Doctor who recommended Keto says it isn't great as a long term diet



Hi all,

I’ve been a lurker here since starting keto in May of this year. I love this forum and without it I’d be a little lost. This is my first post. So far I’m absolutely loving this diet save for a few days of extreme breast pain due to increased estrogen in body. I’ve lost 12 lbs and gained in self confidence and a general sense of well being.
I’ve been reading a lot of negative press on keto and harmful effects long term and mostly stayed immune to them until today. I visited my internal medicine doctor today who recommended the keto diet to begin with and he suggested that I move from a keto to a paleo diet in november-december as ‘keto long term can lead to serious deficiencies’ ! I’ve been on a fairly strict regimen on keto , religiously testing bloods and urine and always staying over 1.4mmol and he thinks its better to be borderline keto for 3-4 months in a year and then go to a mediterranean or a paleo diet long term to balance things out and provide the body with essential nutrients in fruits, root vegetables etc. He has suggested my husband stick to the diet though as he is type 2 diabetic but for ‘mostly healthy’ people like me he thinks its better to cycle this diet on an yearly basis.

I was naturally surprised to hear this (especially since he seemed to be such an advocate to begin with!) and now I find myself questioning my choices to begin with and wondering if there’s some serious issues going on somewhere which will crop up in five years time or so.

Does anyone have any thoughts or experience of people talking about this? Will really appreciate some inputs . To the long term ketoers - do you do this for a few months in a year only? We love it so much- we were thinking of just sticking to this diet for the imaginable future if we could.

Thanks in advance !

(Keto Victory) #2

In keto, year 3. I’m a T2D and I haven’t heard any remotely compelling reasons to abandon it, so I plan to stay on it indefinitely. (Occasional small amounts of berries in season and other minor deviations are about the extent of my transgressions, sad to say.)

Maybe your physician follows Dr. William Davis, who mysteriously uttered some vague warnings about unspecified dangers of long-term keto on a recent YouTube video…


Ask him how would those deficiencies exhibit themselves? Almost all of my blood work has improved (although I am a T2 diabetic). Ironically, my protein levels have gone from just above borderline low to just below borderline low.


Has anyone here had issues with kidneys or heart? He kept talking about the benefits of fruits which if we avoid in the long term could lead to issues?

(Ron) #5

(Banting & Yudkin & Atkins & Eadeses & Cordain & Taubes & Volek & Naiman & Bikman ) #6

I dunno if I would cycle, so much as transition. I am nominally keto (higher protein, slightly higher, yet still ketogenic levels of carbs), and plan a maintenance diet that will be a bit more like paleo or WAPD with carb restriction.

That said, it’s entirely possible to be keto paleo, as some folks do. I’m working towards that, with better sourcing of meats. And I eat berries a couple times a week, in season or from the freezer. It’s possible for me to do non-tropical fruit and stay roughly ketogenic.


Based on lab tests, my kidney function has improved (they had failed in 2007, due to an infection gone rampant). I no longer use oxygen therapy, and my blood pressure and pulse are both down. At some point, I’ll ask about reducing my hypertension medications.

As a T2, I no longer use insulin or metformin.

I was on lazy keto for three years (with a fair amount of cheating), followed by the past 18 months of restricted calorie keto. Most improvements have been over the past 18 months.


@OgreZed, Congrats on the improved numbers and ridding yourself of T2 meds. I am aT2 as well, 4 weeks into keto, and rapidly reducing my DM meds. It’s very encouraging to see a T2 who has improved lab numbers and gotten off their meds.


There are several LC gurus who think it’s probably unnecessary or less than ideal to maintain a state of ketosis indefinitely, especially in the absence of an underlying condition (ie. T2D, obesity, neurodegenerative) that mandates otherwise.

One concern probably stems from keeping carbs so low that it limits intake of nutrient dense foods that may be necessary for optimal health. Dr Wahls has done extensive work in this area. Dr. Mercola addresses the topic in his book. Dr Pompa has written several blogs on the subject.

Another concern may stem from the lack of emphasis on food quality. Processed meats, high dairy consumption, copious oil ingestion aren’t ideal. Paleo tends to place a high value on the how and where of the food came from, and eating whole foods not macros.

Another concern may be that there is no one optimal diet for everyone. Up until 100 years ago, diet was dictated by geographic area. Some peoples likely spent many months of the year in ketosis, while others routinely spent less. Genetic differences still persist. Food tolerances vary across ethnicities/ancestry.


Well done Ogrezed !


Thanks Not a Chef … that sounds doable and very encouraging after I hot my six month strict keto mark. And makes a lot of sense .


Thanks 4dml. This is similar to what the doctor was saying. He mentioned how seasonal crop cycles mandated cyclical ketogenic states in our ancestors which accounted for a healthier state. He mentioned ayurveda as well and indicated that in ayurveda they recommend a three to four month state of ketosis and ghee purgatory techniques on an annual basis …


Is he a naturopath or functional medicine doctor or is he your standard MD or DO?

In either case I would ask for his sources and read them myself. Otherwise you are relying on his interpretation of the data. It sounds like he is saying what SEEMS to make sense but not everything is what it seems. People still believe many things that seem to make sense but are myths (not saying his beliefs do or do not make sense but it sounds like without empirical data, such as either patient case studies, clinical experiences or actual patient exoeriments, they are beliefs. His beliefs are just as valid as my brother in law’s. My brother in law is a plumber! If he is a regular MD, know that he has gotten less than 20 hours of nutrition advice in medical school, less if he is over 35. Doctors unless they are self taught (which is no different than you or my brother in law being self taught) have no background in nutrition

Carl has been on this since February 2016 and @richard for much longer. I believe Gary Taubes states he has been keto since before his first book was published in 2008

I do eat low carb berries a few times a week but have noticed that my weight is much better when I eat less of them. They are on my list of foods I suspect are responsible for my stall


Before taking any decisions, I would take a test of my insulin. I’d do fasting insulin, or even better, the simplified dr. Kraft’s test: they talked about it in the keto dudes podcast, I can explain it if it’s not been covered in the forum. Btw don’t forget being out of keto for 2 weeks before the test, if not the value would be lower due to keto state.
If your value in Kraft’s test 2h after glucose intake is under 30, I wouldn’t stay on any diet at all and I would enjoy eating whatever I fancy, as long as it’s not processed, and as long as you don’t snack, and that should be more than enough to keep healthy.
If your value is above 40, then you need to stay LCHF for a few months and then check again, Paleo and Mediterranean diet are great but if your insulin is high, there’s no getting around the elimination of carbs.
I am just assuming you’re not too far from your goal weight, if you’re still overweight or obese well forget those diets, and even forget the Kraft test, you’re just still metabolically unbalanced and keto and fasting are, to my knowledge, the best strategies to lower the insulin and by this correct the underlying unbalance. You can open your diet after, when the insulin problem, if it’s there, has positively been addressed.

(Chris Robertson) #15

Some people find that long term keto doesn’t agree with them while others do just fine on years of keto. If you find the good things from keto seem to be less good and old symptoms start coming back or that weight loss no longer seems possible there is a good chance you need to go paleo for a short period of time and then you can go keto again. A lot of people find that 1-2 weeks over the summer is just right. Others need carb up days more often. Some people never need them. So pay attention to how you feel and what your body is doing.

(Jay Patten) #16

I would highly recommend going back and listening to the 2 Keto Dudes podcasts from the first epidsode (archives).

When I started keto I thought to myself “I’ll only do this until I lose XXX pounds and then I’ll switch.”

Then I started listening to their podcast and I will never return to the SAD diet.

My mom started doing it a few months after me and cured her nonalcholoic fatty liver disease and chronic high blood pressure within months of starting. It turns out that her cardiologist does keto as well.

Now my sister (who is not overweight at all) and brother/ sister in law do keto after seeing the benefits.


@FatBomb The benefits are there if your body typically reacts to glucose with a higher than usual peak of insulin that takes too long to go down, like dr. Kraft showed. If your insulin doesn’t spike too high and drops relatively fast, you don’t need to keto. You’re already living a low insulin life. Now I don’t know if after reversing diabetes like the Keto Dudes you can ever hope to have a “normal” insulin behavior, because there are many factors to that, also genetic factors. But generally speaking, a person whose insulin behaves, has no particular reason to do LCHF, because he’s already in a prevalently low insulin state. And I remember once Richard stated that 10 years after reversing diabetes and lowering IR, your body has completely forgotten it’s ever been sick. So in theory, given enough time, anyone could get out of keto and keep thriving.

(Janet) #18

Why doesn’t he ask the Medical Doctors who have been researching and treating patients for 20 years, like Dr. Westman, Dr. Eades, and many more.

Here is Dr. Westman’s answer. I was a client in 2010 and have been eating his LC clinic diet for the eight years. 67 years old, take no meds not even an aspirin, perfect bloodwork (Trigs 30, HDL 100! crazy good ratio), excellent CAC score, healthy BMI, many other improvements in skin rash, allergies, joint pain, etc…never going back to a SAD.


@JEY100 Because keto doctors are quite partial to keto? it’s like this in every field, if you’re into ancient watches you really think they are the center of the world. My mom is 84 and it’s almost perverse how healthy she is, and she never even contemplated going keto. Then again she’s italian and never contemplated eating crap food either, and seldom eats pasta.
I totally understand the OP for giving a good thought to what her doctor suggested.

(Chris Robertson) #20

That is only true of your only reason for being keto is weightloss. Ketones have a lot of metal and physical benifits that have nothing to do with weight loss. I’m not trying to lose weight but I keep myself in ketosis because I feel better when I’m in ketosis.