Why Your Doctor Says Keto Is Dangerous

Added: 2026-05-18

[00:00:00]Don't do keto. It's dangerous. That's what the doctor told him. Meanwhile, his blood sugar was 312. His waistline kept growing. He was taking more medications every year. His feet were starting to burn at night. His vision was getting blurry. And nobody seemed concerned about that part. But suddenly, the dangerous thing was eggs. Now, to be fair, the doctor wasn't completely wrong because keto can become dangerous if nobody adjusts the medications. And that distinction may be the single most important thing people with diabetes need to understand. What's up everybody?

[00:00:38]I'm Dr. Tony Hampton, board certified family physician, obesity specialist, and a doctor trained in nutrition and functional medicine. And today we're talking about how to start keto safely if you use insulin, sulfuras, SGL2 inhibitors, blood pressure medicines, and diuretics because this conversation is long overdue. And before we begin, let me know in the comments where you're watching from. Now, here's the irony.

[00:01:05]The very reason keto can become dangerous for some people with diabetes is the same reason it can become life-changing. It works. Blood sugar can improve fast. sometimes within days. And when blood sugar improves rapidly, medication needs can change rapidly, too. That's the part many people miss.

[00:01:24]So, when somebody says, "I tried keto and almost passed out." My first question usually isn't, "What did you eat?" It's, "What medications were you taking?" Because if somebody dramatically lowers carbohydrates while continuing the same insulin dose, that can absolutely become dangerous. That's not keto failing. That's physiology moving faster than the prescription pad.

[00:01:47]And honestly, medicine hasn't always trained doctors for this moment. Most physicians were trained extensively on prescribing medications, but not always on deprescribing medicines when nutrition starts working. That's changing now, thankfully, because patients are demanding something different. People don't just want management anymore. They want remission.

[00:02:08]They want fewer medications. They want energy back. and they should. Now, let's talk about the biggest medication risk.

[00:02:16]First, insulin. Insulin is powerful, life-changing for many people. But if carbohydrates suddenly drop while insulin stays high, blood sugar can crash. That's hypoglycemia, shakiness, sweating, confusion, dizziness, palpitations, and severe lows can become medical emergencies. Now, let's add another layer. sulfur uras, medicines like g liposide and glyberide. These drugs stimulate insulin release even if carbohydrates are dropping. So imagine forcing insulin production while removing most of the glucose coming in.

[00:02:52]That's like five security guards tackling one guy stealing a grape at Costco. It's too much force for the situation. And this is why these medications often require adjustment early. Now let's talk about the medication category almost nobody in the internet explains correctly. SGLT2 inhibitors, Jardius, Farza, Imbakana.

[00:03:12]These medications can have real heart and kidney benefits. So this is not a these drugs are evil conversation, but strict ketogenic dieting combined with SGLT2 inhibitors can increase the risk of something called uclycemic diabetic ketoacidosis. And yes, that's the type of phrase doctors say when they want patients to stop listening halfway through the sentence. So let me simplify it. Normally diabetic ketoacidosis comes from very high glucose. But with SGLT2 inhibitors, a person can become dangerously acidotic while blood sugar doesn't even look that elevated. That's what makes it tricky. Symptoms may include nausea, vomiting, rapid breathing, abdominal pain, extreme fatigue, confusion, and this is why people on these medications should absolutely work with a clinician before starting strict keto. Now, here's something else people don't expect.

[00:04:04]blood pressure medicines and diuretics can also become an issue because when insulin drop the kidneys release sodium and water. That's one reason people lose weight quickly early on. But it also means blood pressure can improve rapidly and suddenly somebody who was appropriately medicated 2 weeks ago is now dizzy every time they stand up.

[00:04:24]That's why some people feel weak or lightaded during the transition. Not because keto is inherently bad, but because the medications may no longer match the new physiology. That's why I keep saying if the food changes, the medications often need to change too.

[00:04:39]And this is exactly why the guidelines from the Society of Metabolic Health Practitioners are so important because they give clinicians and patients a framework for doing this safely. I strongly encourage patients to share these guidelines with their doctor, not to fight with their doctor, not to win against their doctor, but to partner with them because most doctors generally care. Many simply were never heavily trained in therapeutic carbohydrate restriction during medical school. And honestly, patients are pushing medicine to evolve in this area. Patients are saying, "I don't just want another medication added every year. I want another option." And many people with type 2 diabetes absolutely can improve dramatically. Some can even achieve remission. Now, I prefer the word remission instead of cure because remission means blood sugar normalized without medication. for a sustained period of time while consuming healthy behaviors and monitoring. And that's important medically. Now, one question I get all the time is, "How do I know if I can reverse my diabetes?" Excellent question because not everyone diagnosed with type 2 diabetes has the same biology. Some people may have autoimmune diabetes. Some may have very low pancreas reserve. This is where labs like ceptide and diabetes antibodies can become incredibly helpful. If somebody still produces a healthy amount of insulin, that's encouraging. It means there may still be significant capacity for metabolic recovery. And honestly, I may dedicate an entire future video just to that topic because it's incredibly important. But the earlier somebody attacks insulin resistance, the better the odds usually become. That's why waiting until diabetes becomes severe is not ideal. This is not just about glucose. This is about protecting the brain, the kidneys, the nerves, the heart, the future. And I've watched this transformation happen in real life.

[00:06:33]People lowering insulin dosages, coming off medications, reducing fatty liver, improving energy, sleeping better, thinking more clearly, getting hope back. That's why I'm so passionate about this conversation. But passion without safety becomes recklessness. So, let me give you my quick safety list. Do not start strict keto on your own if you take insulin. Do not freestyle this if you take sofauras. Do not combine strict keto with SGLT2 inhibitors without a clear medical plan. And if you develop nausea, vomiting, abdominal pain, confusion, or rapid breathing, seek medical care immediately. Now, let me end with this. Keto is not dangerous because it lowers blood sugar. For many people with diabetes, that's exactly the point. The danger comes when medications designed for a high glucose lifestyle are left unchained after the lifestyle changes. That's the real issue. So, don't let fear stop you from exploring metabolic healing. But also, don't let internet confidence convince you to ignore physiology. Use wisdom, use partnership, use monitoring, and use resources like the guidelines from the Society of Metabolic Health Practitioners, which I'll link below, so you can share them with your healthcare team. Because the goal isn't rebellion, the goal is remission. So, if this video helped you, hit like, subscribe, and share this with somebody taking diabetes medications who's interested in keto.

[00:08:00]And do me a favor before you leave.

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