Keto constipation and a sluggish metabolism got ya down? Here are 10 roadblocks why keto constipation and a slowed metabolism happens on a keto diet. Also included is the 6 do-now action steps to bust keto constipation and get into ketosis (in a healthy way)!
Like all popular diets, ketogenic diets don’t work for everyone. (After all, there’s no one-size-fits-all approach to eating).
Common side effects of keto “gone wrong” include:
- Keto Constipation
- Bloating or Stomach Pain, especially after meals
- Difficulty losing weight or unwanted weight gain (instead of weight loss)
- Muscle loss or unwanted weight loss
- Fatigue or low energy
- Decreased fitness/athletic performance
- Low thyroid function/hypothyroidism
- Nutrient deficiencies
—All seemingly the opposite of all the amazing benefits of the diet.
Keto Diet As a Therapeutic Diet
Additionally, while the keto diet is recognized as a great “therapeutic diet”— used for healing neurological conditions, correcting blood sugar imbalances, or a short term metabolic reset—keto dieting often gets taken out of context—as a long-term diet or eternal lifestyle, posing carbs as the evil enemy for life.
If we look to our ancestors, however, humans were not meant to live in ketosis forever, nor were they meant to measure their ketones in their urine or blood every day. Instead, ketosis happened naturally—during months and seasons where less carbohydrate sources were available. Sometimes people fasted. Other times people foraged. And others, people feasted. People typically ate what was in season or what they caught in the latest hunt; and they thrived. Aside from natural disasters, war and inclement weather, humans of the past did not know the same chronic diseases 1 in 2 people have today.
How to Make Keto Work for You
The optimal way to integrate a Ketogenic diet or lifestyle entails an initial “Keto reset” (typically 21-90 days), followed by an integration of “balance” back into a more balanced diet diet to encourage optimal metabolic flexibility—even if it is still keto-based.
1. Metabolic Flexibility
“Metabolic flexibility” is a fancy way of saying “the ability to adapt” in response to changes in nutrient availability (the ability to eat proteins, fats and/or carbs, as well as a variety of real, whole foods without freaking out your body or metabolism). Additionally, metabolic flexibility allows you to live your life, not confined to blood keno-glucose monitors or freaking out about the number of net carbs in your steak and baked potato on a hot date.
2. Carb Re-feeds
Many healthy ketogenic dieters include regular carb refeeds. This could be every night (such as a sweet potato or winter squash with your dinner), a few times a week, or once a month. Yes, this is true even for people who are trying to maintain a ketogenic diet year round. Furthermore, keto dieters will still sometimes do carb re-feeds that take them out of ketosis, because this ultimately helps them maintain their insulin sensitivity, athletic performance, thyroid–adrenal–gonadal/ovary function.
3. Cyclical Keto
Other people choose to do a keto diet cyclically or periodically, while maintaining a paleo-based diet with starchy plants and some fruits the other times. Cyclical or periodic keto eaters may choose to go into “ketosis” 3-4 weeks at a time, several times per year. This approach, too, also helps them to recover better insulin sensitivity and maintain healthy glucose regulation. Outside of those 3-4 weeks the diet can be expanded to be a more liberal, whole-food, carbohydrate intake or just a low-carb intake.
The Bottom Line:
If you are “going Keto,” it’s vital to be aware that, for most people, strict keto is not an optimal long-term human diet (unless used or needed for a therapeutic cause).
Additionally, knowing about the most common roadblocks people run into on a ketogenic diet (i.e. why keto often fails) can help you avoid these same mistakes, and thrive in the process. Many also experience some problems like keto constipation.
Here are 10 Common Keto Diet Roadblocks (plus 5 simple steps you can take to get into ketosis the “healthy way”).
10 Common Keto Roadblocks
Roadblock 1: Decreased Healthy Gut Bacteria
You gut is home to upwards of 15-30,000 different SPECIES of bacteria, and trillions of individual bacteria critters.
Gut bacteria DIVERSITY (different strains of bacteria) is associated with better health overall (Mosca et al, 2016).
Ketogenic diets have been shown to improve gut bacteria diversity in the presence of disease as a “therapeutic” diet (such as Autism (Newell et el, 2016) , Diabetes (Yancy Jr. et al, 2015) and Epilepsy Xie et al, 2017).
However, in healthier individuals and long-term dietary implementation, gut bacteria diversity appears to diminish (Xie et al, 2017), as well as increase systemic inflammation (Tagliabue et al, 2017; Schugar & Crawford, 2012) in the body—particularly without enough butyrate (Bourassa et al, 2016) (prebiotic fiber) present.
Low-carb, high-fat and higher-protein diets can also a decrease beneficial bacteria, while spiking overgrowth of negative bacteria in the gut, if and when dietary “balance” is lacking (particularly DIVERSITY of healthy fats). (Singh et al, 2017).
In addition, while many people believe that carbohydrates and sugars alone are the culprits for breeding “bad” gut bacteria, “bad” gut bacteria can EQUALLY breed from ketone bodies (the substances formed in the body from fatty acids to replace glucose—sugar—on a keto diet). Excess ketone bodies (such as from long term ketosis) have been linked to symptoms of IBS—explaining close ties for some who experience keto constipation or other gut symptoms (loose stools, bloating, diarrhea) when following a Ketogenic diet. (Campbell et al, 2010).
The Bottom Line:
Keto diets appear to improve gut bacteria diversity in unhealthy, disease state individuals. But for those who no longer have a disease or adhere to a long-term Keto diet however, healthy gut bacteria and diversity may lessen.
Roadblock 2: Lack of Fiber & Keto Constipation
By default, people on low carb diets aren’t eating a lot of color and plants—where most of the “push” for your food lies.
Each macronutrient we eat plays a unique role in your body and digestion:
- Fat = The “slippery slope” to help ease food down through the “tubes” of digestion. This can help with your keto constipation problem.
- Carbohydrates = The “bulk” to carry food through (and ride the slippery slope from fatty acids)
- Protein = The “building block” of your cells and muscles—essential for healthy cell metabolism and body structures/organs, as well as helps stimulate stomach acid and enzyme production (to break down food).
Ultimately, a healthy body desires balance from all food groups—and although it CAN create “glucose-like” energy from fats or proteins, or “protein-support” from broccoli and mushrooms, or extract fat from your chicken breast, ideally, it just wants the real deal so each macronutrient can stay in its lane and do their job—ESPECIALLY prebiotic foods, soluble fibers and short chain fatty acids to maximize healthy digestion (like starchy tubers and veggies, white rice, and fruits). Have you ever wondered why you experience keto constipation while on keto diet?
Prebiotic foods, fibers and short chain fatty acids are foods with fiber that “feed” healthy gut bacteria (probiotics), helping them populate the gut and feed beneficial bacteria in the colon. Prebiotic fiber has long been touted for promoting a healthier gut microbiome (Saha & Reimer,2014). Unlike other low-starchy carbs, like greens, cucumbers and celery (wonderful in their own right), pre-biotics help make our probiotics (healthy gut bacteria) STICK in our gut for the long term. Prebiotic fiber has also been shown in studies to significantly increase ketone production (body’s ability to burn fat for fuel) and boost metabolism (Vetali et al, 2010).
With less than 20-net carbs per day, some people develop keto constipation on a ketogenic diet, which is probably related to this. Although there aren’t any long-term studies to date on how keto affects gut health (since keto is so new), but there has been some research that suggests that very-low-carb diets may have a detrimental impact on the gut flora. Fortunately, there are effective ways to fix keto constipation.
The Bottom Line:
Resistant starch, pre-biotic foods support healthy digestion and a diverse microbiome.
If you choose to follow a very-low-carb or ketogenic diet over an extended period of time, using prebiotic, short chain fatty acid supplements and probiotic supplements to essentially replace the role that soluble fibers and resistant starches would play in the diet is essential You can also focus on the high-FODMAP vegetables that are rich in the non-starch polysaccharide fibers that can feed the beneficial bacteria in the gut.
Roadblock 3: Bulletproof Coffee, Bars, Shakes, Cheese & Other Dry Foods
Aside from running low starchy fibers, many people on a keto or Atkins’ style diet fail to eat enough color and green things in general—hydrating foods that support elimination (poop)—NEGLECTING carbohydrates and fiber altogether.
Bring on the butter, bacon, eggs, nutbutter, shakes and coffee! Opting for more white, brown and tan colors on their plate (instead of rich greens, reds, oranges, yellows, blues and purples) can keep you clogged! While bacon, butter and eggs are NOT bad things by any means, if and when we keep putting these dry foods down the hatch—without some hydrating foods from leafy and colorful things—we run “dry” ourselves (i.e. keto constipation).
Not to mention, many of the supplemental products like (exogenous ketones, shakes, bars, nutbuttter packets) people turn to when they “go Keto” are filled with fillers, additives, soy, artificial sweeteners and chemicals equally havoc-wreaking for your digestion; as do trans fats and industrial vegetable seed oils such as canola, soybean, corn, cottonseed oil, and so forth (often snuck into restaurant food—even at Whole Foods hot bar).
Lastly, food quality also matters. Is your dinner from Tyson Farm’s conventional chicken farm? Your “butter coffee” made from Keurig or Starbucks’ finest grounds (and highly cross-contaminated with gluten (Vojdani & Tarash, 2012 )? Your cheese from a high-pasteurized, hormone-infused dairy source? Do you experience keto constipation? Chances are, your gut knows the difference.
The Bottom Line:
Food quality, hydrating foods and nutrient-density matters, especially when you try to address keto constipation. If you’re eating conventional meats and dairy, bars, industrial seed oils shakes and processed Keto products, your body (digestion and metabolism included) is naturally going to struggle.
- Roadblock 4: Liver & Gallbladder Congestion
Do you ever get gas or a tummy ache after eating lots of healthy fats with your meal? Greasy stools or clay-colored stools? Pellets or rocks? You may have a sluggish or congested liver and/or gall-bladder—the organs essential for creating waste. When our detoxifying organs can’t do their job efficiently, “back up” (i.e. keto constipation) happens. In addition, your gallbladder is SPECIFICALLY responsible for digesting your fats and forming bile salts. If queasiness hits you when you eat a little too much coconut oil, or dig into a fatty steak, this could be because your gallbladder is not strong enough to break those fats down.
How do your liver or gallbladder go “bad?”
Common triggers to liver/gallbladder congestion include:
- History of low-fat diet
- Lack of (real food) fiber
- Low stomach acid
- History alcohol/processed food diet
- Toxin exposure (conventional beauty/cleaning products, tap water, plastics)
- Long term medication/NSAID use
- Poor quality meat/dairy
The Bottom Line:
Fats cause digestive distress if your liver/gallbladder is sluggish OR if you are not eating enough fiber (especially dark leafy greens) and hydrating water to assist in detoxification and elimination.
Roadblock 5: Feast & Fast
All or nothing. Many people on a keto diet dabble with IF (intermittent fasting), fasting and intermittent feasting. Going from 16-hours to days without food, then “feasting” on everything in site (within their dietary constraints of course). Sure, this all or nothing style of eating CAN mimic the way humans DID eat for centuries (times of “feast” and times of “famine”) and serve many well…
However, from a biological perspective, this “food dump” into your system with all of your daily calories at once (or within a shortened time frame) can ALSO be ALOT of “information” for your body to process at once. Couple this food dump (or feast) with any underlying “gut issues” (such as underlying bacterial overgrowth, low stomach acid or slow motility), blood sugar imbalances or metabolic issues (such as low thyroid function or high cortisol), and your ketogenic diet PLUS intermittent fasting may stress your body, digestion, blood sugar and metabolism out more. Unfortunately, some complain about keto constipation.
The Bottom Line:
Consider how well you digest your food and feel during your feeding periods. Bloated? Gassy? Constipated after a large meal post-fast, or trying to get all your energy needs in to a shortened time frame? Trying to figure out how to fix keto constipation? Your digestion may not be able to handle larger meals at once and can benefit from smaller. In addition, raise awareness to your own blood sugar stability and metabolism.
Do you get shaky or light headed if meals are skipped for long periods of time? Feel less energetic on days you’re not eating? Holding on to extra body fat despite following all the “rules” of intermittent fasting. Your body (and cortisol levels) may not be in a place to handle it right now. Experiment.
Roadblock 6: You Think About Food…And Carbs…And Counting Macros…Alot
Keto can become an obsession—just like any diet with rules. Counting and tracking carbs, fats and proteins has a time and place—especially when first starting out, but once you get into a groove or “ketosis,” counting and tracking is often unnecessary. Ketogenic diets can take on a life all their own, and you may find yourself spending more time than before, reading keto blogs, calculating macros, drooling over keto recipes, talking about keto dieting, posting on keto social media forums and occupying precious time with obsessive keto hacking.
The Bottom Line:
Eating keto is not a “bad” thing, but when it takes on a life of its own, it may be doing you more harm than good.
Roadblock 7: Eating the Same Thing Every Day
Keto diets often include about 5-10 foods at most: Eggs, bacon, steak, chicken or fish, cauliflower, avocado, nuts, tomatoes and salad greens. Repeat. The problem with this lack of variety is that it deprives your body of nutrients, essential to overall health and gut health. We can be eating, but starving at a cellular level, leading to low energy, poor digestion, hormone imbalances, low thyroid function and more.
The Bottom Line:
Mix it up. Aim to eat at least 2-3 different breakfasts, lunches and dinners throughout the week to keep your body guessing.
Roadblock 8: Not Losing Body Fat or Weight
For most folks, it is generally not necessary to go “full keto”in order to lose weight. Instead, what works best for most people is to match your carbohydrate intake with your style, frequency, intensity, and duration of exercise. If you lead a fairly sedentary lifestyle or you’re just walking, keto (lower carb) might be a great approach.
Additionally, if you’re an endurance athlete or do a lot of aerobic exercise such as running, cycling, or swimming, keto may also work well—as your body uses fatty acids for longer endurance activities. If you’re into high-intensity anaerobic exercise such as weightlifting, CrossFit or sprinting, keto is probably not a great choice.
If you find yourself gaining weight, despite following all the “keto rules,” you may want to check in with your total calorie intake. Sometimes under-eating can actually cause weight gain or slowed metabolism, and in other cases over consuming too many calories can cause weight gain as well. Starvation is not necessary, but finding the appropriate amount of daily energy intake is.
In addition, in some cases, people are also more sensitive to fat and simply put, thrive better on having some carbs or lower fat intake. Your doctor or healthcare provider may also want to check your thyroid function and/or hormone levels (cortisol), but generally, keto isn’t right for everyone and a different approach may work better.
The Bottom Line:
If you’re gaining weight on a keto diet and this is not your goal, keto simply may not be the best option for you. (And that’s ok).
Roadblock 9: Accidental Dieting
Whenever we eliminate a complete food group, we automatically eliminate calories or energy our body once thrived upon. On a keto diet, our former sweet potatoes, bananas, coconut flour tortillas and winter squashes get replaced with a couple eggs and bacon for breakfast, mixed greens with chicken and avocado for lunch, and some salmon and broccoli for dinner.
Some people even keep protein super low—fearing that the proteins they eat will also turn into glucose. While this is scientifically true, most people generally are not sensitive to protein in the same way as carbs, and very-low-protein diets with extremely high fat intake ) as some advocates of the ketogenic diet recommend), are usually not necessary and, in fact, can also be very counterproductive.
The result? Low calorie intake, lower energy overall and a host of health side effects. Unfortunately, since we are eating some more fat in our diet, we often don’t feel deprived at all or recognize the signs of undereating until several weeks or months later.
“Keto flu” also must be discussed—resulting from lack of carbs and electrolytes (sodium, potassium, magnesium and calcium) in foods. One of the biggest concerns with drastically reducing your carb consumption is not getting enough electrolytes (since the best natural sources of electrolytes are found in starchy veggies and fruits). Symptoms of the “keto flu” and low electrolytes may include fatigue, dizziness, muscle cramping, headaches and nausea.
Additionally, for people with HPA axis dysfunction (“adrenal fatigue”) and stress prior to “going keto,” keto can also make things even worse, particularly since blood sugar dysregulation is a primary cause of HPA axis dysfunction. While a diet high in refined sugar and carbs can also worsen HPA axis dysfunction, a diet that is too low in carbohydrate intake can actually cause similar problems.
Several signs of under-eating or stress from the keto diet may include:
- Amenorrhea/period loss
- Muscle wasting
- Perpetuated HPA Axis Dysfunction (elevated cortisol)
- Low energy
- Low libido
- Slowed digestion or keto constipation
- Not feeling like ourself
- Poor performance in the gym/fitness
- Unwanted weight loss
- Hypothyroidism/Low thyroid function
- Feeling wired and tired—at night
- Needing coffee to function or keep going
- Low blood pressure or heart rate
The Bottom Line:
It’s vital to be aware of how much you’re eating in order to prevent a nutrient and caloric deficit (and all the health issues—like keto flu and HPA Axis Dysfunction—that come with it). Establish your baseline caloric needs (typically anywhere from 2000 to 2600 for most moderately active adults), then aim for 60-80% of your calories from fat, 15-30% of calories from proteins, and 5-10% of calories from carbs, while supplementing with essentials (like electrolytes and amino acids) missing in your diet.
Roadblock 10: Insomnia or Disturbed Sleep
Insomnia or waking up in the night can go hand-in-hand with both under-eating as well as lack of carbs in the diet, as carbohydrates can stimulate serotonin (feel good brain chemical) production for a good night’s sleep. First things first: If sleep is disturbed, check your total calorie intake. In addition, make sure your are eating enough.
If so, then consider doing a mild carb refeed at night—especially if blood sugar is dropping too low overnight (a common reason for waking up in the middle of the night). In addition, consider checking sex hormones (particularly women) and cortisol levels. Low estrogen in women can contribute to insomnia, as can high cortisol.
The Bottom Line:
Some people don’t sleep well on a very-low-carb intake, and keto may be for you for that reason.
How to Get into Ketosis (the Healthy Way): 6 Simple Steps
Initially, it can take anywhere from 2 to 7 days to first jump into ketosis, however, it can take 3 to 4 weeks to actually start to become “fat adapted” so your body starts using fat for fuel all the time.
Here are 6 simple steps for getting into ketosis for the first time and turning your body to turn into a fat-burning machine (without running into the 10 Roadblocks we discussed):
Step 1: Know Where You’re Starting.
Get a baseline assessment of what you’re currently eating.
How many carbs are you taking in on a daily basis? How about fats and proteins? Know what a general day looks like because this will be important for Step 4.
Step 2: Address Stress.
Ketosis CAN’T happen if your body is under stress—it will only drive it into a negative spiral. “Addressing stress” initially means starting with these basic lifestyle factors:
- Sleep 7-9 hours each night.
- Exercise and move daily (but moderately; cut back on intensity if you’ve been overtraining as well as you begin to cut back on food intake)
- Reset your circadian rhythms (ideally waking before 8 a.m.; limiting screen exposure at night; and eating at regular intervals throughout the day)
- Descreen (we can spend upwards of 12 hours per day staring at screens and phone; practice mindfulness with your use and only use as needed)
- Boost your gut health (see step 5 for suggestions)
Step 3: Up the Fats
Eat at least 2 servings of added fats or organic fatty cuts of meat and eggs with each main meal. If you snack, opt for a fat-based or protein-based snack (instead of carbs)
Step 4: Cut the Carbs in Stages.
Depending on how many carbs you were eating before (ex. 100 grams), it’s recommended you first cut that number in half (i.e. Drop it down quickly to 50 grams) the first day, followed by about another 50-percent decrease the next day (i.e. to 25 to 30g), then about 20 grams of carbs on the third day. Also, this can be accomplished easily by introducing more leafy greens and fiber rich veggies (Brussels sprouts, cauliflower, broccoli, asparagus, cucumber, zucchini) in place of starchier carbohydrates you were eating (potatoes, breads, rice, oats, starchy tubers).
Note: Remember, this is only for the initial stages of ketosis too, as you become more fat-adapted, you may find that you are able to reintroduce some starchy carbs later. Keep the short-game and long-game in mind.
Q. How Do I Know if I am in Ketosis?!
Tracking ketone production is important, especially initially if you’re is not used to doing the ketogenic diet. There are several ways to do this, including blood ketone meter monitoring, urine and breath testing at home; however, the only one that is truly accurate is using a blood ketone meter. (This is where you prick your finger, and put blood on a little strip and put it into the meter—similar to how a person tests their glucose for diabetes).
Keep in mind, this measure of testing is not (and should not be) forever. Generally, after measuring your ketones for 1-2 weeks, you should have sense of whether or not you are in ketosis (even without checking). More importantly, the only other time you may have to measure is if you make a change in terms of their protein intake, carbohydrates, exercise, or something else that affects ketone production.
Here are some Blood Ketone Meter recommendations:
Step 5: Love Your Gut
Lack of fiber in the diet can disrupt the gut microbiome and lead to keto constipation, indigestion, slowed metabolism and other imbalances (hormones, energy, thyroid, immune system, etc.). Also, prevent this from happening by arming your gut with some extra “gut love” on your keto reset including:
Add in 5 Daily Gut Loving Habits
- Water. Drink half your bodyweight in ounces of water. A sure way to help you with keto constipation.
- Apple Cider Vinegar. Add 1 tbsp apple cider vinegar to 2-4 oz. of water with meals.
- Probiotic & Prebiotic. Take a daily soil-based probiotic and prebiotic fiber, along with a short-chain fatty acid supplement support.
- Variety. Eat variety and lots of color (even on a limited diet, don’t eat the same things every day)
- Soothe Your Gut. Sip a daily cup of herbal tea and/or bone broth. Bonus: Add in a gut-lining and repair support, such as L-Glutamine, colostrum, collagen and other gut healing nutrients.
Practice Good Food Hygiene
- Chew your food thoroughly.
- Eat slowly.
- Drink plenty of water throughout the day, and just sip throughout meals.
- Sit and enjoy your meals—in a relaxed (Digestion occurs ideally in a parasympathetic state–i.e. no stress)
- Clean your hands & wash fruits and veggies thoroughly.
- Eat home cooked meals as often as possible.
Step 6: Supplement Smart
In addition, to your gut healing supports (a daily soil based probiotic, prebiotic and short chain fatty acids), as you’re “going keto” and establishing your baseline, a smart supplementation plan can help ensure your electrolytes and micronutrient balance stays in tip top shape (so you don’t send your body over the edge). A few additional smart supplements that may support your keto diet, include: