Many people have been following the keto diet to achieve weight loss.

This diet involves increasing your fat intake and limiting your carb intake to eventually get into full ketosis—a metabolic state wherein the body uses fat as the fuel source instead of carbs.

Although this fat-rich, low-carb diet has many potential health benefits, it also comes with risks you should be aware of.

So below are 7 keto risks to be aware of.

1. The keto diet may cause keto flu

Shifting into a keto diet means limiting your carb intake to not more than 50 grams per day, and this may cause shock to your body.

As you transition into this diet, you may experience some ketosis symptoms known as the keto flu when your body depletes its carb stores and eventually uses fat and ketones for fuel.

Some symptoms of this condition include difficulty sleeping, headache, foggy brain, dizziness, irritability, fatigue, constipation, and nausea. This may be due in part to electrolyte imbalances and dehydration that happen as you transition into this diet and your body adjusts to ketosis.

Some people may experience the keto flu in just a few days, while others may experience it longer than the usual. It is therefore essential to monitor the symptoms throughout the diet, eat healthy and filling foods, and stay hydrated.

2. The keto diet may cause stress to your kidneys

Since the keto diet is a low-carb, high-fat diet, keto dieters usually stick to high-fat animal foods, including meat, eggs, and cheese. However, eating a lot of these foods may lead to a higher risk of kidney stones.

Your blood and urine can become more acidic when you consume a lot of animal foods, which can then lead to increased excretion of calcium in your urine.

Some studies also found that this high-fat, low-carb diet reduces the amount of citrate released in the urine. Considering that citrate helps the kidney get rid of uric acid, reduced levels of it may also increase your risk of developing kidney stones.

Moreover, people with chronic kidney disease should not follow a keto diet because their kidneys may not be able to remove the acid buildup in the blood that stems from animal foods. It can only worsen the progression of CKD.

What’s more, people with CKD are often recommended with lower protein diets, and it can be noted that the keto diet involves moderate to high protein.

3. The keto diet may cause dangerously low blood sugar

The keto diet and other low-carb diets have been found to help manage the levels of blood sugar in diabetic individuals.

In fact, some studies demonstrated that this diet may help reduce hemoglobin A1c levels—a measure of average levels of blood sugar. While reduced hemoglobin A1c levels can help slow the progression of diabetes, it may lead to hypoglycemia, which is marked by sweating, shakiness, confusion, and fatigue and can eventually lead to coma and, if left untreated, death.

If individuals with type 1 diabetes are taking too much insulin and not eating enough carbs, they may experience low blood sugar levels. Thus, following a keto diet may only increase their risk of dangerously low blood sugar levels.

This does not happen only to people with type 1 diabetes. It may also happen to people with type 2 diabetes who are taking insulin medications.

4. The keto diet may damage bone health

The keto diet may also lead to impaired bone health.

Several animal studies have linked this diet to reduced bone strength, maybe due to bone mineral density losses during the transition wherein the body adapts to ketosis.

A 6-month study in 29 epileptic children who followed a keto diet found that 68% of the participants had a lower mineral density score.

What’s more, another study in 30 elite walkers found that those who followed the diet for almost 4 weeks had significantly increased levels of blood markers for bone breakdown as compared with those who followed a high-carb diet.

All the same, further extensive research is necessary to fully elucidate the keto diet’s effects on bone health.

5. The keto diet may increase your risk of chronic diseases and even early death

The effect of keto diet on the risk of chronic diseases, including cancer and heart disease, is not yet fully understood and still hotly debated.

Some evidence found that diets that focus on animal foods, which include the keto diet, may lead to poor health outcomes, while those that emphasize vegetable fat and protein sources provide benefits.

A long-term observational study concluded that a low-carbohydrate diet based on animal sources increases the risk of all-cause mortality in men and women.

Vegetable-based low-carb diets, on the other hand, were found to result in a lower rate of death from heart disease and all several other chronic diseases.

Another prospective cohort study and meta-analysis found similar results but interpreted that both high- and low-carb diets were associated with increased mortality.

However, more substantial studies are necessary to fully elucidate the claim.

6. The keto diet may cause digestive issues and changes in gut bacteria

Since a keto diet involves sticking to certain keto diet foods only, keto dieters may find it difficult to meet their daily fiber needs. They have to restrict their carb intake, so they tend to eliminate some of the richest fiber sources, including whole grains, starchy vegetables, beans, and high-carb fruits.

As a result, they experience digestive discomfort and constipation.

A 10-year study in epileptic children who followed a keto diet found that 65% of them reported constipation as a common side effect.

In addition, fiber feeds the beneficial bacteria in the gut, which may help reduce inflammation, boost immunity, and improve mental health.

Thus, a keto diet, which may be lacking in fiber, may negatively affect your gut bacteria.

Although there are also some keto-friendly, fiber-rich foods available, such as leafy greens, coconut, cauliflower, chia seeds, and flax seeds.

7. The keto diet may lead to nutrient deficiencies

Since the keto diet restricts whole grains, nutrient-dense fruits, legumes, and several other healthy foods, you may not get the recommended amounts of vitamins and minerals your body needs.

Some research also found that this low-carb, fat-rich diet does not provide enough vitamin D, phosphorus, magnesium, and calcium.

A study by Calton (2010) found that people following low-carb diets, such as the Atkins diet and the keto diet, have a likelihood of becoming micronutrient deficient, obtaining only 12 of the 27 vitamins and minerals the body needs.

That is why clinicians recommend for those people following a keto diet to achieve weight loss to supplement with vitamins B, C, and E, omega-3 fatty acids, potassium, magnesium, sodium, calcium, and psyllium fiber.

But a diet rich in healthy low-carb foods, such as non-starchy veggies, nuts, and avocados, is more nutritious as compared with the one that focuses on processed meats and other keto treats. The nutritional adequacy of the keto diet is therefore dependent on the foods that you eat.

Conclusion

Although the keto diet is known to have several potential health benefits, such as weight loss and reduced risk of diabetes, it may also lead to digestive issues, nutrient deficiencies, poor bone health, and other complications over time.

Thus, people with underlying medical conditions, including diabetes, kidney disease, and heart of bone ailments, should seek advice from their healthcare provider before starting off with the keto diet.

You may also want to speak with a dietitian if you want to monitor your nutrient levels or come up with a keto diet plan to help minimize the risks of nutrient deficiencies and other complications.