What I wish everyone knew....my checklist before recommending keto to clients. I've been getting more messages like this
Is keto right for you (or should you be recommending it)? Read this first...
A woman recently came to me extremely frustrated.
Her friend dropped 20 pounds on keto and felt amazing.
But when she tried the same thing, her energy tanked, her sleep got worse, and her hormones tanked (cycles became irregular).
She had been told (actually yelled at 😓) by her practitioner that she was doing it wrong....needed more fat - more iodine - more electrolytes....but when I looked at her food diary, supplements, blood sugar & ketones - she was right on track.
The truth is that keto didn’t backfire because of non-compliance or lack of willpower. It backfired because her biology wasn’t ready.
With more and more of these people coming to me for help - I wanted to take today to chat about this.....so if you are interested in my checklist - keep reading!
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The checklist I wish more people understood
What do I mean by "biology isn't ready for keto" ?
Before I’d ever recommend keto to someone, I run through a checklist of red flags. If these aren’t addressed, keto can create more problems than it solves (and I feel like every practitioner should understand this):
Low leptin → Leptin is a master circadian signaling hormone released from fat cells that signals the hypothalamus about energy sufficiency, and when leptin levels are low or the brain is resistant to leptin, the body interprets this as “starvation.” The result is increased hunger, decreased energy expenditure, and a strong push to store fuel rather than burn it. Entering keto in a low-leptin state often makes fat loss & ketosis more challenging - and hormones & thyroid suffer more. (click here for the leptin test you can order yourself)
Low thyroid (T3) → Active thyroid hormone (T3) drives basal metabolic rate and mitochondrial energy production. Carbohydrate restriction lowers insulin, which in turn can reduce the conversion of T4 into T3. If T3 is already low before starting keto, restricting & lowering carbs can suppress metabolism further, leaving people fatigued and metabolically sluggish.
Poor sleep → Carbohydrates are one pathway (light is also a pathway) that supports the production of serotonin, which is a precursor to melatonin, the hormone that regulates circadian rhythm. Over time - eating too few carbs - can blunt melatonin release, disrupt sleep cycles, and impair recovery. Without quality sleep, fat loss and metabolic flexibility are much much harder.
Chronic stress → Cortisol is a catabolic hormone that raises blood glucose to help the body respond to stress. Keto itself is a metabolic stressor, and layering it on top of chronic psychological or physiological stress can keep cortisol chronically elevated. High cortisol antagonizes insulin, disrupts thyroid conversion, and promotes central fat storage. (which is why some people feel more inflamed on keto)
Electrolyte depletion → Glycogen is stored in the liver and muscles with water and electrolytes. When carbs are removed, glycogen depletes much faster, flushing out sodium, potassium, and magnesium. Without replenishment, this can lead to muscle cramps, low energy, and impaired cardiac and nervous system function. Adding more electrolytes doesn't always fix this.
Low hormones (like progesterone) → Sex hormones depend on adequate energy availability and cholesterol-derived steroidogenesis. Prolonged carb restriction can lower luteinizing hormone (LH) signaling, suppressing progesterone and estrogen production in women. This may contribute to cycle irregularities, low fertility, and mood changes.
Low stomach acid → A ketogenic diet is typically higher in fat and protein. Proper digestion of these macronutrients requires robust hydrochloric acid in the stomach. People with already low stomach acid often experience bloating, reflux, or nutrient malabsorption when they suddenly increase protein and fat without addressing digestive support.
Mitochondrial haplotype → Human mitochondrial DNA evolved under different environmental pressures. Some haplotypes (common in populations near the equator) are more efficient at carbohydrate metabolism, while others (from northern latitudes) are more adapted to fat oxidation. This means not all genetic backgrounds tolerate long-term carb restriction equally. For some, jumping into strict keto can unmask energy deficits or hormonal imbalances more quickly. (click here to read my haplotype article)
When these things are not carefully taken into consideration - keto can backfire, and the end user often feels like a failure.
A Better Way:
Instead of jumping right into keto (there are instances of cancer - epilepsy or severe inflammation where we bypass these things & support the person), I focus on restoring leptin signaling with nutrition, circadian alignment, re-mineralizing & sleep.
Once those foundations are in place, keto can be used strategically - as a tool or a lever if desired or needed.
Leptin is the “master signal” that tells your brain whether you’re fed and safe. When that signal is broken, the pituitary, thyroid, and pancreas can’t run metabolism effectively. Fix leptin first (using circadian biology, quantum biology & nutrition) and everything downstream works better.
I actually spent a few hours this week revising my Leptin Reset program to make this even more practical & easy to implement.
I added updated macros and an “on-ramp” and “off-ramp” program specifically for people in a low leptin state. That way you can ease in, repair signaling, and rebuild flexibility instead of crashing your metabolism.
I hope after reading this that if you’ve ever felt worse on keto, it’s not a personal failure. Your body probably wasn’t prepared for it.
