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Why Your Keto Diet Might Not Be Working

Common mistakes that could impact your wellness results.

common mistakes to avoid on keto diet
There comes a time when a social media-fueled wellness trend reaches its zenith. We saw the celery juice trend come and go, for example. And while most are debunked because of little to no scientific backing, when it comes to the ketogenic diet, there’s a plethora of studies from doctors and nutritionists. So why is it that it’s not working for you? Are you consuming too much of one thing, but not enough of the other? Are you getting your fats in from the wrong places—i.e., bacon? When it comes to reaching ketosis, there is little room for error, so we asked Dr. Josh Axe D.N.M., C.N.S., D.C., founder of Ancient Nutrition and, and author of the best-selling book KETO DIET, to lay out some ground rules and point out some common mistakes.


Common Errors

1. “Eating too little fat.

2. “Eating too much protein.

3. “Consuming too many carbs, sometimes without realizing it.

4. “Not consuming enough water, fiber, and electrolytes (which you get from eating whole foods, especially vegetables).

“The three macros in your diet are fat, carbohydrates, and protein. Fats should provide roughly 75 percent or more of your daily calories on the Keto diet. Aim to get about 15 to 20 percent of [your] calories from protein, and just 5-10 percent from carbs.

“On a traditional Keto diet, the goal is to keep your daily net carb intake below 2530 grams. Net carb intake refers to the total grams of carbs you eat per day minus the grams of fiber. In order to do this and avoid consuming excess carbs, high-carb/high-sugar foods, avoid anything made with added sugar, foods made with any grains or grain flour, corn and all products containing corn, potatoes and starchy veggies, conventional dairy products such as most yogurts, ice cream, milk, and all fruit (while berries can be eaten in small quantities).”

Rules to stick to

1. “Hit your macronutrient target (see above).

2. “If you feel hungry, make sure to eat plenty of healthy fats, since lingering hunger may be a sign you’re simply not consuming enough calories. Consume beneficial fats, oils, and nutrient-dense foods with every meal, or else you won’t be giving your body the energy it needs. Examples of healthy fats to fill up on include: coconut oil, avocados, nuts and seeds, steak, chicken (dark meat is best), fish, eggs, butter, etc. Some of the healthiest oils include: real olive oil, coconut oil and nut- and seed- based oils, ghee, avocado oil, and organic mayonnaise.

3. “Don’t over-consume protein. This isn’t a high-protein diet; it’s a moderate-protein, high-fat diet. Eating too much protein may prevent you from getting into ketosis. Eat no more than a moderate serving size per meal.

4. “Learn to read ingredient labels carefully, keeping an eye out for hidden sources of sugar and carbs.

5. “Make sure you’re consuming plenty of electrolytes (magnesium, potassium, sodium, etc.) by eating lots of vegetables, using sea salt on your meals, drinking bone broth, and taking a magnesium supplement or multivitamin if you’d like.

6. “Drink lots of water, since the Keto diet causes increased urination.”

Signs it may not be for you

“While it’s not uncommon for the Keto diet to cause side effects initially, which collectively have been nicknamed ‘the Keto flu,’ these shouldn’t last for more than one to two weeks, at which point most people have become what’s referred to as ‘fat adapted.’ Side effects when starting Keto can include fatigue, constipation, cravings, headaches, trouble sleeping, and bad breath.

“If symptoms linger on for weeks, even after you’ve taken steps to ensure you’re following the diet correctly (this is important, since being in ketosis is what resolves side effects), then you may want to call it quits and try another approach instead. Warning signs that you should probably increase your carb intake include: mood related issues, trouble sleeping, digestive issues, ongoing fatigue, too much weight loss, muscle weakness and trouble exercising, and irregular or absent periods in women.

“If this applies to you, then a modified Keto diet may be a better option. This is similar to a modified Atkin’s diet that includes a bit more protein and carbs than a traditional Keto diet. It’s still high in fat and low in carbs, but allows for more flexibility and food variety, and many feel it’s a healthy and sustainable way to eat long-term.”

How to know if you’re in ketosis

“In order to determine whether or not your body is in ketosis, there are several types of tests you can utilize. Ketones are a byproduct of fatty-acid breakdown, and testing your blood, breath, or urine for ketones can be a useful indication of whether or not your body has reached ketosis. You can choose to test ketone levels using urine strips (the easiest and most popular method), blood tests, or breathalyzer tests.”

It should be part of a healthy lifestyle

“Like with any other diet plan, you’re only going to feel great and experience meaningful results if you approach things holistically. Prioritize getting enough sleep. Resting and managing stress are [both] important for regulating your appetite and supporting cognitive health, your immune system, and mental health.

“You can still experience weight loss and other health improvement on the Keto diet even if you aren’t exercising vigorously, due to the anti-inflammatory effects that ketones have. Focus on stress reduction and also exercising in an enjoyable way, and doing things that feel sustainable. Movement is important for the body, mind, and spirit. Twenty to thirty minutes of walking or light-to-moderate exercise is encouraged, or something more intense if you’ve previously been pretty active.”

If you’re not seeing or feeling results

“The Keto diet is a type of dietary strategy that requires a commitment and being pretty strict with what you do and don’t eat; there isn’t a big margin for error when trying to get into ketosis, since your macronutrient intake determines whether you will or won’t be successful.

“First make sure you’re following the diet correctly. You may want to keep a food journal to help with this. Review the common mistakes described above, and determine if any may apply to you.

“If you do believe you’re in ketosis, and maybe you’re losing weight but overall still don’t feel great, then it’s time to focus on two things: the quality of the foods you’re eating, and whether another diet may be a better fit.

“I recommend adhering to a ‘clean Keto diet’ as much as possible. By this I mean a ketogenic diet that focuses on whole foods, including plenty of healthy fats/oils (not things like tons of bacon, cheese, and pork rinds), quality meats/protein in moderation, and lots of non-starchy vegetables. A clean Keto diet is more anti-inflammatory and alkalizing, which means it not only helps with weight loss, but also tackles other health concerns, too. For example, it may help keep Keto side effects at bay, improve your energy, digestion, mood, and potentially other markers of health, like blood sugar, cholesterol, blood pressure, etc. Focusing on quality also will help you learn healthier habits that you can continue to implement once you transition away from the Keto diet.”

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