The Keto Diet: Are There Benefits for People With MS?

The human studies mentioned here are small, involving fewer than 100 people, and other results come from animal studies. This means that applying their findings to the wider human population with MS isn’t possible, but they do show some promising results that warrant further research down the line and highlight possible links between MS treatment and keto diets.

Findings suggest that a keto diet may:

Reduce Fatigue and Depression and Improve Quality of Life

“Our study provides evidence that a ketogenic diet may indeed be safe and beneficial, reducing some symptoms for people with MS when followed for six months,” says J. Nicholas Brenton, MD, the lead author of the study and an associate professor of neurology and pediatrics at the University of Virginia in Charlottesville. “However, it’s important that people with MS consult their doctor before making any big changes to their diet and that they be regularly monitored by a physician and registered dietitian if on a ketogenic diet.”

Changes the Gut Microbiome

Protects the Brain, at Least in Mice With MS

Decreases Hunger and Inflammation While Increasing Lean Body Mass

The researchers found that following a ketogenic diet for four months helped people with MS feel fuller after meals and led to an increase in lean mass and lowered levels of oxidation and inflammation.

Changes How Immune Cells Work and Use Energy

Experts don’t yet know specifically what about the keto diet leads to the changes they observe in study subjects with MS, but they have a few theories.

Following the Diet May Reduce Inflammation

MS is an inflammatory disease that damages the central nervous system. According to Dr. Brenton, research supports the theory that keto diets decrease inflammation, increase the process by which cells produce new mitochondria called mitochondrial biogenesis, and reduce levels of oxidative stress. He suggests that these may improve MS symptoms.

“Additionally, fat is a more efficient energy source than carbohydrate for the brain,” he advises. “This may be particularly important in a brain that is battling inflammation, as is the case in MS.”

People With MS May Respond Better to Ketones Than to Glucose

Inflammation isn’t the only cause of MS symptoms. As Mary Rensel, MD, a staff neurologist and the director of wellness and pediatric MS at the Cleveland Clinic’s Mellen Center for MS in Ohio, points out, people with MS also experience neurodegeneration, a progressive loss of nerve cell function that contributes to disability.

“One of the questions in MS is ‘What's hurting the nerves?’ and one of the possible answers is that mitochondria are not working correctly,” Dr. Rensel says. Mitochondria are the “energy producers” within the cells, and according to Rensel, they may not use glucose, the primary fuel the body takes from carbohydrates, in people with MS. These people may respond better to energy markers called ketone bodies, which develop as a result of ketosis.

“Ketone bodies get through the blood-brain barrier,” Rensel says. “This means they can reach the brain, and the brain can use them as an energy source,” Rensel says.

Weight Loss May Improve Quality of Life in People With MS

“It seems that people who have obesity and a poor diet may be at an increased risk of getting MS,” Rensel suggests. “And when you have MS, obesity and poor diet can lead to more progressive disability, so [being overweight] may indeed increase the risk of getting it or [negatively influence] the course of it.”

Brenton agrees that a healthy body weight, whether managed through the keto diet or another method, is beneficial. “I do believe that weight management can positively impact many comorbid MS symptoms, including pain, fatigue, and mood disorders,” he says.

The first potential pitfall of a keto diet for MS is that it can be challenging to stick to. “Ketogenic diets take effort to adhere to, and these types of diets will not fit into every individual’s life situation,” Brenton says.

Brenton adds that in his research, the most common side effects of the keto diet were constipation, menstrual irregularities, and diarrhea.

Do Experts Recommend the Keto Diet for MS?

The completed studies about the effectiveness of the keto diet for people with MS have been promising, but too small to draw broad conclusions. “It's interesting, but not necessary for everyone to follow this minute,” Rensel advises. “At this very moment, we don't know the perfect diet for people with MS.”

“While I think there are many benefits these diets can offer to people with MS, there needs to be more research into the ‘hows’ and ‘whys’ of these diets,” Brenton says. He also reiterates that studies have not yet looked at the long-term safety of keto diets for MS. “I would further argue that the ketogenic diet needs further study. Our data demonstrate its safety over six months, but our study was not designed to study the long-term implications of this diet in MS.”

He suggests that while the study’s results support a larger-scale study of ketogenic diets as a complementary MS treatment, the current data do not support their widespread adoption outside of a clinical trial.

• Some small studies have shown that keto diets may help to promote weight loss, reduce symptoms like fatigue and depression, reduce inflammation, and protect the nervous system.
• Larger studies are necessary to confirm the long-term safety of following a keto diet with MS.
• Side effects might include constipation, fatigue, menstrual changes, or diarrhea.
• If you’re interested in following a keto diet to help manage your MS symptoms, be sure to speak with your physician first to discuss the benefits and risks.