Leena Watts
Diarrhea is a common side effect of the ketogenic diet, which is a low-carb, high-fat eating plan. The diet consists of less than 5% carbs, 10-30% protein, and 65-90% fat. The high-fat content can be difficult for the body to break down, leading to diarrhea. Other causes include bile problems, too much protein, and sugar alcohols found in sugar-free and low-carb products. To treat diarrhea on a ketogenic diet, it is recommended to cut back on protein, stay hydrated, and increase electrolytes.
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What You'll Learn
Stay hydrated with water, salt, and electrolytes
Staying hydrated is crucial when you are on a ketogenic diet. This is because the shift from burning carbohydrates to burning fat causes your body to flush water that is attached to the glycogen stored in your muscles. As excess water leaves your body, it can speed up transit time, resulting in diarrhoea.
Drinking enough water is essential, but it is also important to replenish your electrolytes. Electrolytes maintain fluid balance, and when you are on a ketogenic diet, your body excretes more salt, which means you lose more water. Electrolytes such as sodium, potassium, and magnesium are key to good hydration. You can increase your electrolyte intake by salting your food, drinking bone broth, or taking electrolyte tablets.
It is recommended that you drink 2-2.5 litres of water per day. You can also add a teaspoon of salt to a litre of water and drink this throughout the day. You can also increase your electrolyte intake by eating an extra avocado, a portion of leafy greens or mushrooms, or seeds such as hemp, pumpkin, and chia.
If you are experiencing diarrhoea on a ketogenic diet, it is important to stay hydrated and replenish your electrolytes.
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Avoid sugar alcohols
Diarrhea is a common side effect of transitioning to a ketogenic diet. While it is not a signal that something is wrong, it can be uncomfortable and inconvenient. One way to alleviate diarrhea on a keto diet is to avoid sugar alcohols.
Sugar alcohols are a type of sweetener commonly used in low-carb, keto, sugar-free, or diet-friendly foods. They occur naturally in foods like berries and fruits but can also be manufactured from other sugars. Sugar alcohols include xylitol, sorbitol, mannitol, maltitol, lactitol, and isomalt. These sugar alcohols have been known to cause gastrointestinal distress, including gas, nausea, and diarrhea, especially when consumed in large amounts.
When following a ketogenic diet, it is important to reduce sugar intake. Sugar alcohols are often seen as suitable substitutes because they are less calorie-dense than sugar and provide a similar level of sweetness. However, they still contain carbohydrates, which need to be factored into your total daily carbohydrate intake. Sugar alcohols are also not easily absorbed, which can lead to digestive issues.
It is important to note that everyone's tolerance for sugar alcohols is different. Some people may be able to enjoy a few tablespoons of sugar alcohols each day, while others may have zero tolerance and need to avoid them completely. If you are experiencing diarrhea on a keto diet, it may be helpful to reduce or eliminate your consumption of sugar alcohols to see if that provides relief.
Additionally, individuals with irritable bowel syndrome (IBS) or other pre-existing digestive ailments may be more susceptible to the negative side effects of sugar alcohols. If you have IBS or other digestive issues, it may be best to avoid sugar alcohols altogether to prevent gastrointestinal distress.
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Reduce protein intake
Diarrhea is a common side effect of transitioning to a ketogenic diet. It is usually not a sign that something is wrong, but rather your body adjusting to the new diet. However, if your diarrhea is severe or persistent, it is important to consult a doctor.
One possible cause of diarrhea on a ketogenic diet is consuming too much protein. While a ketogenic diet is typically moderate in protein, it can still be a significant increase in protein intake for those transitioning from a high-carbohydrate diet. Eating more protein than your body can break down may result in a buildup of toxic byproducts like ammonia, which can lead to diarrhea.
To reduce protein intake on a ketogenic diet, it is recommended to consume no more than 1 gram of protein per pound of body weight. For example, if you weigh 160 pounds, aim for no more than 160 grams of protein per day. You can use apps like Cronometer to calculate your ideal protein intake.
Instead of meeting your calorie requirements with excessive protein, opt for healthy dietary fats like butter or ghee. A well-formulated ketogenic diet should obtain 70-80% of its calories from these healthy fats. However, be cautious with ultra-saturated fats like MCT-rich coconut oil, as they can speed up transit time and contribute to diarrhea. Choose lean meats, poultry, and fish, such as sirloin, chicken breast, and wild cod, over fattier options.
In addition to reducing protein intake, staying hydrated is crucial when on a ketogenic diet. The shift from carb-burning to fat-burning causes your body to flush out water, leading to faster transit times and potential diarrhea. Aim for a water intake of 2-2.5 liters per day, and include electrolytes to replenish lost salts. Bone broth, coffee, and tea also count towards your daily fluid intake.
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Consume healthy fats
Consuming healthy fats is a key component of the ketogenic diet. A well-formulated ketogenic diet is low in carbohydrates, high in fat, and moderate in protein. The majority of this fat intake needs to come from mono-unsaturated and saturated sources such as olive oil, high oleic versions of safflower and sunflower, coconut oil, lard, butter, cream, and high-fat cheese.
A truly ketogenic diet should obtain 70-80% of its calories from healthy fats. However, it is important to note that the high-fat content of the keto diet can be challenging for some people to adjust to. This is because the keto diet requires the body to enter a state of ketosis, where it uses fat instead of carbohydrates for energy. As a result, there may be a delay in the enzymes that digest fat, leading to fat reaching the colon and being digested by bacteria, causing gas, bloating, and fat in the stool.
To avoid these issues, it is important to choose healthy fats that are suitable for a ketogenic diet. In addition to the sources mentioned above, avocado oil, avocado, nuts, and seeds are good sources of healthy fats. It is also important to be mindful of portion sizes and not to consume excessive amounts of fat, as this can contribute to diarrhea.
Additionally, some people may benefit from easing into the keto diet by slowly reducing carbohydrates and gradually increasing fat intake. This can help the body adapt better and may reduce the risk of gastrointestinal issues. It is also important to stay hydrated, as the shift to a fat-burning mode causes the body to flush out water, which can speed up transit times and lead to diarrhea.
If you are experiencing diarrhea on a ketogenic diet, it is important to address the issue. Firstly, ensure that you are staying hydrated and replenishing electrolytes. Additionally, consider reducing your protein intake and meeting your calorie requirements with healthy dietary fats.
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Consult a doctor if symptoms persist
Diarrhea is a common side effect of the keto diet, especially during the transition phase. However, if your symptoms persist or worsen, it is important to consult a doctor.
Firstly, it is important to note that there are many causes of diarrhea independent of a ketogenic diet. Therefore, if your diarrhea is severe or lasts longer than a week, it is advisable to seek medical attention. Severe diarrhea can lead to dehydration, which can have serious health consequences. Additionally, persistent diarrhea could indicate an underlying condition unrelated to your diet.
Secondly, while the keto diet is generally safe, it is not suitable for everyone. If you experience any red flags, such as blood in your stool, severe or constant abdominal pain, or diarrhea that occurs more than six times a day or disrupts your sleep, it is crucial to consult a doctor. These could be warning signs of a more serious condition or an allergic reaction to certain keto-friendly foods.
Furthermore, if your diarrhea persists for more than two to three weeks, it is recommended to seek medical advice. This is to ensure that your body is adjusting well to the diet and that there are no underlying health issues. A qualified healthcare professional can provide guidance and help you determine if the keto diet is suitable for you.
Lastly, if you experience bile malabsorption or have pre-existing digestive ailments like IBS, IBD, Crohn's disease, celiac disease, or SIBO, it is important to consult a doctor. They can advise you on modified keto diets or pharmaceutical treatments for bile acid-related diarrhea.
Remember, while the keto diet can be beneficial for some, it is not a one-size-fits-all solution. Always prioritize your health and well-being, and do not hesitate to seek medical advice if you have any concerns or if your symptoms persist.
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Frequently asked questions
Diarrhea is a common side effect when making the transition to ketosis. This is because the keto diet is low in carbs and high in fat. If fat isn't broken down in the small intestine, it travels to the colon and gets digested by bacteria, leading to gas, bloating, and fat in the stool.
To treat diarrhea on a keto diet, it is important to stay hydrated and replenish your electrolytes. You can also try bile and enzyme supplements, bone broth, and low-impact movement. If your diarrhea is caused by bile malabsorption, you might consider trying the carnivore-adjacent diet or the cyclical ketogenic diet, which allow for small amounts of fruits and root vegetables.
Sugar alcohols such as xylitol, sorbitol, maltitol, and lactitol are known to cause gastrointestinal distress and diarrhea. Vegetable and seed oils high in omega-6 fats, such as soybean, corn, safflower, or sunflower oils, have also been found to cause diarrhea.
If your diarrhea is severe or persistent, or if you experience any red flags such as blood in your stool, severe or constant abdominal pain, or diarrhea that happens more than six times a day, see your doctor.
