When you visit The Charlie Foundation for Ketogenic Therapies website, you see a quote at the top of the homepage: “In 1993 the ketogenic diet cured Charlie Abrahams’ epilepsy.”

“Cured” is a word you don’t often see. To learn more, I reached out to Charlie’s dad, Jim Abrahams (who directed the Hollywood movie Airplane! in 1980). Abrahams is the co-founder of The Charlie Foundation, established in 1994 to provide information about ketogenic diet therapies for people with epilepsy and other disorders.

“The word cure is controversial,” Abrahams said. “The Epilepsy Foundation raises money by saying there are no cures. But I know hundreds of people who have been cured. Charlie turned 30 in March 2022, and he has had no seizures in 25 years.”

This story starts in 1993, when 11-month-old Charlie developed severe epilepsy, sometimes suffering as many as 100 seizures a day, even while on several medications. His medication-resistant condition, known as refractory epilepsy, occurs in about 30 percent of people with epilepsy, according to Johns Hopkins Medicine. Even brain surgery provided no relief. And the drugs his son had to take had massive side effects, effectively turning him into a nonfunctioning zombie, Abrahams said.

Desperate to help Charlie, Abrahams began reading medical studies at the library. He came across a study published in late 1992 in Epilepsia, the leading authoritative source for clinical research for all aspects of epilepsy and seizures. The study showed that in 58 consecutive cases, putting kids as sick as Charlie on the ketogenic diet improved seizure control in 67 percent of them. When Abrahams came across that study, only about a handful of children around the world were still being treated with a keto diet, despite the fact that it was a well-established approach to controlling epilepsy.

As the 1992 study explained, “the ketogenic diet was developed in the 1920s as a treatment for intractable childhood seizures when few antiepileptic drugs (AEDs) were available.” However, as AEDs were developed by pharmaceutical companies, doctors began abandoning the keto diet in favor of using drugs.

“There are still children whose seizures are refractory even to modern therapy, but use of the ketogenic diet appears to be waning,” the 1992 study warned. “At Johns Hopkins, we continue to believe that the diet is very effective and well accepted by patients and families.”

“The study was hot off the presses,” said Abrahams. “Still, no doctors had mentioned it to me. I called Dr. John Freeman at Johns Hopkins,” who had worked on the study.

Dr. Freeman immediately began working with the family. In just one month on the original ketogenic diet designed in 1923 by Dr. Russell Wilder at the Mayo Clinic, Charlie became seizure- and drug-free. There are five variations of the keto diet, and “classic keto,” the original, is the strictest, with 90 percent of calories coming from fat, 6 percent from protein, and 4 percent from carbs.

“Most kids like Charlie can get off the keto diet after 18 months to two years. After two years, they are drug- and seizure-free,” said Abrahams. “We tried after two years to wean him off the diet, but the seizures returned. For his brain to heal itself took longer than some other kids.”

The family was able to get Charlie off the keto diet after a total of five years. The seizures never returned, and Charlie now eats whatever he wants.

Unnecessary Suffering

While Abrahams was very grateful his family got Charlie back, he began to realize that much of the suffering his son went through had been unnecessary. He would wake up in the middle of the night, thinking "90 percent of these seizures didn't have to occur. This was not a pie-in-the-sky diet,” he said. “There were 70 years of medical history about the diet and how well it worked for kids like Charlie. Different hospitals with the same patient populations published about the efficacy and had the same results. For roughly one-third of the children who experienced multiple daily seizures, the seizures went away with the ketogenic diet.”

Abrahams expressed his frustration in a 1994 Dateline special. "You pour the drugs down your child's throat despite the fact there's something inside you that says, 'Wait a minute, this can't be right.'"

Dr. Donald Shields, a child neurologist, was one of Charlie's doctors. He also appeared on the Dateline episode to talk about the drug protocols he had tried with Charlie. Most of the mainstream drugs had been exhausted, and Dr. Shields was considering using more experimental ones. Even though he had some knowledge of the work Johns Hopkins was doing with the keto diet, he admitted on the program that he had tried to dissuade the family from pursuing the dietary approach.

"There's no big drug company behind the ketogenic diet," Dr. Shields said. He said he "hated to admit it" but agreed with the reporter that one of the reasons the ketogenic diet was not more popular with doctors was because there was not a big drug company behind it, selling it to the doctors.

Abrahams soon channeled his anger into action, first co-founding The Charlie Foundation with his wife, Nancy, in 1994. In 1997, he directed and produced “First Do No Harm,” a made-for-television movie starring Meryl Streep that somewhat mirrors his family’s experience with the ketogenic diet, highlighting the side effects anticonvulsive drugs can have on children with epilepsy.

“When we started the foundation, I said, ‘I’ll be doing this maybe a year. It’s so obvious. Do you want to drug your kid, cut his brain, or change his diet?’ I was wrong,” Abrahams said.

Thirty years ago, when Abrahams questioned doctors about how much of their formal medical training was devoted to studying nutrition and diet therapies, he would usually get an answer of “zero” or worse, a lecture.

Back then, the doctors would argue that they didn’t have the science so they couldn’t recommend the diet, he said. But now the mechanisms of how the ketogenic diet works are understood and its effectiveness against certain diseases, like epilepsy, are known in the medical field.

Still, Abrahams gets emails every year from upset families saying their doctors never mentioned the ketogenic diet. “It’s a broken record. It’s more maddening today than it was 20 to 30 years ago. I still struggle with the whole notion of forgiveness.”

If a person is working with a trained dietitian and there are no contraindications, like if the body can’t digest fat, there’s no excuse not to recommend the keto diet, he said. He used to believe that if a neurologist ended up having a child with epilepsy, that would help advance the use of the diet. Over the years, he did meet two neurologists in that position, neither of whom put their children on the keto diet. While this may seem baffling, it makes a certain type of sense to Abrahams.

“Imagine being a 60-year-old neurologist. God knows how many patients you never recommended the diet to even with the abundance of efficacy. How do you look in the mirror and think, ‘How many people’s lives did I screw up?’ All of the other influences add up. Medical schools—who designs the curricula? Is that influenced by the drug companies? I don’t know. Let food be they medicine has been around 2,500 years. There are powerful forces that influence our medical system that don't have much to do with good health."

Lynn Tryba: How did you come to learn about the keto diet for cancer?

Miriam Kalamian: In December, 2004, my husband, Peter, and I found out our 4-year-old son, Raffi, had a brain tumor the size of an orange. They said it was inoperable, told us what we had to do, and warned us not to go online. I went online.

Tryba: What did you see?

Kalamian: It was a horrible shock—it was all bad, nothing positive, nothing to give us hope. We went along with the standard of care, which was chemotherapy every week for 14 months. Three months later at his post-treatment MRI, they said, “It’s lit up like a Christmas tree. We have to radiate.” He wasn’t even 6. They don’t usually do radiation to kids that young because it impairs cognition. We were on the edge of agreeing to this, but then they said they couldn't do it because the tumor was diffuse and infiltrated, the same reason they couldn't operate. We did the unthinkable and had surgeries done by the only doctor who would agree to it. He did it in a two-part surgery. The first part was fairly successful in that it stopped the tumor growth, but it impaired a lot of my son’s executive functioning. The second surgery was not successful. It grew back in they hypothalamus within a few weeks and started invading new areas as well.

Tryba: What did you do next?

Kalamian: We enrolled Raffi in a clinical trial, but it didn't take long to learn that it wasn't working. At this point, they were out of treatment options and were going to move Raffi to palliative care. I was looking online at one of the drugs in the palliative protocol. The drug had a lot of awful side effects so I wanted to print this out to review it with his doctor. I was staying with my mom at the time because my son’s trial was in New York. Her printer wouldn’t work, so I bookmarked the page. A few days later, when I was at a spot with a working printer, I went back to the bookmark. Except it wasn’t the article about the chemo drug anymore. It was an article by Dr. Tom Seyfried involving a diet he had used in a mouse model of glioma, a type of brain tumor. I had brought up mouse model studies to my son’s medical team in the past and they would say it was going to be years before the research can be done in people, if they were tried at all, and years more before a treatment was approved. But Dr. Seyfried’s paper also included a reference to a case study with two children with advanced brain tumors who had been put on a ketogenic diet for eight weeks. The tumors had responded in both cases. I emailed Dr. Seyfried’s lab. A couple of hours later, he emailed me back, sending me a paper by Linda Nebeling PhD, MPH, RD, FAND. He also told me about The Charlie Foundation for Ketogenic Therapies. Although he's not a medical doctor, he was passionate and excited to help. I’m looking at this information and thinking, “Well, why wouldn’t we want to try it?” One of the kids was still alive more than a decade after the treatment. And we could still do the chemo alongside of the diet if that’s what we decided to do.

Tryba: You stumbled across the ketogenic diet by serendipity.

Kalamian: The other serendipitous thing was that the team of epileptologists at Johns Hopkins hospital, led by John Freeman, MD, had just put out their fourth edition of The Ketogenic Diet: A Treatment for Children and Others with Epilepsy. This was the first time they offered any speculation on the use of it in brain tumors. It was just one paragraph buried in a short section on speculation near the end of the book, but it was the first glimmer of hope we'd had in ages. Keto diets had been used as a treatment for epilepsy since the 1920s. And here it was, a protocol for kids that we could use with Raffi.

Tryba: Did you put Raffi on a ketogenic diet after that?

Kalamian: Yes, and I was terrified to take this on without medical support from his brain tumor team, but we had no choice. When you’re dealing with kids, doctors are even more reluctant to stray from the norms than they are with adults. We had local support from his pediatrician, general oversight from his local oncologist, and two moms in a support group for kids with epilepsy who were following the modified Atkins diet. That was enough of a start. I fasted Raffi like they were doing at the time for kids with epilepsy, but this was trickier to do outside of a hospital setting. Kids shift quickly into ketosis and by by night time, that poor kid was ketotic. That’s how quick kids can make that switch to ketosis. The book had warned this could happen and we followed the protocol to reverse it, and just kept going. We had started it right after an MRI showing progression had formally kicked him out of the trial. Three months later, his next MRI showed the tumor had shrunk. The only other treatment he'd received was a reduced dose of a chemo drug that Raffi had already failed. We had to go along with that because the local oncologist had to stay within the good graces of his profession, but he was clear that this is not what had caused the shrinkage. After Raffi’s next good MRI, the oncologist started skipping treatments. He gave us a three-week holiday and finally said, “We’re just damaging him with this stuff. Let’s not do this anymore to him.”

Tryba: How were you feeling at that point?

Kalamian: It’s what put me on the path to get my degree in nutrition. I was hoping for anything, just a few more months with Raffi, anything. When we were told the tumor had shrunk, we sent the MRI scan to two other centers, the one that had conducted the clinical trial and another center where he had been treated. Both concurred there had been tumor shrinkage, between 10 to 15 percent. But nobody was going to say it had anything to do with the diet. I literally begged the consultant nutritionist for The Charlie Foundation to have a call with me. She was resistant due to the liability. I said, “Listen, I’ll sign any waiver you want. I know I’m doing this wrong, and I’m afraid I'm going to harm him.” That’s what got her to work with me. She has a heart, and the thought of damaging a kid . . . She spent an hour and a half on the phone with me, and cleared up the things I was doing wrong. The good MRI was June. My talk with the nutritionist was July. By August, I was enrolled in a program leading to a Master’s degree in human nutrition.

Tryba: How was Raffi by then?

Kalamian: My son was doing great! He was getting stronger and healthier and back to school and enjoying life. Peter and I were enjoying this extra time with him. I got my degree from Eastern Michigan University in 2010. To become a Certified Nutrition Specialist took another couple of years. My son died in 2013, a year after I got my certification. If we could have gotten the tumor to shrink before his surgery, if we had known then what we do now, we could have avoided a lot of the damage. One of the main benefits in initiating a ketogenic diet early on is you can get a better tumor resection. But most people are not finding out about this until after surgery because they’re rushed into surgery being told it’s an emergency. In many cases, it’s not.

Tryba: Does the keto diet help with all cancers?

Kalamian:. There’s a standard of care therapy for brain cancer, and it has a standard outcome, which is piss-poor. When you combine the diet with it, you can get another year. I have clients who are four, six, eight years out from diagnosis. I work with one that’s 10 years out. The ketogenic diet’s positive effects are clear on brain cancer, not so clear on other cancers. I still think reducing inflammation and lowering glucose and insulin impacts the tumor or just the cancer, in general, and makes the other therapies you’re doing more impactful. If you can compromise the metabolic needs of the cancer cells while nourishing the rest of the body with the right kinds of nutrition, with ketones to replace the sugar you’ve pulled out, then you’re going to get a better outcome, even if it's just an improved quality of life. That alone is huge!

Tryba: Why don’t doctors start using food in conjunction with standard of care medicine?

Kalamian: Because they don’t understand the power of food and nutrition. They just see food as something that provides enough calories so you don’t lose weight. But the type of fuel you put in the body makes a difference in what the cancer can utilize and what compromises it. When it’s compromised and you hit it with therapy, it’s going to be more impactful.

Tryba: How do we change the perception that nutrition doesn’t matter?

Kalamian: Change is happening, but most oncologists are so stuck in the nutrition paradigm. You could hand them all the evidence on diet, but their bias prevents them from believing it. Then you have the ones who say, “It looks like maybe nutrition does have an influence,” but they often end up suggesting a plant-based diet as though there was evidence for it, which there's not. There's this fear that their patients will lose weight, which is often the case with keto. Thankfully, recent research has shown that the weight loss with keto is more likely be from fat, not muscle. There also seems to be some benefit from fasting around chemotherapy. I have a modified fasting protocol that includes broth that people drink for a little bit of protein and gut protection. It provides calories but keeps you in a fasting mimicking state during chemo treatments, which lessens GI side effects and makes infusions more impactful. The fasting state sensitizes cancer cells, making them easier to kill.

Tryba: What clinical evidence shows following a ketogenic diet offers therapeutic potential for people with cancer?

Kalamian: There’s been some beautiful work with women with breast cancer showing that the body composition is better in women who are able to follow even a modified low-carb ketogenic diet and that their biomarkers are better than women on a control diet. You may have seen an explosion of information about a new preclinical pancreatic cancer study that came out showing people on the ketogenic diet were doing better than those who were not. They’re organizing an official clinical trial. A few years ago, Memorial Sloan Kettering, a very reputable center, started a trial for ketogenic diet for newly diagnosed endometrial cancer. Almost 100 percent of women who develop endometrial cancer are obese and insulin resistant. There are some high-level people involved in this research, like Lewis Cantley, he’s the one who discovered a pathway that promotes cancer called P13K. That pathway is very active in a lot of cancers, like ovarian, breast, and prostate cancers. Cantley spent the majority of his career working with pharmaceutical companies to develop P13K inhibitors for that pathway. Sorry to get technical. These inhibitors block phosphorylation of the insulin receptor on cancer cells.When you do that, then glucose and the insulin stay in circulation instead of going to feed the cancer cell. But this can turn people into diabetics, which results in poor cancer outcomes.

Tryba: Wow.

Kalamian: The next level of that was, “Now they're diabetics, and this drug is failing, so what should we do?” They knew from earlier research that women on Metformin because of high blood glucose had a better outcome in cancer. Then, it became, “Well, what if we combined it with a ketogenic diet?” since that also lowers blood glucose. They spent all this time and research money on a drug with horrible side effects of hyperglycemia and other issues. And here’s this diet that also inhibits that pathway because the body is perceived to be in a starvation state so Cantley began to suggest putting these women on keto diets alongside the drug. In a starvation state, activity in these pathways associated with growth slows down.

Tryba: Could you explain that a little more?

Kalamian: I call it abundance and austerity. When there’s abundance, the body goes, “Oh yeah, let’s grow, grow, grow. Hey, you cells over there, we don’t know what you’re about, but here, take some of this, we got plenty.” But when you’re fasting or when you’re calorie restricting or you’re carb restricting, when you’re limiting those nutrients the body is used to getting, then the body goes, “Wait a minute, we’ve got to keep the essentials up and running. But you cells over there, you're not helping us at all so you’re not getting any of this supply.” It has a major impact on those pathways. Everybody that’s even studied a little bit of cancer biology understands this but they don’t make the mental leap needed to of put it into practice. I mean, think about it. Oncologists have spent a fortune on medical school. Protocols replace curiosity. They have an algorithm they’re going to work with. They're in a clinical practice where they are respected by their colleagues.

Tryba: It’s perverse though.

Kalamian: It is perverse. It’s not in the best interest of the patient. But they don’t have the time, number one. They don't make a move without evidence from clinical trials, which are so much more challenging in diet research. They’re also worried about losing their standing in their profession. There’s a few of them out there. There’s Dr. Jethro Hu at Cedars-Sinai. He’s running a clinical trial on the effects of a ketogenic diet on newly diagnosed glioblastoma. After he was about year into that study, he said to me, “I was blown away. I expected there to be some impact on the tumor. But I didn't expect to see this much improvement in quality of life.”

Tryba: What was he seeing in the trial?

Kalamian: His clients were generally sailing through the radiation and chemo intensive protocol, whereas the people who continued eating standard diets were experiencing more profound side effects. For the most part, if you’re not reducing the inflammation caused by the treatment, you’re having to take a steroid drug called dexamethasone. It reduces inflammation yes, but one of its many side effects is that it raises glucose. In most cancers, but especially in brain cancer, this is associated with a much poorer prognosis.

Tryba: Some oncologists are kept in place by their financial dependency or fear of losing their status where they are working?

Kalamian: Yes. One example is Colin Champ, a radiation oncologist. He’s a Paleo guy, goes by Caveman Doctor. You look at what he was putting out there 10 years ago, and you’re thinking, “Oh great, a whole new wave of people who are going to make a difference.” And then he gets dismissed because of his blog posts. He's now started his own clinic in Florida.

Tryba: I feel bad for the people who might not find a person like you to work with.

Kalamian: Or the people being fed this misinformation about how unpalatable, dangerous, or impractical keto is. In my practice, we meet with people, collect information about their food preferences, and make beautiful meal plans or recipe books for them based on what they want to eat, not on what we think they should eat. We take people’s desires into account, but if they desire Entenmann’s pastry, well that’s definitely not going to work. Keto is about 5 to 10 percent carb. When you have fat and carb in combination, like an Entenmann’s pastry, that’s where you’re doing the most damage. But there are replacements for those things. If you’re a packaged food addict and you want to do keto, there are packaged foods you can buy. Of course, that's not ideal, so we steer people toward the better quality ones if that’s what they need to do to get up to speed with the diet. But we’re always working on moving them to the next step of using whole foods and tracking their nutrient intake for themselves. My son’s endocrinologist told me that the diet was not possible for most people. He said it was too difficult. I explained to him that difficult was sitting in the waiting room when my kid’s having his third surgery. That’s difficult. The diet’s a walk in the park.

Tryba: I don’t understand the disconnect. When you have someone you love who’s going through treatments, especially radiation, or if you read about the possible side effects from drugs, it’s endless. You have to get your blood and organ function monitored to make sure that the treatments are not pushing them into organ failure. It’s strange to me that doctors will say, “Oh, but asking someone to change their diet will be too hard for them.” Not only that, if you get away from packaged simple carbs, you feel better, even if you don’t have a cancer diagnosis. I have a friend who has multiple sclerosis. She found the Wahls Protocol. And just recently there has been some exciting new published research showing that keto is slowing progression of MS.

Kalamian: Absolutely. Good choice.

Tryba: Her doctor said the same thing, “Diet doesn’t do anything.” Really? Because it dropped her inflammation significantly. She lost the extra weight she was carrying. She has had no disease progression for years and has not had to use any of the MS drugs.

Kalamian: Isn’t that amazing? It’s food and supplements and exercise and improving sleep. I saw somebody took a photo of something on a doctor’s wall, and it said, “Don’t confuse your Google search with my medical degree.” It was up next to his medical degree on the wall. It’s this hubris. It’s this arrogance about their position in life because there’s that reverence for doctors. You go to other countries where doctors don’t have that status, where it may be easier to get your degree because you don’t have to have all that money for med school, you don’t have the status either. You’re there to help the family figure out what to do because they don’t have the resources to do a $100,000 treatment.

Tryba: The hubris is weird because there are advances in some cancer statistics but so many of them remain horrendous.

Kalamian: Peter Attia has a podcast called The Drive. He’s a medical doctor interested in healthy aging. He has interviewed doctors about this exact thing. I saw it early on when people said a miracle drug had come out for brain cancer called Temodar. It moved the needle on the median survival by just 10 weeks. That makes it a breakthrough drug, 10 weeks. The ketogenic diet alongside the standard of care often gives people at least an additional year, maybe a year and a half. They’re not going to get a dime for the diet. That’s the other part of it, the funding for the research. Pharmaceutical is not going to fund a diet study. Siddhartha Mukherjee wrote a book called The Emperor of All Maladies: A Biography of Cancer, which won the Pulitzer Prize. He posted at one point, “We’ve got the funding for the drug. But now we need $300,000 for the ketogenic part. Does anybody have any idea of how we can find the funding?” That’s Siddhartha Mukherjee. Nobody’s handing him $300,000. Dr. Jethro Hu at Cedars-Sinai also needed to get companies to donate equipment and food for his clinical trial on the effects of a ketogenic diet on glioblastoma.

Tryba: Why doesn’t the government provide more funding for studies?

Kalamian: It’s the government’s ties with the pharmaceutical industry. They want to support the institutions. Institutions get some of their money from the government. But they get the major part from pharmaceutical companies. The more clinical trials they’re running, the higher their prestige. Mass General and Dana-Farber are constantly pumping out all these clinical trials where all they’re doing is using people to gather data so they can move to another part of the clinical trial. They’re getting these tiny little incremental benefits. A couple of doctors are understanding of that and are more supportive of the diet option now. If somebody brings up that they want to do a ketogenic diet, the doctors will say, “Yes, that’s a really good plan.” But they never bring it up because it’s not a part of the standard care. It’s not an approved therapy. They don’t feel it’s within their wheelhouse to discuss diet unless they're asked to.

Tryba: How do you do this work of educating people about the power of keto for cancer without feeling crushed?

Kalamian: Because of my son. Any time somebody wants to put their foot on my head, I say, “No, I’m fighting for my kid right here. I’m fighting for the families, not just kids anymore. I’m fighting for the families that have a dog in this fight.” That’s what keeps me going. I have always looked at what I do as leaving a legacy for my son. I attribute that legacy to Dr. Tom Seyfried's efforts. A change in diet won't appeal to everyone with cancer, but it should be an option for those who want to make the effort. I want other people to be successful without having to cobble bits of info together like I had to do.

When following any diet it is important to be sure you are not only getting enough nutrients, but to be conscious of you constitution or dosha. Learn more here from Amber Lynn Vitale on what to consider when following the keto diet to ensure you are living healthily, giving your body the nutrition it requires and how to avoid putting your body at risk!

From “keto flu” to kidney stones and even pancreatitis, some people are finding the keto diet is not the “one size fits all” weight loss plan they thought it was.

As the First Lady of Nutrition, I have more than four decades of experience with diets and weight loss, and the associated trends that come and go. One thing I’ve observed is that when we go to drastic extremes with diets, whether it’s extremely low fat or, in the case of keto, extremely low carb, it puts too much stress on the body and serious problems arise.

I get it—it truly is inspiring to see the celebrities and doctors we admire have such dramatic weight-loss results with the keto diet. Even though it’s such a huge departure from the way we’re used to eating, we rationalize that “desperate times call for desperate measures” because we see the health impact that carrying all this extra weight is having—not to mention the painful blow to our self-esteem. But...

When a diet like keto sounds too good to be true, it probably is.

The Origins of the Ketogenic Diet and How it Works

Originally developed in the 1920s as a medical treatment for children with a seizure disorder, the ketogenic diet has taken the weight loss world by storm for the past few years. With its goal of 75 percent fat, 20 percent protein and a mere 5 percent carbs, it’s a huge change from the standard American diet of more than 50 percent carbs.

This way of eating switches your body from burning sugar and carbs as fuel to using fats as its primary energy source, and this can be a total game changer in your health—when it’s done properly. But, with huge changes comes huge challenges for those whose genetics and fat metabolism just aren’t geared for it.

Who Shouldn’t Go Keto

First of all, I need you to know: if keto failed you-you didn’t lose weight and you felt awful—it’s NOT your fault! One diet truly does not fit all, and keto may not be the right fit for you. The high amount of fats required for your body to go into ketosis and extreme fat-burning are not right for everyone.

Here’s a List of Everyone Who Should Avoid the Keto Diet:

• You have a history of pancreatitis or high triglycerides. High triglycerides circulating in the blood for a prolonged period of time can lead to acute pancreatitis. The high fat keto diet is a known cause of acute pancreatitis, because it causes an increase in circulating fats.
• You have gallbladder disease or no longer have a gallbladder. The gallbladder stores and concentrates the bile, which is made by the liver. Bile is essential for fat metabolism. A high fat keto diet can aggravate existing gallbladder disease. Also, if your gallbladder has been surgically removed, you may have trouble digesting all the fat you eat on the keto diet. Weight gain, bloating, and other digestive discomforts would be the first signs you would notice with this.
• You have low blood pressure (hypotension). The ketogenic diet makes your body more acidic as it starts producing ketones. Prolonged low blood pressure combined with acidosis can lead to cardiac arrest.
• You have kidney disease or a history of kidney failure. The way you test to see if you are in ketosis and burning fat as your primary tool, is to see if ketones are present in your urine. If you already have kidney issues, the added stress of the diet on the kidneys may worsen existing disease.
• You have multiple nutrient deficiencies or have had weight-loss surgery. If you already have poor nutritional status from either prolonged sickness or severe calorie restriction, a full nutrition workup is recommended before starting any diet. You need to nourish your cells and rebuild them, not stress them further.
• If you’ve had gastric bypass or other weight loss surgery, it is likely a diet was prescribed for you at the time of your surgery. These surgeries often change how you break down your food and limit the amount of each nutrient you are able to metabolize.
• You have tumors in your abdomen or liver. While keto can be helpful when you have cancer, it must be supervised by a knowledgeable professional so you don’t further compromise your digestive and liver functioning or develop deficiencies.
• You have low gastric motility. The ketogenic diet is known to cause constipation from the start, you need to be cautious if you already have impaired motility, because bowel obstruction can result.
• You have known genetic conditions—from birth—that can’t tolerate ketosis. Several genetic disorders that are identified at birth are known contraindications for the keto diet. With the exception of Porphyria, which can develop later in life, you would be aware if you have one of these conditions.

Fix Your Fat Metabolism and Make It Work for You

Underlying most problems with the keto diet is trouble with fat metabolism. Your body wants to burn fat as its primary fuel, but if your bile is congested, you have too little bile, you’re missing your gallbladder, you have fatty liver disease, or you have other digestive issues, then you can’t digest all the fats the keto diet requires you to eat, and you’ll feel worse instead of better.

The first step to fixing your fat metabolism is building better bile. Free-flowing bile is essential for eliminating toxins and digesting fats properly.

The next step is to rev-up your fat-burning metabolism by eating the right fats—essential omega 3 and omega 6 fats from good quality sources. When it comes to weight loss, good quality fat is your friend—essential fats nourish and create healthy cells, reduce inflammation, and help shift your body into burning fats for fuel, all while feeding your brain and balancing your hormones. Choose grassfed meats, free range poultry and eggs, and cold-pressed organic oils like hemp, flax, and walnut to maximize your omega 3 and omega 6 fat intake.

Once your fat metabolism is working optimally, you may still find keto just isn’t right for you. Your ancestors may have had less of a fat-focused diet, and this is still in your genetic make-up. It’s important to listen to your body and do your homework to find the diet that’s right for you.

How to Know When You’re Eating Right for YOU

There isn’t a single diet out there that will work for everyone, unless it has the flexibility for you to customize it to suit your individual needs. But how do you know when you’ve struck gold and found the plan that fits you, your lifestyle, your genetics, and your metabolism to a tee? Here are the signs I recommend looking for:

• You wake up with energy and in a good mood.
• You feel more energetic after you eat—not less.
• You lose weight easily.
• Cravings are a thing of the past.
• Your blood tests show you are healthy.
• Your digestion works the way it should.
• Exercise doesn’t leave you feeling drained.
• You handle stress well.
• You fall asleep easily and wake feeling well-rested.
• Your body feels good and you have a strong sense of wellbeing.

Sounds too good to be true? Then you haven’t found the right diet for you! You might be thinking, “But I’ve tried so many diets, Ann Louise, and I’m still sitting here feeling fat and fatigued, and I just can’t seem to lose the weight!” Trust me, I’ve turned around thousands of “hopeless causes” and I can help you, too! 

The underlying premise of the keto diet is right—your body wants to burn fat as its primary source of fuel. The problem is, you still need carbs to make hormones—thyroid, sex, and stress hormones, to be precise. Without enough carbs, you can feel tired, sluggish, unable to handle stress, have night sweats, and gain weight far too easily, among other signs of hormone imbalance. Too many carbs and the bloating, blood sugar increases, and fatigue set in.

Carbs, fats, and proteins all have one thing in common—they each have a “sweet spot” that creates optimal health in your body—too much or too little of any one of them is not a good thing.

I created my Radical Metabolism plan for even the slowest of losers, the most sluggish of metabolisms, and even those with autoimmune and other chronic illnesses that make a healthy weight seem so far out of reach. Thousands of people like you have already seen success with my plan, and found their ideal amounts of carbs, proteins, and fats, and they’re loving their new lifestyle! They’ve seen their energy levels soar, the inches and pounds fall off, and their blood tests improve—even thyroid! I invite you to get RADICAL, and find your way back to feeling good again.