Several conditions are often linked to keto in popular discussion, but more research is needed to support its use.
Gout
During a gout flare, Moree doesn’t recommend following a keto diet, as it may make symptoms worse, she says. Talk to your doctor about other ways to manage gout flares.
Certain Cancers
Using the ketogenic diet as one aspect of cancer treatment is certainly gaining traction. “We now know that epileptic syndromes are due to the same genetic mutations in PIK3CA as are seen in some cancers,” says Lewis Cantley, PhD, a professor of cell biology at the Dana-Farber Cancer Institute in Boston.
Limited studies suggest that ketosis may also enhance chemotherapy effectiveness by activating specific proteins and causing cancers to consume less glucose. But they’re offering a rationale for further research, not providing robust evidence of its effect in humans.
Dr. Cantley says that more well-designed, well-controlled clinical trials are needed to show what role, if any, the keto diet may play in cancer treatment. Talk to your oncologist before any major change to your diet.
“Unfortunately, different oncologists will provide different advice. I know that some physicians recommend low-carbohydrate diets to their cancer patients, but they are in the minority. Until the U.S. Food and Drug Administration weighs in on this based on well-designed clinical trials, there will be widely differing views by physicians,” Cantley says.
Epilepsy in Adults
The Epilepsy Foundation notes that a ketogenic diet is usually not recommended for adult patients because it’s so restrictive.
Migraine
There’s growing knowledge about the role that inflammation plays in migraine, and for that reason, a keto diet may be useful in reducing headache days, says Moree.
The Migraine Trust notes that some people following a keto diet or other diets — such as the Mediterranean, dietary approaches to stop hypertension, low-fat, or gluten-free diets — have noticed reductions in migraine frequency, severity, or duration.
However, the evidence around managing migraine with a fixed diet is weak, and further research is needed to make firm claims about the effectiveness of cutting out entire food groups. Talk to your doctor if you’re considering a keto diet to manage migraine.
Polyendocrine Metabolic Ovarian Syndrome
Polyendocrine metabolic ovarian syndrome (PMOS) is a metabolic condition in women. Women who have PMOS have an increased risk for insulin resistance, diabetes, and obesity.
Moree says that inflammation is another factor in exacerbating symptoms. “The two main things that keto can help with — inflammation and insulin resistance — play a big role in PMOS. I commonly use the keto diet as a first line of defense in patients with PMOS,” says Moree.
Autism
A more recent review of seven studies also found that a keto diet can improve certain behaviors in autism.
Still, more studies are needed to generalize the keto diet as a proven treatment for autism.
Dementia and Alzheimer’s Disease
Nonetheless, experts say that more research is needed, and that it’s a sweeping generalization to say that a keto diet is appropriate for everyone at risk of Alzheimer’s.
Some, like Richard Isaacson, MD, an adjunct associate professor of neurology at Weill Cornell Medicine in New York City, support low-carb diets to reduce aging’s impact on the brain. “I believe when people are fueling their brain using ketones or calorie or carbohydrate restriction, it’s a cleaner burning fuel, and a better way to delay brain aging,” he says. Still, the evidence isn’t there to say that the keto version of the low-carb diet is always necessary or even helpful.
A review of 12 studies (including eight human studies) concluded that ketogenic diets improved brain metabolism and provided cognitive benefits to Alzheimer’s. However, the reviewers state that like in many other studies of the keto diet, these short interventions led to frequent, minor gastrointestinal side effects.
For others with certain genetics, though, it may be harmful, says Dr. Isaacson. For that reason, there’s no one-size-fits-all recommendation. Isaacson advises anyone going on keto to have their labs taken throughout the process and do the diet in conjunction with their treating physician and a registered dietitian.
Parkinson’s Disease
According to an older study led by Dr. Krikorian, ketosis appears to have multiple effects, including improved brain function and cognition, potentially by enhancing energy production and normalizing insulin levels in the brain.
Low-carb diets like keto may improve cognitive function by reducing insulin secretion, according to research. That’s important because research suggests that higher insulin in the circulation correlates with lower levels of insulin in the brain, says Krikorian.
He explains that insulin in the brain is necessary to support memory consolidation. It also correlates with an enzyme that helps clear beta amyloid (the proteins that form Alzheimer’s disease’s brain-function-disrupting plaques) from the brain, he says.
That said, while it’s a promising area of research, more long-term studies need to take place before doctors widely recommend the keto diet for this disease.
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