5.0. So you are well within the normal range for nutritional ketosis.
If your doctor is at all interested in reading the original research, you can refer her to early papers by Stephen Phinney, M.D., Ph.D., and later ones Dr. Phinney co-wrote with Jeff Volek, Ph.D. If she doesnāt want to read the original papers, but would like a more popular account (and assuming her conversational English is adequate to the task), you can refer her to the various presentations Dr. Phinney and Prof. Volek have given at Low Carb Down Under events in Australia and the U.S. (they are available on LCDUās YouTube channel). Eric Bergman, M.D., Benjamin Bikman, Ph.D., Mary Dan Eades, M.D., Michael Eades, M.D., Andreas Eenfeldt, M.D., Michael Gerber, M.D., and ZoĆ« Harcombe, Ph.D., are some other physicians or researchers who have studied the ketogenic diet, and who have published their results.
If you think it is at all worth it to try to direct your doctor to the science, it would be a great help to her and to all her future patients. If it were me, I would probably make the attempt, at least before giving up and trying to change doctors.
Wow. Iām quite the opposite. About as open as can be without getting a bull horn and announcing it on the street like a 19th century evangelist.
There have been many times in the past year where someone mentions ANYTHING that can remind me of diabetes or diet in general, and I point things out. Like sugar being poison, or how fat isnāt bad at all, and the evils of vegetable oils. While standing in the drinks aisle at S-mart one day I overheard two guys, about my age (50 ish) talking about how a friend āold Billā just died from complications with diabetes. When their conversation got to a natural entry point for me I stepped in. Informed them how I cured my diabetes after less than 4 months. Their eyes got big, and in unison the both asked if I did it with Keto. 
They had both heard of it but hadnāt met anyone that did it and assumed it was a fad or a scam. I explained what I did, my weight loss, my medication no longer needed, etcā¦ and they didnāt lose interest. They began to follow me around the store asking questions about food, and exercise, et al.
I gave them the url to this site, and told them not to be afraid of fat. It will save their lives.
You are healing your liver.
However next time, eat up until the deadline to fast prior to bloodwork to maybe not get so high a ketone number.