It’s interesting that doctors will generally tell you not to take life-sustaining vitamins and minerals because they may interact with the medications that you have been given. They hold the medications at a higher priority than the life-giving vitamins and minerals.
Well, here’s a twist to their thinking today: some of the medications your doctor is giving you may be throwing off your ketogenic diet, and knocking you out of ketosis!
The fact of the matter is that almost all medications contain at least SOME carbohydrates, according to Jeff Curless, PharmD, author of Medication Management on the Ketogenic Diet. And this can actually mean diet failure, which directly affects one health, especially if you’re on the ketogenic diet as a “last resort” type of diet. Those with seizures and other neurological disorders may fit into this category.
The problem lies in the range of drugs on the market that are considered generic. To be called generic, the only requirement is the specific dosage of the active ingredient. All the other ingredients can be varied in amounts – and even some new ones added to the mix.
- Your first guideline is to keep the carbohydrate content of all medications for the day to 500 mg or less. Count this carefully, as some medications will contain 160-200 mg carbohydrates per dosage, and if you’re taking them three times daily, then you’ve exceeded the amount for the day.
- Count the number of carbohydrates in tube feedings. High-calorie tube feedings will have more than 100 grams carbohydrates in them, and with this amount, one tube feeding means the whole ketogenic diet is worthless for the day!
- Whenever possible, avoid medications that are liquid. These are the ones that will generally add sweeteners and most sweeteners are from carbohydrate sources.
- If you don’t see a carbohydrate count for the medication on the package insert, examine the ingredient list, searching for sources of carbohydrates. If you see some on the list, call the manufacturer and talk to the consumer education department. Get the answer in writing from them.
- Don’t put your medication in applesauce or dessert to mask a bitter taste. The applesauce will contain a minimum of 15 grams carbohydrates per one-half cup, and generally may be as high as 38 grams. This dose is enough to cancel the benefits of a ketogenic diet.
- Beware of over-the-counter medications, too. These may also contain carbohydrates.
Here’s a list of some that do:
- Tylenol, cherry flavored pediatric version, 420 mg carbohydrates
- Tylenol, grape and dye-free cherry flavors, 1000 mg
- Tylenol Children’s Meltaways Chewtabls, 1000 mg
- Advil Pfizer, 100 mg tablet Jr Strength, 131.5 mg
200 mg tablet, 258 mg carbohydrates
200 mg Liqui-Gels 39 mg carbohydrates
- Aleve Bayer 220 mg tablet, 44 mg carbohydrate
- Sudafed Nasal Decongestant Maximum Strength, Non Drowsy, 30 mg tablets, 120 mg carbohydrates per tablet
- Senokot tablets, Purdue Products, 1 tablet, 100 mg carbohydrate
- Baby Powder – main ingredient is cornstarch (100% carbohydrate) and it’s absorbed through the skin
- Zantac Boehringer Ingelheim, 70 mg carbohydrates per tablet
- Mylanta liquid, 700-800 mg carbohydrates per teaspoon
Keep all this in mind when you are taking medications!
Source: Curless, Jeff, PharmD. Medication Management on the Ketogenic Diet. https://www.choc.org/wp/wp-content/uploads/2017/03/RT-6-CurlessJ-RDsInPractice-Keto.pdf