Is it true that ketosis can cause diarrhea? Well... It is somewhat true but not entirely. While the state of ketosis itself will not cause diarrhea, a ketogenic diet can.
Keto diets are so well known for causing diarrhea that people have even coined the term "keto diarrhea" to refer to it. So if you are on a ketogenic diet and having frequent volcanic eruptions in the toilet, don't worry, you are not alone.
Ketosis is a metabolic state where the body, instead of using glucose for energy as it normally would, uses ketone bodies in the blood which come from the breakdown of fats.
This state can be achieved by a keto diet, which is extremely low in carbs and high in fat. Essentially what you are doing is starving your body of carbs and forcing it to burn fat, which is said to provide a more steady and smooth form of energy along with other benefits.
Why Keto Diets Can Lead to Diarrhea
Keto diarrhea has nothing to do with ketosis and your body burning fat for energy, but instead comes from the diet that brings about this process.
There are many reasons such a diet could bring about frequent trips to the toilet, some of the more common reasons include...
Reason #1 - Low In Fiber
Too much fiber can cause diarrhea but not enough fiber can also be the cause. As with anything, you want a healthy balance.
Soluble fiber absorbs excess water and helps thicken loose stool. It turns into a gel-like substance and makes bowel movements much more healthy and normal.
Unfortunately fiber is a carbohydrate (although no nutritional value) and with a keto diet you are much less likely to get adequate amounts of fiber, depending on how you formulate your diet of course.
*Too much or too little fiber is by far one of the most common causes of diarrhea.
Reason #2 - High In Fat
The big fat intake that keto dieters have could also be the problem. Changing your diet from "normal" to keto and increasing your fat intake like this can take some time for your body to adjust to.
Enzymes that digest fat might not be able to handle it all and this can cause extra fat to be in your stool, which makes it looser. When fat goes un-absorbed and passes into the small intestines and colon, it causes more water to be pulled in.
The GI tract may be able to adjust to the higher level of fats passing throughout your body, but for some people this side effect may never go away.
Reason #3 - Sugar Alcohols Could Be to Blame
Keto diets can be hard to stick to, and some may find comfort consuming sugar-free beverages and candies. But these may not be good choices.
Sugar-free food and drinks often contain sugar alcohols like xylitol, sorbitol, mannitol and lactitol which give off a sweet flavor, but unfortunately can upset the GI tract.
Sorbitol is the most well known to cause side effects like gas, bloating and diarrhea. According to a 2006 study published in the World Journal of Gastroenterology, the main reason for diarrhea after consuming too much sorbitol is malabsorbance of the substance.
Reason #4 - Too Much Protein
We know you might want to lose weight and build big muscles at the same time, but having too high of a protein intake can lead to such an unwanted side effect such as diarrhea.
Some sources say that you should keep your protein intake about about 10-20% of your daily energy need. You want to keep it at moderate levels.
Eating high amounts of protein from dairy sources, fried foods and protein shakes are sources you might want to try to avoid because these are well known to cause diarrhea in many individuals.
A high protein diet coupled with the fact that you are eating very low fiber from carbs can really increase the risk.
Constipation Is Another Common Side Effect
Believe it or not, constipation is also another common side effect of a keto diet. It may seem strange that you could have side effects on both sides of the spectrum, but it is possible.
The low fiber intake that commonly comes with a keto diet would be a common culprit if you are experiencing such.
But if you do things the right way you can have a well "balanced" keto diet without these problems.
"Well-Formulated" Keto Diets Do Not Cause Diarrhea
The main problem that people have is with fiber. They don't get enough of it and this is because getting enough can be tricky.
Of course the whole point of this diet is to get into ketosis, and in order for you to do this you have to eat very little carbs.
The solution: Get your fiber from nuts, seeds, leafy greens, broccoli, etc. These are good sources of fiber but don't have massive amounts of carbs.
Dairy Might Be Worth Avoiding:
As you already know, diary is a common cause of diarrhea. You may want to try removing some of the cheese you eat and see if that makes a difference, even if you are not lactose intolerant.
Ease Into It:
Another good piece of advice is to slowly get into a keto diet. Slowly add fat and take away carbs. This way your body can get used to it and build up tolerance if it needs to.
What Works for One Person Might Not Work for You
We are all different and just because one person's keto diet might work perfectly for them, it might cause you to have volcanic diarrhea.
You have to find what works best for your body. Maybe you need more fiber, or maybe not so much. Maybe you can't handle all that protein. Who knows...
So find what works. And if you can't find anything that works and still have diarrhea then it is probably time to quit and go back to a diet that does work for you.
Maybe having diarrhea helps you reach your goal of losing weight, but it is not a healthy way to go about it and achieving ketosis is definitely not worth it if you have this problem constantly. Diarrhea leads to a loss of hydration and nutrition which can impact your health in every way imaginable.
It Also Might Not Be The Keto Diet That Is To Blame
Even if you just switched to a keto diet and just started experiencing diarrhea, it might not be the keto diet's fault.
Switching diets like this more than likely means that you added new foods to what you eat and/or more of certain foods. It is possible that you have an allergy or intolerance which could be causing the problem. If this is possible, you are going to want to try an elimination diet to narrow down the cause, or see a doctor if it is rather serious.