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If you have recently started the keto diet, you have probably done a total overhaul of your diet. There's no way to sugar coat it: Following the keto diet is hard work, which is why some people have turned to keto pills and supplements to stay in ketosis, where your body burns fat instead of carbs for fuel.
"While our bodies’ preferred energy source is glucose (the breakdown of carbohydrates), following the keto diet the way it is intended will put a person in ketosis," says Jordan Hill, RD, CSSD, of Top Nutrition Coaching. "As you can imagine, shifting one’s dietary pattern from a higher carbohydrate intake to a very low one and significantly upping the fat intake can be challenging. Cue the desire to take a supplement."
ICYMI, the keto diet requires you to cut lots of carbs. Followers of this eating style take in 70 to 80 percent of your daily calories from fat, five to 10 percent from carbs, and 10 to 20 percent from protein. It drives the body to go into a state of ketosis, says Brittany Michels, RDN, LDN, CPT, of The Vitamin Shoppe.
Fun fact: The keto diet was originally used to treat neurological diseases, such as epilepsy, says Michels. But the keto diet has since been used for not only weight loss, blood sugar management, and more.
You should know you shouldn't rely on supplements alone to keep you in ketosis. "Keto supplements can be effectively used in tandem with following a keto diet," notes Michels. "They are not meant to replace the diet."
Meet the experts: Jordan Hill, RD, CSSD, is a nutritionist and certified specialist in sports dietetics.
Brittany Michels, RDN, LDN, CPT, is a nutritionist and trainer with The Vitamin Shoppe.
Hold on, keto pills and supplements? What are those?
Basically most keto supplements, which typically come in powder or capsule form, contain two specific ingredients, according to Wesley McWhorter, RD, a chef and dietitian at UTHealth School of Public Health in Houston, Texas:
Medium chain triglycerides (MCTs), which are predominantly saturated fats that break down in the liver
Exogenous ketones or ketone salts (a.k.a. beta-hydroxybutyrate, or ketones made outside of the body in a lab)
Together, these reportedly work to increase the amount of fat in your body and kick you into ketosis (a.k.a. your fat-burning zone) faster, says McWhorter. Ketone supplements also allegedly block carbs from being absorbed or metabolized, he adds.
See all the celebs who have dabbled in the keto diet:
So...can keto pills make you lose weight?
Those claims are, well, just claims—"If you want to waste your money and potentially consume adulterated products with little or no research backing them, then sure, go right ahead and get those keto supplements," says McWhorter. Yep.
And because there's such limited peer-reviewed research to support using them, they might even be harmful to your health in the long run, says Michelle Milgrim, RD, a nutritionist at Northwell Health in New Hyde Park, New York.
"Only short-duration studies examining small samples have found that exogenous ketones can help achieve ketosis quicker and may decrease appetite," she says. But there haven't been any long-term studies looking at these outcomes over time, she adds.
Smith adds that one of the most common ingredients in keto supplements is the ketone body beta-hydroxybutyrate (BHB). BHB is naturally synthesized in the liver from fatty acids and is used for energy when a person is in ketosis.
And a 2021 study found that consuming BHB supplements for six weeks enhanced ketosis in a group of people who were already following a keto diet, but there were no significant health benefits or weight loss compared to the group that did not take BHB supplements.
"This suggests that taking keto supplements do not enhance weight loss when paired with a keto diet," says Smith. "More research is required to know exactly why."
What side effects do keto supplements cause?
Side effects from keto supplements are also a red flag. "You should be concerned about side effects,” says Maucere. One study found that 13 of 19 participants who consumed ketone salts—a popular ingredient in keto supplements—suffered GI distress.
Smith notes that keto supplements have also been shown to cause other side effects such as nausea, vomiting, abdominal pain, and diarrhea in some people.
Well, can keto supplements do anything at all?
While keto pills, like exogenous ketones, do temporarily elevate the level of ketones in the blood, says Amanda Maucere, RD, a nutritionist at Lung Health Institute in Tampa, Florida, the overall impact on the body is not the same as getting there via your dietary choices.
"Think of it like taking a vitamin C supplement versus eating a cup of strawberries. The supplement will provide an adequate amount of vitamin C, but so will eating a cup of strawberries,” she says. Plus, with the cup of strawberries you’re also getting a dose of fiber, antioxidants and phytochemicals—other things that your body needs.
McWhorter agrees: "Simply swallowing a pill does not give us the same benefit as eating vegetables and whole, plant-based food," he says.
Are there any supplements I should be taking on the keto diet?
First, you should always check with your doctor before starting any new nutritional supplements (and even before starting a diet like keto).
Once you get the all-clear, it's important to know that cutting carbs can make you a bit deficient in other vitamins and minerals—specifically chromium, B5 (pantothenic acid), B7 (biotin), and calcium. "People can become deficient in these vitamins and minerals because they are found in grains and, if you're going keto, that usually means very low carbohydrate," Scott Keatley, RD, of Keatley Medical Nutrition Therapy, previously told Women's Health.
Electrolytes like sodium, potassium, and magnesium are also good additions to the keto diet—especially if you're struggling to feel your best on it because of issues like the keto flu, which can cause dehydration or cramping. "Magnesium can be particularly helpful with constipation or leg cramps on your keto journey," says Maucere—notice none of those suggestions were MCT oil or exogenous ketones.
The bottom line: Keto supplements are unnecessary and possibly even harmful. If you're set on the keto diet, fill your plate with foods that contain lots of healthy fats, and round it out with non-starchy veggies—not exogenous ketone supplements.
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