Keto During Pregnancy? The Science, Struggle & Results

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Ok before anyone tries to spear me- let me just say right now- this has NOTHING to do with weight loss! Yes Keto is considered a “fab” diet- but this diet offers much more than mere weight loss and has saved me from a world of hurt. Follow along and you’ll find out how!

The Science

Surprise, surprise- we are talking about morning sickness again! Having HG (hyperemesis gravidarum syndrome) in my last two pregnancies made me think I would NEVER have any more kids. I couldn’t seem to find answers, solutions, or remedies that helped me at all. In fact, during my first pregnancy I was on 2 different medications until I was 35 weeks…

If you read my post Preparing for Pregnancy: Nutrition and Beyond you know that my first real breakthrough with finding answers came from research relating to gut health and the overgrowth of bacteria that can have some huge consequences during pregnancy. Well that was just the first step.

My second step was going full blown 100% strict Keto– like the kind of Keto where you examine 15 jars of pasta sauce to try to find the ones with out added sugar. Why did I do this? Well you can thank Dr. Micheal Fox, a Reproductive Endocrinologist, OB-GYN and the founder and medical director of Jacksonville Center for Reproductive Medicine.

While listening to the podcast titled “The Real Cause of Hyperemesis Gravidarum” I heard something I have NEVER heard a doctor say in my lifetime of questions. “I always start with the nutrition“. Needless to say he had my attention. After explaining how insulin works, how pregnant women become 3-to sometimes 4x more insulin resistant in pregnancy (basically extreme hypoglycemia) and how stabilizing blood sugar could “cure” morning sickness I was a little skeptical. 

Yeah…um…sure you “cured” morning sickness…those women might have been a little queasy but I doubt they were as bad as I was… bet they weren’t peeing their pants because of the forcefulness of their relentless bile puking all day and night…

Well I was wrong. He brought up a case of a woman who really wanted to have kids (she was pregnant on purpose) but had aborted 6 babies due to her extreme HG. She was pregnant with her 7th and talked to Dr. Fox because she was desperate. He talked with her about her diet and wanted to work with her like he does with other women with this type of illness. Unfortunately she was deep in the throws of HG and aborted that baby as well. However, she later returned to be walked through his nutrition plan. She was put into ketosis 12 weeks before she conceived her next pregnancy and stayed in ketosis through her pregnancy and guess what? FLAWLESS. That was the word used to describe her next pregnancy. She was able to carry all the way till birth with out HG…

I mean- how could I not jump all in?? You don’t make up stories like that… Also let me just throw out a disclaimer…I’m pro-life but I cannot tell you the compassion I feel for this woman and the empathy in my heart for her. Chronic illness is no joke. It breaks you in ways you can’t image. I can’t say I ever considered abortion but I can say I desired to die and be put out of my misery on several occasions. So yeah, I don’t feel hate or disgust, I feel empathy.

I want to go ahead and just link this article Is Low Carb Pregnancy Safe During Pregnancy? now so you can start your own research on it!

In addition to Dr. Fox, Dr. Robert Kiltz, a fertility specialist at CNY Fertility, has been recommending the ketogenic diet for fertility treatment and pregnancy for the last five years.

“I like to say that ‘ketogenic’ means ‘the key to genius’!,” says Dr. Kiltz who posts inspirational, pithy videos on Facebook in part to support and encourage women to eat low-carb high-fat foods for conception and pregnancy. “We have zero need for carbohydrates as humans.” Despite now witnessing many successful keto pregnancies, he says he is still in the minority of fertility doctors who recommend this approach.

The last and final point I will make on this is; Keto during pregnancy isn’t just for desperate HG mommas or moms with gestational diabetes. There are SO many benefits, like lower rates of high blood pressure, lower risk of infection, less bloating, better functioning immune system… the list goes on.

The Struggle

Honestly, I don’t know where to start.

Has this pregnancy been a struggle even on keto? Yep.

Am I disappointed? Yep.

But has it been better than the last two? Double Yep.

So my first two pregnancies I was veryyyyyy limited. With Flora it was mangos…oatmeal… crackers… and lots and lots of vomiting, dizziness and fainting spells. With Lemen I ate potatoes… crackers… that’s all I can remember and once again lots of puke and fainting spells as well. I mean it makes sense- I was eating the worst diet for someone who was struggling with insulin resistance.

Fast forward to this pregnancy and guess what? Still pretty limited. I pretty much eat 2 eggs every few hours. Some days it’s the ONLY thing I can stomach. On a good day I’ll swirl my eggs in with broth for an egg drop soup. I’ll be able to eat nuts, cheese, and maybe some chicken, steak or veggies. But those days are rare and meats are very hard for me to break down, and veggies? Well it depends on the veggie but if it is one that is notoriously “gassy” like cabbage or brussels I feel pretty crappy. I feel awful after I eat salads unfortunately. I can tell these struggles have more to do with the low acid in my stomach and slow digestion rather than the hypoglycemic nausea I had in my first two.

Another struggle of mine is having to bring snacks with me 24/7. It requires a lot of planning and can be quite difficult to figure out- especially on those ‘eggs only’ days. Normally I try to have pecans, a few cheese sticks or some boiled eggs but some days I drop the ball and you know what has been a real lifesaver? Starbucks sous vide egg bites– these bad boys might have 9 grams of carbs but they also have 20 grams of fat and are DELICIOUS. The hardest part of snacking is the fact that I have to eat every TWO hours… I honestly never thought I could hate eating and resent food as much as I do when I have to shove food down my throat every two hours while extremely nauseous. It’s such a battle… but I know if I don’t eat- I’ll puke…and then get dehydrated… and thus the dreaded HG cycle will start.

The last big hurdle is food aversions. Of course this is a thing with most pregnancies but what’s hard about being Keto and having aversions means your already limited foods can become more limited. For example, one day Cam and I were on our way to visit a friend and my dreaded two hour snack time was coming up. I was prepared and had a jar of almond butter on me but I was extremely nauseous and after force feeding myself two tablespoons I had to stop. This resulted in a complete almond butter aversion and I have not been able to eat a single spoonful of it since… which is really unfortunate because I bought like 4 jars and it was so easy and fast to get down… this has happened with a lot of foods this time but I still have some cheeses and nuts I can still handle

The Results

Even with a limited diet, and the fact that I have to eat every two hours- this time around has been so much better and here’s why.

• I have not fainted or been close to fainting once!
• I have only thrown up one time (and it was because my toothbrush made me gag)
• I have been able to avoid extreme dehydration (because my puking doesn’t out do my drinking which was a major issue last pregnancies)
• I have been able to cook food 75% of the days
• I am getting more fluids down (idk why but drinking in general has been hard for me all three pregnancies)
• I have not had extreme weight loss or gain (actually haven’t gained anything yet)
• Not a lot of acne this time
• Extreme decrease in sciatic never pain then previous pregnancies
• Better sleep
• Much less depressed then the first two pregnancies (yes, HG can definitely cause depression)
• I can go grocery shopping this time around (usually)
• Improved reflux
• Able to take vitamins most days

The things I have struggled with all three pregnancies 

• very very fatigued
• nausea (but not as debilitating this time)
• cranky (but apologetic lol)
• increased sensitivity to motion sickness
• “drooly” (like the kind of drooling that happens before you puke #glamorous)
• very sensitive to smells (again not as bad this time)
• letting things slip (ie- chores, friendships, responsibilities in general lol)
• constipation
• “sour” stomach…idk the medical term for this but I think it has to do with low stomach acid issues during pregnancies
• Lots of annoying burping

In Conclusion

Keto has helped me a lot this time around but the word “cured” isn’t one I would use. I have seen massive improvements and maybe things would have been even better if I would have started on this nutrition plan 90 days before conception but we’ll never know now.

If you are struggling with hormones- whether that be to get pregnant, stay pregnant, or maintain a HG free healthy pregnancy, I would start looking into true and healthy Keto. I will link in different resources you can look up in the bottom but remember- this isn’t an overnight fix! It takes 90 days for your egg to mature meaning it will take 3 months at minimum for the effects of your diet to change the “quality” of your egg.

Drop a comment below- especially if you’ve had experience with this or any helpful HG/ morning sickness tips!

Additional Resources

PubMed-Mitochondria: The ketogenic diet–A metabolism-based therapy

Dr. Pearlmutter Resources 

Dr. Berg- Keto and Hormones 

Fertility Diet