The Best Supplements To Elevate A Ketogenic Diet

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The ketogenic diet has gone from virtually unknown to mainstream in record time. It may seem like everyone you know is trying this easy-to-follow diet, that makes weight loss a snap, and may quickly resolve symptoms of less-than-optimal health. As a functional medicine practitioner, the ketogenic diet isn’t new to me. I’ve been recommending it to my patients for years, due to the documented health benefits of ketosis, but it’s exciting to see that people are now talking about it on a global scale. It’s become part of pop culture and an integral part of the modern wellness landscape.

By focusing on a low-carb, moderate-protein, high-healthy-fat ratio of macronutrients, my patients are able to transition their bodies from burning sugar in the form of glucose to burning fat in the form of ketones, with amazing results such as lowered inflammation, enhanced brain health, rebalanced blood sugar, and restored energy. I also have had quite a bit of luck with a plant-centric version of the keto diet that I developed, called Ketotarian.

But there is one thing you should know about this way of eating, whether you’re doing a traditional keto diet or a plant-based one: There are a few supplements that will help stabilize your health and maximize the benefits of this health-enhancing diet. Here’s what I recommend:

1. Probiotics

Your microbiome contains trillions of bacteria that influence every aspect of your health, even seemingly unrelated health problems like anxiety or a weakened immune system. The trick is to keep the good bacteria in charge and the bad bacteria at a minimum, where they won’t take a serious toll on your health. A ketogenic diet has been shown to balance (1) beneficial bacteria, but a daily dose of probiotics is still a good idea to optimize your dietary efforts and keep the good-bacteria population higher. This can also help you digest your food better. Look for a probiotic formula that contains at least 10 billion CFUs as well as the bacterial strains Lactobacillus and Bifidobacterium, which have been shown to help lower inflammation. (2)

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2. Vitamin A

A clean ketogenic diet is a diet higher in healthy fats, and that is the perfect way to enhance the bioavailability of fat-soluble vitamins such as vitamin A. Although fat-soluble vitamins are super important for our health, they are often deficient in the modern Western diet. We have all heard about vitamin D deficiencies, but vitamin A deficiencies aren’t as widely discussed, even though this vitamin is essential for a healthy immune system. A deficiency in vitamin A has been linked (3) to autoimmune conditions, likely linked to (according to research) our dendritic cells - the alarm cells of our immune system. These cells send out calm-down signals when the immune system over-reacts, and they rely on vitamin A to function. Without enough of this vitamin, they are unable to do their jobs properly, and the result could be the development of an autoimmune disease.

The best, most bioavailable sources of vitamin A are from animals, especially from liver, oily fish, and egg yolks. However, for those following a plant-based ketogenic diet, this can quickly become a deficiency if ignored. While sweet potatoes and carrots contain plant beta-carotenes, a precursor to vitamin A, the conversion rate to retinol is weak at only 3 percent. (4) This isn’t a problem for everyone, so running labs is the best way to determine if you are deficient. If lab work determines that supplementation is a good idea for you, dosage can range between 2,000 and 10,000 IU per day.

3. Vitamin K2

Another lesser known fat-soluble vitamin is vitamin K2, which is essential for calming inflammation. One study (5) showed that vitamin K2 inhibited the pro-inflammatory iNOS in the spinal cord and brain immune system in rats with symptoms of multiple sclerosis. Unfortunately, many people are deficient in vitamin K2. Whole-food plant-based keto sources of vitamin K2 include natto and coconut or water kefir; however, it can be difficult to get in an adequate amount from these two sources alone. That is why I recommend looking for the MK-4 version of this vitamin. This alternative form is a cancer-fighter, improves sexual health, and regulates gene expression more than any other form of vitamin K.

4. MCT oil

There are many types of fatty acids, but medium-chain triglycerides are the best for ketogenic fuel because they are very easy for your body to break down. You can find MCTs in either natural or synthetic forms. Coconut oil is one of my favorite sources - it has the highest amount of all natural sources, at 15 percent. You can also buy pure MCT oil to add to your diet (it’s good in your daily smoothie, tea, or coffee). It is one of the quickest ways to reach and maintain a state of ketosis, even when you have an increased carb intake. (6) Because they are so easily absorbed, they provide a quick energy boost via ketones. They can also improve brain health, enhance immunity, and keep blood sugar balanced.

5. Turmeric

Speaking of inflammation, curcumin, a compound found in the spice turmeric, is one of the most powerful natural anti-inflammatories available. The ketogenic diet is a great way to down-regulate pro-inflammatory cytokines in the body and activate anti-inflammatory pathways such as the AMPK pathway, Nrf-2. However, those with higher levels of inflammation can amplify the anti-inflammatory benefits of a clean ketogenic diet even further by adding turmeric to their food. However, you can get greater concentrations in supplement form. If you want to seriously target inflammation, you can take up to 10 grams per day. (7) It’s also important to find a supplement that also contains piperine, which increases the bioavailability of curcumin by 2,000 percent. Since inflammation is at the root of almost every modern-day health problem, cooling inflammation should be one of our number one health priorities.

6. Exogenous ketones

These ketones in supplement form can provide additional fuel for your body to augment the endogenous ketones your body makes on its own during nutritional ketosis. In addition to MCT oil, these are a great way to enhance the benefits the ketosis: they can lower inflammation, increase energy, improve brain function, and boost metabolism. (8)

7. Magnesium

Magnesium is the fourth most abundant nutrient in your body. You need it for over 300 essential biochemical reactions. (9) Yet, close to 80 percent of the population is deficient (10) in this nutrient due to sub-par diets, gut problems, and poor soil quality, which can impact the amount of magnesium available in otherwise magnesium-rich foods.

Since a ketogenic diet can lead to a decrease in this already deficient electrolyte due to increased water excretion and decreased water retention, it is important to add in a magnesium supplement to replenish this vital nutrient. There are many forms of magnesium, and they aren’t all the same. Some are more effective than others, and some are more appropriate for particular symptoms than others. Although most over-the-counter magnesium and multi-vitamin supplements contain magnesium oxide, most doctors recommend magnesium glycinate for optimal benefits and better absorption. Try to get in at least 350 milligrams per day.

8. Sole water

This electrolyte-infused water supports the adrenal hormone aldosterone, which is partially responsible for electrolyte and fluid balance. Sole water stabilizes the electrolytes like magnesium, sodium chloride, and potassium in the body, and it’s a snap to make at home.

First, find a large Mason or other jar with a plastic lid. Metal can oxidize and corrode when it comes into contact with salt, so avoid it for this purpose. Your jar can be any large size - you can find these online if you don’t have one handy. Fill the jar one quarter of the way up with high-quality sea salt, Celtic salt, or Himalayan pink salt, or a combination of these three. Fill the rest of the jar up with filtered water, leaving a little room at the top. Cover it with the lid, shake it up, and let it sit overnight. In the morning, check your sole water. If you can see some salt in the bottom of the jar, the water is saturated with the salt. If you don’t see any salt, add a teaspoon more. Shake, and give it an hour to dissolve. Keep going until some salt remains at the bottom. When the sole water is fully saturated, it is ready. Begin your day by adding 1 teaspoon to a glass of water, before you eat  anything. Use a plastic teaspoon, not a metal one. Drink it down and enjoy the electrolyte-enhancing properties all day long.

These are the eight supplements I consider to be the most beneficial for most people following a ketogenic diet. However, it is important to work with your practitioner, as not every supplement is right for every person. You may not tolerate some of these, or you might require some additional supplementation, depending on your individual health case.

As one of the first functional medicine telehealth clinics in the world, we provide webcam health consultations for people around the globe. 

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References:

  1. Newell, Christopher et al. “Ketogenic diet modifies the gut microbiota in a murine model of autism spectrum disorder.” Molecular autism vol. 7,1 37. 1 Sep. 2016, doi:10.1186/s13229-016-0099-3
  2. Rodes, Laetitia et al. “Effect of probiotics Lactobacillus and Bifidobacterium on gut-derived lipopolysaccharides and inflammatory cytokines: an in vitro study using a human colonic microbiota model.” Journal of microbiology and biotechnology vol. 23,4 (2013): 518-26. doi:10.4014/jmb.1205.05018
  3. Ikeda, Utako et al. “1α,25-Dihydroxyvitamin D3 and all-trans retinoic acid synergistically inhibit the differentiation and expansion of Th17 cells.” Immunology letters vol. 134,1 (2010): 7-16. doi:10.1016/j.imlet.2010.07.002
  4. Hedrén, E et al. “Estimation of carotenoid accessibility from carrots determined by an in vitro digestion method.” European journal of clinical nutrition vol. 56,5 (2002): 425-30. doi:10.1038/sj.ejcn.1601329
  5. Moriya, Masayuki et al. “Vitamin K2 ameliorates experimental autoimmune encephalomyelitis in Lewis rats.” Journal of neuroimmunology vol. 170,1-2 (2005): 11-20. doi:10.1016/j.jneuroim.2005.08.001
  6. Liu, Yeou-mei Christiana, and Huei-Shyong Wang. “Medium-chain triglyceride ketogenic diet, an effective treatment for drug-resistant epilepsy and a comparison with other ketogenic diets.” Biomedical journal vol. 36,1 (2013): 9-15. doi:10.4103/2319-4170.107154
  7. Aggarwal, Bharat B et al. “Anticancer potential of curcumin: preclinical and clinical studies.” Anticancer research vol. 23,1A (2003): 363-98.
  8. Cox, Pete J et al. “Nutritional Ketosis Alters Fuel Preference and Thereby Endurance Performance in Athletes.” Cell metabolism vol. 24,2 (2016): 256-68. doi:10.1016/j.cmet.2016.07.010
  9. National Institutes of Health "Magnesium" Fact Sheet. https://ods.od.nih.gov/factsheets/Magnesium-HealthProfessional/
  10. Killilea, David W, and Bruce N Ames. “Magnesium deficiency accelerates cellular senescence in cultured human fibroblasts.” Proceedings of the National Academy of Sciences of the United States of America vol. 105,15 (2008): 5768-73. doi:10.1073/pnas.0712401105

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BY DR. WILL COLE

Evidence-based reviewed article

Dr. Will Cole, DNM, IFMCP, DC is a leading functional medicine expert who consults people around the globe, starting one of the first functional medicine telehealth centers in the world. Named one of the top 50 functional and integrative doctors in the nation, Dr. Will Cole provides a functional medicine approach for thyroid issues, autoimmune conditions, hormonal imbalances, digestive disorders, and brain problems. He is also the host of the popular The Art of Being Well podcast and the New York Times bestselling author of Intuitive Fasting, Ketotarian, Gut Feelings, and The Inflammation Spectrum.

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