6 Medications That Interfere with Ketosis

Are there medications that interfere with ketosis? Yes, certain pharmaceutical compounds can impact metabolic processes and liver function, which can make it difficult to trigger and maintain a fat-burning state.  

Discover common prescription medications that can interfere with the body’s ability to achieve ketosis, and understand how the ketogenic diet itself may affect how certain drugs work in the body.

What is ketosis?

Ketosis is a metabolic state in which the body shifts from using glucose as a fuel source to burning fat, which generates ketone bodies as an alternative energy source. 

This state can be induced by following a ketogenic diet, which is characterized by carbohydrate restriction and a high intake of dietary fats.

To trigger ketosis, carbohydrate intake is typically reduced to 20 to 50 grams per day, prompting the body to deplete its glycogen stores and produce ketones from dietary and stored body fats in the liver. 

In contrast to glucose, ketones offer a more efficient and stable energy source, particularly for the brain, heart muscle, and central nervous system.

Initially developed as a therapeutic intervention for seizure control in cases of drug-resistant epilepsy, the keto diet has shown a broad range of health benefits. 

One of the primary effects of this low-carb diet is weight loss, which is attributed to decreased insulin secretion and increased satiety. This dietary approach can also help improve insulin resistance, one of the major risk factors in metabolic disorders such as type 2 diabetes. 

Additionally, the ketogenic diet has been found to support cardiovascular health by promoting balanced lipid profiles and lowering levels of systemic inflammation.

Watch the video below to discover whether you can do keto if you are taking medication. 

Can you do keto while taking medication?

Yes, it’s possible to follow a low-carb diet while taking medication, but it requires careful consideration. 

Certain drugs can affect ketosis by interfering with how the body processes fat or carbohydrates, or by altering liver function, which plays a critical role in ketone production. These effects can make it more difficult to maintain ketosis consistently.

Furthermore, some medications may require dosage adjustments as the body adapts to lower carbohydrate intake and improved metabolic markers such as blood sugar and insulin sensitivity.

Understanding how different pharmaceutical compounds impact ketosis is crucial to safely and effectively following a ketogenic diet while on medication. 

6 medications that interfere with ketosis

While the ketogenic diet offers profound benefits for weight loss, metabolic health, and brain function, it’s important to consider how certain frequently prescribed medications may interfere with the body’s ability to enter or maintain ketosis. 

Here are six common medications to be aware of when considering a ketogenic lifestyle.

1. Anti-diabetic drugs  

Medications prescribed to manage diabetes, such as insulin and sulfonylureas, can interfere with ketosis by lowering blood glucose levels too aggressively. 

Because a ketogenic diet already reduces carbohydrate intake and improves insulin sensitivity, combining it with these drugs can lead to dangerously low blood sugar levels, also known as hypoglycemia.

In addition, research published in StatPearls found that metformin, a commonly prescribed diabetes medication, can carry a rare but serious risk of metabolic acidosis, especially when ketone levels are elevated.¹ 

2. Blood pressure medication

According to a study published in Nutrients, ketogenic diets often lower blood pressure naturally due to weight loss, improved cardiovascular health, and less water retention.² 

When low-carb diets are combined with blood pressure medications like angiotensin-converting enzyme (ACE) inhibitors or diuretics, they can amplify the blood pressure-lowering effects, potentially leading to hypotension, dizziness, fatigue, or dehydration.

Diuretics, in particular, can disrupt electrolyte balance, which is already a concern during the early phases of adapting to ketosis and is linked to an increased risk of experiencing symptoms of the keto flu. 

3. Psychiatric medications 

Certain psychiatric medications, including valproic acid, antipsychotic drugs, and mood stabilizers used for conditions such as depression and bipolar disorder, can interfere with ketosis by affecting liver function, which may impact fat-burning and ketone production.

“Antipsychotic drugs have been found to alter blood sugar balance and stimulate the release of insulin, a crucial metabolic hormone that blocks fat-burning,” explains Dr. Berg. “These types of drugs can make it challenging to maintain ketosis.”  

These medications may also impact appetite, making it potentially more difficult to sustain the dietary changes needed to trigger and maintain ketosis. 

4. Statins 

Statins, commonly prescribed to manage cholesterol and protect against heart disease, may interfere with the liver’s ability to efficiently produce ketones. 

Research published in Diabetes & Metabolic Syndrome: Clinical Research & Reviews highlights that statins have been found to alter glucose regulation and can induce a state of elevated blood sugar levels.³

High blood sugar levels trigger insulin release, which directly inhibits fat-burning and ketone production. 

5. Corticosteroids 

Drugs such as prednisone, dexamethasone, and other corticosteroids are known to trigger significant metabolic changes linked to increased blood glucose and insulin levels, impairing the body’s ability to enter or sustain ketosis. 

These medications mimic the effects of stress hormones and can trigger a rise in blood sugar, directly counteracting the key benefit of a ketogenic diet. 

Long-term corticosteroid use can also increase the risk of insulin resistance and weight gain, making it more difficult to achieve full ketosis.

This has been confirmed by research published in Epilepsy & Behavior, summarizing, “Steroids are antiketogenic and will lower ketosis.”⁴

6. Beta blockers 

Beta blockers are commonly used to manage heart disease, high blood pressure, and certain types of anxiety. 

These medications can blunt the body’s natural response to low blood sugar, which may mask symptoms of hypoglycemia, a potential concern when starting a ketogenic diet. 

Additionally, beta blockers may slow metabolic processes and reduce exercise capacity, both of which can affect fat burning and energy levels during ketosis. 

How ketosis affects medication

Ketosis can alter how medications work in the body. This shift is driven by a significant change in fat intake, reduced carbohydrate consumption, and improved metabolic efficiency. 

As fat becomes the primary fuel source, liver cells convert fatty acids into ketones, which can influence liver function and the way drugs are absorbed, metabolized, and excreted.

For people with existing health conditions such as diabetes or high blood pressure, ketosis may improve markers like blood glucose and body weight. While this can be beneficial, it may cause medication doses to become too potent, increasing the risk of side effects and overmedication.

Significant changes in dietary patterns can also trigger mood swings and impact emotional stability, particularly in individuals taking psychiatric medications.

As the immune system adapts to a ketogenic diet, inflammation may decrease, potentially changing the need for medications used to manage chronic inflammatory or autoimmune conditions. 

How to do keto while you’re on medications 

If you’re considering a keto lifestyle while taking medications, consulting your healthcare provider is essential. 

Before starting a low-carb diet, discuss your current medications and health conditions with your doctor to develop a safe, personalized plan. 

Because ketogenic diets can significantly change how your body processes drugs, it may be necessary to adjust medication doses to prevent side effects such as low blood sugar levels or low blood pressure.

Carefully monitoring your symptoms and regular blood work can help track your progress and ensure your medications are working effectively. 

As the keto diet improves symptoms such as insulin resistance, inflammation, or blood pressure, your doctor might gradually lower medication doses to match your body’s changing needs.

Working closely with your healthcare provider is critical to enjoy the profound health benefits of keto while minimizing risks, making your ketogenic journey both effective and sustainable.

FAQ

Sources

1. https://www.ncbi.nlm.nih.gov/books/NBK580485/ ?
2. https://pmc.ncbi.nlm.nih.gov/articles/PMC8398985/ ?
3. https://www.sciencedirect.com/science/article/abs/pii/S1871402120302678 ?
4. https://pmc.ncbi.nlm.nih.gov/articles/PMC3637968/ ?