FAQ – Ketogenic Diet & Mental Health
Explore the intersection of metabolic health and cognitive well-being. Our scientific approach to the ketogenic diet prioritizes mental clarity and emotional stability.
1. Isn’t eating a lot of fat unhealthy – and won’t it make me gain weight?
Not necessarily. In a medically ketogenic diet, fat is deliberately used as the primary energy source, while sugar and starch are significantly reduced. This lowers insulin levels and encourages the body to efficiently burn fat and produce what are known as ketone bodies. Many people actually lose weight on a ketogenic diet or maintain a stable weight. What matters most is total energy intake, the quality of fats consumed, and an individually tailored approach to nutrition.
2. Does a ketogenic diet damage the liver?
In healthy individuals, there is no evidence that a properly implemented ketogenic diet causes liver damage. In fact, some studies have shown an improvement in fatty liver values in people with obesity or insulin resistance. However, caution is advised for those with severe liver conditions – in these cases, a ketogenic diet should only be followed after consulting a doctor.
3. Will I eventually be able to stop taking my medication?
This varies greatly from person to person. Some people are able to reduce or even discontinue medication over time. Others continue to need a lower dose. Still others benefit long-term from a combination of dietary changes and medication. Important: Medication should never be reduced on your own. Any changes should always be made in close collaboration with a doctor – and especially for psychiatric medications, reductions must happen very slowly and gradually.
4. When should extra caution be taken with a ketogenic diet – or when should it be avoided?
A ketogenic diet is not equally suitable for everyone. Extra caution is needed for:
- Bipolar disorder → in rare cases, hypomania or mania may occur → usually manageable under medical supervision → temporary medication or a slight increase in carbohydrates may help
- Those taking blood pressure medication → dosage may need to be adjusted
- Those taking diabetes medication → hypoglycaemia may occur; medical supervision is required
- Type 1 diabetes → only under very close medical monitoring (risk of ketoacidosis)
- Those taking SGLT-2 inhibitors → these diabetes medications increase the risk of ketoacidosis and are contraindicated; consult your doctor
- Severe liver conditions
5. Are there side effects?
At the beginning, a so-called “keto flu” may occur. Typical symptoms include: fatigue, headaches, dizziness, difficulty concentrating. These symptoms are usually temporary and can often be avoided or significantly reduced by:
- drinking enough fluids
- taking electrolytes (e.g. salt, magnesium)
- gradually reducing sugar and carbohydrates
6. Can I still live a normal life on a ketogenic diet – for example, at restaurants or social gatherings?
Yes. With a little planning, an active social life is very much possible. Helpful strategies include:
- choosing suitable dishes at restaurants
- making small adjustments (e.g. swapping a side dish)
- having a small snack before attending social events
- drawing on coaching support and practical everyday tips
7. What is ketosis?
With a medically ketogenic diet, the body enters a metabolic state known as nutritional ketosis. In this state, the body primarily uses fat as its energy source. The liver produces so-called ketone bodies, which circulate in the blood and can also serve as fuel for the brain. Ketosis begins at approximately 0.5 mmol/l in the blood and can be easily measured using a blood ketone meter. A ketogenic diet typically produces levels of around 0.5 to 4 mmol/l. Higher values can occur, for example, during fasting.
8. Can you follow a ketogenic diet as a vegetarian or vegan?
Yes — with good planning, it is possible. A vegetarian ketogenic diet is very achievable with the support of a coach. Since dairy products contain more carbohydrates than meat or fish, they should be used mindfully and in moderate amounts. With the right food choices, high levels of ketosis that may benefit mental health can still be achieved. A vegan ketogenic diet is considerably more challenging, but also possible. Professional guidance is especially important here, as careful planning and supplementation are often necessary to meet the body’s nutritional needs.
9. What ketone levels are needed for mental health benefits?
This varies from person to person.
- Some people notice significant improvement at mild ketosis (from around 0.5 mmol/l)
- Others benefit only at higher levels, for example above 2 mmol/l
- What matters is not a fixed target value, but rather how you personally feel – alongside guidance from qualified professionals.
10. How many carbohydrates can I consume?
This is highly individual and depends on various factors, such as metabolism, physical activity, health status, and personal goals. Many people achieve stable ketosis with fewer than 20g of net carbohydrates per day. Others may need – or be able to tolerate – slightly more carbohydrates in order to feel their best long-term and integrate the diet into daily life. As part of professional coaching, you and your coach will work together to find the carbohydrate intake that works best for you and how to best achieve your personal level of ketosis.