[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-456022-105":59,"doc-detail-456022-en":130},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":123,"head_meta":125,"extra_data":127,"updated_unix":129},105,"en","the-ketogenic-diet-is-not-for-everyone-contraindications-side-effects-and-drug-interactions","The ketogenic diet is not for everyone - Contraindications, side effects, and drug interactions","","The ketogenic diet (KD), initially developed for neurological disorders, has attracted growing interest for managing metabolic diseases. This review synthesises key contraindications and clinical situations requiring caution, highlights drug interactions, and summarises commonly reported adverse effects. Absolute contraindications are rare and include certain inborn errors of metabolism and porphyria, while relative contraindications cover acute pancreatitis, advanced hepatic or renal disease, and selected comorbidities. Particular vigilance is recommended for diabetes, hypertension, gallbladder disease, electrolyte disturbances, arrhythmias, pregnancy, lactation, underweight, intensive activity, psychosocial stress, and post-operative recovery.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/the-ketogenic-diet-is-not-for-everyone-contraindications-side-effects-and-drug-interactions/456022/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/the-ketogenic-diet-is-not-for-everyone-contraindications-side-effects-and-drug-interactions/456022.png","ImageObject",300,407,{"name":92,"@type":93},"Rizky","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-31","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":44},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What kinds of contraindications are discussed for the ketogenic diet?","Question",{"text":112,"@type":113},"The review distinguishes rare absolute contraindications (specific inborn errors of metabolism affecting metabolic pathways and porphyria) from broader relative contraindications such as acute pancreatitis and advanced hepatic or renal disease.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"Which medication classes are highlighted for potential interactions with the ketogenic diet?",{"text":117,"@type":113},"Interactions reviewed include SGLT2 inhibitors, metformin, GLP-1 receptor agonists, insulin and sulphonylureas, antiepileptic drugs, diuretics, lipophilic drugs, and corticosteroids.",{"name":119,"@type":110,"acceptedAnswer":120},"What adverse effects are commonly reported with the ketogenic diet?",{"text":121,"@type":113},"Reported effects range from transient “keto flu” symptoms such as fatigue, headache, and nausea to gastrointestinal disturbances, polyuria, and hypoglycaemia.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},456022,1790831009,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":44,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":139,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145,"preview_page_count":4},962085564807,"https://ap-avatar.wpscdn.com/davatar_6f874abed73319feea01a86fa6f0fab8","AnnAls of Medicine  \n2026, Vol. 58, no. 1, 2603016  \n[https://doi.org/10.1080/07853890.2025.2603016](https://doi.org/10.1080/07853890.2025.2603016)  \nREVIEW ARTICLE     \nThe ketogenic diet is not for everyone: contraindications, side effects, and drug interactions  \nDamian Dyńkaa, Łukasz Rodzeńb, Mateusz Rodzeńb, Dorota Łojkoc, Hanna  \nKarakuła-Juchnowiczd, Georgia Edee, Żaneta Grzywaczf, Katarzyna Antosika, Shebani Sethig and David Unwinh  \nainstitute of Health sciences, faculty of Medical and Health sciences, University of siedlce, siedlce, Poland; bRodzen Brothers foundation, Wieleń, Poland; cdepartment of Psychiatry, Poznan University of Medical science, Poznan, Poland; ddepartment of Psychiatry, Psychotherapy and early intervention, Medical University of lublin, Poland; eindependent Researcher, Amesbury, Massachusetts, UsA; ffaculty of Production engineering and logistics, opole University of Technology, opole, Poland; gMetabolic Psychiatry, department of Psychiatry and Behavioral sciences, stanford University school of Medicine, Palo Alto, california, UsA; hfaculty of Health social care and Medicine, edge Hill University, ormskirk, UK  \nABSTRACT  \nBackground: The ketogenic diet (KD), initially developed for the treatment of neurological disorders, has gained increasing attention for its potential role in the management of various metabolic diseases. Alongside its expanding clinical use, concerns have emerged regarding its safety, tolerability, and suitability in specific patient populations. This review summarises key contraindications, clinical situations requiring caution, relevant drug interactions, and commonly reported adverse effects associated with KD.  \nDiscussion: Rare absolute contraindications include selected inborn errors of metabolism affecting pyruvate carboxylase activity, carnitine transport or utilisation, fatty acid oxidation pathways, as well as porphyria. Relative contraindications encompass acute pancreatitis, advanced hepatic or renal disease, familial hypercholesterolaemia, and other conditions that may be aggravated by KD-induced metabolic changes, including concomitant use of propofol. Particular caution is warranted in patients with type 1 or type 2 diabetes receiving specific glucose-lowering therapies, pharmacologically treated hypertension, gallbladder disease or prior cholecystectomy, electrolyte disturbances, cardiac arrhythmias, pregnancy or lactation, underweight status, intense physical activity, significant psychosocial stress, or postoperative recovery.  \nClinically relevant interactions with medications are reviewed, including sodium–glucose cotransporter 2 (SGLT2) inhibitors, metformin, glucagon-like peptide-1 (GLP-1) receptor agonists, insulin and sulphonylurea derivatives, antiepileptic drugs, diuretics, lipophilic drugs, and corticosteroids. The most frequently reported adverse effects range from transient “keto flu” symptoms (fatigue, headache, nausea) to gastrointestinal disturbances, polyuria, and hypoglycaemia.  \nConclusions: KD demonstrates therapeutic potential in the management of a broad range of metabolic and neurological diseases; however, it is not an intervention suitable for all clinical situations. Awareness of existing contraindications, conditions requiring particular caution, and potential drug interactions enables a more responsible, individualised, and safe approach to patient selection and clinical management. In this context, the present paper provides a concise yet comprehensive synthesis to support clinicians and researchers in the rational and effective application of the ketogenic diet in both clinical practice and scientific research.  \nARTICLE HISTORY  \nReceived 26 September 2025  \nAccepted 6 December 2025  \nKEYWORDS  \nKetogenic diet (KD); absolute contraindications; relative  \ncontraindications; drug interactions; side effects; diseases  \nCONTACT damian dyńka  [damian.dynka24@gmail.com](damian.dynka24@gmail.com)  institute of Health sciences, faculty o","cbCaios0GUgkLof7","https://ap.wps.com/l/cbCaios0GUgkLof7","pdf",1361998,38,"English","# Abstract\n## Contraindications and clinical caution\n## Drug interactions\n## Adverse effects\n## Conclusions\n## Introduction\n## Target conditions and emerging evidence","[{\"question\":\"What kinds of contraindications are discussed for the ketogenic diet?\",\"answer\":\"The review distinguishes rare absolute contraindications (specific inborn errors of metabolism affecting metabolic pathways and porphyria) from broader relative contraindications such as acute pancreatitis and advanced hepatic or renal disease.\"},{\"question\":\"Which medication classes are highlighted for potential interactions with the ketogenic diet?\",\"answer\":\"Interactions reviewed include SGLT2 inhibitors, metformin, GLP-1 receptor agonists, insulin and sulphonylureas, antiepileptic drugs, diuretics, lipophilic drugs, and corticosteroids.\"},{\"question\":\"What adverse effects are commonly reported with the ketogenic diet?\",\"answer\":\"Reported effects range from transient “keto flu” symptoms such as fatigue, headache, and nausea to gastrointestinal disturbances, polyuria, and hypoglycaemia.\"}]","The ketogenic diet is not for everyone - Contraindications, side effects, and drug interactions | PDF",1790744954,96]