Keto Diet for Lupus: Why Your Rheumatologist Doesn’t Recommend a Keto Diet
Keto diet for lupus

Does a keto diet for lupus help to decrease lupus symptoms and flares? While many have tried, or are currently following this fad diet, here’s what you need to know before you try a keto diet for lupus.

 

What is the Keto Diet?

Often, the body uses glucose, broken-down carbohydrates, as its primary energy source. Circulating blood sugars provide accessible energy for your body and are typically the first energy source your body utilizes. The keto diet alters the way the body utilizes energy sources. A high-fat, low-carbohydrate diet will put the body in a state of ketosis, where fat becomes the primary energy source.

The keto diet was originally designed to help prevent and reduce seizures in epileptic children. Ketosis has been shown to alter parts of the brain that are linked to epileptic episodes. There is also research to suggest that the keto diet may be beneficial for other health-related conditions, including Parkinson’s disease or Alzheimer’s.

In practice, the keto diet focuses on increasing fats, incorporating a small amount of proteins, and limiting carbohydrates. An example of a keto diet may look like:

What to Eat on the Keto Diet

Fats

  • Healthy oils including avocado, coconut, and olive oils
  • No-sugar-added nut butter
  • Butter and ghee
  • Cheese, especially low-carb varieties like cream cheese, goat cheese, blue cheese, and cheddar
  • Oily fish like mackerel, salmon, sardines, and anchovies
  • Eggs

Proteins

  • Meats, including chicken, pork, and beef
  • Greek yogurt (no sugar added)
  • Some low-carb nuts like pecans, macadamia nuts, and Brazil nuts
  • Tofu

Low-carb Fruits and Vegetables

  • Berries (strawberries, blackberries, raspberries, blueberries)
  • Avocado
  • Watermelon
  • Lemons
  • Tomatoes
  • Green beans
  • Cauliflower
  • Cucumbers
  • Bell peppers

What Not to Eat on the Keto Diet

Starches

  • Bread
  • Pasta
  • Crackers
  • Chips
  • Oatmeal
  • Tortillas
  • Rice

High Sugar Foods

  • Candy
  • Sugary cereals
  • Fruit juice
  • High-carb fruits like apples, bananas, grapes, pears
  • Energy bars
  • Smoothies

Keto Diet for Lupus

Research on keto diets for autoimmune conditions, including lupus, is limited. In a study on the ketogenic diet for patients with lupus nephritis, it was found that while a keto diet for lupus reduced inflammation, it did not slow or prevent disease progression. The reduction in inflammation is likely associated with the reduced intake of inflammatory foods containing processed carbohydrates and sugar, not the high fat intake or the state of ketosis itself.

Dr. Brittany Panico, DO of Summit Rheumatology weighed in on the keto diet for lupus:

“When your body is in a state of inflammation, and you start to limit or restrict your diet, more inflammation is triggered resulting in a state of starvation. This then can lead to the loss of muscle mass and strength, increased fatigue, and decreased ability for your body to heal.”

The state of ketosis can lead to short-term weight loss, which can be helpful for overweight individuals with lupus, but is not desirable when you are trying to gain control of your disease during a flare or at the time of a new diagnosis. According to the Lupus Foundation of America, women with lupus are more likely to experience negative effects of obesity at lower weights than those without lupus. However, long-term weight loss and maintenance can be difficult on the keto diet.

“Ketosis can also put a strain on the liver and sometimes kidneys, which can be affected by lupus in some individuals,” says Dr. Panico. “Protein supplementation can stress the liver, so it is important to discuss how your diet can play a role in the symptoms and management of your disease.”

The Dangers of the Keto Diet for Lupus

Long-term use of the keto diet for lupus comes with risks.

Liver Damage

Studies have shown that a ketogenic diet has been linked to liver complications, including elevated cholesterol and liver enzymes, and non-alcoholic fatty liver disease. The keto diet for lupus can also make existing liver problems worse and is not recommended for individuals with kidney disease.

“If your liver function is altered by your diet, it can be challenging to know if your liver tests are abnormal due to your diet or due to your lupus,” says Dr. Panico. “Medications may not be as effective if your liver is not functioning at its best. It’s also possible that if your provider thinks your lupus is causing your liver tests to be abnormal, that more medication is added than you actually need.”

Increased Risk of Osteoporosis

Individuals with lupus have an increased risk of developing osteoporosis. Research has shown that women with Lupus are 5 times more likely to experience an osteoporosis fracture. This is often due to the combination of long-term use of corticosteroids like prednisone to treat lupus, and the effects of chronic inflammation on bone loss and kidney function.

Ketogenic diets have been associated with bone mineral loss, and therefore may not be the best choice for individuals with lupus. There is not enough evidence to confirm these findings, but high-risk groups should be cautious if they plan to maintain the keto diet for the long term.

“Bones need other minerals besides calcium to build optimal strength,” says Dr. Panico. “When we offset the balance in our diet, those minerals like magnesium, potassium, phosphate, and certain amino acids, are not consumed in enough quantity to supply nutrients to our body.”

Organ function is also dependent on these minerals and our body will naturally shift the balance to our heart, brain, muscles, and nerves, while taking away storage from our bones.

“It is important if you have lupus to consume nutrients that are found in fruits and grains and not limit these from your diet entirely.”

Other Risks of Keto Diet for Lupus

Additionally, if you have a history of the following medical conditions, the keto diet for lupus may not be a good option for your long-term health:

  • History of eating disorders, disordered eating, or yo-yo dieting
  • Pregnant or breastfeeding
  • Thyroid problems, including hypo or hyperthyroidism
  • Gallbladder disease
  • Pancreatitis or other diseases of the pancreas

Alternatives for the Keto Diet for Lupus

While the keto diet may not be the best option for individuals with lupus, an anti-inflammatory diet for lupus has been shown to improve symptoms and reduce lupus flares. The mediterranean diet is a great example of an anti-inflammatory diet high in vitamins and minerals, lean proteins, and healthy fats.

“The mediterranean diet has been the diet that has withstood the test of time and survived the winner of all diet approaches due to the variety of foods and ease of making this way of eating a lifestyle change rather than a fad,” says Dr. Panico. “The Mediterranean diet is also a favorite among cardiologists and those who treat other chronic diseases like diabetes because a natural consequence of the Mediterranean diet is also weight and blood sugar control.”

Ultimately, it’s important to consult your primary care provider or rheumatologist before starting a new diet. When navigating an autoimmune diagnosis, there is a balance of lifestyle management tools, including diet, exercise, mental health, and stress management. Understanding how each of these factors affect your condition can help you better manage disease flares and reduce inflammation.

Do you want to learn more about managing your diet as an important piece of your lupus treatment? Our team of lupus specialists at Summit Rheumatology helps lupus patients manage their condition with dietary conditions and appropriate medications. We are accepting new patients in-person and via telemedicine.

Give us a call at (480) 494-2770 or send our team a message to schedule your visit.