Keto Diarrhea And Remedy: The Other Side of Ketosis

• Among the many benefits of keto diet, it may cause some side-effects like keto diarrhea.
• While on keto diet, sudden change in dietary habit may cause loose stools initially and momentary diarrhea is completely customary.
• If keto diarrhea does not heal over a weeks time, we should stop the keto diet immediately.

Keto Diarrhea: Prologue

In the past few years, we see keto diet making headlines for various number of times, articulating how professional athletes and celebrities get their body in shape and enhance their performance by adopting keto diet. I can clearly recall two articles featuring LeBron James and Halle Berry, where they explicitly expressed how keto diet helps them to excel in their respective fields.

However, what never comes to the fore or makes stories is the unwarranted hassle that comes along with those benefits. As the third law of motion goes, “every action has its own and opposite reaction”. While keto diet in action, we enjoy a lot of health benefits, but, on the flip side, we face some unpleasant side-effects as a reaction.

While on keto diet, we tend to put a lot of weight on fat intake and take a go-slow approach when it comes to carbs consumption. This sudden change in dietary habit may cause loose stools initially. This loose stool occurrence in keto diet is commonly referred as Keto Diarrhea.

Remember, momentary diarrhea is completely customary in keto diet most of the time. So, there is nothing serious to worry about as a few steps will help us overcome that.

Keto Diarrhea: A Real Life Tale

Mr. Andrew, a senior sales executive of a private firm, has to visit so many clients daily as his profession demands, hence he stays a bulk of his office time outside. One thing he hates to do or don’t feel comfortable to have a bowel movement in public restrooms.

Today, he has visited his client’s washroom three times already and interestingly in three different places. The same situation he also faced yesterday. He is concerned about what his clients would think as he is taking too much time in the bathroom or the way he rushes to the bathroom. Today, he doesn’t forget to bring an air freshener in his bag and sprays it in the air while on the toilet.

Mr. Andrew is thinking about the keto diet he started a few days ago. He blames this diet for all the hassles he is facing for the last two days. He reads all the good health benefits that this diet provides. But, he has never thought this diet would make his life miserable.

What Mr. Andrew is facing is called keto diarrhea, this keto flu symptoms will go away naturally once his body learns the art of using fat as fuel and runs on ketones. Usually people face this keto side-effect during the transition period that our body goes through after a few days of embracing keto diet.

Potential Causes That Lead To Keto Diarrhea

It is not true that all people who adopt the keto diet go through this keto flu symptom. Some people do not experience keto diarrhea while reaching ketosis state. As we are aware, keto diet is a low carb diet. Therefore, due to lack of fiber in the foods some people experience constipation. Whereas, experts point finger to excessive fat intake and artificial sweeteners & sugar alcohol and deem them as the main culprits behind keto diarrhea while on keto.

1. Surge in Fat Consumption: Blow to Gastro Intestinal (GI) Structure

When we embrace keto diet, we choose to enter into a new lifestyle – using fat as a fuel source and our body does need some time to cope up with that new diet domain.

In keto, we are usually allowed to eat meat, eggs, and fish meaning foods that are dominated by fats. Even fruits and a few types of vegetables off the menu. Therefore, we forced to introduce a new bunch of foods instead of all those carb-ridden delicious foods. Our body does need some time to adjust to that sudden change in food regimen.

Low-carb foods means we are forsaking sources of dietary fiber and fiber is one of the important elements to keep our bowel movement functional.

How Supplementary Fat Plays a Part

Keto diet is a fat-centric diet and by nature it is an arduous task to break all those fats down. And some people initially find it hard to absorb all those fat advocates in the keto diet. Supplementary fats like MCT or coconut oil just exacerbated the whole state of affairs as these products are totally new to our guts environment. However, that unused fat needs to be discharged. Hence, as a consequence we end up with running loose stool.

Gillian McKeith, a nutritionist articulated the whole condition very neatly:

“Whenever a change happens in our food regimen, our body starts to feel an imbalance in the system. In standard diet, foods like vegetables, fruits and grains are included. These foods are a great source of short chain fatty acids and our gut microbiome lives on that acids.”

“Whereas, keto diet are full of fats. And when our body can’t absorb all those fats, unused fats takes shelter into tiny intestines and colon. In the process, more water is used to make way for those fats, causing upset stomach.”

Experts recommend following fat sources as they are rich in omega-6 and omega-3.

Bottom line:If keto diarrhea becomes chronic, we can reduce the amount of fat intake for the time being. Especially, we got to be careful on the quantity MCT or Coconut oil consumption. We can switch to monounsaturated and saturated fat sources like olive oil, sunflower oil, avocado oil, Canola oil, lard, etc. to meet our fat demand during keto diarrhea.

2. Sugar Alcohols and Artificial Sweeteners: Vicious Circle of Carbs

We substitute our regular sugar with two alternatives – artificial sweeteners and sugar alcohol.

As we said earlier, keto diet is a fat-rich and low-carb diet. With all those tasty carb-infested food off the table, keto diet also strictly prohibits us from taking any kind of sweets, as they are full of carbs. So, in order to fill the vacuum of sugar, we tend to choose nutrition-free sugars in a bid to rein in carbs.

Those non-nutritive sugars, which are full of sugar alcohol, provide us with sweet taste but they do not absorb in our gut, causing harm to our gastrointestinal system. As a consequence, it leads to an upset stomach and makes us pay frequent visits to the loo.

Another serious issue is that almost all the sugar alcohol doesn’t help initiate insulin discharge in our body. Among many sugar alcohols following sugar alcohols cause gastrointestinal distress:

• Lactitol
• Maltitol
• Sorbitol
• Mannitol
• Xylitol

Here it is worth mentioning that despite using all the ingredients keto-friendly, only presence of artificial sweetener makes a lot of products non keto-generic. A prime example of this scenario is quest bar.

Bottom line: We should not consume sugar alcohol more than stipulated amount. The fewer we consume them, the earlier we get rid of diarrhea. Most of these sugar alcohol are not metabolized in our intestinal zone, hence, they time and again reach in gut area undigested, triggering loose stool.

3. Too Much Protein Intake: Derailing From Keto Basics

The ideal keto diet advocates for foods high in fat, moderate in protein and low in carbs. However, if we don’t monitor our macros properly, we may land us in trouble by unintentionally consuming too much protein. Dairy products coupled with extremely processed low-carb snacks are main culprits behind keto diarrhea. Besides, lack of fiber in the foods add to the cause.

We have to keep a vigil eye not only on the types of protein source, but also on the quantity. There are various types of cheese and creams in the market. So, while selecting we must have a look at the macros that they possess. We have to make sure that our protein intake limit doesn’t exceed 15-20% of our daily input.

Bottom line: Among three pillars of keto diet, one pillar stands for moderate protein intake. So any deviation from that basic task would cause bodily side-effects, while at the same time kicking us out of ketosis. Therefore, selecting the right protein source and right amount is highly recommended on keto diet.

4. Magnesium: Overindulgence Can Cause Bowel Tsunami

When we choose a low-carb eating scheme, imbalance in electrolyte is bound to happen. To make up for that minerals deficiency, we take vitamins and electrolyte supplements. Supplementing magnesium is very common in keto diet.

However, excessive magnesium intake can cause loose stool. When we consume too much magnesium, our body discharges those additional magnesium through stool, triggering diarrhea. The other two side-effect that we see as the result of high dose magnesium intake are:

• Bloating
• Abdominal Cramp

Experts recommend taking magnesium from foods rather than through supplementation. One magnesium-rich food is bone broth. A 300-320 mg/day intake of it would fill up the magnesium quota.

Bottom line: Since, keto diet is a low carb diet, absence of this nutrient leads to some mineral deficiency. In order to fulfill that deficiency, supplementation is a common phenomenon. However, we have to keep in mind that we don’t cross over the amount that is prescribed by experts.

5. Lactose Intolerance: Dairy Consumption Can Expose Food Allergy

Experts find lactose intolerance as one of the major sources of keto diarrhea. Keto is a fat dominant diet and many of us add dairy products to meet that fat demand. Adding fat in diet is not an issue to reach ketosis state.

However, we have to keep an eye on our bowel as to how it reacts to lactose. Even with no previous history of lactose intolerance, we may experience this food allergy, if we make a surge in our dairy intake while on keto.

Keto Diarrhea: Ways to Remedy

We hear people making a moan out of Diarrhea, when they are on keto diet.

We have figured out the prospective causes of keto diarrhea, now it time to get things back on track again.

The word supplement is very critical in fighting diarrhea. Because, in order to get rid of this distress, we need to introduce some supplements in our diet, while at the same time, some supplements have to be thrown away.

We have divided our remedy path in two sections. One section says we must do things while the other portion advocates us about things that need to be avoided. Following steps would help us fight diarrhea.

Must Do things: Adding New Macros

1. Fiber

“Take more fiber”, we will hear these words almost from everyone who embraces keto diet and has experienced keto flu like diarrhea. Fiber plays a big role in following two bodily functions:

• Regular Bowel Movement
• Digestive Health

It helps surge stool bulk, which pave the way to diminish diarrhea symptoms.

Taking fiber supplement would help in this cause, but most nutritionists decide against prescribing it. Rather, they advise us to increase our fiber consumption through seeds, nuts, leafy greens and other low-carb veggies. Following seeds are a great source of fiber:

• Chia Seeds (serving 1 oz): contains 10 grams fiber, only 2 grams net carbs
• Flaxseed (serving 2 tablespoons) : possesses 4 grams fiber, less than ¼ g net carbs

Gillian McKeith, a nutritionist voiced her concern on fiber supplements:

“Most of the fiber supplements are full of carbohydrates, in fact, possess more grams of carbs than prescribed amount. So, when we go for fiber supplementation and don’t carefully counts carbs macros, then it can create a barrier to reaching ketosis”

2. Probiotic and Fermented Foods

Probiotic plays a big role in retaining a balance of our gut bacteria and they help reinstate the health of our digestive tract. When in our gut bad bacteria supersedes good bacteria, it may lead to digestive problems. Here comes the role of probiotics, as it balances everything out.

Experts suggest consuming foods that are rich in dynamic bacterial cultures. Following are a few examples of probiotic foods:

• Kefir
• Pickles
• Sauerkraut
• Raw kimchi etc.

If probiotic foods don’t go with our taste, we can always try supplements in capsule shape or in powder form sprinkling on our food.

3. Drinking Water Aplenty

As we are aware, keto diet is dehydrated by nature. Besides, on this diet our body tends to discharge water more hastily than before. So, drinking a lot of water is imperative. Besides, if we are affected by any keto flu like diarrhea, we should drink water profusely.

Moreover, we lose fluid and electrolytes as an aftermath of diarrhea. So, replenishment of both do hold great significance.

A homemade bone-broth can be a good alternative to substitute our electrolytes.

4. Activated Charcoal

This has been used to treat this sort of keto flu from medieval times. Though fails to deal with the core cause of diarrhea, but works as a good substance for any sort of digestive indications.

Activated charcoal helps in following bodily functions:

• Lift our digestive system
• Detoxify our body
• Help glow our skin

It fixes pollutants and chemicals in the gut and helps prevent absorbing them. Again, be cautious on quantity, excessive intake may trigger another keto side effect – constipation.

5. Using Digestive Enzymes

As keto diet is a fat dominated diet, we are inclined to choose foods that are fat-ridden. There is nothing wrong with that but suddenly consuming tons of fats puts pressure on our body’s digestive system – may lead to off colored, soft and loose stool. However, we can help our digestion by introducing digestive enzymes. But while selecting enzymes, we keep an eye on the supplement’s level for,

• Lipase
• Protease
• Bile

Must Avoid Things: Pampering Supplements and Starches

1. MCTs Including Coconut Oil

A great source of Medium chain triglycerides is coconut oil. Nowadays, specialists suggest to include coconut oil in the diet, particularly as a cooking oil. As we are aware, MCTs are digested in our body really quickly as they directly enter into the bloodstream bypassing the liver. It is true that MCTs help accelerate ketosis process and stay in it.

Since they are absorbed fairly fast, excessive intake of them can lead to frequent bowel movement. Therefore, when supplementing MCT, we have to be careful about dosages, especially on the initial phase of keto diet.

If we get affected by loose stool, temporarily we can suspend MCT supplement intake or foods that contain loads of MCTs. When things get back into track, we can slowly incorporate them in our meals.

2. Magnesium

It is common traits in keto diet to use supplements to fulfill the different minerals deficiency. If we use magnesium supplement, then it would be wise to stay put that supplement until diarrhea fizzles out. The reason being magnesium draws more water into our colon.

3. Starchy Vegetables

Leafy and green vegetables are highly recommended in keto diet as they are full of fiber. However, our body is not accustomed to digest all the vegetables as there is a sudden surge in it. when we face keto side effect like diarrhea, we should try to avoid vegetables like leeks, brussels, onions, garlic, artichokes etc. rather our focus should be on following vegetables:

• Tomato
• Lettuce
• Cucumber
• Bean sprouts
• Bell pepper
• Zucchini

Conducting Test For Allergies and Intolerances

If the above mentioned steps fail to stop diarrhea, there is a big possibility that it might be the result of allergies and food intolerances. For both of these symptoms, we can run an allergy test and simultaneously can exclude all common allergens and intolerances from diets for a phase of 2-3 weeks. Usually following foods are dubbed as allergy-prone:

• Eggs
• Wheat
• Dairy
• Nuts
• Soy
• Nightshade veggies
• Shellfish

If we notice things getting back into normalcy, then we can start adding them back in phases. Remember, while on keto, we need to put our body in a surveillance mood. Because, a tiny derailment from keto basics can get us out of ketosis state or can cause keto flu. If we feel our body is reactive to above-mentioned foods, then, it indicates that our body has either allergy or food intolerance.

Dogged Diarrhea: Finding the Suitable Solutions

After making all the adjustments, if we still face stomach issues after a week or symptoms become severe, then it is time to visit a doctor. It may be the case that there are other reasons behind this chronic diarrhea other than keto diet.

We may see some health complications due to chronic diarrhea. Following are a few to name:

• Muscle Decline
• Vitamin Deficits
• Inequity in electrolyte

Gillian McKeith, a nutritionist give her final verdict on persistent keto diarrhea:

“If someone face chronic keto diarrhea that does not heal over a few weeks of time, while s/he already got adapted to keto diet, I would advise them to stop the keto diet with immediate effect. Because it may cause damage to short/long term health”

That’s why it is always recommended to visit a doctor whenever we decide to alter our food habits.

Keto Diarrhea: How Long Does It Last

Typically, keto diarrhea subsides within a days or two. In most acute situations, it may last up to a week depending on various issues.

If diarrhea carries on after our body gets fat adapted, then it is an obvious signal that the problem lies with something else. Allergies and food intolerance are the two common reasons that we see responsible for diarrhea besides keto diet.

We can try an elimination diet method to figure out which foods cause these keto flu symptoms. If situation goes beyond control, we should consult a doctor without further delay.

Conclusion

Keto side-effects like diarrhea is a common phenomenon while we embrace the keto diet. Sudden change in dietary habit certainly plays a role behind this issue. Besides, introduction of supplements like MCTs and magnesium add more fuel to the cause. Moreover, our body reacts negatively to some sort of vegetables like leeks, brussels, onions while on keto. Furthermore, sensitivity to food allergy is another variable that works behind this keto flu.

All in all, a lot of issues involved behind this keto side-effect. If it becomes persistent, we should consult with a doctor without further delay.

References:

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