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Ketogenic Diet

Keto Plateau & Keto Stall Troubleshooting Diet Guide

March 16, 2019 //  by Dr. Daniel Pompa//  28 Comments

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Ketogenic Diet

Ketosis, a metabolic process by which your body uses predominantly ketones for energy (instead of glucose) has taken the nation by storm. This high-fat, moderate protein, low-carb diet is having a profound impact on many disease models and is proving to be an incredible tool for weight loss and improved body composition. Although the method is fairly simple, it is quite common that people will find their weight loss stalling… Welcome to a keto plateau. Today we are going to explore the key reasons your progress might stall while on a keto diet, and simple ways to break through them.

Keto Plateau:
Why Keto Stalling Happens and How to Stop It

The benefits of a ketogenic diet generally kick in very quickly; most people notice their body composition transforming dramatically within weeks. It can be frustrating, however, when all of a sudden your progress stalls, and you find yourself in a keto plateau. Let’s explore the many ways in which too much or too little of something can be the culprit, and how to continue striving towards your goals.

Why Does a Weight Loss Plateau Happen on Keto?

A weight-loss plateau on keto can occur for multiple different reasons, including:

  • Too much or insufficient amounts of fat in the diet;
  • Too much or too little exercise;
  • Dehydration.

On top of addressing these issues, there are many tricks to break through a plateau, like using digestive enzymes and intermittent fasting.

Eating Too Much Protein, Or Not Enough Fat Can Cause a Keto Plateau

Keto stalling can occur if you’re on either end of the fat-consumption spectrum: you may be eating too much, or too little. A ketogenic diet is a high-fat, moderate-protein, low-carbohydrate diet, and many people underestimate how much fat they need. A common ratio is 75-80% fat, 15-20% protein, and about 5% carbohydrates. Understanding how much fat your individual body needs is something only you can really figure out, through trial and error. A good place to start when you’re trying to incorporate more healthy fats into your diet is my 2-2-2 rule, which consists of adding the following to your daily diet:

  • 2 tbsp of coconut or medium-chain triglyceride (MCT) oil
  • 2 tbsp of grass-fed butter or ghee
  • 2 tbsp of olive oil (or avocado oil)

Your daily fat intake should not be limited to these fats, but simply adding them in will ensure you’re taking in enough. For some people, the problem lies in eating too much protein (and often, this also means not enough fat). Protein is a great nutritionally dense macronutrient, but when you consume too much of it the body actually converts protein into glucose through a process called gluconeogenesis. Everyone’s protein tolerance on a keto diet is slightly different, and those exercising hard can generally tolerate a bit more. Remember, the keto diet is a high fat, moderate protein, low carbohydrate diet!

Exercising Too Much (or not enough) Can Cause a Keto Plateau

Exercise plays a vital role in an overall healthy-keto approach, by not only burning fat but also regulating hormones. Exercising too much can cause an excess of oxidative stress on the body, especially at a time when it is adapting to this new method of fuel (ketones, instead of glucose). Other harmful effects of too much exercise include:

  • Hormone imbalances (especially depletion of testosterone)
  • Poor sleep
  • Brain Fog
  • Irritability
  • High blood sugar
  • Weakened immune system
  • Chronic stress-related symptoms

Exercising too fails to harness all the benefits that exercise has on your physiology, including:

  • Increasing hormone sensitivity (especially insulin sensitivity)
  • Increasing your resting metabolic rate
  • Boosting Human Growth Hormone and IGF-1
  • Boost brain health and memory
  • Improved sleep quality
  • Improved mood
  • Stronger muscles and bones
  • Better energy levels

Finding the right balance with exercise is much like finding the right balance for fat consumption: you need to explore your bio-individual needs. If you are exercising hard every day of the week, you are likely setting yourself up for a hormone imbalance like adrenal fatigue, especially if your sleep is suffering. My preferred method of exercise to pair with keto is burst-training. Burst-training (or high-intensity interval training) involves high-intensity bursts of exercise, followed by periods of rest, repeated a handful of times. Sprints are a great example of burst training, and an entire session can last about 20 minutes. Burst-training increases both aerobic and anaerobic fitness and is a great way to break through a keto-plateau.

Not Drinking Enough Water Can Cause a Keto Plateau

Staying hydrated is an important part of any healthy-eating plan or lifestyle. Upping your water intake is especially important as you start off on the keto diet to help your body transition into using a new energy source. You should opt for spring or properly filtered water, and make sure you’re consuming enough electrolytes as well. Adding a pinch of high-quality salt (sea or pink Himalayan) will help you stay properly hydrated and replenish mineral stores.

Other Causes of a Keto Plateau

Other possible factors contributing to keto stalling include:

  • Neurotoxicity
  • Food Allergies
  • Parasites or SIBO
  • Infections
  • Severe hormone imbalances
  • Staying keto (restricted carbohydrates) for too long (diet variation = hormone optimization)

If you are having trouble diagnosing the root cause of your keto stalling, consider working with me as your online diet coach, a service you can learn more about at DrPompa.com

How to Stop Keto Stalling

Preventing or stopping keto stalling requires a multi-therapeutic approach, and getting to know what works for your individual body. The foundation relies on diet and exercise, and by quantifying your habits, you’ll be able to better understand where you need to make changes.

Measure Your Diet & Exercise

Measuring your diet will require keeping track of what you’re eating, and breaking down the caloric intake into a macronutrient ratio. There are many apps out there that can help you better understand the breakdown of your foods, and with the time you will innately know without having to track everything. A standard keto macronutrient breakdown is 75-80% fat, 15-20% protein, and about 5% carbohydrates. By calculating your own individual resting metabolic rate (there are websites online that can help you do this using your weight and height), you can then create a 15-30% caloric deficit per day, and then calculate an approximate ratio of fat-protein-carb intake. You will also have to factor in your exercise and movement for the day. Exercise increases your resting metabolic rate, and different styles of exercise will create a variety of different short and long term impacts on calories your body burns. By incorporating burst-training (HIIT) into your routine (3-4x per week), you will maximize not only the metabolism-boosting benefits but also create hormone adaptation and optimization.

Use Digestive Enzymes

If you are having trouble digesting your high-fat meals, it’s possible that your body is having a hard time breaking down the fats. The solution to this (while your body adapts to its new fuel source) is to take a digestive enzyme that contains bile salts (ox bile), and lipase. Take digestive enzymes with each high-fat meal.

Intermittent Fasting

Those having a hard time keeping their food-intake low enough to lose weight on keto can benefit greatly from intermittent fasting. Intermittent fasting (or IF) is the extended period of time between your last meal (before bed) and your first meal (after waking up). The benefits of intermittent fasting go far beyond natural caloric restriction and include:

  • Improved body composition
  • Increased hormone sensitivity (especially insulin sensitivity)
  • Autophagy (cellular cleanup)
  • Boosts longevity
  • Supports a healthy microbiome

The minimum effective fasting window to see benefits on IF is 12 hours, but a 16-18 hour fasting window is suggested for optimal results. If you are new to IF, have breakfast at the same hour in the morning that you had dinner the previous night (i.e. 8 am breakfast if you had dinner at 8 pm). Slowly increase your fasting window (to an ideal 7 pm dinner, and 11 am breakfast, for example). You don’t need to use IF every single day to reap the benefits. Studies show that even 5 days per week generate the aforementioned results. A great tool is my 5-1-1 rule, that uses diet variation to boost hormone optimization.

  • 5 days intermittent fasting + keto diet
  • 1-day feasting (carb reload)
  • total fasting (water only)

By keeping the body guessing, it is always adapting. By adapting, you’re preventing (or getting out of) that dreaded keto-plateau.

Dextrose & Keto Diets

Many people can have a hard time transitioning out of a conventional high-sugar diet into a low-sugar keto lifestyle. Dextrose (sugar) raises blood sugar levels, and will quickly knock you out of ketosis. While you transition out of a high-sweet palate, better alternatives to conventional sugar include:

  • Stevia
  • Erythritol
  • Monk Fruit Sweetener (Lo Han/ Luo Han)
  • Xylitol
  • Yacon Syrup
  • Inulin-Based Sweeteners
  • Tagatose
  • Mannitol
  • Freeze-Dried Berry Powders
  • Lucuma Powder

Sweeteners you will want to avoid on a keto diet include:

  • Fruit juice
  • Dried Dates and Figs
  • Rice Malt Syrup
  • Raw Honey
  • Coconut Palm Sugar
  • Maple Syrup
  • Date Syrup
  • Blackstrap Molasses
  • High-Fructose Corn Syrup
  • Conventional Sugar (White or Brown)
  • Agave Syrup
  • Artificial Sweeteners (like Aspartame)

Loose Stool & Diarrhea on Keto

If you’ve been eating a low fat and high carb diet for a long time and now are eating low carb and high fat, loose stools may occur temporarily. Up your healthy fat intake and loose bowels should dissipate as your body adjusts to the new way of eating.

Rashes on Keto

Some people suffer from rashes or itchy skin when they switch to a keto diet, that often develops on the chest, back, armpits, and sometimes the neck- generally in a symmetrical pattern. There is no hard science on the keto rash, but speculations suggest that it is caused by ketones in the sweat, perhaps as they dry on the body. Ways to cure the keto rash include:

  • Dress appropriately: sweat-wicking fabrics, comfortable clothing, and avoid over-dressing (sweating).
  • Shower: straight after exercise.
  • Up your carbs: people with severe keto rashes have found salvation by increasing their carbs 50-100 grams, and opting for a low-carb diet instead of a strict keto diet.

Feeling Bloated on Keto

Bloating can occur on any diet, especially as your body transitions into a new way of eating. Ways to minimize bloating include:

  • Drink more water
  • Up your electrolytes
  • Consume probiotic-rich foods (fermented foods like sauerkraut)
  • Take a digestive enzyme
  • Eat smaller meals
  • Up your fiber intake (especially low-carb vegetables like leafy greens)

Summary

A keto plateau is when your ketogenic diet results begin to stall, and there are multiple ways to a breakthrough that includes finding your balance for fat consumption and exercise and staying hydrated. Other factors that contribute to keto stalling include neurotoxins, parasites, infections, food allergies, and hormonal imbalances. Ways to prevent keto stalling include measuring your diet and exercise regime, incorporating intermittent fasting, and using digestive enzymes with high-fat meals. You should also consider replacing dextrose-based sugars and artificial sweeteners with lower GI alternatives like Stevia and Erythritol. Keto rashes are likely caused by ketones in the sweat, which can be prevented with proper clothing, and post-exercise showers, or by increasing carb intake. You can reduce bloating by staying properly hydrated, upping your electrolytes, consuming probiotic-rich foods, eating smaller meals, and increasing your fiber intake.

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Category: Diet, Diet Variation™ GuidesTag: blood ketone, bone broth, burst training, carbohydrates, cellular healing diet, cellular inflammation, coconut oil, grass-fed organic, hypothyroid, intermittent fasting, keto diet, keto-adaptation, ketogenic diet, ketosis, MCT oil, weight loss

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Reader Interactions

Comments

  1. AvatarDan

    October 16, 2014 at 2:48 pm

    Can coffee consumption prevent one from becoming or taking a lot longer to adapt ketogenically?
    Can being dehydrated and/or low blood volume skew one’s ketone and/or blood glucose readings on the high side?
    I feel like I eat a very low carb diet (less than 30grams) yet my fasting morning blood sugar levels fluctuate from 81 to 105. While ketones follow ranging from .4 to 1.1. Can stored toxins being released into circulation contribute to these fluctuations and prevent or extend the ketogenic adaptation phase?

    Thanks,

    Reply
  2. AvatarMeredith Dykstra

    October 17, 2014 at 11:18 am

    Hi Dan!
    Thanks for reaching out. Coffee doesn’t typically impact keto-adaptation, and if you enjoy drinking it make sure to add in healthy fats like grass-fed butter/ghee, heavy cream, and/or MCT oil. While adapting, make sure to stay hydrated, drinking plenty of filtered water, and consume enough quality salt as well to maintain electrolyte balance. Toxin release may be impacting the adaption process, so supporting your detox pathways (liver, kidney, digestion) is key. Be patient, the process can take longer than expected! 🙂

    Reply
  3. AvatarHélène

    February 20, 2015 at 4:45 pm

    If you put a good amount of fat in your morning coffee or tea, I would say that’s eating. There are roughly 28g of fat in 2T of fat after all. It’s not just a dribble of cream; it’s close to a meal’s worth of your fat macro.
    So really, even with intermittment fasting, food is coming in before the 16-18 hrs are up. Which makes sense looking at ALL the data/studies. I’m going to try just eating 2T coconut oil 2mrw for brkfst. I’m never hungry for brkfst anyway. I’ve been skipping lunch except for some coconut oil to ensure I don’t feel nauseated later when I can’t eat due to situations. I think eating a whole meal during midday makes more sense tho!

    Reply
  4. AvatarHélène

    February 20, 2015 at 8:26 pm

    I have another question, about dairy. Specifically about calcium. If Im not eating dairy, and have to limit my greens so much to be under 30g of carbs, Im stuck having to take a calium supplement, rite?
    Even if I ate dairy, a few slices of cheese aint gonna be 1200mg for that day. I am perimenopausal (50yo), so worried about my bones!

    Reply
    • AvatarMeredith Dykstra

      February 23, 2015 at 4:59 pm

      Unless you’re staying in ketosis for a longer period of time for a specific reason, don’t limit your non-starchy vegetable intake: bring on the greens (especially served with a nice dose of good fat)!

      Reply
  5. AvatarGloria

    May 29, 2015 at 5:55 pm

    Dr Pompa: I have been following an intermittent fasting program for nearly two years now. My objective was to reverse diabetes. My last A1c was 5.4 so I guess Ive nearly accomplished that. The problem is that my overnight blood sugar readings are now way out of control. I understand this is called gluconeogenesis–wherein blood glucose is made out of protein by the liver instead of from carbohydrates. I also understand that growth hormone produced as a result of the intermittent fasting can cause high fasting blood sugar, and cortisol can do the same.

    So how do you control overnight blood glucose while intermittent fasting?

    My doctor’s response was “don’t worry about it.”

    Reply
  6. AvatarAideen Oswald

    August 6, 2016 at 10:26 am

    I working on losing 100 lbs, I have been vegan for 9mths and lost before that tried the whole 30 challenge. I had to stop the whole 30 as I’m 1] not big on eating meat 2] my colon was not cooperative and was not letting anything go! Doing the whole 30 and then going vegan yielded 20lbs weight loss. I lost about 10 on the vegan diet and for most of it stayed right at the same weight, No gain no lost. I have started to add in orgamix chicken breast and eggs back to my diet for past 2 wks, at least 1 serving per day and I stopped having rice and pasta. This has kicked started my weightloss and I’ve lost 4 lbs in 2wks. Ive inadvertently started daily intermittent daily fasting. I start to eat at 12-1 and have 2 big meals within 5 hrs, also do some type of hiit excercise for 20 mins + weight training. I am again stuck not gain but not losing. I do have trouble making it to 1000 calories per day. I also do use any oils as Dr. McDougal Ostarch solution] says the fat you eat is the fat you wear. So I’m mortified to add olive oil or avacado oil since going vegan. I want to start this approach but I’m concerned about 1] going into ketosis and strainining my liver SI have Hepatitis B since I was ten. 2]that my colon will get angry at me and not release anything [no bowel movent] as it did with the atkins. It took me about 10 yrs to get back to normal.

    Reply
    • AvatarMeredith Dykstra

      August 8, 2016 at 12:00 pm

      Hi there Aideen!
      Fat does NOT make you fat; it’s the inability to burn fat that is the underlying issue. Considering your past, add back in the good fats slowly to avoid shocking your system. Adding in burst training, fasting, diet variation, and True Cellular Detox are all important components of Dr. Pompa’s Multi-Therapeutic Approach to getting your best health. Check out the episode here for more info: https://www.youtube.com/watch?v=VAfFvO2_cfs&list=PLQQiGbs4j_5bgigIxzeE6-pWS-WgJsxO-&index=122

      Reply
  7. AvatarLuis Corchero

    August 28, 2016 at 11:14 am

    Hello Doctor Pompa,
    I’ve been fat adapted for quite some time now, but tried the 5,1,1 rule last week. It went great, but the carb day was rather hard. I also had breakfast that day. (typically I intermittent fast) could you show what you would typically eat on a carb day? Is whole grain, wild rice and sweet potatoes good choices of carbs? Thanks in advance, did everything you have taught me to get my health back!

    Reply
    • AvatarMeredith Dykstra

      August 29, 2016 at 8:40 am

      Hi Luis!
      Thanks for the support, so glad the info has helped you. The carb day can be a challenge for Dr. P too 🙂 He often incorporates, sweet potatoes, wild rice, properly prepared ancient grains, dark chocolate and red wine. Remember, variation is key. Best!

      Reply
  8. AvatarSuzanne

    May 3, 2019 at 11:41 am

    I have been on the Keto diet for two weeks and I have gained 5 pounds! What am I doing wrong? Please help

    Reply
    • AvatarAshley Smith

      May 8, 2019 at 10:01 pm

      Are you eating too much, or mindlessly snacking on foods like nuts? Are you eating in a shortened window (fasting at least 16-18 hours a day)? Are you using alternative “carb free” sweeteners?

      Reply
  9. AvatarEric Gilliom

    June 19, 2019 at 4:12 am

    Hi,
    After 10 days on a Keto diet I’m now doing an extended water fast and at the end of day 2 my Keto level was 7.5 but a day later dropped to 3.5 and I’ve had nothing but water, why the fluctuation?

    Thanks so much
    Eric

    Reply
    • AvatarAshley Smith

      July 9, 2019 at 10:49 pm

      Exercise? Stress?
      Your body is adapting and your ketones will fluctuate.
      Are you checking your glucose too?

      Reply

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