One of the nastiest side-effects of the keto diet is no doubt the keto diarrhea.

We all have heard about how Jenna Jameson or Halle Berry have achieved their dream bodies using the keto diet...

But, the one thing that these stories never mention is the unwanted bonus that often comes with that - upset stomach.

The surprising side-effect that isn't so uncommon after all.

Before you go all-in on the worry-train, know that in most cases temporary diarrhea is totally normal and there are several ways to overcome that.

This is a way how your body is adjusting to your new lifestyle, burning fat for energy.

There are various reasons why your body can react with diarrhea: from fat intake to supplementation.

In this article, we give you 4 exact tips on how you can calm down the firehouse and start enjoying the ketogenic journey again.

Does keto really cause diarrhea?

You either have just started your ketogenic journey or you have been enjoying high-fat lifestyle for months now, and all of the sudden your stomach starts blowing up and wants you to officially move into the bathroom.

This is can be very uncomfortable and scary. And you may start wondering if this is what ketosis really looks and feels like? Not quite.

does keto cause diarrhea

When you change your diet so drastically, as keto does, you don't only change your food but also your gut flora (bacteria).

It's normal to experience a period of digestive tract issues like diarrhea, while you dramatically have raised the fat intake and have cut out all the carbs from your menu.

Common causes of diarrhea

In general, there are 4 main reasons why you may be experiencing diarrhea during the keto diet: increased fat intake, sugar alcohols, too much protein and excessive magnesium supplementation.

  1. Increased fat intake - This is probably the first and the most common reason why your body is experiencing sudden diarrhea. It's your body’s way to adjust to the high-fat content that you have started to eat. This is especially true if you are taking added fats like MCT oil or coconut oil. These products are known to be the source of diarrhea by their own, if taken too much too sudden. Your gut isn't used to it yet. Your body is using bile to break down fats. So, if you increase fat intake, your body needs to make more bile which is also a lubricant for the colon. And since your colon is more lubricated, well, you get the picture. [1]

  2. Sugar alcohols - The keto approach is focused on high fats and removing carbs from the menu. With carbs, you will simultaneously remove everything sweet from your diet, because well, at the end of the day most sweets are carbs. The only choices you have left with are sugar-free and low-carb products, which most are pumped up with sugar alcohols which give them the sweet sweet heavenly taste. The most popular sugar alcohols are xylitol, sorbitol, mannitol, maltitol, lactitol, and isomalt. They have also known to be causing gastrointestinal distress.

    All of these can cause gas, nausea, and diarrhea if consumed more than your body can tolerate. Simple conclusion, the less you eat sugar alcohols, the better it will help your diarrhea. Most sugar alcohols don't stimulate insulin release in the body. One reason for that is that half of these sugar alcohols are not properly absorbed through the digestive tract. The more you eat them the more symptoms it will cause in your GI tract. [2]

  3. High protein - The proper keto diet relies on high fat, medium protein, and low carb. It can be easy to accidentally ramp up your protein intake too much. An over consumption of dairy products like cheese or cream or highly processed low carb snacks combined with lack of fiber can result in gastric distress and diarrhea. That is why it's vital to keep your protein intake at about 10-20% of your daily input. [3]

  4. Magnesium supplementation - That was the main reason why experienced diarrhea during keto at first. It had nothing to do with the keto diet itself, just the high magnesium intake. Excess magnesium gets excreted through the stool which results in diarrhea. Diarrhea, abdominal cramps and bloating all are common side effects of exceeding the suggested daily quantity of magnesium supplementation. The main key takeaway from this is that one should not supplement on what one is not showing symptoms of slight deficiency in.

  5. Other - There can be a million other reasons why you are experiencing diarrhea, which has nothing to do with the ketogenic diet. For example, you may be experiencing food allergies, SIBO (small intestinal bacterial overgrowth), food intolerance or something completely else.

Isn't diarrhea a keto-flu symptom?

Well, not exactly.

While yes, diarrhea can be one of the side-effects of the keto flu, in addition to headaches, nausea and brain fog.

But the keto-flu typically disappears during a couple of weeks (if you act accordingly - electrolytes and no cheating).

This happens because your body is transitioning to the fat burning mode and is getting used to the new situation.

After the transitioning phase, usually, the keto-flu related diarrhea symptom will fade.

Any time you drastically change your diet, your GI tract will most likely to react.
This will happen when you follow either a raw or high-fiber diet as well.

So, what it comes down to is what are your circumstances. If you are experiencing diarrhea during the keto flu process, then yes, it is a side effect.

If you have already been in ketosis for a long time and suddenly experience GI issues, then the reason can be somewhere else.

Maybe you have cheated and carbs are doing its job?

Maybe you have strained your body with MCT products?

Or maybe your body just don't digest certain foods well.

How long does it last?

If diarrhea really is keto related, then it probably disappears from a couple of days to a couple of weeks as the keto-flu symptoms, in general, will disappear.

After that, your body should have been effectively been transitioned to ketosis and will be running on fat.

If your diarrhea persists after the keto-flu then this is a clear sign that the problem is somewhere else.

There can be many reasons for simple food intolerance to allergies or something else.

You can try the elimination diet to rule out some specific food.

If you are still having issues, then contact your doctor.

How to treat it?

Now you know all the potential reasons why you are experiencing keto diarrhea. There are many ways to combat diarrhea.

You can find relief by supplementing your diet as well as removing some supplements and foods you are currently taking.

Often the things that you need to stop doing are more effective than the things you are doing.

What to take

  • Fiber - This is the number 1 suggestion if you are experiencing keto diarrhea. Getting more fiber through healthy foods is clearly the main strategy. You can increase your fiber intake by adding more veggies to your meals. Some awesome examples are leafy greens and broccoli.  

    If you don't like broccoli  and don't enjoy greens or your daily calorie intake is already maxed out, then 9/10 helps fiber supplementation. There has been even done a research [4], that has prescribed extra fiber for GI tract issues, without reporting that this compromised the effects of the keto diet.

    » Check out organic Psyllium Husk ​here

  • Activated charcoal - The oldest treatment in the book. Although it doesn't treat the root cause, it's a good remedy for any kind of digestive symptoms. It has been used for thousands of years to detoxify the body, boost your digestive system and help with your skin. It binds toxins and chemicals in the gut and stops your body absorbing them. Use in reasonable limits, too much of that can cause constipation. [5]

    » Check out highly absorbent activated charcoal here

  • Probiotic foods - They are a good way to restore your digestive tract health. First, we would suggest eating probiotic foods that contain live and active bacterial cultures. The side-benefit comes thanks to the fermentation process which makes it easier to digest. Some examples of probiotic foods are sauerkraut, probiotic yogurt[6], kefir and pickles. They are awesome at helping your gut bacteria grow. If probiotic foods are not just your game, then you can also check out probiotic supplements.

    » Check out natural probiotics here

  • Digestive enzymes - With the start of keto, your body has an important task to do - digest loads of fat daily which can be hard on your body. That is why it may be beneficial for you to support your digestion with digestive enzymes. Make sure that it has ox bile, lipase, and protease in the ingredient list.

    » Check out digestive enzymes here (with pre-and probiotics)

What to stop doing

  • Magnesium supplements - If you are supplementing with magnesium, then it may be beneficial to put that supplement on pause until your diarrhea has subsided. This is because it draws additional water into the colon. [7]

  • Coconut products (incl. MCTs) - Coconut oil is rich in MCTs which are digested really fast and used for energy. Adding MCTs to your diet will help to reach and maintain ketosis, but because they are so rapidly digested, it can also cause abdominal cramps and diarrhea. This is especially true if you have just started taking MCT supplements. During the diarrhea phase, ease up on the MCTs and MCT rich foods to take the load of your body. When you are feeling like million bucks, then SLOWLY add them back into your diet. [8]

  • Certain vegetables - Another big reason is that your body is probably not used to digesting the number of leafy greens and other veggies. Some vegetables can be harder on your belly than others. Consider cutting down on onion, garlic, artichokes, leeks, brussels sprouts, cabbage, and cauliflower. Prefer lettuce, cucumber, tomato, bean sprouts, bell pepper, and zucchini. Once you feel better, try bringing these foods back on your menu. [9]

If any of the above didn't work for you then it may be related to allergies or food intolerances. The best way is to do an allergy test and try an elimination diet that removes common allergens and intolerances from your menu. Some of them are for example wheat, eggs, fish, dairy, nuts, peanuts, soy, some veggies, and shellfish.

If you are seeing positive changes then start adding foods back to your diet one by one. Monitor how you feel and how your body reacts. If you suddenly feel any reactions to these foods, then chances are that you have either allergy or food intolerance.

If anything didn't work, then there maybe is time to look the truth and consider that maybe the keto philosophy is just not for you. As you already know, the best diet and best results will come from a diet that you feel comfortable sticking into while not experiencing daily firehouse on the toilet.