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Consumer reports of “Keto Flu” associated with the ketogenic diet


Bostock, ECS and Kirkby, KC and Taylor, BV and Hawrelak, JA, Consumer reports of 'Keto Flu' associated with the ketogenic diet, Frontiers in Nutrition, 7 Article 20. ISSN 2296-861X (2020) [Refereed Article]


Copyright Statement

Copyright 2020 Bostock, Kirkby, Taylor and Hawrelak. Licensed under Creative Commons Attribution 4.0 International (CC BY 4.0)

DOI: doi:10.3389/fnut.2020.00020


Background: The ketogenic diet (KD) is a high-fat, low-carbohydrate diet that limits glucose and results in the production of ketones by the liver and their uptake as an alternative energy source by the brain. KD is an evidence-based treatment for intractable epilepsy. KD is also self-administered, with limited evidence of efficacy, for conditions including weight loss, cognitive and memory enhancement, type II diabetes, cancer, neurological and psychiatric disorders. A commonly discussed side effect of KD in media and online forums is "keto flu," a cluster of transient symptoms generally reported as occurring within the first few weeks of KD. This study aimed to characterize the pattern of symptoms, severity and time course of keto flu as related by users of online forums.

Method: Online forums referring to "keto flu," "keto-induction," or "keto-adaptation" in the URL were identified in Google. Passages describing personal experiences of keto flu were categorized manually with reference to pattern of symptoms, severity, time course, and remedies proposed.

Results: The search criteria identified 75 online forums, 43 met inclusion criteria and contained 448 posts from 300 unique users. Seventy-three made more than one post (mean 3.12, range 2–11). Descriptors of personal experience of keto flu, reported by 101 of 300 users, included 256 symptom descriptions involving 54 discrete symptoms. Commonest symptoms were "flu," headache, fatigue, nausea, dizziness, "brain fog," gastrointestinal discomfort, decreased energy, feeling faint and heartbeat alterations. Symptom reports peaked in the first and dwindled after 4 weeks. Resolution of keto flu symptoms was reported by eight users between days 3 and 30 (median 4.5, IQR 3–15). Severity of symptoms, reported by 60 users in 40 forums, was categorized as mild (N = 15), moderate (N = 23), or severe (N = 22). Eighteen remedies were proposed by 121 individual users in 225 posts.

Conclusions: Typically, individual posts provided fragmentary descriptions related to the flow of forum conversations. A composite picture emerged across 101 posts describing personally experienced symptoms. User conversations were generally supportive, sharing remedies for keto flu reflecting assumptions of physiological effects of KD.

Item Details

Item Type:Refereed Article
Keywords:ketogenic diet, keto flu, symptoms, online forums, consumer reports
Research Division:Biomedical and Clinical Sciences
Research Group:Nutrition and dietetics
Research Field:Sport and exercise nutrition
Objective Division:Health
Objective Group:Public health (excl. specific population health)
Objective Field:Nutrition
UTAS Author:Bostock, ECS (Dr Emmanuelle Bostock)
UTAS Author:Kirkby, KC (Professor Kenneth Kirkby)
UTAS Author:Taylor, BV (Professor Bruce Taylor)
UTAS Author:Hawrelak, JA (Dr Jason Hawrelak)
ID Code:137949
Year Published:2020
Web of Science® Times Cited:34
Deposited By:Pharmacy
Deposited On:2020-03-16
Last Modified:2022-08-29
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