Keto Q&A: Your top keto questions answered

Keto is in. One quick spin around the health and wellness sections of the internet or your grocery store, and you’ll probably see a reference to the ketogenic diet.

Ketogenic diets have earned their time in the spotlight. They’ve helped everyone from stay-at-home moms to Olympic athletes. Even the US military is studying the benefits of extended keto and how it might help make soldiers field-ready.1

However, despite all the attention, you may wonder, “What exactly is a ketogenic diet? Is a keto diet healthy? Should I try a keto diet?”

Take a look at the most popular ketogenic diet questions to determine if this trendy approach to eating can help you achieve your health goals.

1. What is keto?

First, keto is short for ketogenic. Your body goes into a ketogenic state in different times, such as when consuming less carbohydrates or when not consuming any type of food during a fast.

Without food coming in, your body adapts to the situation and creates its own energy source. This energy source is called ketones. When you are producing and using ketones for energy, you are in ketosis.

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2. What are ketones?

When you cut back on the sugar and carbs, your body makes ketones. These ketones are produced through the process of metabolizing fat. You can get this fat from one of two sources. First, you can eat healthy fat from real foods like avocados, extra-virgin olive oil and grass-fed butter. (Skip that trans fat and vegetable oils.)

Second, you can produce ketones from your adipose tissue (a.k.a. the unwanted fat on your body). Want to know the key that unlocks your fat cells? Low insulin. You must keep insulin levels low for ketone production and to burn fat. You can find out more about insulin in Part 2 of this series. 

When ketones, the main ketone being beta-hydroxybutyrate, reach a certain level in the blood, you are in ketosis. Translation: your body is getting more efficient at burning fat for fuel.

Four ways you can speed up ketosis: fasting, exercise, low carb diet, supplement with ketones

3. How long does it take to get into ketosis?

There are different factors that determine how long it will take for you to get in ketosis, including activity level and carbohydrate levels.


First, consider your the speed of your transition. Are you wading in to your keto diet, lowering carbs bit by bit or are you diving in, going cold turkey on your former high carb ways? The quicker your lower carbohydrate intake (and the lower the amount of carbs), the faster you’ll achieve ketosis. Faster ketosis means faster results.

Factors that promote a state of ketosis include:

  • Fasting
  • Exercise
  • Carbohydrate restriction
  • Exogenous ketones supplementation

What strategy is best for kicking your body into high gear? Talk with your functional medicine doctor to see what keto supporting strategies are best for you and your unique health story.

4. Is ketosis safe?

First, remember that ketosis a natural state of the body. Your body makes ketones for times when there’s not enough food. Ketosis is safe.

However, many people often confuse ketosis with the condition “ketoacidosis,” a serious state that can occur in diabetics when insulin is dangerously low.

Improper medication dosage and illness can lead to ketoacidosis in those with diabetes. In ketoacidosis, ketone levels reach sky-high levels, threatening to damage organs with their acidity. Put simply, the difference between ketosis and ketoacidosis is that ketosis is a natural state of the body and ketoacidosis is a pathological state.

5. Who should follow a ketogenic diet?

Often touted for weight loss success, keto has applications beyond the lose-weight-quick crowd.

First used medically as a way to control epilepsy, ketogenic eating can reduce seizures in children and adults. 3Reduced carbohydrate consumption and increased fat consumption has been studied for the use in treating drug-resistant epilepsy.4

Some pursue ketosis as a way to optimize brain function, reaping the benefit of increased focus and clarity. Others seek out the benefits of greater athletic composition and endurance.5 6

With its anti-inflammatory benefits, the ketogenic diet can benefit those wanting to lower inflammation. A study on keto diet improved sleep in those with prediabetes and those with type 2 diabetes. Participants were educated on the benefits of the ketogenic diet for managing blood sugar, cardiovascular and body weight risks.7

Keto is also being studied as an intervention for Alzheimer’s and drug-addiction.8 9

6. How do you know when you’re in ketosis?

One way is to test. You can use urine strips or a special glucometer to measure ketones in the blood. The urine strips are available for a few bucks at your local drug store. Functioning like some at-home pregnancy test, these little strips of paper are dipped in a cup of urine to measure ketones; however, they aren’t 100 percent accurate. If you’ve followed a keto diet for a while (recently or in the  past), then your results may be skewed.

Special ketone-reading glucometers like the Keto Mojo provide more accurate measurement. If you want to be on the cutting edge, there are a couple new breath-reading keto monitors, as well.

Or, you could go for the standard “How do I feel” test. Look for the physical and mental signs of ketosis.

7. How do I know I’m in ketosis?

There are several signs of ketosis than can indicate you’re burning ketones.

  • Bad breath10
  • Weight loss11
  • Alertness & energy12
  • Not “hangry” or hungry13

Stable moods, stable blood sugar, easier weight loss may all be signs your body has switched to ketones as their fuel source.

8. How many carbs should I eat to get into ketosis?

The number of carbs you need each day to still be able to reap the benefits of a ketogenic state vary from person to person. While some people need to drop to 30g of carbs, those who are highly active may reach ketosis (and all its benefits) on three times that amount. You will need to gauge how you feel and adjust accordingly. Note, when first starting a keto diet, you may develop symptoms of “keto flu” which are more or less carbohydrate withdrawal symptoms that should pass with time.

9. What is keto flu?

Don’t worry, it’s not really the flu; however, the symptoms that appear when they first transition from burning carbs to ketones as fuel are absolutely real. And sometimes, they’re really annoying. Thankfully, these unpleasant side effects of reducing your carbohydrate intake are short-lived.


Keto Flu Symptoms:

  • Headaches
  • Fatigue
  • Sugar cravings
  • Irritability
  • Brain Fog
  • Insomnia


Note, some people won’t experience any of these symptoms at all. How well you feel when switching to keto may be greatly influenced by how much sugar you were consuming each day before. The sugar and carbohydrate withdrawal symptoms will decrease in the first weeks.


Consuming appropriate amounts of electrolytes are the perfect way to ensure you have a (relatively) painless transition to a ketogenic diet.

10. Is keto safe without a gallbladder, during pregnancy, or if I’m diabetic?

Working with a functional medicine expert means you have someone looking at all the pieces of your health history, ensuring you have all the information you need to make the best decisions for your health. If you have specific health conditions and are curious about implementing a ketogenic diet, set up a consult with Dr. Emily.


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Want to take the next step toward a keto diet? Download this Top Ten Keto Tips.

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Next Steps:

  • Get answers to your questions: Got a keto question? Leave it in the comments below for Part 2 of this series!
  • Get tips: Download our Top Ten Keto Tips by clicking the images above.




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  2. “Efficacy of the classic ketogenic and the modified Atkins diets in … – NCBI.” Accessed 3 Apr. 2019.[/enf_note] 2 “Three and Six Months of Ketogenic Diet for Intractable … – NCBI.” 15 Mar. 2019, Accessed 3 Apr. 2019.
  3. “Ketogenic diets for drug-resistant epilepsy. – NCBI.” 7 Nov. 2018, Accessed 3 Apr. 2019.
  4. “A low-carbohydrate ketogenic diet reduces body mass without – NCBI.” Accessed 3 Apr. 2019.
  5. “Keto-Adaptation and Endurance Exercise Capacity, Fatigue … – NCBI.” 13 Feb. 2019, Accessed 3 Apr. 2019.
  6. “Improvement in patient-reported sleep in type 2 diabetes and … – NCBI.” 3 Jan. 2019, Accessed 3 Apr. 2019.
  7. “The ketogenic diet as a potential treatment and prevention … – NCBI.” 10 Oct. 2018, Accessed 3 Apr. 2019.
  8. “A ketogenic diet diminishes behavioral responses to cocaine in … – NCBI.” 4 Feb. 2019, Accessed 3 Apr. 2019.
  9. “Breath Acetone Is a Reliable Indicator of Ketosis in Adults … – NCBI.” Accessed 3 Apr. 2019.
  10. “Lack of suppression of circulating free fatty acids and … – NCBI – NIH.” 27 Jan. 2010, Accessed 3 Apr. 2019.
  11. “Low-carbohydrate weight-loss diets. Effects on cognition and … – NCBI.” 29 Aug. 2008, Accessed 3 Apr. 2019.
  12. “Do ketogenic diets really suppress appetite? A … – Wiley Online Library.” 17 Nov. 2014, Accessed 3 Apr. 2019.