Like many nutritional regimes, the ketogenic diet is a journey, not a destination. Because every person’s physiology is unique, every person will experience the ketogenic journey slightly differently. For individuals on a ketogenic diet, nutrient supplementation at different stages of the ketogenic journey can support a well-formulated diet plan. 

By greatly restricting the consumption of carbohydrates and sugars from all food sources, the ketogenic diet focuses on fats, sufficient protein, and a balance of vitamins and minerals. The diet forces the body into a metabolic state called ketosis, in which the body converts fats into ketones to be used as a source of energy. 

This way of eating changes how nutrients are metabolized and stored as the body begins to produce ketones, which has been shown to have direct effects on cholesterol levels, brain function, adipose tissue, fat oxidation, and mitochondrial function. Research on the ketogenic diet suggests it has beneficial effects for individuals with metabolic syndrome, diabetes, hyperlipidemia, cardiovascular disease, PCOS, epilepsy, Alzheimer’s and other dementias, Parkinson’s disease, and some cancers, as well as perhaps benefiting athletes who participate in endurance or weight-class sports.

The process of entering the state of ketosis, and how one experiences ketosis, varies from person to person. Some enter ketosis earlier than others, and some experience different side effects and outcomes than others. Understanding the body’s responses along the way provides insight into how to supplement a keto diet plan.

The Very Beginning

In the first days of a ketogenic diet, total food intake contains less than 25 grams of carbohydrates daily – equivalent to trace carbohydrates in vegetables, low-glycemic-index fruits, and no additional carbs. The body is forced to tap its stored carbohydrates, in the form of glycogen, for energy. Over the next few days or weeks, depending on physical activity level, the body depletes these glycogen stores. The initial weight loss on a ketogenic diet can cause cellular dehydration, because for every 1 gram of glycogen used, the body releases 2-3 grams of water. Sometimes called the “keto flu,” this phase can make the dieter feel imbalanced with flu-like symptoms, such as headache, nausea, and fatigue, as the body sheds water weight and electrolytes.

At this stage, food intake should account for the loss of sodium, magnesium, and potassium to minimize side effects. Adding electrolytes will help maintain proper intra- and extracellular hydration and support chemical reactions throughout the body, including in the brain, gastrointestinal tract, skeletal muscles, and heart. Drink plenty of water and consider adding these foods:

  1. Sodium: Some individuals might need upward of 4-5 grams of sodium a day, which is 2-3 times what is recommended for individuals not on this diet. Start adding salt at the beginning of the diet and continue as long as you are in ketosis. Liberally salt foods and consider drinking bouillon broth or Thorne’s Catalyte, which contains almost 500 mg of sodium and only 5 g of carbohydrates per scoop. Individuals with congestive heart failure or hypertension should consult a physician to determine their sodium protocol.
  2. Magnesium: Many of the foods allowed on a ketogenic diet – nuts, leafy greens, and meat – contain magnesium. But shedding electrolytes like magnesium can cause cramps when the body signals a need for more magnesium. Increase the consumption of magnesium-rich foods and consider Thorne’s Magnesium CitraMate in the daytime, to provide 135 mg one to three times daily, or Thorne’s Magnesium Bisglycinate in the evening, to provide 200 mg per scoop. The glycine in Magnesium Bisglycinate combines with the magnesium to support restful sleep.* Some individuals on a keto diet experience sleep issues when their insulin level begins to decrease and, in some instances, cortisol increases – both affecting sleep.
  3. Potassium: Some foods allowed on the ketogenic diet, like meats, non-starchy vegetables, and avocados, provide potassium. Inadequate potassium intake can result in changes in heart rate and blood pressure, muscle contractions, and improper nerve function. Consider Thorne’s Potassium Citrate if your diet is lacking. 

Note: Thorne’s Catalyte contains sodium, potassium, and magnesium, for individuals wanting a combination product for these three electrolytes.

Daily Maintenance

The ketogenic diet should continue to provide a daily variety of protein sources, healthy fats, and colorful vegetables. For individuals with food allergies or intolerances, or those who eat the same thing every day, some keto-friendly supplements can fill the gaps: 

  1. Multi-vitamin/mineral supplement: Because the keto regimen avoids certain food groups – like most fruits and other carbohydrates – and utilizes some cooking techniques that can cause foods to lose nutrients, a multi-vitamin/mineral supplement can ensure the diet plan hits all the micronutrient requirements daily. Thorne’s Basic Nutrients 2/Day provides highly absorbable forms of daily essential vitamins and minerals.
  2. Omega-3s: The foods highest in omega-3 fatty acids are fish sources, and all fish are appropriate for a ketogenic diet. Fish should be consumed three times weekly or omega-3-rich eggs daily. Individuals who do not meet recommendations should consider a supplement. Fatty-acid intake can be supplemented with Thorne’s Omega Plus, a formula that provides an optimal blend of omega-3 and omega-6 fatty acids.
  3. Fiber: This diet can cause constipation if enough high-fiber vegetables are not eaten or if they are over-cooked. In addition to staying hydrated and balancing electrolytes that also support bowel movements, Thorne’s FiberMend promotes regularity and optimal digestive function.* Fibers are also prebiotics, which support good bacteria growth in a microbiome that can become altered on a high-fat or excessive animal-based protein diet.

Specific Nutrient Support

For most individuals, the ketogenic diet diverges significantly from their former eating habits, necessitating the addition of other nutrient support.

  1. Protein: The ketogenic diet is not a high-protein diet because some amino acids are glucogenic when consumed in excess. On a daily basis, a moderate amount of protein should be consumed; usually about 2 g per kilogram of body weight, or 25 percent or less of total calories. For a person weighing 150 pounds (about 68 kg), that’s 136 g of protein daily. To vary the routine or for added convenience, Thorne’s Whey Protein contains 21 g of protein and only 3 g of carbohydrates per serving.
  2. L-carnitine: Regular consumption of meats, which naturally contain L-carnitine, can assist a keto diet plan. But because this diet is so high in fat, supplementing additional L-Carnitine promotes the metabolism of additional fatty acids into energy.*
  3. Digestive support: Some might notice gastrointestinal issues like bloating or feeling full for longer – a side effect of a high-fat diet. A digestive enzyme like Thorne’s Bio-Gest supports digestion and absorption of nutrients, including fats.*

Although many other Thorne supplements are keto-friendly, their use should be on a case-by-case basis as determined by the desired health conditions and health goals. Probiotics, products containing nicotinamide riboside, sleep support, and sports/exercise supplements can all be valuable when embarking on a personalized ketogenic journey. 


References

  • Masood W; Annamaraju P; Uppaluri KR. Ketogenic Diet. 2022. StatPearls Publishing LLC. https://www.ncbi.nlm.nih.gov/books/NBK499830/ [Accessed 5/10/22]
  • Paoli A, Rubini A, Volek JS, Grimaldi KA. Beyond weight loss: a review of the therapeutic uses of very-low-carbohydrate (ketogenic) diets [published correction appears in Eur J Clin Nutr. 2014;68(5):641]. Eur J Clin Nutr 2013;67(8):789-796. 
  • Volek JS, Noakes T, Phinney SD. Rethinking fat as a fuel for endurance exercise. Eur J Sport Sci 2015;15(1):13-20.
  • Volek JS, Phinney SD.  The Art and Science of Low Carbohydrate Performance.  2012. 78-85.  Beyond Obesity Publishing, Miami, FL.