Typically, to gain lean body mass one needs to have some degree of caloric surplus, or at the very least, not be in a significant deficit. This is especially true when looking to add muscle mass. It is certainly possible to gain muscle mass on a ketogenic diet. For most individuals this would require consuming adequate protein (while still remaining in ketosis), enough calories to support growth, sufficient electrolytes to support muscle function, as well as incorporating progressive resistance training. The type and volume of resistance exercise needed to add lean body mass will be very dependent on the individual and their age, training status, health status, etc. Therefore, the answer to this question can become quite nuanced, but in simple terms, yes, it is very possible to gain lean body mass on a ketogenic diet while still taking advantage of the health promoting effects this way of eating provides.
The first modern study of fasting as a treatment for epilepsy was in France in 1911.[12] Twenty epilepsy patients of all ages were "detoxified" by consuming a low-calorie vegetarian diet, combined with periods of fasting and purging. Two benefited enormously, but most failed to maintain compliance with the imposed restrictions. The diet improved the patients' mental capabilities, in contrast to their medication, potassium bromide, which dulled the mind.[13]
I'd recommend starting with glucose and hemoglobin A1C, along with a good multi like https://bengreenfieldfitness.com/multi and a fish oil like the one at greenfieldfitnesssystems.com – Anyways, I'd be happy to help you via a personal one-on-one consult. Just go to https://bengreenfieldfitness.com/coaching. and then choose a 20 or 60 minute consult, whichever you'd prefer. I can schedule ASAP after you get that.
Long-term use of the ketogenic diet in children increases the risk of slowed or stunted growth, bone fractures, and kidney stones.[18] The diet reduces levels of insulin-like growth factor 1, which is important for childhood growth. Like many anticonvulsant drugs, the ketogenic diet has an adverse effect on bone health. Many factors may be involved such as acidosis and suppressed growth hormone.[38] About one in 20 children on the ketogenic diet develop kidney stones (compared with one in several thousand for the general population). A class of anticonvulsants known as carbonic anhydrase inhibitors (topiramate, zonisamide) are known to increase the risk of kidney stones, but the combination of these anticonvulsants and the ketogenic diet does not appear to elevate the risk above that of the diet alone.[39] The stones are treatable and do not justify discontinuation of the diet.[39] Johns Hopkins Hospital now gives oral potassium citrate supplements to all ketogenic diet patients, resulting in one-seventh of the incidence of kidney stones.[40] However, this empiric usage has not been tested in a prospective controlled trial.[9] Kidney stone formation (nephrolithiasis) is associated with the diet for four reasons:[39]
The low glycaemic index treatment (LGIT)[49] is an attempt to achieve the stable blood glucose levels seen in children on the classic ketogenic diet while using a much less restrictive regimen. The hypothesis is that stable blood glucose may be one of the mechanisms of action involved in the ketogenic diet,[9] which occurs because the absorption of the limited carbohydrates is slowed by the high fat content.[5] Although it is also a high-fat diet (with approximately 60% calories from fat),[5] the LGIT allows more carbohydrate than either the classic ketogenic diet or the modified Atkins diet, approximately 40–60 g per day.[18] However, the types of carbohydrates consumed are restricted to those that have a glycaemic index lower than 50. Like the modified Atkins diet, the LGIT is initiated and maintained at outpatient clinics and does not require precise weighing of food or intensive dietitian support. Both are offered at most centres that run ketogenic diet programmes, and in some centres they are often the primary dietary therapy for adolescents.[9]
^ Hochachka PW, Storey KB (February 1975). "Metabolic consequences of diving in animals and man". Science. 187 (4177): 613–21. Bibcode:1975Sci...187..613H. doi:10.1126/science.163485. PMID 163485. In the terminal stages of prolonged diving, however, even these organs must tolerate anoxia for surprisingly long times, and they typically store unusually large amounts of glycogen for this purpose.

The ketogenic diet is calculated by a dietitian for each child. Age, weight, activity levels, culture, and food preferences all affect the meal plan. First, the energy requirements are set at 80–90% of the recommended daily amounts (RDA) for the child's age (the high-fat diet requires less energy to process than a typical high-carbohydrate diet). Highly active children or those with muscle spasticity require more food energy than this; immobile children require less. The ketogenic ratio of the diet compares the weight of fat to the combined weight of carbohydrate and protein. This is typically 4:1, but children who are younger than 18 months, older than 12 years, or who are obese may be started on a 3:1 ratio. Fat is energy-rich, with 9 kcal/g (38 kJ/g) compared to 4 kcal/g (17 kJ/g) for carbohydrate or protein, so portions on the ketogenic diet are smaller than normal. The quantity of fat in the diet can be calculated from the overall energy requirements and the chosen ketogenic ratio. Next, the protein levels are set to allow for growth and body maintenance, and are around 1 g protein for each kg of body weight. Lastly, the amount of carbohydrate is set according to what allowance is left while maintaining the chosen ratio. Any carbohydrate in medications or supplements must be subtracted from this allowance. The total daily amount of fat, protein, and carbohydrate is then evenly divided across the meals.[37]
Acetyl-CoA can be metabolized through the TCA in any cell, but it can also undergo a different process in liver cells: ketogenesis, which produces ketone bodies.[27] Ketone bodies are also produced in mitochondria, and usually occur in response to low blood glucose levels.[28] When glucose levels are low, oxaloacetate is diverted away from the TCA cycle and is instead used to produce glucose de novo (gluconeogenesis). But when oxaloacetate is unavailable to condense with acetyl-CoA, acetyl-CoA cannot enter the cycle, and so the body has evolved an alternative way to harvest energy from it.
The process of generation ketones (ketogenesis) is kept in check by the presence of insulin in the body. Insulin regulates the flow of fatty acids from our fat cells, and it acts in a feedback loop to regulate ketogenesis. As long as insulin is circulating within the body, in general, the flow of fatty acids and the production of ketone bodies will be limited to a range that is not dangerous.  In contrast, ketoacidosis is a condition associated with a lack of insulin.  For example, it can manifest in type 1 diabetics who fail to inject enough insulin, or who are newly diagnosed.
Once inside the mitochondrion, the dominant way that the bound fatty acids are used as fuel in cells is through β-oxidation, which cleaves two carbons off of the acyl-CoA molecule in every cycle to form acetyl-CoA.[24] Acetyl-CoA enters the citric acid cycle, where it undergoes an aldol condensation with oxaloacetate to form citric acid; citric acid then enters the tricarboxylic acid cycle (TCA), which harvests a very high energy yield per carbon in the original fatty acid.[25][26]
Apparently, Dominic’s research seems to be suggesting the fact that diet-induced ketosis from a high-fat, low-carb intake, especially when combined with the use of nutrition supplements such as powdered ketones or MCT oil, can vastly reduce the need for the brain to use oxygen to burn glucose. This is because the brain can use up to around 75% of its fuel from ketones. So a ketone-fed or a fat-adapted brain can be better equipped to withstand low oxygen availability and potentially support longer breath-hold times. Dominic’s research also shows that in the presence of ketosis, the brain and body are able to resist the potential cell damage of long periods of time with low oxygen, also known as “hypoperfusion”.
And what I’m writing has nothing to do with taking supplements to induce ketosis or whatever. I believe these things are covered in Volek & Phoney’s book The Art and Science of Low Carb Living, which I would have thought you to be very familiar with. The iodine stuff you can read about in Iodine, Why We Need, Why We Can’t Live Without It by Brownstein.
-Nervous System Damage: It’s been shown that patients with neuropathy whose after-meal glucose readings were above the diabetic threshold sustained damage to their large nerve fibers. Even neuropathy patients whose glucose readings remained well within the normal range showed damage to their small nerve fibers. Studies have shown that within any blood sugar range, the higher the glucose, the greater the damage to nerve fibers.
I'd recommend starting with glucose and hemoglobin A1C, along with a good multi like https://bengreenfieldfitness.com/multi and a fish oil like the one at greenfieldfitnesssystems.com – Anyways, I'd be happy to help you via a personal one-on-one consult. Just go to https://bengreenfieldfitness.com/coaching. and then choose a 20 or 60 minute consult, whichever you'd prefer. I can schedule ASAP after you get that.
The Dr. Formulated Keto line of products is fully transparent, compliant to the keto guidelines and designed to be convenient—we’ve done the math for you—just mix. Crafted for those seeking to enter into ketosis or stick to a low-carbohydrate diet for weight loss and health purposes, all Dr. Formulated products are Keto Certified, Paleo Friendly and clean: Non-GMO Project Verified and Truly Grass Fed.
Ketosis is the metabolic process of using fat as the primary source of energy instead of carbohydrates. This means your body is directly breaking down its fat stores as energy instead of slowly converting fat and muscle cells into glucose for energy. You enter ketosis when your body doesn’t have enough glucose (carbohydrates) available. The prime function of the ketogenic diet is to put the body in ketosis.
Wilder's colleague, paediatrician Mynie Gustav Peterman, later formulated the classic diet, with a ratio of one gram of protein per kilogram of body weight in children, 10–15 g of carbohydrate per day, and the remainder of calories from fat. Peterman's work in the 1920s established the techniques for induction and maintenance of the diet. Peterman documented positive effects (improved alertness, behaviour, and sleep) and adverse effects (nausea and vomiting due to excess ketosis). The diet proved to be very successful in children: Peterman reported in 1925 that 95% of 37 young patients had improved seizure control on the diet and 60% became seizure-free. By 1930, the diet had also been studied in 100 teenagers and adults. Clifford Joseph Barborka, Sr., also from the Mayo Clinic, reported that 56% of those older patients improved on the diet and 12% became seizure-free. Although the adult results are similar to modern studies of children, they did not compare as well to contemporary studies. Barborka concluded that adults were least likely to benefit from the diet, and the use of the ketogenic diet in adults was not studied again until 1999.[10][14]
The trick here is not only to avoid all obvious sourced of carbohydrate (sweets, bread, spaghetti, rice, potatoes), but also to be careful with your protein intake. If you eat large amounts of meat, eggs and the like, the excess protein will converted into glucose in the body. Large amounts of protein can also raise your insulin levels somewhat. This compromises optimal ketosis.
-Cardiovascular Disease: High blood sugar has been shown to increase the risk for cardiovascular events, cardiovascular disease, and cardiovascular mortality—while lower glucose levels result in lower cardiovascular risk. Coronary artery disease risk has been shown to be twice as high in patients with impaired glucose tolerance, compared with patients with more normal glucose tolerance. The risk for stroke increases as fasting glucose levels rise above 83 mg/dL. In fact, every 18 mg/dL increase beyond 83 results in a 27 percent greater risk of dying from stroke. Incidentally, glucose can “stick” to cholesterol particles and render these particles extremely dangerous from a heart health standpoint, which is why it’s all the more important to control blood sugar levels if you’re eating a “high-fat diet.”
On a low carb or ketogenic diet my fasting blood sugar is 90-120. I think it may get higher the lower carb I go. Most internet sources say don’t worry about it, worry about your Ha1c. Is this insulin resistance? Anyone have better information? If I do a water fast my morning blood sugar will go down and down each day, til it reaches about 50 in 4 days. But as soon as I start eating it pops right back up.
Would be curious to receive feedback on any of the above! And if anyone is interested in more info on my future Ketone product which will taste great, have 11.7g of BHB, 30 servings and priced lower than all the competitors, then message me on FB under Rhys Kabra, or email [email protected] for status updates on the upcoming new Brand of Ketone products! :)
This is why Gaspari Nutrition chose highly branched cluster dextrin for what we consider to be the gold standard of recovery and performance drinks. This high molecular weight carbohydrate has a special helical structure, which gives it unique properties unlike many of the corn starches or polysaccharides out there. I'll be real with you and say this stuff isn’t cheap, but you certainly pay for what you get, and highly branched cluster dextrin is unlike any carb source I've found – especially if you want to control blood sugar levels and gut issues.

So in the end, I ordered 1kg of pure BHB Magnesium from a supplier in China and I will be developing my own Ketone product with 30 servings as a lower price than all the competitors, and with more Magnesium, and Calcium in it than Sodium so that it tastes the best and actually helps with weight loss (which Magnesium is proven to do at the right amount). What the companies don’t tell you is that actually Sodium BHB is the cheapest, then Calcium BHB and then Magnesium BHB to source so I would be interested in knowing if what you wrote is actually true or just an excuse to make the product cheaper. Probably a mix of both.
A: The amount of weight you lose is entirely dependent on you. Obviously adding exercise to your regimen will speed up your weight loss. Cutting out things that are common “stall” causes is also a good thing. Artificial sweeteners, dairy, wheat products and by-products (wheat gluten, wheat flours, and anything with an identifiable wheat product in it).
The same goes for people with type 2 diabetes. While some preliminary research suggests the keto diet may be safe and effective for certain people with type 2 diabetes, there’s still the risk for low blood sugar, especially for those on insulin, and the keto diet omits certain food groups known to benefit those with this disease. For example, a study published in September 2016 in the journal Nutrients highlights the importance of whole grains for helping to control weight as well as episodes of high blood sugar. Whole grains are off-limits on the ketogenic diet.

"The keto diet is primarily used to help reduce the frequency of epileptic seizures in children. While it also has been tried for weight loss, only short-term results have been studied, and the results have been mixed. We don't know if it works in the long term, nor whether it's safe," warns registered dietitian Kathy McManus, director of the Department of Nutrition at Harvard-affiliated Brigham and Women's Hospital.
Frankly, the results of my foray into ketosis and eventually keto-adaptation were astounding. I had the best Ironman triathlon season of my life and shocking levels of mental focus and physical ease, especially for races and workouts that lasted longer than two hours. Without experiencing muscle loss, hunger pangs or brain fog, I found I could go the entire day without eating, which was enormously helpful for business and personal productivity. My gas, bloating, fermentation and GI “issues” disappeared. My blood levels of inflammatory markers like HS-CRP and cytokines dropped to rock-bottom, while my levels of good cholesterol, vitamin D, and anti-inflammatory fatty acids skyrocketed.
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