Keto and Lyme Disease: 5 Ways a Ketogenic Diet Can Aid Lyme Recovery

The ketogenic diet, or “keto” diet for short, is currently all the rage for managing blood sugar and promoting weight loss.

However, the benefits of the ketogenic diet extend far beyond weight loss and blood sugar control. The ketogenic diet profoundly reduces inflammation, supports the brain and nervous system, and regulates immunity, making it a potentially useful tool for Lyme disease recovery.

Read on to learn all about the keto and Lyme disease connection, the potential benefits of the diet for Lyme disease patients, and how to successfully integrate a ketogenic diet into your Lyme treatment protocol.

Please note that I am an affiliate for some of the products that I’ve linked to in this post. If you click the link here and make a purchase, I may earn a commission at no extra cost to you.

What is the Ketogenic Diet?

The ketogenic diet is a high-fat, moderate-protein, very-low-carbohydrate diet.

The typical macronutrient ratios on a ketogenic diet are as follows:

• 60-75% of calories from fat
• 15-30% of calories from protein
• 5-10% of calories from carbohydrates

The ketogenic diet was originally developed by physicians in the 1920s as a treatment for intractable epilepsy. (1) The ketogenic diet may alleviate epilepsy by reducing the excitability of neurons, thereby making them less likely to fire inappropriately, and by shifting energy metabolism in the brain from primarily glucose to primarily ketones.

Ketones are small, water-soluble compounds produced through the breakdown of fats in the liver. When the brain is unable to use glucose efficiently as a fuel, as is the case with some forms of epilepsy, insulin resistance, and neurological disorders (more on this next!) it can use ketones instead. The process by which the liver makes ketones is called “ketogenesis,” and the process by which body cells use ketones for fuel is called “ketosis.”

By significantly restricting carbohydrate intake, the ketogenic diet reduces the availability of glucose as a fuel source for the body, forcing the body to shift into ketosis so it can meet its energy needs.

Science-Backed Health Benefits of a Ketogenic Diet

Scientific research indicates that the ketogenic diet offers several significant health benefits, including:

• Improved insulin sensitivity, reduced blood sugar levels, and lower hemoglobin A1c levels. Hemoglobin A1c is a marker of average glucose levels over the past 3 months. (2) The ketogenic diet has been extensively studied and found effective for reversing type 2 diabetes. (3) It may also be beneficial for improving metabolic health those with metabolic syndrome and non-alcoholic fatty liver disease (NAFLD). (4, 5)
• Improved cognition, including improvements in memory. The ketogenic diet may even offer benefits for people with Alzheimer’s disease and Parkinson’s disease. (6, 7)
• Pain-relieving effects, via a reduction in systemic inflammation (8)
• Improved mitochondrial function. (9) Mitochondria are the “energy powerhouses” of your cells that make your cellular energy, ATP.
• Improved immune system function. (10) The ketogenic diet has been shown to improve the function of T cells; T cells are immune cells that focus on attacking specific foreign particles in the body, including specific type of bacteria.

How do these health benefits relate to Lyme disease? Next, let’s dive into the potential health benefits of the ketogenic diet for Lyme disease.

5 Potential Health Benefits of a Ketogenic Diet for Lyme Disease

The health benefits of the ketogenic diet may help Lyme disease patients better manage certain symptoms and experience a higher quality of life. Let’s dive into the reasons why!

A Keto Diet May Improve Your Immune System’s Ability to Fight Lyme By Regulating Blood Sugar

Blood sugar doesn’t just matter for people with type 2 diabetes! How our bodies handle blood sugar impacts our inflammation levels and immune function. In fact, research shows that proper blood sugar regulation is essential for maintaining a robust immune response against Borrelia burgdorferi, one of the primary bacteria that causes Lyme disease. (11)

Conversely, poor blood sugar control may make it harder for your body to fight Lyme disease.

While eating a whole-foods diet free of processed carbohydrates, exercise, sleep, and stress management can help many people regulate their blood sugar, these strategies aren’t sufficient for regulating blood sugar in some people. If you are dealing with Lyme disease and struggle to maintain healthy blood sugar levels through the strategies I just listed, then a ketogenic diet may be helpful for you.

A Keto Diet May Reduce Lyme-Induced Inflammation

Lyme disease induces inflammation throughout the body. It inflames the brain and peripheral nervous system (the part of the nervous system outside the brain and spinal cord), the heart, the joints, and the eyes. (12, 13, 14, 15) In fact, the chronic inflammatory response elicited by Lyme disease is, in large part, responsible for many of the symptoms of chronic Lyme.

The ketogenic diet offers significant anti-inflammatory benefits in the brain and musculoskeletal system by reducing the activity of an inflammatory pathway called the “NLRP3 inflammasome.” (16, 17) Interestingly, various Lyme co-infections, including Herpes viruses and Ehrlichia, boost the NLRP3 inflammasome. (18) It also inhibits the inflammatory signaling molecule NF-kB, a key inflammatory molecule triggered by Lyme. (19)

In addition, the ketogenic diet increases autophagy, the process by which your body cleans out damaged cells in order to regenerate new, healthier cells. Autophagy is crucial for alleviating inflammation in Lyme disease. (20, 21)

Through these mechanisms, the ketogenic diet may help alleviate symptoms of Lyme disease-induced inflammation, such as brain fog, achy joints, and headaches. (22)

A Ketogenic Diet May Improve Mitochondrial Dysfunction in Lyme Disease

Mitochondria are tiny structures inside your cells that make ATP, your body’s cellular energy “currency” that drives nearly every biochemical reaction that keeps you alive.

However, mitochondria aren’t just energy “factories.” They also regulate the immune system and antioxidant balance inside the body. (23, 24) Dysfunctional mitochondria = a dysfunctional immune system and oxidative damage to the cells and tissues in your body.

Lyme disease may damage mitochondria, resulting in mitochondrial dysfunction. (25) Lyme-induced mitochondrial function may drive symptoms such as chronic fatigue and ongoing immune dysfunction.

A ketogenic diet has been shown to improve mitochondrial function. (26) Therefore, it’s possible that it could improve mitochondrial function in Lyme disease patients. Improved mitochondrial function in the context of Lyme disease may lead to increased energy levels and a more balanced immune system.

A Ketogenic Diet May Reduce Lyme-Related Pain

Musculoskeletal pain, including arthritis, is a common symptom of Lyme disease. Research indicates that ketogenic diets reduce inflammation-induced pain, at least in preliminary animal research. (27) Therefore, it seems plausible that a ketogenic diet may have pain-relieving effects in humans, including humans with Lyme disease.

A Keto Diet May Improve Lyme-Related Mood Imbalances

Mood imbalances, including anxiety and depression, are exceedingly common in patients with Lyme disease. Individuals diagnosed with Lyme disease have a 28% higher risk of experiencing a mental health disorder compared to individuals without a Lyme disease diagnosis. (28)

A growing body of research indicates that a ketogenic diet can improve mental health. It may exert anti-depressant effects by regulating the activity of microglial cells, immune cells in the brain and spinal cord that influence inflammation, and by regulating the excitability of neurons. (29)

A ketogenic diet may relieve anxiety by enhancing GABA signaling. (30) Gamma-aminobutyric acid, or GABA for short, is the primary inhibitory neurotransmitter in our nervous systems. Boosting GABA signaling can alleviate anxiety. (31) Based on these findings, it’s possible that a keto diet could quell anxiety caused by Lyme disease.

Foods to Eat and Foods to Avoid on a Ketogenic Diet for Lyme Disease

Now that you know the basic facts about a ketogenic diet and how it can support Lyme disease recovery, you may be wondering how to get started with a keto diet! Let’s discuss the primary foods you should eat and the foods you should avoid on a keto diet for Lyme disease.

Foods to Eat

The ketogenic diet for Lyme disease is nutrient-dense and centered around whole foods, including plenty of plant foods. It is not focused primarily on cheese, eggs, and cured meats, like some versions of the keto diet that are popular on the internet!

With Lyme disease at play, we really need to focus on eating keto-friendly foods that reduce inflammation and provide our bodies with the vitamins, minerals, proteins, fibers, and fatty acids that we need to heal. A plant-rich ketogenic diet does just that!

• Protein: Grass-fed beef, bison, elk, venison, and other types of wild game, pork (try to choose organic or heritage pork, if possible), organic or pastured chicken and turkey, eggs, fatty cold-water fish such as salmon, shrimp, oysters, mussels and other shellfish, and organic tofu (if you tolerate soy).
• Non-starchy vegetables, including leafy greens, broccoli, cauliflower, garlic, onions, summer squash, bell peppers, mushrooms
• Small amounts of root vegetables, such as jicama, beets, and carrots
• Berries (no more than 1/2 cup of berries per day to begin with)
• Nuts and seeds, including almonds, macadamia nuts, pecans, chia seeds, pumpkin seeds, and hemp seeds
• Healthy fats: Extra virgin olive oil, avocado oil, olives, avocados, coconut, nuts, and seeds. 

Foods to Avoid

• Grains (I recommend that most Lyme patients avoid gluten-containing grains, but a ketogenic diet typically removes ALL grains because grains are high in carbohydrates.)
• Legumes, including chickpeas, lentils, split peas, black beans, pinto beans, etc. Legumes are a dense source of carbohydrate.
• Most starchy tubers and fruits, including sweet potatoes, cassava, plantains, white potatoes, apples, pears, mango, pineapple. While these are nutrient, anti-inflammatory foods, the carbohydrate content is high enough that it will “kick” most people out of ketosis when consumed.
• Conventional dairy products from non-organic cows: I recommend avoiding conventional dairy products because they may contain inflammatory pesticide and herbicide residues, mycotoxins, and synthetic growth hormones. (32, 33)
• Industrial seed oils: Industrial seed oils are the oils expressed from oilseeds, including canola (rapeseed), corn, cottonseed, grapeseed, safflower, soybean, and sunflower oils. These oils are recent additions to the human diet and, research suggests, increase inflammation when we eat them.
• Processed and refined foods: You’ll naturally avoid most processed and refined foods by sticking to the foods on the “Foods to Eat” list.

Are Dairy Products Allowed on the Keto Diet for Lyme Disease?

I typically recommend that people avoid dairy products for at least the first few weeks of their ketogenic diet. After a few weeks, as long as you don’t have a dairy allergy or sensitivity, you may try including some A2 dairy products.

A2 dairy products contains A2 casein, a form of the dairy protein casein that is less inflammatory to the body than A1 casein, which is found in most commercial bovine (cow-derived) dairy products. The types of cows that produce A2 milk include Guernsey, Jersey, Charolais, and Limousin breeds. Goat, sheep, and water buffalo milk-based dairy products are also a good option because they contain primarily A2 casein.

How to Measure Ketones:

If you decide to try a ketogenic diet, it is important that you measure your ketone levels for at least the first few weeks of the diet. This will allow you to determine if you are entering ketosis; entering ketosis is critical for experiencing the health benefits of a ketogenic diet.

If you find that you’re not entering ketosis, or barely in ketosis, then you may need to adjust your macronutrient ratios (the amount of fat, carbs, and protein you’re eating) on your ketogenic diet.

There are a few ways to measure ketones. Urinary ketone test strips are inexpensive, but they are not very accurate. In my experience, they can be helpful for the first 1-2 weeks of a keto diet. However, as your cells become adapted to using ketones for fuel, ketone levels in your urine will drop, causing the urine test strips to show lower ketone levels despite there likely being higher ketone levels in your bloodstream.

Measuring blood ketones is convenient, accessible, and more accurate than urine ketone strips. The KetoMojo ketone meter is a good option. Ketosis begins at around 0.5 mmol of ketones in the blood (the main ketone being measured in the blood is beta-hydroxybutyrate). However, please note that many of the anti-inflammatory effects of ketones start at around 1 mmol of ketones in the blood.

Finally, there are now devices on the market that measure a ketone released through the breath, acetone. The BioSense meter is one example of a breath ketone meter. On the BioSense Meter, 15+ ACEs (this is the unit of measurement used for breath acetone).

Who Shouldn’t Try a Ketogenic Diet?

There are a few subcategories of people with Lyme disease who should avoid a ketogenic diet. People who should avoid the ketogenic diet include:

• People with a history of an eating disorder or disordered eating.
• Inborn errors of metabolism, including but not limited to carnitine deficiency, carnitine palmitoyltransferase I or II deficiency, and carnitine translocase deficiency.
• Porphyria. Carbohydrate restriction can exacerbate symptoms of porphyria.
• People with gastrointestinal issues that cause significant fat malabsorption.
• People who are underweight. Please note that this is a relative contraindication because the ketogenic diet often, but not always, induces some weight loss. So, if you don’t have much weight to spare, it can push you into the “underweight” category, which isn’t ideal for overall health. However, if you are underweight and committed to trying a ketogenic diet, then I strongly recommend working with a healthcare professional who can build a personalized keto nutrition plan for you to ensure you maintain your weight.
• Women who are pregnant or breastfeeding. Pregnancy and breastfeeding are not the time to implement a keto diet because the diet may adversely affect fetal development and breast milk supply, respectively.
• Most pre-menopausal, menstruating women are not good candidates for a ketogenic diet. In these women, a ketogenic diet can drive hormone imbalances. Pre-menopausal women typically need a moderate-carb diet to support healthy sex and stress hormone levels and to optimize fertility.

Supplements for Supporting Ketosis

If you decide to try a ketogenic diet for Lyme disease, there are several supplements that may be helpful: Magnesium,

Magnesium

Magnesium is one of the body’s electrolytes and can become depleted by the diuresis stimulated by nutritional ketosis. Magnesium deficiency is also common in the general population.

Magnesium is a critical cofactor for over 300 enzymatic reactions inside the body, including reactions involved in mitochondrial energy production, insulin sensitivity, muscle function, and mood. Maintaining optimal magnesium levels is paramount for experiencing success on a ketogenic diet and for Lyme disease recovery. An intake of 500-800 mg of magnesium a day may be ideal.

Top food sources of magnesium on a ketogenic diet include dark leafy greens, avocado, nuts, seeds, salmon, and halibut. However, many people also need to supplement with magnesium to maintain optimal levels of this vital mineral. The best supplemental form of magnesium for replenishing whole-body stores of this mineral is magnesium glycinate.

Magnesium threonate is another useful form of magnesium. However, it is more specifically used for supporting cognition and mood and shouldn’t be relied upon as the sole source of supplemental magnesium.

Electrolytes

The diuresis (extra urine production) that is triggered by nutritional ketosis can deplete electrolytes, resulting in uncomfortable symptoms such as headaches and muscle cramps. If you choose to try a ketogenic diet for Lyme recovery, I recommend taking an electrolyte supplement daily. LMNT is an excellent keto-friendly electrolyte.

Final Thoughts

Are you recovering from Lyme disease and curious about whether a ketogenic diet could enhance your healing process? I regularly help clients with Lyme disease implement a ketogenic diet and would love to help you! You can book a discovery call with me to learn more about how we can work together.