Joint pain on keto

Did you know the number one threat to your health is inflammation and the best way to fight it is with a healthy diet?

There’s a difference between acute and chronic inflammation.

Acute inflammation is the redness and swelling that happens after you’ve had an injury, for example.


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Chronic inflammation is the type that constantly tears down your body’s immune system and increases your susceptibility to serious health conditions.

Chronic inflammation is linked to most diseases, including cardiovascular disease, obesity, high blood pressure, diabetes, arthritis, leaky gut syndrome and mental illness.

Fortunately, the biggest thing you can do to reduce inflammation is completely within your control — your diet.

Your diet is one of the most influential factors in your inflammation levels. Today you’ll learn how to start reducing inflammation through your diet, which foods to eat, and recipes to get you started:

The Link Between Your Diet And Inflammation

Every cell in your body is made of what you eat.

Certain foods can trigger inflammatory responses that put stress in your body, weaken your immune system, and prevent your body from functioning at its best.

The Standard American Diet (SAD) is an inflammatory diet — full of refined grains, sugar and chemical food additives.

Your best defense against chronic inflammation is adopting a healthy low carb diet. A ketogenic diet in specific has powerful anti-inflammatory benefits.

Removing refined grains, sugar and food additives from your diet is the best health choice you can make. The next right step is to replace those with healthy, anti-inflammatory foods.

The 7 Best Anti-Inflammatory Foods on a Ketogenic Diet

Whether you’re starting keto or have been keto for a while, adding these powerful anti-inflammatory foods to your diet can make a dramatic difference in your internal inflammation levels:

#1: Turmeric

Turmeric shines through as the anti-inflammatory superstar. In the last two decades alone, there have been over 6000 scientific studies showing the benefits of turmeric curcumin — the compound in turmeric that has been found to significantly reduce inflammation.

Curry isn’t just delicious, it’s a functional food. Turns out, curcumin is 154% more effective when combined with black pepper, specifically the piperine compound in black pepper.

Not only that, but when curcumin and piperine join forces, inflammation goes down quicker and curcumin stays in your blood for longer, which provides more anti-inflammatory perks from the same amount of curcumin.

Make turmeric a daily non-negotiable in your life to maximize the health benefits. From curry to golden smoothies there are plenty of ways to enjoy this wonder root. When you can’t enjoy turmeric in food, you can still get the perks with a high-quality supplement blend of curcumic and peperine.

Takeaway: Turmeric is one of the most anti-inflammatory foods and its effects are amplified when combined with black pepper.

#2: Ginger Root

This root is mostly known for its ability to soothe an upset stomach, but it also contains significant anti-inflammatory properties whether it’s fresh, dried, ground, cooked, in oil form or supplemental.

Research finds that ginger extract:

  • May be as effective and have fewer side effects than non-steroidal anti-inflammatory drugs (NSAIDs). Studies find it can be as effective as ibuprofen in the treatment of both severe menstrual cramps and post-surgical pain because it reduces the prostaglandins that cause inflammation.
  • Inhibits the induction of genes involved in the inflammatory response. This means ginger may be able to modulate biochemical pathways activated in chronic inflammation.

Add more ginger to your recipes for a spicy kick that actually reduces indigestion and significantly reduces inflammation.

Takeaway: Ginger can suppress the expression of genes involved in inflammation and may be even more effective than NSAIDs.

#3: Salmon

The fat profile of salmon is particularly impressive. A single 3 ounce serving of salmon contains 1921 mg of inflammation-fighting omega 3 fatty acids.

Salmon may be the star player, but other fatty fish help reduce inflammation as well. Look for wild, sustainably fished salmon, anchovies, sardines and butterfish. Fatty fish is defined as fish that is more than 5% fat by weight.

Takeaway: Salmon is rich in anti inflammatory omega 3 fatty acids.

#4: Macadamia Nuts

Macadamia nuts are the fattiest nuts of them all and that’s just one of the many reasons they’re healthy for you.

These nuts are up to 75% fat, and much of that fat is healthy monounsaturated fat, which has anti-inflammatory effects.

Macadamias also pack some magnesium to help turn off pain signals and lower blood sugar, both of which have a positive impact on inflammation.

Magnesium deficiency can lead to chronic, low grade inflammation, so hitting your daily intake with magnesium-rich foods is beneficial.

Takeaway: Macadamias are rich in monounsaturated fat and magnesium, which are anti-inflammatory.

#5: Walnuts

Walnuts are slightly higher in net carbs, but as long as you keep your consumption in check, it’s totally worth it.

Each 1-ounce serving of walnuts contains :

  • 2542 mg of omega 3s
  • 44.2mg of magnesium

An adequate intake of magnesium is necessary to prevent chronic inflammation and reduce pain, while omega 3s have powerful anti-inflammatory properties.

Takeaway: Walnuts are high in omega 3s and magnesium, which work together to prevent chronic inflammation.

#6: Healthy Fats

All the vegetable oils you find on grocery shelves today, such as canola oil, are rancid and pro-inflammatory.

Stay away from these and choose healthier fats, including:

  • MCT oil
  • Coconut oil
  • Organic ghee from grass-fed cows
  • Grass fed butter
  • Palm oil from sustainable sources
  • Olive oil

Takeaway: Avoid vegetable oils as they dramatically increase inflammation. Choose healthier fats such as MCT oil, coconut oil, or olive oil.

#7: Green Leafy Vegetables

Is there anything kale can’t do?

Kale, spinach, chard, mustard greens, romaine lettuce and other leafy greens are extremely rich in anti-inflammatory polyphenols.

These vegetables are also rich in antioxidants that repair and fend off the damage of free radicals, such as beta carotene, and vitamins C, E and K.

Leafy greens also provide some magnesium, which helps prevent chronic inflammation.
The amount of nutrients is going to vary from green to green, so the key is to get variety.

Takeaway: Leafy greens are packed with nutrients that help lower inflammation.

7 Anti-Inflammatory Keto Recipes To Get Your Started

#1: Curry Chicken Lettuce Wraps

Curry is both delicious and a functional food. Take advantage of the synergistic, inflammation-fighting effects of turmeric paired with black pepper. This recipe is both off the charts delicious and great for reducing inflammation one delicious bite after another. .

#2: Crispy Skin Salmon with Pesto Cauliflower Rice

Now that you know how nutritious salmon is, it’ll taste even better. This Crispy Skin Salmon with Pesto Cauliflower Rice is perfect for getting your omega-3s in. Dig in with the recipe here.

#3: Macadamia Nut Fat Bombs

This indulgence is actually good for you. These Macadamia Nut Keto Fat Bombs pack loads of healthy fat plus another anti-inflammation powerhouse: dark chocolate. Treat yourself to these delicious, inflammation-fighting treats here.

#4: Spicy Ginger Salmon Buddha Bowl

This spicy bowl packs anti-inflammation power from omega-3-rich salmon and ginger. Get the recipe here.

#5: Refreshing Smoked Salmon Keto Avocado Toast

This keto-friendly toast combines avocado and salmon to give you an inflammation-busting breakfast, lunch or dinner. Find the recipe here.

#6: 4-Ingredient Coconut Lemon Fat Bombs

These fat bombs are packed with healthy fats from coconut butter and coconut oil, on top of having all the antioxidant and anti-inflammation power from Perfect Keto Microgreens Powder. Get this recipe here.

#7: Irresistible Nut Butter Keto Fluff

Yes, dessert can be anti-inflammatory. This keto fluff is bursting with the anti-inflammatory benefits of macadamia nuts because the star ingredient is Perfect Keto Nut Butter, which is a creamy blend of macadamia, cashews, and coconuts. Get the recipe here.

Fight Inflammation On Keto

A ketogenic diet cuts out the most inflammatory foods there are — refined grains and sugar — and replaces them with a variety of fatty, anti-inflammatory foods.

The most anti-inflammatory foods you can add to your keto diet include turmeric, ginger, salmon, macadamia, walnuts, healthy fats, and leafy greens.

If you’re currently dealing with an inflammation related condition or have a family history of these conditions, start incorporating these foods into your diet today.

Reducing Inflammation: Why the Ketogenic Diet and Exogenous Ketones Are Key

To stay up to date on the cutting-edge of health and performance, H.V.M.N. Research Lead Dr. Brianna Stubbs tends to read a lot of scientific literature…a lot. Every month, she will dive into the latest and most exciting research papers by walking us through the experiment process, dissecting the results and implications, and candidly sharing her own thoughts on the study and subject as a whole.

Today, we’ll be going down one of Brianna’s personal favorite rabbit holes: How ketones (from both through the ketogenic diet and exogenous ketones) affect inflammation in the body.

Is the ketogenic diet as a whole responsible for the reduction of inflammation? Or is it the specific ketone body BHB (beta hydroxybutyrate) that has the most impact? This is a major question that Brianna brings up and explores in this episode.

Referenced Studies

  1. Comparison of Low Fat and Low Carbohydrate Diets on Circulating Fatty Acid Composition and Markers of Inflammation
  2. The Ketone Metabolite BHB Blocks NLRP3 Inflammasome-Mediated Inflammatory Disease
  3. The Activation of Retinal HCA2 Receptors by Systemic BHB Inhibits Diabetic Retina Damage Through Reduction of Endoplasmic Reticulum Stress and the NLRP3 Inflammasome

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Today, we’ll be going down one of my personal favorite rabbit holes: The way that ketones affect inflammation. Specifically, the ketone body BHB – beta hydroxybutyrate. It’s one of the three ketone bodies, and it’s the present at the highest concentration in the blood. We’ll go through three studies on this topic, where I’ll walk you through the research process, discuss and analyze the results, and muse over the potential implications.

Let’s start from the top with a bit of background on inflammation. I’m sure you’ve heard a lot about it over the years, with it often being portrayed in a negative light. It seems like we are always trying to reduce inflammation. We’ll take a step back and paint a balanced picture, as every process in the body has its purpose.

Inflammation is the body’s natural response to injury. A sequence of complicated, interrelated events work to defend the body, ultimately bringing plasma proteins and phagocytes (white blood cells that engulf and consume foreign material and debris) to the injured area for the purpose of initiating tissue repair. Inflammation has also long been a well-known symptom of many infectious diseases, but molecular and epidemiological research increasingly suggests that it is also intimately linked with a broad range of non-infectious diseases…perhaps even all of them.

The association of inflammation with modern human diseases, (like obesity, cardiovascular disease, type 2 diabetes, mellitus, cancer) remains an unsolved mystery of current biology and medicine. The inflammatory response evolved as a protective response to noxious stimuli (which is the fancy way of saying, stuff that might harm us), but inflammation unavoidably occurs at a cost to normal tissue function. This fundamental tradeoff between the cost and benefit of the inflammatory response has been optimized over evolutionary time for specific environmental conditions.

The rapid change of the human environment that has occurred in the last 100 years or so outpaces genetic adaptation through natural selection, leading increasingly to a mismatch between the modern environment and selected traits. Consequently, the multiple tradeoffs that were made over evolutionary time and affect human physiology are not optimized to the modern environment, leading to increased disease susceptibility.

An inflammatory response can be triggered by a variety of noxious stimuli, including infection and injury. Accordingly, inflammatory responses are highly variable in terms of the cell types and molecular mediators involved. Inflammation can be classified in several ways: acute versus chronic and local versus systemic. Despite this complexity, all inflammatory responses can be broken down into four common components that align in a universal configuration of the inflammatory pathway: inducers, sensors, mediators, and target tissues.

Inflammatory inducers can be exogenous signals (e.g. bacteria, viruses or toxins) or endogenous signals (e.g. ATP or urate crystals- which are fine for us if they are in the right place in our body, but trigger inflammation when damage means they leak into places they shouldn’t be). These signals report on tissue stress, injury, or malfunction. Sensors can be cells, such as tissue-resident macrophages and mast cells, or special protein complexes such as the ‘inflammasome’. Sensors detect inducers with specific receptors and respond by producing inflammatory mediators. Depending on the nature of the inducers, sensors produce different combinations and amounts of mediators, creating a unique mediator signature for the inducer. These inflammatory mediators, in turn, act on target tissues and alter their functional states, promoting elimination of the inducers, adaptation to the noxious state, and restoration of normal tissue function.

So…do we want and need inflammation to survive? The answer is YES, absolutely. But, it is one of those things that I like to call a ‘Goldilocks’ problem- we don’t want too much, we don’t want too little- it needs to be just right. Now that we have the basics fresh in our minds, let’s take a look at the three papers demonstrating positive effects of ketones on inflammation.

Comparison of Low Fat and Low Carbohydrate Diets on Circulating Fatty Acid Composition and Markers of Inflammation

The first paper we will look at today addresses how long-standing, low-level inflammation that bubbles away in people with metabolic disease can be improved through a low carb, ketogenic diet. It was written in 2008 by some of the leading researchers in the keto space- Dr Jeff Volek and Dr Stephen Phinney, who are pioneering the widespread adoption of the ketogenic diet through telemedicine, as well as conducting cutting edge research studies into the effects of the diets.

Published in the journal ‘Lipids’, this study looked at the effects of a 12 week long ketogenic diet on blood biomarkers in 40 overweight men and women who had metabolic syndrome.

Another quick bit of important background here. Metabolic syndrome is generally defined by high fasting glucose, high triglycerides, high blood pressure and waist circumference, and low HDL cholesterol. New markers that appear to be associated with metabolic syndrome include disturbed circulating fatty acid composition, perturbed lipid metabolism and increased oxidative stress and inflammation. Fatty acids themselves contribute to overall inflammatory balance by several mechanisms. In a subset of sensor cells called macrophages, fatty acids activate receptor signaling leading to activation of a transcription factor that regulates over 100 genes. Many of these downstream genes have a role in inflammatory responses and atherosclerosis, and may therefore represent a crucial link between fatty acids, metabolic syndrome and atherogenesis.

Another way fatty acids contribute to inflammation is through conversion into pro-inflammatory metabolites, either by enzymes or by reactions with oxygen based free radicals. One example is arachidonic acid in membranes, which is commonly thought to have a deleterious effect on overall inflammatory balance.

Now, back to the study. The participants were asked to follow a diet that was either low fat, with less than 10% of calories from fat, or a diet that was around 60% of energy from fat…so nearly keto. They had weekly follow up counselling, and kept week long diet diarys for week 1, 6 and 12 of the study. They had blood samples taken in the morning after an overnight fast at the start and end of the study.

This paper describes the changes in the amounts and types of fatty acids in the blood pre and post diet, along with the level of inflammatory mediators that could be related to these fatty acids. In terms of overall changes in their metabolic syndrome, the researchers found there was a clear advantage of the low carbohydrate diet over the low fat diet. The keto diet group lost more weight, more fat mass, had better glycemic control, improved insulin sensitivity, and better blood work specifically with regard to triglycerides and HDL (which is known informally as the ‘healthy’ kind of cholesterol). Cholesterol is a hefy and nuanced topic, make sure to check out our podcast episode with Dave Feldman. I’ve listened twice already, and each time I learn something new.

The researchers also looked at biomarkers that might indicate that someone was at risk for cardiovascular disease, with a detailed analysis of lipoprotein types and ratios. These markers also went in favor of the ketogenic diet group. Now, what about the main area of interest here: Inflammation?

Despite the two diet groups consuming roughly the same caloric intake and all losing at least some weight, there were larger reductions in the keto group in many biomarkers of inflammation. The levels of the mediator molecules TNF-a, IL-8, MCP-1, PAI-1, E-selectin and I-CAM all went down. These markers showed little change on the low fat group, suggesting that it is the macronutrient composition not weight loss or caloric reduction that is key. The researchers noted that most of the inflammatory markers did not correlate with weight loss. A correlation would not have proved that weight loss caused change in inflammatory markers, but the lack of correlation makes it extremely unlikely.

I’m going to throw out a curve ball here. One result that doesn’t fit the expected picture is that the low fat dieters had LOWER levels of the pro-inflammatory fatty acid that we mentioned earlier: arachadonic acid. Levels were actually increased in the keto group. The researchers suggest that the increase in plasma arachidonic acid with the keto group is best explained by decreased degradation, which is presumably due to less interaction with reactive oxygen species. If more arachadonic acid is consumed in a higher fat diet and less arachadonic acid is broken down into those pro-inflammatory downstream end products, the net effect would be less inflammation and more arachadonic acid in the membranes. The paper suggests that, rather than being a negative factor within lipid membranes, increased arachidonic acid appears to be a beneficial outcome of weight- reducing diets.

This paper is now often cited as one of the first studies that really started to unpick the beneficial non-weight loss effects of the ketogenic diet, and there certainly were some striking observations.

The Ketone Metabolite BHB Blocks NLRP3 Inflammasome-Mediated Inflammatory Disease

On to the second paper!

So, we have seen that the ketogenic diet can alter overall inflammation status, but the previous paper focused in on the role of the fatty acids from the diet on blood lipid profiles, presumably because fat consumption increases so much on the ketogenic diet.

But in 2015, a new paper was published in the journal ‘Nature Medicine; that revealed that it might not just be the type and amount of fat and carbs in the diet that could regulate inflammation. In the study described in the paper, the key endpoint biomarker of the ketogenic diet, beta-hydroxybutyrate (or BHB) itself, was found to directly affect inflammation.

Through a series of elegant studies, the researchers described how the compound BHB directly inhibits NLRP3, which is part of a complex set of proteins called the inflammasome that are a part of our innate immune system. The inflammasome drives the inflammatory response in several disorders including autoimmune diseases, type 2 diabetes, Alzheimer’s disease, atherosclerosis, and autoinflammatory disorders.

This was exciting as BHB is a key biomarker that links the anti-inflammatory effects we just heard about with respect to the ketogenic diet, with the well known inflammation busting effects of fasting and calorie restriction. Up until this study pointed the finger at BHB, it was unclear how immune cells adapt to reduced availability of glucose in all these states and if the cells can respond to metabolites produced from fat oxidation.

Working with mice and human immune cells, the researchers focused on how macrophages — specialized immune cells that produce inflammation — respond when exposed to ketone bodies and several different types of noxious stimuli and ultimately whether the BHB impacts the inflammasone complex. The cell experiments showed that BHB inhibited the inflammatory cascade in a dose dependant way. What’s more, the doses tested were 1mM to 10mM, in the same range as the levels obtained through fasting, the ketogenic diet or exogenous ketones. They also tested other ketone bodies, acetoacetate and the butyrate molecule, and these compounds did not have a helpful effect. But very interestingly, there was some activity of the non natural form of BHB: L-BHB.

The researchers looked at other types of inflammasome, not just NLRP3- and found that BHB was specific and only interacted with the NLRP3 pathway. They then dug around using different methods to target all the possible ways that BHB might actually have this effect. They looked at oxidative stress and changes in internal metabolites, which were not important, before finding that an effect of BHB on the flux of the ion potassium into the cells was key. Armed with this new understanding from their in vitro experiments, the researchers did animal experiments to see if these effects occurred in a whole organism. Firstly, they took mice and injected them with BHB that was modified so it wasn’t cleared by metabolism as quickly as usual. They then injected a bacterial toxin called LPS, which often strongly activates the inflammasome. In the BHB injected mice, there were fewer white cells that migrated into the site of infection and lower levels of pro-inflammatory mediators. They also looked at a genetically modified mouse that rapidly developed an inflammatory condition of the joints called gout. In these mice, they used an acetoacetate ketone diester to raise ketone levels, and saw that this was protective against the some of the symptoms of gout.

The researchers conclude very neatly: “Our findings suggest that the fasting- or exercise- induced metabolite BHB inhibits the NLRP3 inflammasome in immune cells independently of binding to surface signalling receptors or undergoing mitochondrial oxidation. Thus, in states of extreme energy deficit such as starvation, metabolic signals such as BHB can dampen innate immune responses, sparing energy for the functioning of ketone-dependent organs such as the brain and heart.”

To me, whilst it make sense and is a nice story that we evolutionarily needed to dampen the immune response to spare energy during energy scarcity, the practical utility of the observation in the modern setting is even more impactful. So many pernicious conditions are driven by uncontrolled or unnecessary inflammation. Therefore, the observation that a molecule like BHB, that we can boost in many simple ways could help us to control this problematic process is exciting and could have pretty broad applications. But there is a lot of work still to be done to work out how much BHB could contribute in the many different conditions where inflammation is a problem.

The Activation of Retinal HCA2 Receptors by Systemic BHB Inhibits Diabetic Retina Damage Through Reduction of Endoplasmic Reticulum Stress and the NLRP3 Inflammasome

And lastly, let’s dive into our our third paper.

After the breakthrough study that we just discussed, more and more papers have been published specifically looking at the role of BHB and the NLRP3 inflammasome in several disease models, including gout, neuroinflammation, etc. This final paper was published in January 2019 by the journal PLOS One.

It’s quite a short and sweet set of experiments that used a mouse model of diabetes to look at inflammation in the back of the eye, which is called the retina. The retina is the light sensitive part of our eye that is responsible for seeing detail. Retinal damage is one of the most common complication of diabetes, occuring in about one half of type I and II diabetics, and is a major cause of several visual impairments leading to adult blindness. The potential of going blind as a result of poor blood sugar control and diabetes probably doesn’t get enough air-time, and was something I found personally terrifying when I learned about just how common this is.

Part of what causes diabetes-induced retinal damage is a chronic low-grade inflammatory state. This results in the increased leakiness of the blood-retinal barrier, and ultimately leads to lack of sufficient blood supply and cell damage. In this study, the researchers wanted to find out if BHB had any effect on retinal inflammation in a mouse model of diabetes. They wanted to look to see if there was a role of the NLRP3 pathway, but also if there was an extra effect of BHB binding to a cell surface receptor called HCA2. It was already known that BHB could bind to HCA2, and that the receptor when active had some anti inflammatory and anti-oxidant effects that could also play a protective role.

The researchers made the mice diabetic using an injection of a toxin that killed off cells in the pancreas. They then injected the mice with BHB at increasing doses, reaching blood ketone levels of 0.2 up to 1mM. The first thing that they saw was that the mice with diabetes had higher levels of HCA2 and higher levels of cellular stress markers. In the diabetic mice that had been injected with BHB, there were fewer signs of NLRP3 activation- specifically, the inflammatory mediators IL-1 beta and IL-18 were lower. In essence, this demonstrates that BHB was directly protective against inflammation in the eye that results from diabetes.

To me, this paper is certainly interesting and expands on the potential use cases and indications for methods that elevate BHB. However, the study is overall less complete than the previous paper we discussed. This leaves me with a few unanswered questions.

The researchers spend a while talking about HCA2 and the effect of BHB, but to be sure that there is a link, perhaps they should have either used a pharmacological blocker of HCA2 or else genetically modified their mice to not express HCA2, to see if this changed the degree of benefit offered by BHB, that way they could have been more sure there was a connection. To me, clearly NLRP3 is involved and the results here support that but it’s not too clear about HCA2. Just because it is known that BHB binds, it doesn’t mean that it is the driving factor for the beneficial effects on the retina.


So, there we are. It is pretty tremendous to see how rapidly our understanding of inflammation has grown in the last few decades as analytical techniques have got more and more sophisticated.

To restate some of the points in this episode, we have talked about how changing fatty acid profiles with a ketogenic diet can affect inflammation, but also about how the key endpoint of the ketogenic diet, BHB also directly regulated inflammation. It is interesting to speculate about the relative contribution of diet (for example what types of fat you eat and how much you eat) and BHB on inflammation. As yet there aren’t well run studies that directly contrast the ketogenic diet with the the isolated effect of giving BHB through an exogenous source. For me, this is one of the biggest questions that researchers need to address- in terms of inflammation control, how important is it that you follow the keto diet, or can you use brief periods of fasting or exogenous ketones to get similar health benefits. We have so much work still to do in this field.

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Ketogenic diets – extreme low-carbohydrate, high-fat regimens that have long been known to benefit epilepsy and other neurological illnesses – may work by lowering inflammation in the brain, according to new research by UC San Francisco scientists.

The UCSF team has discovered a molecular key to the diet’s apparent effects, opening the door for new therapies that could reduce harmful brain inflammation following stroke and brain trauma by mimicking the beneficial effects of an extreme low-carb diet.

“It’s a key issue in the field – how to suppress inflammation in the brain after injury,” said Raymond Swanson, MD, a professor of neurology, member of the UCSF Weill Institute for Neurosciences, chief of the neurology service at the San Francisco Veterans Affairs Medical Center, and senior author of the new study.

In the paper, published online Sept. 22 in the journal Nature Communications, Swanson and his colleagues found the previously undiscovered mechanism by which a low-carbohydrate diet reduces inflammation in the brain. Importantly, the team identified a pivotal protein that links the diet to inflammatory genes, which, if blocked, could mirror the anti-inflammatory effects of ketogenic diets.

“The ketogenic diet is very difficult to follow in everyday life, and particularly when the patient is very sick,” Swanson said. “The idea that we can achieve some of the benefits of a ketogenic diet by this approach is the really exciting thing here.”

Low-Carb Benefits

The high-fat, low-carbohydrate regimen of ketogenic diets changes the way the body uses energy. In response to the shortage of carb-derived sugars such as glucose, the body begins breaking down fat into ketones and ketoacids, which it can use as alternative fuels.

In rodents, ketogenic diets – and caloric restriction, in general – are known to reduce inflammation, improve outcomes after brain injury, and even extend lifespan. These benefits are less well-established in humans, however, in part because of the difficulty in maintaining a ketogenic state.

In addition, despite evidence that ketogenic diets can modulate the inflammatory response in rodents, it has been difficult to tease out the precise molecular nuts and bolts by which these diets influence the immune system.

Intricate Molecular Waltz

In the new study, the researchers used a small molecule called 2-deoxyglucose, or 2DG, to block glucose metabolism and produce a ketogenic state in rats and controlled laboratory cell lines. The team found that 2DG could bring inflammation levels down to almost control levels.

“I was most surprised by the magnitude of this effect, because I thought ketogenic diets might help just a little bit,” Swanson said. “But when we got these big effects with 2DG, I thought wow, there’s really something here.”

The team further found that reduced glucose metabolism lowered a key barometer of energy metabolism – the NADH/NAD+ ratio – which in turn activated a protein called CtBP that acts to suppress activity of inflammatory genes.

In a clever experiment, the researchers designed a drug-like peptide molecule that blocks the ability of CtBP to enter its inactive state – essentially forcing the protein to constantly block inflammatory gene activity and mimicking the effect of a ketogenic state.

Peptides, which are small proteins, don’t work well themselves as drugs because they are unstable, expensive, and people make antibodies against them. But other molecules that act the same way as the peptide could provide ketogenic benefits without requiring extreme dietary changes, Swanson said.

The study has applications beyond brain-related inflammation. The presence of excess glucose in people with diabetes, for example, is associated with a pro-inflammatory state that often leads to atherosclerosis, the buildup of fatty plaques that can block key arteries. The new study could provide a way of interfering with the relationship between the extra glucose in patients with diabetes and this inflammatory response.

Funding for the research came from the U.S. Department of Defense, the Department of Veterans Affairs, and the National Institutes of Health.

UC San Francisco (UCSF) is a leading university dedicated to promoting health worldwide through advanced biomedical research, graduate-level education in the life sciences and health professions, and excellence in patient care. It includes top-ranked graduate schools of dentistry, medicine, nursing and pharmacy; a graduate division with nationally renowned programs in basic, biomedical, translational and population sciences; and a preeminent biomedical research enterprise. It also includes UCSF Health, which comprises three top-ranked hospitals, UCSF Medical Center and UCSF Benioff Children’s Hospitals in San Francisco and Oakland, and other partner and affiliated hospitals and healthcare providers throughout the Bay Area.

Will the Keto Diet Help Ease Joint Pain?

While weight loss can be beneficial for many types of joint pain, the nutrients you eat while you are shedding pounds are the essential ingredients for good health. The ketogenic diet, the buzzworthy high-fat, low-carb diet commonly called keto, is based on the idea that cutting out carbohydrates — the body’s primary source of energy — forces the body to burn fat for fuel, supercharging your weight loss.

RELATED: The Best Foods to Add to Your Diet to Fight Rheumatoid Arthritis

But eliminating grains, fruits, many vegetables, as well as other healthy foods from your diet depletes your body of the vitamins and minerals that help keep your body in balance. “It’s not a good choice for people with systemic inflammatory conditions, because it completely goes against the science we know that prevents inflammation in the body,” says Lona Sandon, PhD, RDN, an associate professor in the department of clinical nutrition at UT Southwestern in Dallas, who also has rheumatoid arthritis.

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Why Keto Isn’t Healthy for Your Joints

Carrying extra weight isn’t ideal for anybody’s joint health, so deciding to lose weight is a wise choice. But the keto diet is very high in fat — which can help you feel satisfied — and it’s not high in the types of fats that help decrease inflammation, which is the root cause of joint pain. “This diet is higher in the fats that promote inflammation,” says Dr. Sandon. “If your keto diet contains a fair amount of red meat, you will be eating more of the types of saturated fats that increase the inflammatory compounds that make you feel worse.” One type of fatty acid that’s found in higher amounts in red meats promotes the cytokines and leukotrienes that cause more damage and inflammation in the body, according to Sandon.

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Plus, eliminating entire food groups from your diet — and in turn essential nutrients — is depriving your body of optimal nutrition. “It is absolutely terrible for people with RA,” says Sandon. “People with RA need more antioxidant vitamins that those who do not live with a chronic inflammatory disorder.”

RELATED: 8 Ways to Prevent Rheumatoid Arthritis Joint Damage

Why Keto Is a Short-Term Weight Loss Fix

The goal of the keto diet is to get your body into a state of ketosis, which is when your body doesn’t have enough carbohydrates to burn for energy, so it starts to burn fat instead. “If you can get through the first three days to get into ketosis, it can help to shut down appetite and control cravings,” says Sandon. “From a weight loss perspective, it can be effective in the short term. But eventually you do get hungry, and you need to get back to eating regular food again.”

RELATED: 7 Reasons to Lose Weigth When You Have Arthritis

The Better Way to Eat to Help Control Inflammation

Many experts agree that the Mediterranean diet is advised for people who have RA, as well as other types of arthritis. It emphasizes a plant-based eating approach, loaded with vegetables and healthy fats, including olive oil and omega-3 fatty acids from fish.

It’s also the dietary approach with the most research behind it. A study published in 2017 in the journal Frontiers in Nutrition investigated dietary interventions for rheumatoid arthritis and determined that an ideal meal would include raw or moderately cooked vegetables (lots of greens and legumes), with the addition of spices like turmeric and ginger, seasonal fruits, and probiotic yogurt — all of which are good sources of natural antioxidants and deliver anti-inflammatory effects. They also recommend avoiding processed foods, foods with high sodium levels, oils, butter, sugar, and animal products.

RELATED: Top Foods to Fight Inflammation

But when it comes to minimizing the symptoms of RA, no one diet works for everyone. “It depends on the person,” says Christine Palumbo, RD, a nutrition expert in Naperville, Illinois. “For some people, gluten can be a trigger. For others, salmon, nuts, or eggplant can be inflammatory.” She suggests that people who have joint pain associated with RA should consider food sensitivity testing or try an elimination diet where you avoid common culprit foods, such as dairy, gluten, nightshade vegetables (which include tomatoes, white potatoes, and bell peppers), and alcohol.

RELATED: Arthritis, Ankylosing Spondylitis and Autoimmune Diseases: Your Questions, Answered

Rheumatoid Arthritis Diet: Is Keto the Way?

Rheumatoid arthritis, or simply RA, is an autoimmune disease that causes the body’s immune system to attack healthy cells as if they were foreign invaders. This causes swelling, pain, inflammation, and redness in the joints and surrounding tissue. With an increasing understanding of nutrition and disease, we will investigate if there is an ideal rheumatoid arthritis diet to improve this condition.

The exact cause of RA is not understood but appears to be related to genetic and environmental factors. This disease affects more women than men and typically shows up in those between the ages of 40 and 60. RA is a very complex issue and can have crippling pain for many. Less than 1% of those who have been diagnosed with the disease will go into remission. Certain lifestyle factors may be able to improve your chances of remission or at least lessen symptoms associated with RA.

Chronic Inflammation & Autoimmunity in RA

RA involves the accumulation of inflammation in and around the joints caused by a chronically elevated immune response. A typically beneficial and protective mechanism of the immune system, in this case, turns into a damaging force.

A commonly prescribed treatment is pain medication and immune system-suppressing drugs. This is in an attempt to calm the immune system and decrease the perception of pain. The issue here, though, is that the underlying issues are not addressed in any way. Consequently, many people do not feel any improvement while using these therapies.

This is why I would like to express my thoughts on a rheumatoid arthritis nutrition template that may be used as an alternative or complementary therapy.

Overview of Therapeutic Options for RA

There are numerous other holistic ways of improving rheumatoid arthritis symptoms including:

  • Reducing stress
  • Consuming foods and herbs high in anti-oxidants
  • Supplementing the diet with omega-3’s
  • Supplementing with Vitamin D and K2
  • Several other considerations, as you can read about in this article: Beat Rheumatoid Arthritis Naturally

In addition to the recommendations above, I believe that there is still another way to help control many of the symptoms and pain that RA patients deal with on a daily basis. Much of the pain that RA patients feel comes from inflammation.

If inflammation can be controlled, then it follows that pain could also be controlled. To a large degree, your nutrition plays a role in inflammation levels in the body. This is why it is possible to design an effective rheumatoid arthritis diet. In particular, a ketogenic nutrition plan may be able to provide several benefits.

A ketogenic diet may be an effective rheumatoid arthritis diet not only by helping control weight through accelerated fat loss – but by also providing a substantial reduction in inflammation levels.

What is the Ketogenic Diet?

Chances are, you have at least heard about this eating plan. Often referred to simply as “keto”, this is a low-carbohydrate, high-fat diet that was originally created to help treat epileptic children not responding to medications.

When we lower the number of carbohydrates that we consume, we transform the body’s reliance on glucose (sugar) and force it to rely on ketones (fat) for its primary source of energy.

This may sound extreme, but ketosis is actually a built-in mechanism that our bodies use to thrive. The keto diet can vary, but generally speaking, it calls for a consumption of 70-80% of calories from fat, 15% from protein, and only 5-10% from carbs.

Benefits of A Ketogenic Diet

A ketogenic lifestyle can be the perfect rheumatoid arthritis diet because shifting into a state of fat-burning has several benefits in the body. The primary two benefits that would offer those with RA relief are:

  1. A reduction in inflammation due to improved mitochondrial energy production from fats (as opposed to sugars)
  2. A reduction in excess stress on the joints and ligaments if weight loss is achieved

Additionally, the way I advocate a ketogenic diet also eliminates virtually all sugar, gluten, grains, and several other common inflammatory foods. As you will see below, I take an additional step and remove some other common keto foods that I have seen clinically be more likely to provoke more autoimmune symptoms. This special autoimmune focused keto diet is a powerful way to reduce inflammatory symptoms.

Ketogenic Food Pyramid

There is plenty of evidence linking certain foods to higher levels of inflammation, including:

  • Sugar, especially high fructose corn syrup (1)
  • Trans Fats, such as those found in margarine and GMO vegetable oils (2)
  • Refined Carbohydrates, including white bread (3)
  • Processed Meats, such as bacon, ham, and beef jerky (4)

Other than processed meats, the keto diet eliminates virtually all the above foods. Therefore, subjects who wish to begin the keto diet be aware and/or be informed that the protein they consume should never include processed meats. Protein sources should focus on grass-fed, organic meats and animal products, such as cage-free eggs.

The graphic below shows how a ketogenic rheumatoid arthritis diet food pyramid would look. Below that are additional foods that would nourish the bones and joints further.

Keto as a Rheumatoid Arthritis Diet

As a chiropractor in Anchorage, I have seen several patients with RA have their lives changed simply by changing their diet. Lifestyle adjustments and supplements often help promote healing even further.

However, my own anecdotal experiences cannot be considered scientific evidence. Luckily, there is substantial scientific evidence to support the idea of a rheumatoid arthritis diet:

  • In August 2013, an article published in the Journal of Child Neurology concluded that a ketogenic diet could inhibit pro-inflammatory pathways associated with pain. (5)
  • As I mentioned earlier, this diet was designed to help children with brain disorders, such as epilepsy. One of the mechanisms by which this works is by lowering inflammation. Since the mechanisms of inflammation are similar through the body, this would lead to less pain via inflammation. A review of studies found that the keto diet did indeed reduce inflammation. (6)
  • While many studies in this area use animals, a small study performed in 2000 found that after just 7 days on the keto diet, subjects with RA had lower levels of cortisol, lower body weight, and a reduction in pain levels. (7)

Mental Improvements

RA patients commonly have depression and mood disorders. This is likely another consequence of chronic inflammation as it extends into the brain.

Two studies involving animals have found the following:

  • The keto diet can have an anti-depressive effect (8)
  • It can also promote physical activity due to an increase in dopamine and serotonin in the brain (9)

While human studies are needed to further support these findings, clinical experience supports this.

Weight Loss & RA

In humans, a strong link has been established between obesity and the heightened risk of developing RA (10). For those who are overweight and have RA already, promoting weight loss will have a very relieving effect. Because of these considerations, a ketogenic diet is likely a great strategy to both prevent and improve RA (11).

While physical activity is generally desirable for those with RA, being overweight can make it very painful. Luckily, a ketogenic diet can improve weight loss even in the absence of exercise. Once the excess weight is lost, then exercise may be reintroduced with much less pain.

How to Design a Rheumatoid Arthritis Diet

A nutrition plan designed for RA, from my perspective, would likely rely on a ketogenic template with an autoimmune twist. Common keto foods that are more commonly immune triggering include dairy, eggs, nuts, seeds and nightshade vegetables.

To replace these foods, we would add in more coconut fats, bone broth, fermented veggies, green leafy veggies, avocados, olives and olive oil. In addition to this, it would include several of the world’s most anti-inflammatory herbs and nutrients. These foods tend to reduce inflammation in the body and support healthy bone and joint structure.

Healthy Fats

Healthy fats should make up the bulk of your diet. Not only do they provide a fuel that your body can convert into ketones, but they are an important component of your cells. Not many people realize this, but fats also serve as a transport vehicle for several nutrients like Vitamins A, D, E, and K. The combined effect of these nutrients ensure bones remain strong and inflammation is kept at bay.

Saturated fats like grass-fed butter and coconut oil are some of the best options. Other great sources of fat include pastured meats, avocados, olive oil, and MCT oil. The graphic below shows which are best for cooking and dressing purposes.


Protein, in general, should make up about 20-30% of your calories. A good way to calculate your protein needs is by converting your bodyweight in pounds to kilograms. Next, multiply your weight in kilograms by 0.8 and 1.0. The result is the range (in grams) of protein you will want to shoot for on a daily basis. More detailed recommendations are illustrated in the graphic below.

The best sources of ketogenic protein are things like pastured meats, organ meats and bone broth. A high-quality plant-based cleansing protein powder like this one can also be great. Finally, if you are someone who is highly active and trying to build lean body mass, essential amino acids are an excellent keto companion.

Non-Starchy Vegetables

Vegetables are a crucial part of a rheumatoid arthritis diet. While healthy fats should make up the majority of calories on this nutrition plan, plant matter should make up a large physical volume of each meal. Non-starchy vegetables are full of anti-inflammatory nutrients and provide the digestive tract with prebiotic fiber.

This fiber nourishes the bacteria in the gut which helps promote healthy digestion. Poor digestion and an inflamed gut are both primary sources of inflammation that can be addressed on this diet.

The list of vegetables includes celery, leafy greens, broccoli, cabbage, cauliflower, peas, green beans, cucumbers, asparagus and all types of lettuce. More of my favorite foods in this category can be found below.


Since fruits are high in sugar (even if it is natural sugar) they should be eaten only in moderation. Look for low glycemic fruit such as berries, green apples, and grapefruit.

I would not consider these a particularly necessary aspect of the diet if you are consuming a wide variety of herbs and vegetables. The one exception would be organic berries as they are loaded with antioxidants called anthocyanins. Blueberries and dark cherries are some of the best options but keep the servings low (about ½ cup).

In general, with all foods considered, most people do best with a net carb amount of 20-30 grams per day. Net carbs can be calculated by subtracting fiber from total carbs in a given food.

Bone-Building Foods

When it comes to rebuilding your bones, tendons, and ligaments – calcium is not really what you need. In fact, most people have plenty of calcium. The issue is that it is not going to the right place. This is because certain nutrients like Vitamin D, Vitamin K, and magnesium all play a role in calcium deposition.

Ensuring you have adequate amounts of those nutrients will be key for a successful rheumatoid arthritis diet.

Some of the best foods that provide these nutrients are listed in the graphic below. Bone broth, in particular, is excellent for nourishing the soft tissues that can become damaged in RA – such as the synovial fluid in joints.

Side Effects

While the ketogenic diet has numerous benefits, it can be a bit of a transition from a carbohydrate-heavy diet. During the initial stages of adoption, your body must adjust to burning fat as a primary fuel source over carbs.

Many people during the first 3-10 days experience a group of symptoms referred to as keto-flu. These symptoms may include:

  • Fatigue
  • Dizziness
  • Fever
  • Chills
  • Headaches
  • Irritability

These symptoms can occur for a few different reasons and only a small percentage of people tend to have them. Check out this article for the strategies to limit your chances: 7 Ways to Prevent Keto Flu.

Concerns About a Ketogenic Diet

If you are hesitant about starting a high-fat nutrition plan as a rheumatoid arthritis diet, there are a number of articles to help clear up your specific concerns. The following articles can help address most questions:

Keto for Menopausal Women

Is a Ketogenic Diet Safe for Diabetics?

Is the Ketogenic Diet Acidic?

Keto Vs Low-carb: What’s the Difference?

How to Begin a Ketogenic Diet

Keto Shopping Guide

Can you Do Keto Without a Gallbladder?

More Help for Those with RA

There is no doubt that the neck (or cervical spine) is often affected by this disease (8). The laxity of the vertebrae and ligaments inhibit the immune system from working properly by blocking signals sent from the brain.

The majority of surgeons will recommend surgery to stabilize the neck. Seeing a chiropractor at the onset of symptoms may help to realigned and strengthen the neck before surgery is considered, however.

While chiropractic adjustments to the cervical spine will not cure RA, it may improve symptoms – including less numbness, fewer headaches, and less general body pain.

**Note: Those with osteoporosis or other skeletal abnormalities should not receive adjustments to the cervical spine.

Author Bio:

Dr. Brent Wells is the founder of Better Health Chiropractic and Physical Rehab. Dr. Wells believes in treating people the way he would want to be treated. Born and raised in Southern California, Dr. Wells received his Bachelor of Science degree from the University of Nevada and his Doctor of Chiropractic Medicine degree from Western States Chiropractic College. He, his wife Coni, and their three children live in and enjoy the great outdoors in Alaska. Dr. Wells volunteers for Reflex Sympathetic Dystrophy Foundation and can be found hiking or rollerblading when he isn’t playing his guitar.

Sources for this Article Include:

2. Nestel P. Trans fatty acids: are its cardiovascular risks fully appreciated?. Clin Ther. 2014;36(3):315-21. PMID: 24636816
3. Spreadbury I. Comparison with ancestral diets suggests dense acellular carbohydrates promote an inflammatory microbiota, and may be the primary dietary cause of leptin resistance and obesity. Diabetes Metab Syndr Obes. 2012;5:175-89. PMID: 22826636
5. Masino SA, Ruskin DN. Ketogenic diets and pain. J Child Neurol. 2013;28(8):993-1001. PMID:23680946
7. Fraser DA, Thoen J, Bondhus S, et al. Reduction in serum leptin and IGF-1 but preserved T-lymphocyte numbers and activation after a ketogenic diet in rheumatoid arthritis patients. Clin Exp Rheumatol. 2000;18(2):209-14. PMID: 10812493
9. Bostock EC, Kirkby KC, Taylor BV. The Current Status of the Ketogenic Diet in Psychiatry. Front Psychiatry. 2017;8:43. PMID: 28373848

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Decrease Joint Pain and Inflammation with Ketogenic LifeStyle

If you want to avoid drugs, surgery and preserve your joints – long term – you will want to get the inflammation down as low as possible. One method that makes a tremendous difference in reducing inflammation is following a ketogenic lifestyle and intermittent fasting. A ketogenic lifestyle means your body will be burning fat for energy rather than sugar

With all the research and studies out there today, there’s no doubt that ketogenic is becoming the way to eat for autoimmune conditions, inflammatory conditions and in general to live a long and healthy life.

The research is also finding with a ketogenic diet that it has done amazing things with people neurogenic degenerative disorders, such as Alzheimer’s, Parkinson’s, dementia and those types of diseases.

The ketogenic lifestyle is a very anti-inflammatory lifestyle. A ketogenic diet is going to have about 70% good fats, about 25% protein and about 5% carbohydrates. A very low carbohydrate intake helps to keep the insulin down, which is very inflammatory to the body. Insulin likes to “light up” joints and muscles and “hang out” in those areas (inflammation). If we can reduce the insulin in the body, we can reduce the inflammation.

Intermittent Fasting also has tremendous benefits when it comes to inflammation in the body. We feel like we have to eat breakfast, lunch and dinner and in addition, have snacks in between. This is how we have been trained through many guides to “keep up your metabolism.” But what research is showing is it does not “keep up your metabolism.”

Every time you eat, and it doesn’t matter what you eat, your insulin levels are going to go up. The key to keeping your inflammatory and your degenerative diseases low is to keep your insulin as low as you possibly can.

Intermittent fasting helps to give the body a break so your insulin levels begin to die down, inflammation starts to go out of the body and it stresses the body in a way that is actually very healthy. Intermittent fasting has also been shown to reset the metabolism, kill off bad cellular components. It has also been shown to help lower insulin and it is also very good for anti-aging.

Knee osteoarthritis: A low-carb diet may relieve symptoms

A randomized controlled study finds that a diet low in carbs can relieve pain for people who have knee osteoarthritis.

Share on PinterestSeniors with knee osteoarthritis may benefit from switching to a low-carb diet.

Osteoarthritis is the most widespread form of arthritis among older adults in the United States.

Knee osteoarthritis, in particular, affects about 10 percent of men and 13 percent of women ages 60 and above. According to some estimates, the condition affects 40 percent of people over the age of 70.

There is currently no cure for knee osteoarthritis, which can cause joint swelling, stiffness, and even severe pain.

Doctors often prescribe pain relievers, such as acetaminophen, opioids, or nonsteroidal drugs, to help alleviate symptoms. Knee replacement surgery is also an option.

However, these treatments are either invasive or could cause a range of unwanted side effects. This is why researchers have decided to investigate whether dietary interventions could relieve some symptoms and signs of knee osteoarthritis.

Robert Sorge, Ph.D., who is the director of the PAIN Collective in the University of Alabama at Birmingham Department of Psychology, led a randomized controlled study that compared the efficacy of two diets: one that is low in carbs and one that is low in fat.

Sorge and colleges published their findings in the journal Pain Medicine.

Studying the benefits of a low-carb diet

The researchers tested the benefits of low-carb and low-fat diets among 21 adults aged 65–75 who had knee osteoarthritis.

The study participants followed either of the two diets or continued to eat normally for a period of 12 weeks.

Every 3 weeks, Sorge and colleagues analyzed the participants’ functional pain — which is pain associated with daily tasks — as well as their self-reported pain, quality of life, and level of depression.

They also examined the participants’ serum blood levels for oxidative stress, both at the beginning and the end of the interventions. Oxidative stress is a chemical imbalance between the production of free radicals and the body’s antioxidant properties.

Scientists generally consider oxidative stress to be a marker of biological aging. In the current study, lower oxidative stress correlated with less functional pain.

The researchers found that the low-carb diet reduced functional pain levels and levels of self-reported pain. The benefits were particularly noticeable, in comparison with the low-fat and regular diets.

Finally, when adhering to the low-carb diet, the participants also showed less oxidative stress and lower levels of the adipokine leptin, a hormone with important metabolic functions.

The diet significantly reduces pain

“Our work shows people can reduce their pain with a change in diet,” comments the study’s lead author.

“Many medications for pain cause a host of side effects that may require other drugs to reduce. The beneficial side effects of our diet may be things such as reduced risk for heart disease, diabetes and weight loss — something many drugs cannot claim.”

“Diet is a great way to reduce the use of pain relievers and to improve general health,” Sorge continues.

“Diet will never ‘cure’ pain, but our work suggests it can reduce it to the point where it does not interfere with daily activities to a high degree.”

Robert Sorge, Ph.D.

Among people who consume meat, popular low-carb options include “lean meats, such as sirloin, chicken breast, and pork.” Fish and eggs are also low in carbs, as are leafy green vegetables, including kale and spinach.

Cauliflower, broccoli, nuts, seeds, nut butter, coconut oil, olive oil, and dairy products are also good low-carb options. For those who wish to avoid animal products altogether, tofu and tempeh are great low-carb alternatives.

A lifestyle modification may help relieve the pain associated with knee osteoarthritis (OA), according to a study published in Pain Medicine.

Opioids, pain relievers, and anti-inflammatory drugs carry unpleasant side effects for many patients with persistent knee OA. Noting the need for alternative forms of pain management, researchers at the University of Alabama at Birmingham (UAB) tested the efficacy of 2 dietary interventions: one low in carbohydrates and one low in fat.1

Adults aged 65 to 75 with knee OA followed one of the dietary interventions or continued to eat as normal for 12 weeks. Every 3 weeks, the researchers assessed the participants’ functional pain, self-reported pain, quality of life, and depression levels. They also examined serum levels for oxidative stress before and after the intervention.

The investigators found that the low-carb diet reduced levels of functional pain and self-reported pain compared with the low-fat and regular diets. Participants who followed the low-carb diet also showed reduced oxidative stress.

The authors concluded that lowering oxidative stress through a low-carb diet may provide relief from pain and offer an alternative to opioids.

“Many medications for pain cause a host of side effects that may require other drugs to reduce,” said Robert Sorge, PhD, assistant professor at UAB and lead author of the study. “Diet will never ‘cure’ pain, but our work suggests it can reduce it to the point where it does not interfere with daily activities to a high degree.”2

  1. Strath LJ, Jones CD, George AP, et al. The effect of low-carbohydrate and low-fat diets on pain in individuals with knee osteoarthritis . Pain Med. 2019. doi:10.1093/pm/pnz022
  2. Greer T. Study: low-carb diet provides relief from knee osteoarthritis. The University of Alabama at Birmingham. March 22, 2019. Accessed April 24, 2019.

A DIET low in carbs may help relieve pain in people who have knee osteoarthritis, say researchers.

There is currently no cure for knee osteoarthritis which can cause joint swelling, stiffness and even severe pain.

Doctors often prescribe pain relievers for knee pain but these can cause unwanted side effects which has prompted researchers to look at whether diet might relieve symptoms.

University of Alabama PAIN Collective researchers led a study that compared two diets – low carb and low fat.

The study participants followed either of the two diets or continued to eat normally for a period of 12 weeks.

Every three week the researchers analysed the participants functional pain associated with daily tasks as well as their self-reported pain, quality of life and level of depression. They also examined blood levels for oxidative stress – lower oxidative stress correlated to less functional pain.

Low carb diet reduced pain in people with knee arthritis.

The researchers found that the low carb diet reduced functional pain levels and levels of self-reported pain. The benefits were particularly noticeable in comparison with the low fat and regular diets.

“Our work shows people can reduce their pain with a change in diet,” said lead author Robert Sorge.

“Many medications for pain cause a host of side effects that may require other drugs to reduce. The beneficial side effects of our diet may be things such as reduced risk for heart disease, diabetes and weight loss – something many drugs cannot claim.

“Diet will never cure pain, but our work suggests it can reduce it to a point where it does not interfere with daily activities to a high degree.”

Popular low carb options include lean meats such as sirloin, chicken breast and pork, fish, eggs and green leafy vegetables.

Arthritis information:

  • Read more: As if arthritis isn’t bad enough
  • Read more: Leafy greens can maintain strong muscles and mobility

The Keto Flu: Symptoms and How to Get Rid of It

The keto flu can make you feel miserable.

Luckily, there are ways to reduce its flu-like symptoms and help your body get through the transition period more easily.

Stay Hydrated

Drinking enough water is necessary for optimal health and can also help reduce symptoms.

A keto diet can cause you to rapidly shed water stores, increasing the risk of dehydration (5).

This is because glycogen, the stored form of carbohydrates, binds to water in the body. When dietary carbohydrates are reduced, glycogen levels plummet and water is excreted from the body (6).

Staying hydrated can help with symptoms like fatigue and muscle cramping (7).

Replacing fluids is especially important when you are experiencing keto-flu-associated diarrhea, which can cause additional fluid loss (8).

Avoid Strenuous Exercise

While exercise is important for staying healthy and keeping body weight in check, strenuous exercise should be avoided when experiencing keto-flu symptoms.

Fatigue, muscle cramps and stomach discomfort are common in the first week of following a ketogenic diet, so it may be a good idea to give your body a rest.

Activities like intense biking, running, weight lifting and strenuous workouts may have to be put on the back burner while your system adapts to new fuel sources.

While these types of exercise should be avoided if you are experiencing the keto flu, light activities like walking, yoga or leisurely biking may improve symptoms.

Replace Electrolytes

Replacing dietary electrolytes may help reduce keto-flu symptoms.

When following a ketogenic diet, levels of insulin, an important hormone that helps the body absorb glucose from the bloodstream, decrease.

When insulin levels decrease, the kidneys release excess sodium from the body (9).

What’s more, the keto diet restricts many foods that are high in potassium, including fruits, beans and starchy vegetables.

Getting adequate amounts of these important nutrients is an excellent way to power through the adaptation period of the diet.

Salting food to taste and including potassium-rich, keto-friendly foods like green leafy vegetables and avocados are an excellent way to ensure you are maintaining a healthy balance of electrolytes.

These foods are also high in magnesium, which may help reduce muscle cramps, sleep issues and headaches (10).

Get Adequate Sleep

Fatigue and irritability are common complaints of people who are adapting to a ketogenic diet.

Lack of sleep causes levels of the stress hormone cortisol to rise in the body, which can negatively impact mood and make keto-flu symptoms worse (11, 12).

If you are having a difficult time falling or staying asleep, try one of the following tips:

  • Reduce caffeine intake: Caffeine is a stimulant that may negatively impact sleep. If you drink caffeinated beverages, only do so in the morning so your sleep is not affected (13).
  • Cut out ambient light: Shut off cell phones, computers and televisions in the bedroom to create a dark environment and promote restful sleep (14).
  • Take a bath: Adding Epsom salt or lavender essential oil to your bath is a relaxing way to wind down and get ready for sleep (15).
  • Get up early: Waking at the same time every day and avoiding oversleeping may help normalize your sleep patterns and improve sleep quality over time (16).

Make Sure You Are Eating Enough Fat (and Carbs)

Transitioning to a very low-carb diet can cause you to crave foods that are restricted on the ketogenic diet, such as cookies, bread, pasta and bagels.

However, eating enough fat, the primary fuel source on the ketogenic diet, will help reduce cravings and keep you feeling satisfied.

In fact, research shows that low-carb diets help reduce cravings for sweets and high-carb foods (17).

Those having a difficult time adapting to the ketogenic diet may have to eliminate carbohydrates gradually, rather than all at once.

Slowly cutting back on carbs, while increasing fat and protein in your diet, may help make the transition smoother and decrease keto-flu symptoms.

Summary You can combat the keto flu by staying hydrated, replacing electrolytes, getting plenty of sleep, avoiding strenuous activities, eating enough fat and cutting out carbs slowly over time.

What Is the Keto Flu and How Do You Cure it?

The keto flu: Yes, it’s a real thing, and it can happen when you drastically and suddenly remove carbs from your diet.

Also known as the “carb flu,” the keto flu is a natural reaction (almost like a feeling of withdrawal) your body undergoes when switching from burning glucose (sugar) as energy to burning fat instead. In fact, some people say the keto flu symptoms can actually feel similar to withdrawing from an addictive substance.

If you’ve recently switched to the keto diet and you’re feeling drowsy, achy, nauseous, dizzy, and irritable, don’t worry. These symptoms are your body’s natural reaction to removing carbs from your diet, and while it may have you second guessing your keto diet decision, we promise you these keto flu symptoms will pass. Stick with it, and soon you’ll be reaping the energizing, fat-burning rewards that come with ketosis.

In the meantime, there are many things you can do to reduce the symptoms of the keto flu. We’ll tell you exactly which remedies you can start using today, but first, let’s take a quick look at why the keto flu happens when you go low carb.

Why The Keto Flu Happens

By default, your body burns glucose (carbs) as its primary energy source, but when you switch to an extremely low carb diet, your body will begin to burn fatty acids for energy instead. Fat is your body’s secondary or “backup” fuel source, which can only be tapped when there’s not enough glucose in your diet. When your body begins burning fat as fuel instead of carbs, you’ve entered the metabolic state known as ketosis (1).

This manipulation of your metabolism yields endless health benefits, and is the whole premise behind the ketogenic diet. If you’d like to learn more, we go into much more detail about ketosis and how it works in our Ketogenic Diet Mastery Guide.

Here’s a list of symptoms that you may experience during the initial transition to the low carb ketogenic diet:

Symptoms of the Keto Flu

  • Sugar cravings
  • Dizziness
  • Brain fog
  • Irritability
  • Poor focus and concentration
  • Stomach pains
  • Nausea
  • Cramping
  • Confusion
  • Muscle soreness
  • Difficulty falling asleep

How Long Does the Keto Flu Last?

For the average person, the keto flu lasts a week or less, and symptoms usually begin within the first day or two of removing carbs. In extreme cases, the keto flu can last up to a month, but that’s not as common.

If you’re used to eating a diet high in refined sugar and processed foods, you’re more likely to experience the “withdrawal” symptoms of removing carbs. Studies show that sugar is more addictive than certain drugs (2).

If your diet is relatively low in processed sugars and starches, you may only encounter mild keto flu symptoms, or none at all.

Not everyone experiences the keto flu, even when switching from diets high in carbs and sugar. Whether or not you experience the keto flu can depend on your genetics. Some people are naturally metabolically flexible, which means they can shift metabolic states easily without experiencing health symptoms.

However, if you are experiencing the effects of the keto flu, here’s what you can do to reduce your symptoms (and how to prevent symptoms if you’re currently considering going low carb).

How to Manage Keto Flu Symptoms

1. Take an Electrolyte Supplement

When you switch to an extremely low carb ketogenic diet, you end up cutting out some of the richest natural sources of electrolytes, such as starchy fruit and vegetables.

Not getting enough electrolytes in your diet can lead to fatigue, irritability, dizziness, muscle cramping, and cognitive symptoms such as confusion (3)(4). Low electrolytes play a big role in the onset of keto flu symptoms.

One way to get more electrolytes in your diet without kicking your body out of ketosis is to take an electrolyte supplement at least once per day. If you’re active, you’ll also want to make sure you’re taking electrolytes after you work out to prevent muscle cramps and dehydration.

You’ll want to make sure your electrolyte supplement is keto friendly, meaning it has no sugar or artificial sweeteners added (zero calorie sweeteners like stevia and xylitol are fine). Look for an electrolyte supplement that contains sodium, potassium, calcium, and magnesium.

As for electrolyte sports drinks, they typically contain processed sugar in some form, like glucose syrup or high fructose corn syrup. Avoid these by making your own keto-friendly sports drink at home using 1 cup of water, 1 teaspoon of mineral sea salt, and freshly squeezed lemon or lime juice.

2. Hydrate

When you have the keto flu, it’s not only important to make sure you’re getting plenty of electrolytes, but fluids in general.

Staying hydrated will help relieve headaches and boost your energy levels when you’re feeling sluggish. If you forget to drink enough water during the day, setting an alarm on your phone can help you remember, as well as keeping a full glass or bottle of water within reach at all times.

Not sure how much water you need? Follow this simple equation:

Take your current body weight and divide it by two to determine the minimum ounces of water you need (plus extra if you’re active). For example, if you weigh 150 pounds, you need at least 75 ounces of water each day.

3. Drink Bone Broth

Speaking of hydration, meet the ultimate keto flu recovery remedy: bone broth.

Rather than going for the carb-loaded chicken noodle soup (or store-bought chicken broth, which can be high in MSG and other additives), give bone broth a try to help alleviate your symptoms. Bone broth is an easy way to sneak more water into your diet and it also provides electrolytes, such as sodium and potassium.

Both varieties of Kettle and Fire Bone Broth fit into the keto diet macros nicely.

Kettle and Fire Chicken Bone Broth contains 10 grams of protein, 1 gram of fat, and 0 carbs per serving.

Kettle and Fire Beef Bone Broth contains 6 grams of protein, 0 grams of fat, and 2 grams of carbs per serving.

Note: These nutritional values of bone broth are specific to Kettle and Fire. Based on ingredients, the macros can vary for other store bought brands or homemade broth.

4. Eat More Fat

If your carb cravings are so intense, you’ve begun to dream of buttered rolls, donuts, and pasta, do the opposite of what your body is asking for and eat more fat instead.

Yes, ramping up your fat consumption can help speed up the transition of burning fat for fuel instead of glucose. Have a tablespoon of coconut oil in your coffee or tea, snack on half of an avocado and some bacon, and load up on egg yolks at dinner before you reach for the carbs, and remember: the keto flu too shall pass (and the benefits that follow ketosis will be totally worth it in the end).

5. Take an Exogenous Ketone Supplement

Taking an exogenous ketone supplement, such as Perfect Keto can also help reduce keto flu symptoms. Exogenous ketones help fight fatigue and boost energy levels by raising the ketone levels in your blood. To be clear, ketone supplements aren’t a replacement for the keto diet, but they can help you stay in ketosis when you’re meeting your macros, and provide all day energy.

6. Check Your Carb Consumption (You May Need a Few More)

We’ve just told you to eat more fat, but now we’re telling you to eat more carbs? How does that work?

There are two scenarios when you may need to increase your carb intake on the keto diet.

1. High Activity Levels: If you’re extremely active and have keto flu symptoms, adding a few more “clean” carbs to your meals (such as 1/2 cup of sweet potatoes, 1/2 a banana in your protein shake, etc.) can help relieve symptoms in the transition phase.

2. Former Carb-Rich Diet: If the keto flu is hitting you hard and you had a carb rich diet before going keto (especially with processed carbs and sugar), you may need to take a few steps back and eliminate carbs gradually rather than all at once.

Before you add extra carbs to your diet, we recommend going back to step four and increasing fat first. If you experience no relief, do a mini transition phase between your normal diet and going low carb. This gradual transition phase will look different for everyone depending on how many carbs you were consuming on a daily basis.

The best starting point for a transition phase is to eliminate all processed carbs and grains, and focus on getting your carbs only from starchy fruit and vegetables. You can slowly phase out carbs each day by reducing the amount you’re eating at each meal until eventually, carbs will only be 5% of your daily diet, which is when your body can enter ketosis.

7. Gentle Exercise

We get it: the last thing you’re thinking of when you have aching muscles and nausea is going for a brisk jog in the park. But gentle exercise, such as a restorative yoga class, can actually help relieve muscle pain and tension and release endorphins to help boost your mood and motivation.

8. Get Plenty of Restful Sleep

The keto flu affects everyone differently. If you have difficulty falling asleep or getting restful sleep, try these tips to sleep soundly.

Take an epsom salt bath: Soaking in a warm epsom salt bath can help soothe and relax your muscles and improve electrolyte absorption. Magnesium (epsom) salts can be found at any grocery store or health food store.

Drink sleepytime tea: A keto friendly herbal tea with a blend of herbs that promote restful sleep (such as valerian root and chamomile) have a calming effect on your nervous system, and can help promote deeper sleep.

Have an electronics curfew: According to Harvard University, the blue light from tablets, laptops, and smartphones can seriously interfere with your circadian rhythm, and make it difficult for you to fall asleep (6). Having an electronics curfew (ideally at least two hours before you go to bed) is an excellent way to improve your sleep quality. Why not replace the nightly Instagram, Facebook, and email-checking time with a bedtime ritual that helps you relax and unwind?

An epsom salt bath with a cup of keto sleepy time tea is a great starting point. You could also try a guided meditation for relaxation, and a few soothing yoga poses (our favorite is putting your legs up the wall).

The keto flu may be a downside to starting a keto diet, but it’s the only disadvantage. Once your body is used to ketosis, you’ll be amazed at the limitless energy you have, the fat loss you see, and how good you feel on a daily basis.

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It seems like autoimmune diseases are popping up everywhere these days. As the incidence of diseases like Hashimoto’s thyroiditis, RA (rheumatoid arthritis), Lupus, Crohn’s disease, and MS (multiple sclerosis) continue to rise, the need for effective treatments also increases.

Diet and gut health are huge areas of opportunity when it comes to reducing inflammation and getting autoimmune diseases under control.

And research is showing some promise when it comes to autoimmunity and nutrient-dense diets filled with coconut oil, bone broth, vegetables, and pastured meats.

The answer to your sweet tooth. 17g of fat, 3g of net carbs, incredibly delicious.

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But is there one diet that’s best for autoimmune conditions?

Popular protocols like the AIP diet (autoimmune Paleo), which limits nightshade vegetables and food additives seems to be gaining traction, but where does a ketogenic diet fit in?

What Is Autoimmune Disease?

The health of your immune system dictates the health of every cell in your body.

Autoimmune disease is a growing issue in the U.S., with an estimated 50 million people currently diagnosed and over 80 types of autoimmune diseases identified.

With numbers like that, it’s highly likely that you know someone with autoimmune disease, or have autoimmune issues yourself.

So, what’s happening in your body when you have an autoimmune condition?

Let’s start by looking at what happens when your immune system is working optimally.

Under normal conditions, your immune system is always on the defense, looking for foreign substances like bacteria and viruses to attack and eliminate from your body. It’s an incredibly intricate and complicated system that’s meant to keep you healthy and shield you from outside invaders.

In the case of autoimmunity, your immune system starts to mistake healthy cells and tissue as outside invaders.

In other words, your immune system turns on you and starts a full-on attack.

Diseases like Hashimoto’s, multiple sclerosis, rheumatoid arthritis, and type 1 diabetes all fall under the autoimmune umbrella.

What Does “Root Cause” Mean?

The cause — or causes — of autoimmune diseases is still under investigation.

However, the main theory is that you are either genetically prone to an autoimmune disease or you’re not.

Then, there’s usually an incident, or a series of incidents, that trigger the condition to manifest.

That initial trigger is usually referred to as the “root cause.”

The trigger can come in many forms, like:

  • A virus
  • Infection
  • Stress (both acute like a car accident, or chronic stress)
  • Injury
  • Pregnancy
  • Chronic poor nutrition

One of the main potential root causes of autoimmune disease is poor gut health leading to leaky gut syndrome, which causes systemic inflammation.

This is where diet and nutrition come into play when it comes to preventing and healing autoimmune issues.

How A Keto Diet Addresses The Root Cause

Hippocrates said, “all disease begins in the gut,” and nothing could be more accurate when it comes to autoimmune disease.

Your gut is your first line of defense for your immune system — the initial barrier that keeps all unwanted substances out of your internal circulation.

Research shows that your gut microbiome and the integrity of your gut lining both play a key role in whether or not you’ll experience autoimmune disease.

One of the most effective ways to keep your gut happy is to eat a diet that reduces overall inflammation. And this is where the ketogenic diet can help.

How The Keto Diet Reduces Inflammation

The keto diet has been shown to decrease inflammation in your body by way of the ketone body BHB (beta-hydroxybutyrate). Ketone bodies are what your body makes when you get into a ketogenic state.

BHB helps reduce all over inflammation, but especially inflammation in your gut lining.

On the other hand, many of the staples of a conventional high-carb diet — refined carbohydrates, sugar, and gluten — are all known to cause inflammation in the gut.

Is Your Diet Flipping the Switch On Your Autoimmunity?

When it comes to genetics, it’s always a game of nature vs. nurture. You may have heard the term epigenetics, which describes your genes’ ability to turn on and off depending on environmental factors like sleep, exercise, and yes — the food you eat.

That means that just because an autoimmune disease runs in your family doesn’t mean you’ll get it.

It also means that your diet, stress levels, and overall lifestyle has a huge impact on whether or not your autoimmune disease will flare. In fact, research suggests an epigenetic component to most autoimmune diseases including multiple sclerosis, type 1 diabetes, rheumatoid arthritis and lupus.

So how can you optimize your lifestyle to stave off autoimmune disease?

Diet, sleep, movement, and stress management are all imperative.

Common Autoimmune Diseases And How Keto Might Help

Crohn’s Disease

Crohn’s disease is a chronic inflammatory bowel disease (IBD) in which your immune system attacks your gastrointestinal (GI) tract.

Most IBD sufferers experience immense pain, inflammation, and scarring. Some need life-changing surgeries for relief

It’s estimated that over 3 million adults in the U.S. suffer from IBD (either Crohn’s or ulcerative colitis).

Because Crohn’s disease is a result of severe chronic inflammation in your gut, dietary interventions that decrease inflammation like the ketogenic diet can be used in an effort to heal your gut lining.

Although more research needs to be done, there is a published case report where the ketogenic diet was successfully used to treat symptoms and normalize the labs of someone with severe Crohn’s disease.

A healthy keto diet eliminates all foods that aggravate your gut lining — sugar, gluten, and refined carbohydrates — all while increasing anti-inflammatory pathways in your body.

Multiple Sclerosis

There are about 200 new cases of multiple sclerosis (MS) diagnosed in the U.S. each week and a recent study reported that nearly 1 million people in the U.S. are living with MS. That’s more than twice the number previously reported from 1975.

Even with numbers on the rise, scientists don’t fully understand what causes MS and there’s currently no cure for this disabling disease.

MS causes damage to nerves that are responsible for communicating between your brain and the rest of your body. This leads to symptoms like fatigue, pain, impaired coordination, weakness, loss of vision, and more.

So how might the ketogenic diet help people suffering from MS?

Some recent research suggests that MS may impair your brain’s ability to use glucose for fuel. This means that all those carbohydrates you’re eating aren’t getting to your brain. And unless it has an alternative fuel source, you’re going to have some problems.

Ketones might help.

There’s also some evidence (in mice models) that by providing an alternative fuel source, the keto diet may be able to help with the neurodegenerative aspect of MS.

Specifically, the ketogenic diet helps increase energy production on a cellular level, which impacts the health of your energy power-houses, mitochondria.

People suffering from MS may have impaired mitochondrial function, so this boost in mitochondrial health could be an essential piece to managing MS symptoms and progression.


Unlike RA and MS, which tend to attack specific areas of the body, Lupus is an autoimmune disease that can attack any part of the body.

Much like the other autoimmune diseases, Lupus can result in inflammation, swelling, and damage to your organs and joints. It’s reported that 5 million people around the world suffer from Lupus, and 16,000 new cases of Lupus are reported each year.

Studies have shown that Lupus can activate a specific immune system receptor (inflammasome NLRP3).

The activation of NLRP3 signals other inflammatory molecules in your body to activate and do what they do best — cause inflammation. When this cascade continues, the inflammation can become chronic and lead to debilitating pain.

Luckily, when your body is in ketosis it can support the interruption of this cascade.

Here’s how:

  • When eating a ketogenic diet your body makes an abundance of the ketone BHB (beta-hydroxybutyrate).
  • One of the ways BHB has been shown to decrease inflammation is by inhibiting the NLRP3 inflammasome.
  • This means that if you have Lupus and you’re eating a keto diet, you’re literally flooding your body with the very antidote to one of the main pathways that is causing your inflammation.

Rheumatoid Arthritis

About 1.5 million people in the U.S, have RA (rheumatoid arthritis), affecting almost three times as many women as men.

Like other autoimmune diseases that target specific tissues (like Hashimoto’s thyroiditis), RA causes your immune system to attack your joints.

This leads to inflammation, which causes swelling and, ultimately, thickening of the tissues lining your joints. It can even lead to cartilage and bone damage.

As you can imagine, it’s incredibly painful.

RA most commonly affects the joints in hands, feet, wrists, elbows, knees and ankles . This critical compound is a key player in your immune system, warding off free radicals and protecting your body from oxidative stress.

When oxidation in your body isn’t balanced with antioxidants like glutathione, inflammation can take over.

An autoimmune diet that controls inflammation and enhances antioxidant activity is essential if you’re suffering from RA.

Although human studies on the ketogenic diet and RA are still lacking, there are a few animal model studies showing that the ketogenic diet increases glutathione, and therefore, antioxidant activity.

This, combined with the known anti-inflammatory effect of the ketogenic diet makes a compelling case to give keto a try if you’re struggling with RA.


Psoriasis is an autoimmune condition that affects your skin.

For most people, it causes red bumpy patches with white scales. It’s incredibly itchy and painful. While it can affect any area, it typically occurs on the elbows, knees, or scalp.

No one knows exactly what causes psoriasis, but like all autoimmune diseases, your immune system and genetics seem to play a role. Typically, Psoriasis will develop between ages 15 and 25, and it affects both men and women equally .

Although no studies to date have looked specifically at the ketogenic diet and psoriasis, it has a lot in common with the other autoimmune diseases discussed. Mainly, flares are linked to inflammation and an overactive immune system.

Therefore, managing inflammation with an anti-inflammatory autoimmune diet (like the ketogenic diet) is an important step in managing the overall effects of psoriasis.

There’s also been a link between weight management and remission of psoriasis. It’s well known that your body fat can have a pro-inflammatory effect on your entire system.

If you’re struggling with psoriasis, or any autoimmune disease for that matter, any reduction in systemic inflammation in your body is helpful.

One case study focused specifically on the ketogenic diet as a tool for weight loss and psoriasis management in a woman struggling with moderate to severe plaque psoriasis [.

This case study is promising and will hopefully drive more research to uncover how the ketogenic diet can help those suffering with this painful skin condition.

Foods To Avoid For Autoimmune Symptoms

If you’re following a low-carb ketogenic diet then you’re already avoiding many common gut irritants like corn and wheat, which is a great start.

On an autoimmune protocol, you’ll want to take that a step further to avoid any foods that might trigger an immune reaction, such as common allergens.

Here’s a list of foods to stay away from if you’re experiencing an autoimmune flare up or you want to heal your gut:

  • All grains (wheat, oats, rice, quinoa, rye, millet, etc.)
  • Dairy (common allergen)
  • Eggs (common allergen)
  • Legumes (hard to digest)
  • Nightshade vegetables (tomatoes, eggplants, peppers, and potatoes), can be inflammatory
  • All forms of sugar, including sugar replacements (except for occasional use of honey)
  • Food additives
  • Alcohol
  • Check out the Ketogenic Diet Foods to Avoid for more info.

What To Eat For Autoimmune Symptoms

Focus on the high-quality, gut-friendly foods below and check out the Low-Carb Keto Food List for more info on keto-friendly foods.

  • Healthy fats (grass-fed butter, ghee, coconut oil, grass-fed beef, avocados, olive oil, MCT Oil or MCT Oil Powder)
  • Fermented foods (kombucha, kefir, kimchi, sauerkraut)
  • Bone broth, offal
  • High-quality organic meat and fatty fish
  • Collagen protein
  • Low-carb veggies (kale, spinach, bok-choy, collard greens, broccoli, cauliflower)
  • Coconut milk (works great to replace dairy)

The Takeaway

Research into the keto diet and autoimmunity looks relatively strong if you’re suffering from MS, and definitely promising if you have lupus, RA, Crohn’s, or psoriasis.

The anti-inflammatory effects of keto can give a boost to the immune system, and in some cases work in direct opposition to autoimmune challenges.

Gut health is one of the major threads that connect all autoimmune diseases.

The ketogenic diet is known as an anti-inflammatory diet when you do it correctly — avoiding most packaged foods and sticking to high-quality meat, low-carb vegetables, and healthy fats.

Everyone’s body is different, so it’s always important to consult your doctor for medical advice if you’re thinking about changing your diet to assist in disease management. Like all things in life — diet is not a one size fits all.

Setting out on your keto adventure can be tricky in the beginning, especially if you’re already managing health issues.

If you’re trying keto for the first time check out the Keto Kickstart Program for a comprehensive 30-day step by step guide with tips, tools, recipes, shopping lists and more.


Nuts, seeds, berries Lower-carbohydrate fruits include strawberries, blueberries, blackberries. My absolute favorite berry is something you probably don’t think of as a berry at all… the AVOCADO! It is technically a single-seeded berry. Avocados provide rich amounts of fiber, antioxidants, such as vitamin E, and heart-healthy fat.
I don’t eat a lot of nuts. They can be high in inflammatory Omega- 6s. This includes almonds, walnuts, pine nuts, and oils like sunflower and corn. If I were going to eat nuts it would be Macadamia nuts which have healthy fats.
Raw, Full Fat Dairy
Dairy products are valuable sources of calcium, vitamin D and protein. Much of the fat in classic ketogenic diets derive from high-fat dairy products, such as cream cheese, sour cream, butter and heavy whipping cream. You can also get your dessert fix by mixing cream cheese or cream with Stevia. And then who can forget CHEESE! I need to try and slow my roll with cheese, but it is SO GOOD! Cheddar, mozzarella, brie etc…
Vegetables (and just say no to Nightshades)
The best choices for vegetables are those that are high in nutrients and low in carbohydrates, so of course anything dark and leafy scores high (kale, spinach). Also veggies that grow above ground like lettuce, cucumbers, brussel sprouts and cauliflower. Sweeter veggies should be avoided (carrots, squash, onions, peppers). Which leads me to Nightshades. I had never heard the term Nightshades until I started researching the Keto lifestyle, but there is a lot of talk about them online because it seems that they can trigger a variety of chronic conditions such as arthritis, fibromyalgia and IBS. This include tomatoes, eggplant, red and white potatoes, and all peppers.
Lean Meat and Fish
You need to be careful not to eat too much protein when you are following a keto diet, because it can kick you out of ketosis. But the easy protein options include chicken of course and lean fish like cod, catfish, mahi mahi, and tuna (a full list can be found here: Fatty Meat and Fish, organ meats, eggs
Bacon! My favorite food group:) Uncured of course. Steak, lamb, and pork are examples. I stay away from organ meats all together… yuck! But to each his own.
Fatty fish is defined as fish with over 5% fat by weight and includes anchovies, eel, salmon, and chilean sea bass (a full list can be found here: I eat lots of salmon! Healthy fats and oils
This includes denser fat sources, such as butter and mayonnaise as well as flaxseed, canola or olive oil. Saturated and monounsaturated fats are more chemically stable and less inflammatory in people so they are preferred.
Herbs and spices
Stay away from pre-mixed spices, they have sugars added to them. Sea salt is better than table salt. Beyond that fresh herbs are always best and then stick to the individual spices and make your own mixes without the unnecessary sugar. Water!
I am a huge water person. Drink your water!!! I drink anywhere from 100oz to 130oz a day normally and I think I may even need to up that a little. It is extra important to drink a lot of water on a keto diet because it has a natural diuretic effect. I don’t drink coffee, but a lot of people do and some do that bulletproof coffee or mix coconut oil into their coffee to get some extra fats in.

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