Most of the questions surrounding medications on a keto diet fall into the categories of; what medications can interfere with weight loss or ketosis? Is there a need for extra medication or supplements on the keto diet? And how do you taper medications when starting a keto diet? Dr. Westman provides us with some insightful answers to these questions.
The topic of starting a low-carb or keto diet with diabetes medication comes up often in Dr. Westman’s clinic. If you have diabetes and you’re taking insulin, following the keto diet is going to be a problem. “That’s why we try to get people off insulin as fast as possible,” warns Dr. Westman. The keto diet drastically improves diabetes and therefore your medication quickly becomes too strong and so it will need to be tapered and your doctor should assist you with this.
Steroids are probably the second most common offender and most people think of steroids in the pill form only, but you get steroids in the form of nasal sprays and joint injections as well, so anything containing steroids that affect the body is going to be a problem. The dose is obviously much less in steroid skin preparations, however, steroids are an issue in oral diabetes medicines, as well as antidepressants and pain medicines like Gabapentin.
Often doctors won’t even reevaluate whether a drug is working or not, if they aren’t sure the medicine is working, they’ll just keep you on it. Dr. Westman says “As a lifestyle doctor, I don’t rely on medications, I try to get people off medications, so if you’re on one and it’s not helping, why are you taking it?”
Beta blockers can, in theory, prevent the fat-burning process from occurring and prevent ketosis, however, there are not many good studies on that. If you’re using beta blockers and are having trouble losing weight on the keto diet, you can try switching medication, but you’ll need to ensure that you do this with your doctor’s approval of course.
Inflammatory disease medication
If you’re on medication for inflammatory diseases such as Crohn’s disease and others like it and you’re experiencing flare-ups, you may be wondering why your weight has stalled, and if maybe this could be attributed to medications you’re taking, such as “Pentasa”. In a case such as this, it may not be the medication at all, but instead, the inflammatory condition itself that’s causing your weight loss to stall and keeping you out of ketosis. Dr. Westman reassuringly states that he has seen a few cases of Crohn’s disease, colitis and other conditions like it get better over time with a keto diet, which is great news for anyone living with inflammatory diseases such as these.
While the effects that antidepressants have on achieving ketosis are uncertain, if your condition is in a stable phase, which means the depression is not severe and your doctor agrees to do the trial off of your current medication, then you can try changing the medicine for a couple of weeks before you truly see if there’s an effect on the weight loss and ketosis. That’s where clinical judgment is going to be important and you’ll need to work with your doctor to monitor the medical condition before you make any changes.
Blood pressure medication
Dr. Westman encourages patients to take their blood pressure at home and familiarise themselves with their blood pressure readings. “Whenever your blood pressure is in a stable phase or even a little low, I like to try tapering the medicine with monitoring, cutting it in half and watching the blood pressure as a tapering method,” says Dr. Westman. Depending on the medicine, the preferred approach is usually to taper it over a period of a couple of weeks, so you use less and less of the medication over time, to give the body room to adjust to the change.
If you’re taking thyroid medicines and want to know how to get off of them, you need to include your doctor in this decision. If you’ve made a major life change, and your metabolism has changed, it’s possible that you may be able to change the hormones or thyroid medication. Once again, you’ll need to do that while monitoring the clinical symptoms, such as the feelings associated with low thyroid or high thyroid and also the blood levels.
There are many sources stating what your blood sugar should be when you’re in ketosis, however, some of you may experience elevated blood sugar first thing in the morning and you may be wondering if there’s any need for medication for your now elevated blood sugar. Dr. Westman reassures those starting out on the keto diet, that this is okay and it shouldn’t be any cause for alarm. Once you’ve fully adapted to the keto diet, this will change and begin to normalize.
For those being advised by their doctors that they should be on one, there is a way you can check if it’s the best possible course of action for you, simply go to the website www.cvriskcalculator.com an online cardiovascular risk calculator and it will let you know if you are at risk of heart disease or not. Dr. Westman advises “If it says you don’t need a statin on that guideline, I would show your doctor that as ammunition that you probably don’t need it.”
What are the best supplements for keto diets?
A common query is whether or not you’ll need to take supplements while on the keto diet to fill any nutritional gaps. Dr. Westman has this to say, “I teach people to use regular whole food as much as possible and then I do recommend a multivitamin, without iron, unless you’ve been told to take iron for some other reason.” However, he also says that most people don’t need any extra supplementation. If you have a symptom like muscle cramps or constipation, it could be helpful to take some magnesium, but it won’t hurt to take a little extra magnesium or potassium if you wish to avoid any side-effects of risks.