How to Do Keto with Dietary Restrictions (and a Giveaway)

Eliminating foods from dietAlmost everyone has at least one dietary restriction. Maybe your religion or cultural traditions prohibit specific foods or food pairings. Maybe your physiological response to certain foods—an allergy or intolerance—prevent you from eating them. Or perhaps your immediate goals preclude a food’s inclusion in your diet.

Like every other diet, keto is already circumscribed by basic principles, which can make further limitations difficult to accommodate. But the benefits of going keto, at least for part of the time, are well-established and worth the effort. You want to do it. How can you go keto while honoring your own dietary bounds?

It depends on the restriction.


This is a tough one. Dairy is one of the most reliably healthy sources of fat available, repeatedly showing strong and consistent links to good cardiovascular and overall health. Many keto adherents rely heavily upon it. We cook our eggs and veggies in butter. We treat ourselves with Greek yogurt. We take our stevia with coffee and cream. Dairy is just a great way to get calcium, healthy fat, and probiotics. What to do without it?

Make sure you know what part of dairy you can’t handle.

If you can’t handle lactose, you can probably do hard cheeses (like pecorino romano), well-fermented yogurt or kefir (the lacto bacteria consume the majority of the lactose), butter, cream, ghee, and pretty much everything but fluid milk or softer, runnier cheeses. Those dairy foods are pretty much fat and/or protein with very little lactose. The most severely sensitive may have to cut out everything but ghee.

If you can’t handle dairy proteins, cheese and yogurt/kefir are out. Depending on the severity, cream and butter may be out too. Again, ghee is still pretty safe in this situation. Casein intolerance is far more prevalent than whey intolerance, so even if you can’t eat yogurt, cottage cheese, cheese, and other high-casein foods, you may be able to do ricotta or whey protein.

How to Replace Cream?

Nut milks are a decent replacement, but they often come loaded with additives, sweeteners, and are almost always low-fat. A good way around this is to find a nut milk without sweeteners or additives and whisk in some powdered coconut oil or MCT oil powder. In times where I’ve run out of cream for my coffee, a couple scoops of MCT powder whisked into whatever nut milk I have lying around is a great approximation. Sometimes I even prefer that. Straight up coconut milk or cream also work well.

How to Replace the Calcium In Dairy?

Canned sardines. Leafy greens, shmeafy greens. The best way to get calcium without dairy is through dietary bone, and canned bone-in sardines are a great way to do it. (Still eat leafy greens, just don’t rely on them for calcium.)

How To Replace the Probiotics?

Eat fermented veggies like sauerkraut, kimchi, real pickles. Take a quality probiotic like Primal Probiotics. And as I mentioned before, you may actually be able to tolerate fermented dairy.

How To Replace the Fats?

Dairy fats are beneficial and convenient, especially if grass-fed, but they aren’t essential. You can get plenty of saturated fat from meat, red palm oil, and coconut oil. You can get conjugated linoleic acid from grass-fed ruminant meat, like lamb or beef. Butyric acid, found in butter, is also produced (in vaster amounts) in our colons when gut bacteria metabolize prebiotic fiber.

Nuts are a handy snack to have around. They’re nutrient-dense, even the ones high in linoleic acid aren’t as bad as eating soybean oil, since nuts come with phytonutrients and micronutrients that protect the fragile fats from oxidation. They’re often rich in sometimes-hard-to-obtain minerals, like selenium in Brazil nuts, manganese in hazelnuts, or magnesium in almonds. And a little known fact is that almonds and pistachios are incredibly rich sources of prebiotic fiber that’s great at increasing butyrate production and improving gut health; that can be hard to find while remaining low-carb.

If you’re allergic to Brazil nuts and walnuts but almonds and cashews are fine, this section doesn’t really apply; just eat the nuts you can safely eat and avoid the ones you can’t. 

How To Replace the Rest…

How to replace the selenium? Eat wild salmon and other wild-caught seafood, pastured eggs, canned sardines. If you’re really adventurous, start eating beef kidney.

How to replace the manganese? Eat shellfish, especially mussels. Another option is pumpkin seeds.

How to replace the magnesium? Eat spinach.

How to replace the prebiotic fiber? Get yourself some resistant starch, which also stimulates butyrate production. Good keto sources include green bananas (the resistant starch has yet to convert to digestible glucose, so don’t worry about the carbs) and raw potato starch. Many other low-carb plants offer prebiotic fiber as well, like garlic, leeks, and Jerusalem artichokes.

How to replace the easy snack? Jerky, hardboiled eggs, cold chicken legs, smoked salmon, and coconut butter are all good options.

Stop snacking. Snacking should be an elective activity. That’s the goal of going keto—the ability to thrive on our own body fat in between meals. We shouldn’t be so ravenous throughout the day that we keep a satchel full of snacks on our persons.


Eggs are great for most people. They contain all the nutrients you need to build an organism, like cholesterol. They’re quick and easy to cook. They go with almost everything. They’re rich in important micronutrients that keto dieters really need to process fat, like choline. The nutrients they do contain, like vitamin D, tend to be more bioavailable than other sources. And they have a great ratio of protein to fat.

But they’re also a common allergen. Many people with the allergy have expressed difficulties making keto work.

First, make sure you’re allergic to or intolerant of the entire egg. Many people are only sensitive to the egg white. If that applies to you, it may be possible to safely enjoy egg yolks (which is where most of the nutrition is anyway). To be even safer, you can puncture the yolk sac, squeeze out the innards, and discard the sac.

How To Replace the Easy Breakfasts?

Eat some combination of bacon, smoked salmon, olives, cheese, Greek yogurt. Try a Turkish breakfast, with olives, cheese, cucumbers, and tomatoes. Eat non-traditional breakfast items, like burger patties with avocado, steak and greens, lamb chops with mushrooms sautéed in the lamb fat.

How To Replace the Choline?

Get acquainted with liver. Liver paté is a delicious, high-fat way to eat the stuff.

How To Replace the Cholesterol?

You don’t necessarily have to replace it. Your liver is probably quite adept at manufacturing it. However, folks engaged in strength training can probably use the extra cholesterol to produce sex hormones like testosterone. Shrimp, liver, and shellfish are solid sources of cholesterol.

How To Replace the Bioavailable Vitamin D?

Take supplements and (of course) sunlight. Eat cod liver oil, sardines, salmon roe, or wild salmon.


Coconut isn’t that common an allergy in the general population, but coconut’s prominence in paleo/Primal/keto circles tends to expose those that are allergic or sensitive rather quickly.

But you don’t actually need to eat coconuts or coconut fat on a ketogenic diet. You don’t need to replace coconuts with anything special. They aren’t particularly high in any specific nutrients you can’t get elsewhere. Sure, the medium chain triglycerides are ketogenic fats, meaning they promote the production of ketone bodies, and that can be helpful. You know what else is ketogenic? Going keto, getting fat-adapted, consuming your own body fat.

There is one major downside: Thai curries will be difficult to make without coconuts. That’s why you turn to Indian cream or yogurt-based curries instead.


You’re not really worrying about this, are you?

That’s it for today, folks. I hope those of you with food restrictions feel empowered and enabled to do keto—because you should. It’s completely doable.

And for the vegetarians out there, I’ve got a post dedicated to you and keto in the works, so stay tuned.

Now For the Giveaway…

Since we’re on the subject of dietary restrictions and selectivity, I’m giving away two products that can help anybody—regardless of eating plan—enjoy good Primal food. One random commenter will receive both products.

pkcb2_ig_2_600xThe Primal Kitchen Cookbook, released just last summer, features 130 mouth-watering recipes that span the sub-interests of everything from keto to vegan, Autoimmune Protocol (AIP) to Whole30®. Each recipe is labeled with icons with this information as well as macronutrient profiles. The cookbook, a fun collaboration with 50 leaders in the ancestral health sphere, offers fresh ideas for every meal and every kitchen skill level. I know I use mine all the time. I made sure it had some of my favorites, in fact.

But that’s not all today. Why not add a little more cowbell?

Whole30_Advanced_1_600xFor that same random winner, I’m also giving away a Primal Kitchen® Advanced Whole30 Kit. With both of our popular mayos, a bottle of our buttery and versatile Avocado Oil, and our five Whole30 compliant dressings (including our new Balsamic), this kit offers big inspiration and convenience—all without any sugar, alcohol, grains, legumes, dairy or unhealthy additives.

I’ll choose a random winner from this post’s comment section. Comment before midnight tonight (1/9/18 PST) to be eligible.

And I’m looking for your thoughts today. What health conditions and healing protocols are you looking for more information on? A particular autoimmune disorder? A particular food allergy? The road back from damage of a specific disease or condition? Whether you’re asking for yourself or a friend, I’d love to hear your interests. Thanks for stopping by today, everyone.

Also, if you have any other questions on the restrictions I talked about today (or others), feel free to leave a comment below!


About the Author

Mark Sisson is the founder of Mark’s Daily Apple, godfather to the Primal food and lifestyle movement, and the New York Times bestselling author of The Keto Reset Diet. His latest book is Keto for Life, where he discusses how he combines the keto diet with a Primal lifestyle for optimal health and longevity. Mark is the author of numerous other books as well, including The Primal Blueprint, which was credited with turbocharging the growth of the primal/paleo movement back in 2009. After spending three decades researching and educating folks on why food is the key component to achieving and maintaining optimal wellness, Mark launched Primal Kitchen, a real-food company that creates Primal/paleo, keto, and Whole30-friendly kitchen staples.

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203 thoughts on “How to Do Keto with Dietary Restrictions (and a Giveaway)”

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  1. Thank you for all the great information! I’ve been doing AIP with reintroductions for over a year now, and I still have yet to figure out how to clear up some skin issues. There is so much info out there on perioral dermatitis and eczema (to name a few), but after trying so many different things, I still have not found relief and I refuse to take antibiotics that the dermatologist recommends. So something more on skin issues specifically would be awesome!

    1. Hi Jean – I’ve been battling granuloma annulare (GA, another skin condition that’s thought to be derived from autoimmunity) since I was 21 (I’m 43 now). I’ve been primal for almost 6 years now but that wasn’t enough to get rid of the GA. Last year, I implemented 12-hour fasting every day and avoided histamines. I had recognized that histamines caused IBS flairs (that are otherwise eliminated by a primal diet), and I then fortuitously noticed an immediate increase in the appearance of GA if I ate histamines by mistake. Anyway, my GA disappeared completely a few months after implementing those changes last year. I’m not saying that histamines are your problem, per se, but rather gut irritation from -something- may be causing your skin issues. I was lucky enough to have IBS as an associated readout.

      1. Cutting histamines means staying clear of canned sardines and the like, dry ages beef and gazillion other. Did you eliminate all the above? I’m not questioning; just carious. There are a few web sites (here’s one that are devoted to raw meat (because of the histamine issue) and they report great success. Personally, 10 years ago I suddenly started to suffer from redness and itching on my back and no dermatologist cream (steroid included) helped. Up to that point I had prefect skin all my life. In an effort to bring my hashi to remission, I started to cut out many food items and basically went Keto. I still don’t know what was the culprit (nightshades?) but for the 1st time in many years I am back to normal.

    2. Jean I also have been dealing with Perioral Dermatitis for a year now. I’ve done the antibiotics, no help!! Now I’ve developed painful gastritis. Is this Leaky Gut syndrome? I want to clear this up but not sure were to begin. I am taking probiotics, no gluten but not fully Paleo. This rash is just awful!!!!

    3. Have you tried just putting coconut oil on your skin? I wonder if that would help. I put it on any sores or rashes that show up on my skin. Sometime Tree Tea oil too.

    4. This.
      I went primal about six years ago, and when I did, psoriasis showed up. At first it was one spot on my calf then it progressed to my shins and the occassional spot on arms torso, etc.
      I tried creams and such from the doc, but no-go. After reading a bit, I saw that eggs can be one of the triggers. So, I cut out eggs at the end of last month. I am going to give it a go for thirty days and see if it clears up. This is very trying because I love eggs! I eat at least two per day and often times more… that is why I think that might be it. It has been the one common denominator since I started.
      Oddly enough, when I had my gall bladder yanked last spring and I couldn’t eat for a few days while they sorted some related medical stuff out, it all but disappeared. After the surgery I went back to normal, and it flared up. That’s when I put 2+eggs= possible trigger.
      We’ll see what happens.

    5. I first developed perioral dermatitis in the mid 90’s, but after discovering that, in my case, it was caused by food allergies/sensitivities, I have been rash-free for most of the time since then. When I do overconsume my allergens and have a breakout, I become very strict with my diet again, avoiding the tiniest bit of my trigger foods, and apply a small amount of steroid cream for about a week. Then I am good for a few years until my resolve weakens, and I eat the offending foods again.

      My food sensitivities are dairy, peanuts and soy. Soy in particular is hidden in small amounts in many products so I have to read labels carefully.

  2. Does Keto have an impact on healing broken bones?

    I’m recovering from a stress fracture and noticed the healing process seems to be moving very quickly

  3. I’m glad to see coconut allergy/sensitivity addressed here. I am one who can’t use coconut in any form, either ingested or smeared on my skin. My GI system doesn’t like it and it does weird things to my lips and skin. Even if that weren’t the case, I don’t like the taste or the smell. That quasi-coconut aroma found in so many skin and hair care products just about gags me. Fortunately, as Mark points out, you can get the same nutrients elsewhere. That’s true of almost everything. It’s never a good idea to force a particular food on yourself just because it’s supposed to be healthy.

  4. This was a fantastic read. I’ve started recently with keto again, and even though I’m lactose intolerant I can handle some dairy. My co-worker was telling me she didn’t think she could do keto, because not only is she lactose intolerant, but hates all dairy. I am curious about how going keto can help PCOS. I don’t have it, but I know someone else who does. Thanks for all the great articles! Keep them coming 🙂

  5. I don’t have any adverse reaction to dairy. In fact, I crave it. But I know my limitations. I try to keep a good balance and variety of different foods in my diet. Great article.

    1. A Naturopath told me many years ago that we crave what we’re allergic to. I used to crave dairy (full fat milk). I try to avoid dairy now. It’s extremely mucus forming and makes my face break out terribly.

      1. I crave a steak; am I allergic? Absolutely not. Meat allergy is one of the rarest out there to the point that it’s negligible; I wonder why? I don’t mean to come across as clever; mischievous? maybe (-:

  6. It’s always a good idea to do N=1 experimentation to figure out foods you might be sensitive to. Formal allergy testing found I was “allergic” to foods I commonly eat, so I cut all of them out, then re-introduced them one-by-one, and I only had a mild reaction to one (of the many) I was told I was allergic to. A consult with a second allergist and another round of allergy testing exposed the weakness of those allergy tests–you can get different results with different testing serums. My new allergist said to go with N=1 over anything else!

  7. Hi Mark! I am curious to learn more about egg intolerances acquired later in life (say, from consuming a lot more eggs when you go paleo/primal). Is it possible that the sensitivity will fade over time? Is there an egg-reset protocol? Is this sort of acquired intolerance also usually egg-white specific?

    1. Hi Danielle – I think egg sensitivities can fade, but that’s just my personal experience! I find if I eat them every single day, after a while, I start to feel a little unwell after eating them. So I give myself a break for a week or two, and so far, have always been able to reintroduce them with no problems. But maybe a vague feeling of “unwell” isn’t really a sensitivity, I don’t know.

  8. I heard joe Rogan say sardines can be high in arsenic, so how many tins a day should one eat? I usually eat a package or two a week because I don’t really enjoy the flavor, and my co workers and family don’t like the smell. It seems like to get an adequate amount of calcium, you would need to eat at least a tin a day.

  9. I have a bit of trouble with Primal and Keto because I have both a histamine sensitivity (so all aged and fermented foods are out) and a salicylate sensitivity (which limits some vegetables as well as coconut and olive oils and most spices). I try to work around this as best I can but am always interested in seeing new blog posts from Mark.

  10. I’ve found I have a dairy sensitively so have removed dairy completely as a first step. Based on this article’s advice, I’m going to try introducing some hard cheeses and well fermented yogurt. Previously I was making my own yogurt before removing it from my diet, as I could control the sugars in it. Are there any yogurt makers here that can tell me to adjust a basic yogurt recipe to ensure it is “well-fermented” to ease my sensitivities?

    1. Just allow it to ferment for at least 24hours to remove the lactose. If possible use raw milk

      1. Dairy allergy here. I make yogurt out of coconut milk and it’s the same as making it w/cows milk. Just have to make sure the starter is dairy free.

  11. I’m gluten sensitive (you’re right, don’t need any more info there really!) that I discovered 10+ years ago when avoiding dairy and gluten for my young son. We discovered your primal books not long after. Over the years I’ve allowed grains back into my diet, mostly for convenience and comfort during stressful times. I’m ‘back on the wagon’ and really my only frustrations, which is quite minor, are all of the lovely looking pork/shellfish/non-kosher meat types recipe meal plans. I’d love a personal chef!

  12. I have found that I can tolerate aged cheeses but have to avoid “runny” dairy products just like you said! Thank you for your insights Mark!

  13. I’ve really enjoyed reading your take on collagen and would love to know more.

  14. MDA has published a number of articles (and books, I purchased one) regarding thyroid health, which is great. However, as an older male, I’m also interested in (not the sexiest topic for sure LOL) prostate health. Almost every article I’ve read out there advises men whose PSA is rising to avoid dairy and eggs. There are some seemingly decent studies correlating increased PSA to egg consumption. So … I eat a lot of organic veggies, nuts, olive oil, coconut oil, chicken, turkey, salmon, sardines, organic berries, tomato sauce, bone broth, collegen powder and take a bunch of supplements including prostate-related supplements, eat a small piece of 88% chocolate daily, drink green tea, and a plant-based protein shake with a couple of scoops of green powder. Bottom line … would be VERY interested in Mark Sisson’s take on prostate health in general and the potential impact of a Primal Blueprint / Primal Keto diet / lifestyle.

  15. What about gastritis? The one not caused by Helico bacteri
    I see a lot of info that LCHF/Keto/Paleo helps to solve that, yet I am still struggling
    And in here the doctors do not really explain what and how to change, they just prescribe proton-pomp inhibitors..

    1. Do you drink coffee, tea, or eat chocolate? All three seem to cause gastritis for me. Decaf is as damaging as caf. YMMV. Physically it’s easy to give those up entirely. Psychologically… *sigh*

      1. yes, I do. all of them, and honestly – I love them, so it would be really hard to give up. just because they please me so much
        however, most of my heartburn comes from eating, not drinking tea/coffee. even if i eat really healthy stuff – i might get unpleasant feelings. and yes, i have tried experimentation with eliminating different stuff to find which one causes it and eliminate that. has found a certain food

  16. Mark could you please give me your thoughts on lymes disease – i have been primal for quite some time but lymes disease realy knocked me back some from the joint pain that it caused – at least i believe that is what caused it – i did seem to feel better when i have done 48 hour fast – but what else could i do ? – have already done two rounds of doxi – no more for me – what do yinz think -ya i am a yinzer lol

  17. Such good info in here! I have a sister-in-law who was just diagnosed with Crohn’s and she shared that she can’t eat salad anymore. Thankfully there are plenty of other vegetable options but it sucks that she can’t do a big ass salad. I’ve tried to encourage her to look into Paleo/Primal but she just stares at me like I have two heads. Maybe someday.

    1. I can’t eat salads without issues digesting it. I’ve not been diagnosed with Crohn’s and have been primal for several years…… maybe I should check with a doctor.
      I hate going to doctors……. sigh.

      1. Don’t go to a conventional doctor for a digestive issue, or they will just give you drugs and send you away and you will just get worse.

        Best bet is to find one of the fabulous LCHF doctors!

        1. I agree, today’s doctors only seem to want to give you drugs. I have seen over 20 specialists for an inflammatory issue that is causing stroke like symptoms (really serious) and after over 2 years, still no diagnosis. They just want to give me drugs to treat my symptoms which will not do anything to address the cause. Good luck with your diagnosis.

  18. I’m curious about dairy. Everything about it. How much can I get away with? Why doesn’t high fat dairy make me feel allergic the way low fat does? How can I make myself even better able to tolerate it? Why is it so delicious?

  19. I’m working on reducing the highest lectin foods from my diet and learning the best ways to prepare them to lower or destroy the lectins. Any tips on this would be great. In the process I’ve been eating a lot more greens (A LOT more) and it doesn’t Look like it’s being totally digested, if you catch my drift. Any thoughts on that?

    1. Well, if you’re interested in removing lectins and preparing foods that contain lectins for safe consumption, Dr. Steven Gundry’s book The Plant Paradox might be a good read for you. At least it might be worth checking out. You might also just check out the website since the info there is free. Good luck!

  20. I’d be curious on your thoughts on the GAP protocol and how wellit fits in with primal principles

  21. I love everything about eggs, and somehow Mark made them sound horrendous with all that talk about punctured sacs and innards. Not cool.

  22. I suffer from chronic pain and my treatment regimen includes several medications. I’m wondering if going keto while taking certain medications could over work my liver as to cause additional health problems. I’ve been keto for a few months and haven’t noticed any additional symptoms but I want to make sure I’m not causing damage.

  23. Pick me! 😉 Also, I could use help. I have a severe allergy to nuts and I’m pregnant. Apparently there is a 65% chance that my child will also have an allergy. Yikes. I’m struggling to find reliable or consistent information about anything I can do to decrease those odds. Does prenatal diet influence this? When is the right time to introduce potential allergens to a child? All the information conflicts! Some help reviewing the available studies and literature would be SO awesome.

  24. First, thank you for all the info in this post (and others!). Would really appreciate some tips on how to eat higher fat/keto when you don’t have a gallbladder.

  25. I would be interested in knowing if keto is compatible with autoimmune protocols?

  26. My husband and myself have been on the 21 day challenge for 7 days so far. We have done quite well. We stopped drinking alcohol all together. We both agree, that all and all we feel pretty good. Increase mental and physical energy. We thought it would be a lot tougher, since we are both big microbrew buffs and wine drinkers.
    For myself one reason why i wanted to change my diet was to improve my health since up to a year ago I was on 3 antibiotics and had been for 4 years. I naturally lost weight because of them. My Doc decided to put me on an antibiotic holiday, you could say, to see how I do. I gained 8-10 lbs over the last year, the beer didn’t help.
    My good friend Pam told me about the diet and challenge she was going on and I decided to give it a try. I am looking for overall improvement in my health and mood. My job keeps me pretty active, I work as an ER nurse, 12 hour shifts so it’s important that I stay healthy, since my exposure to various aliments is greater than the average person.
    So far enjoying the diet

  27. Pursuing Paleo/Keto has been a tough decision. I want to stop grains, legumes and sugars, and limit dairy, and I don’t miss those things. But, I feel heavy when I eat too much animal protein, and some animal fats completely gross me out. But I love coconut oil, and became interested in MDA because I love your avocado oil and mayo, so…here I am! Your plan seems to have more flexibility. I seem to have trouble digesting tomatoes along with meat, so a lot of soups are not a good idea because so many have tomatoes plus meat, and a lot of them have peppers, too. I don’t seem to have much trouble with peppers, though. I do love my veggies but this time of year, it’s hard to find enough truly fresh ones. Any suggestions of how to fine tune this to find options without tomatoes and a lot of animal fat?

    1. Maybe I should have said pursuing Primal, because that’s the idea here, isn’t it!

    1. Me too me too …
      (I forsee a long line with the same incantation)

  28. Thanks for the info. Good to get such detailed information to make our lives more healthy

  29. I’m fortunately not dealing with any health issues but I’m enjoyjng reading about Keto and I’m interested in the giveaway. Thanks for your writing, Mark!

  30. I’m trying to start my children off with a healthy lifestyle and wondered if there is any variant data for nutrition needs of growing bodies – obviously they don’t need to lose weight but I don’t want to feed them a SAD!

  31. I’ve been following Keto after doing the 21 day reset for about 2 months. I love it, but now want to know more about going Primal. Would love to read the book!!

  32. Mark, FYI, the linked-to MCT oil powder (Quest) contains “milk-derived ingredients” = sodium caseinate. This is no bueno for someone avoiding dairy/casein due to intolerance/allergy/sensitivity. (I am eagerly waiting for some entrepreneur to come out with an MCT powder without ANY milk-derived ingredients)

  33. Great suggestions for dairy replacement! I am new to keto and the reliance on many dairy products to meet macros was frustrating.

  34. I developed lactose intolerance a few years ago but luckily have found I can eat most hard cheeses and butter without issue. I second the idea of adding MCT oil powder along with nut milk to coffee and tea for a creamier latte–that’s become a staple for me! Thanks for the great tips and the chance at a giveaway!

  35. I would love this prize. I have type 1 diabetes, celiac disease, autoimmune glomerulonephritis, and polymyositis scleroderma overlap syndrome plus multiple food sensitivities and allergies. Hooke me up! i would like any info on the above – es[especially primal for T1D.

  36. Great article, Mark. I would love for you to address adrenal dysfunction in the context of a Keto diet. Should a Keto diet be avoided entirely or are there modifications one can take to make it doable and prevent an adrenal crash?

  37. I picked up your Keto Reset book after researching dietary treatment for epilepsy. I also have a goal to do a half marathon on every state so my reading led me toward the transition to become fat burning. I’d love more information on these two topics. Thanks for all you do!

  38. I just started Keto after watching a friend of mine find extremely good success so far. I bought your book this weekend, The Keto Reset Diet, and am soaking up all the information I can. I’ve lost four lbs. so far. Thanks for all of the good information and for the opportunity to win.

  39. Great and informative post. was wondring what to do about severe carb/alcohol cravings at night that keep me from going into ketosis. Have a lot of trouble fighting this urge… thx!

  40. I’ve been keto for the past 5 years, thanks for the continued flow of information for all this time. I especially love your weekend love updates

  41. Just starting out on my keto journey. On chapter 6 of the Keto Reset Diet. Can’t wait to get started.

  42. Love Primal Kitchen mayo, dressing and avocado oil!! It makes living keto a joy and delicious bliss!!!

  43. Thank you so much for thinking of us folks with intolerances, seeing all these wonderful recipes that I can’t eat is a little bit frustrating.

    Do you think I could handle whey if I can’t handle butter? I have a casein intolerance but I’m not sure about lactose.

    1. Ok, I read the article on dairy intolerance you linked into the lasted blog post and I understand more about the issue. The take away is that I don’t know if I’m intolerant to casein or whey or both. Thanks!

  44. I’d love more info on the road back from insulin resistance/diabetes. Do we really need to get down to 20g total carbs a day to normalize blood glucose as some books/experts recommend if all carbs are from fresh whole veggies? Once blood glucose/weight is normalized, do we need to stay that low in carbs forever or can we relax a bit without risking increasing insulin resistance and blood glucose again? I love me a Big Ass Salad or 2 a day and the smallness of my salads at 20g total carbs a day is making me a sad panda!

    1. Don’t quote me on that but I’m pretty sure Mark once recommended not counting carbs from leafy vegetables but only from starchy vegetables like sweet potato or beet.

      1. He does, but I am not sure that applies to a diabetic? Most of the keto for diabetes groups are adamant that no more than 20 grams of total carbs a day from anything is necessary to get blood sugar levels normal. I was at 50 grams initially and while my blood sugar went down, it didn’t get to normal. I dropped to 20 grams about 2 months ago, and my blood sugar is normal now the majority of the time. But it will make me sad if I have to stay at 20 grams to maintain normal blood sugars forever!

        1. Ah, maybe you are right, I’m sorry I can’t help you. I understand perfectly that not knowing is worse than knowing for sure if it will improve overtime or not.

  45. How do anchovies compare to say, sardines, as far as micronutrients go? I’m one of the (seemingly) rare people who like them, and usually count them as a serving of fish, but I’ve wondered if whatever processing they go through lowers their nutritional value.

      1. Cool! I must say I’ve read your comments for years, Wildgrok – always interesting. Glad to have your company on the “like” end of the scale for anchovies.

  46. Thanks for all the ideas, Mark. Looks like I’m doing pretty well with my substitutions, but what I’m hoping is that once I get better with my HIIT workouts and fine tune things that the food sensitivities will subside, as I’ve heard happens for some people.

    I would love to start eating dairy and eggs again.

    What I’m wondering is if there is a reliable way I can test myself to sensitivities, as sometimes I wonder if I’m only hurting, or inconveniencing, myself by cutting out some foods unnecessarily.

  47. Great info! Thank you! 🙂
    So, I know many keto recipes include bacon bacon bacon…yech! I don’t do pork. What’re some other similar fatty meats I can use especially for breakfast?
    Also, thoughts on taking a CLA supp? I’ve been taking Tonalin for a few weeks now with about every meal.

  48. Before changing to the Primal/Paleo diet I was extremely intolerant to eggs and dairy, as in major intestinal discomfort and embarrassing situations more times than I want to remember. Now I drinkmy cream with coffee, again; I eat eggs every single day. I enjoy cheese and my love affair with butter knows no bounds! The keto diet has taken my health next level and I thank Mark and Brad for another excellent tome and reference book for a burgeoning nutrition consultant.

  49. These are great ideas! I recently found out I am sensitive to eggs and have been toying with the idea of trying keto but thinking it might be hard without them. They’ve been hard to replace. Thanks for the information, Mark

  50. I was doing keto sans dairy for awhile, and although I hated coconut milk in hot coffee, I loved it in an iced coffee. I actually switched to a caffeinated version of golden milk for my morning hot beverage.

  51. Thank you Mark for this article. I’m just beginning my Keto adventure to see if it helps with my Crohn’s disease. The information you’ve provided here makes me feel very encouraged! Keeping myself positive is a bit hard at times but knowing what to include and alternatives for appropriate nutrition is helpful.

  52. Getting ready for the 21 day challenge. Rheumatoid arthritis, extra pounds and 66 years have brought me to this point. Changes are needed if I want to finish strong, And I have lots left to do. Keto looks like an excellent option and I love the support and enthusiasm here.

  53. I’m new to keto, and thanks to Hashimoto’s disease, I have battled weight gain my entire adult life. The principles behind keto seem sound, and I am looking forward to seeing if it will kickstart my broken metabolism. I have baffled repeatedly all of my doctors by continuing to gain weight on even the most restricted “diets.”

    Even though the weight loss would be wonderful, I will simply be happy if the keto lifestyle helps me feel better. There few feelings that are worse than being a prisoner in your own body.

  54. Great topic…many of my clients have had keto questions lately, and some do have dietary restrictions.

  55. Mark, thanks for all the time and hardwork you’ve put into this. When I look for information regarding diet, it is usually for eating this way without a gallbladder. I do have some hiccups every once in awhile. I have learned that if I fast for anytime longer than while I’m asleep, it’s usually no good for my stomach. I would love to learn more info though!

    Thanks again,

  56. Great article. I can’t digest dairy but have been keto for a year now. I love MCT oil and macadamia nuts! I do ghee just fine. After awhile I don’t miss the dairy. You adapt. I would like to know more about small fishes for the diet other than sardines. What seafood recipes do you have for them.

  57. What health conditions and healing protocols are you looking for more information on? A particular autoimmune disorder?

    Sort of a vague request but I guess more information on gut health? I eat a very clean primal diet (TONS of veggies, highest quality fats and meat) but my gut is only good when I eat TONS of probiotic-rich food like saurkraut. Only when I eat a large amount with every meal will my gut function healthy.

    I feel like this is abnormal and that most don’t need a huge amount of probiotics all the time?

  58. Thanks! Just starting to do the keto after being gluten free for a while. Hoping to finally get rid of this stubborn fat!

  59. Thank you for this article! I have been doing Keto with real food for two years, but have been considering removing dairy from my diet for a month or two. This information is extremely helpful! I’d love to hear more on skin issues (psoriasis, eczema, and dermatitis) and Rheumatoid Arthritis.

  60. Hi about this:

    What health conditions and healing protocols are you looking for more information on?
    Please can you comment on this topic:
    Recommendations for mildly hypothyroid people who take synthoid/levothiroxine

  61. Ok I am ready for my goodies to arrive on the mail:

    Primal Kitchen Cookbook
    Primal Kitchen® Advanced Whole30 Kit

  62. I always enjoy your articles even though I don’t consider myself paleo or Keto? I simply follow what seems to work for me … I believe my reason is more to do with having to be accountable for counting protein fat and carbs and measuring ketones etc … I have been doing some form of daily intermittent Fasting now for quite some time and recently trying a shorter window of time … can someone be a fat burner by simply fasting daily and not worry about what they eat during their feeding time? I would love to hear your thoughts on this … also a I am a 56 year old female and I remember reading an article you wrote about the differences between male & female in regards to Fasting … sorry for the novel! Happy New Year to you and your family!

  63. I am one of those lucky people who is allergic to both casein and whey, cannot tolerate any ghee on the market, and is allergic to eggs – yolk and whites, chicken, duck, etc.. I spent years trying to find a variation of either that maybe I would not be allergic to, but I’m allergic to it all.
    I take Calcium-Magnesium supplement from Natural Calm, although I keep hearing supplementing calcium is bad. I truly hate sardines (and that’s another thing I’ve tried to force myself to like), so does bone broth work? Do you get enough calcium from the bones to be enough? Or, is my supplement ok?

  64. I appreciate your research and information so much! Would love to win, but mostly I already win with the information you give. It’s practical and applicable. Thank you.

  65. Upon using coconut oil, my Total Cholesterol rose from 220 to 265 with no real increase in HDL which basically remained the same (going from 49 to 50). So, my TC/HDL ratio did not decrease but increased from 4.48 to 5.3. I’m not quite sure whether I should continue consuming coconut products (coconut oil, cream, and milk) even though I enjoy their flavor profile. If possible, could you please comment further on this issue? Thanks so much for all the consistently excellent work that you do! I always look forward to your posts with great interest.

  66. I don’t have a question about an autoimmune disease, but rather how can primal or keto help with anxiety?

  67. Thanks for a great article Mark on Keto. I am curious to know more on how to avoid red meat and alternatives for that in keto since I don’t digest that well.

  68. Two things I’ve been curious about lately: what is the least inflammatory fat source for cooking and what foods are known to fight infections?

    An alternative probably more obscure question: how risky would you say raw meat & fish are such as sashimi, beef tartar, or a simple hunk of raw steak?

  69. This was really interesting. I have a feeling I should try to eliminate dairy, at least for a while, but really don’t want to! Have you considered creating cookbooks for elimination diets? Not a single cookbook that includes a few recipes for each food intolerance, so most of the book isn’t relevant to most people, but say a “dairy free” cookbook or an “egg free” cookbook that covers mains, lunchbox foods and the occasional snack or treat?

  70. I’ve been looking at keto because of anti inflammatory effects to combat Ankylosing spondylitis. My wife is suffering from it so we are both gong keto. There is a theory out there that klbsiella in your gut contributes to the inflammation and starving it of starch helps with the pain. What do you know of it? Can you recommend other articles on the site?

    This article is really helpful because my wife has also become intolerant to dairy, it makes things difficult.

  71. Happy to see the egg allergy discussed – that has been a big one for me since an egg allergy appeared rather suddenly!

  72. Good information as my kids have dairy allergies and we try to make the same meals for all of us.

  73. Hey Mr. Mark
    I am excited to find your books and website. I have read the Keto Reset diet book and the Primal Blueprint. I am way too skinny, I have a lot of health issues, leaky gut, gluten and dairy sensitive. I have been Vegan for ten years and vegetarian before that, but now I have made the dramatic change to the Keto diet now trying to be a pescatarian on the Keto diet. Whats your opinion. Do you think I have to eat beef and chicken to be successful on the Keto diet? One of my main reasons for going Keto is Brain Health. Your information on your website and in your books has been a humongous help to me. I like your simple no stress approach. Thank you for all your knowledge, information and experience. I also use to be a Triathlete when I wore a younger man’s shoes. I am now in my 50’s

  74. I would be interested in the effects that keto has on the different types of skin cancer. Living in the Northwest without sun for much of the time has me concerned, I take Vit D but it’s been over 60 years without Vit D supplements.

  75. I’m curious about A Keto plan for folks with Hashimoto’s thyroid disease. Thanks for this great post and giveaway!

  76. This is great information for me as a beginner. Thank you! I’m allergic to dairy and wonder if I’m allergic to eggs also. I have hypoglycemia and tinnitus.

  77. Great Post. I still consume dairy but deep down I believe I could do better without it! I’ll try some of the replacements.

  78. Health condition: none
    Healing protocols: I’d like you to go meta and discuss when to use different protocols. I recently read your Keto reset book and Dr. Fung’s guide to fasting. They both offered healing protocols that one could go on and off of in a targeted way, while also preaching Low Carb High Fat diets for the rest of the time. This is different from a lot of diet books. So, what I’d like to see is an analysis of different protocols and a guide as to when one might want to use it as well as anything to watch out for.

  79. I enjoyed reading about altetnatives to the traditional keto diet. I have been dairy free for a long time and have just come back to it to go keto for weight loss and joint pain. Thank you for the information, very interesting.

  80. I’m interested in foods to flush and heal the liver. The more I read, the more important liver health is to overall health. Thank you for the fantastic giveaway!

  81. I SO appreciate this article. While my wife does not have a dietary restriction, she is super picky about dairy. This makes it difficult to get her macros and make her feel satiated. This definitely helps! Thank you.

  82. Useful and thoughtful information as always. I’ve been doing Primal for a long time and decided to try Keto this month. I don’t have any apparent food sensitivities, but I do have a copy of ApoE4 and wonder if keto is going to really mess with my cholesterol levels… What do you think about keto and dairy/saturated fat and ApoE4?

  83. I have celiac disease and issues with absorption of primarily iron and vitamin D. I am interested in keeping to the keto but also increasing vitamin intake and absorption.

  84. Have just been diagnosed with autoimmune hepatitis….have been doing Keto for a couple of weeks and have lost 7 pounds….also have thyroid issues and doctor says not to do Keto…I’m so confused, and I’m sure this would help me out! Thanks!! Susan

  85. I would love to read more about optimizing natural testosterone levels. I’ve always wanted to get tested because I suspect I have low T, but I’ve never been able to afford. But if I can get ahead of the game and coax my body into manufacturing the most T it can, that would be amazing!

  86. I’ve been eating keto for 3 years now and i’m running out of ideas to keep it interesting. Help! I believe I am allergic to wheat. I always feel so much better when I’m doing keto. I’ve actually done it for over 10 years on and off but 3 years straight now.

  87. Thank you for your knowledge. I have rheumatoid arthritis I take injectables to control the symptoms. I also have 3 1/2 hour hyperglycemia and really have to watch my blood sugars. My question is what combinations of paleo/keno foods help balance both conditions?

  88. Hi Mark, I’ve been subscribed to your email/newsletter for several years but now that my husband is on a ketogenic diet and I am on my first round of whole30 I am finding myself continually drawn to your blog with so much relevant topics and information. I’m not sure what I would like more blog topics on but I really appreciate your work and example. Thank you!

  89. Love it, I like to do vegan keto, although really difficult if soy is intolerable. is a great vegan keto resource. Cricket protein hemp protein, chia, flax, etc, plenty of green veggies & avocado

  90. Vegetarian here, am very much looking forward to that article :).

  91. Great post! I’d love to see information about nutrition/exercise protocols for dealing with stress fractures (and preventing them).

  92. I have issues with dairy so this post was extremely helpful! There are so many keto recipes that have dairy in them so it’s been difficult. Also, I’m obsessed with the primal mayo. So yum!!!!

  93. The word “Gluten” in the picture really piqued my interest… That’s some first-rate trolling, Mr Mark!

  94. I enjoyed reading your article and find that I feel so much better when following a keto lifestyle. Am glad it is getting the attention it deserves.

  95. Thank you! This makes things a bit less intimidating. I’m trying to prioritize how to put myself, my hormones and emotions back together after a decade of a roller coaster ride. Keto is moving up my list as I begin to study it in depth. I’d been taking a break from health goals to work on traumatic symptoms, but the two are so deeply connected. I’m also slightly desperate to get this all figured out before moving forward with fertility goals. I would like to feel calm, clear, safe, and powerful in my body. I’ll get there. Thanks again for the help.

  96. I enjoy your daily apple, oh, about once a week . . .I am a personal trainer and am often asked about Paleo and Keto lifestyles. While it is out of my scope of practice to dispense dietary advice, I often refer folks to your site for what l consider accurate, no-nonsense answers to their questions. Personally, I enjoy a Paleo lifestyle as it keeps me energized, lean and clear. Carb indulgences over the holidays proved the point that as a pre-diabetic, post-menopausal woman, Paleo, LCHF and/or keto is the best solution for me. Thanks, Mark!

  97. I have an autoimmune disease called CREST Syndrome, a limited form of schleroderma. My body over produces collagen, what can I substitute for that in recipes?

  98. So great. Going Paleo then Keto had been a game changer for our health. Thanks for all you do to further the endeavor to help us all become healthier!

  99. Thanks for the info on what to eat to replace the vitamins & minerals if you have an allergen/sensitivity to something. I’ve gotten stuck & am starting to clean up again. Would also love more info on fighting Hashimoto’s. I’m still experimenting on what works & what doesn’t. Love to hear more.
    Thank you

  100. Best foods to naturally increase testosterone and energy.

  101. I’m not allergic to eggs but just dislike eggs and need help for breakfast. I usually only eat bacon and have coffee with heavy cream for breakfast and it’s getting old.

  102. I’d like some more information on the safety on women fasting. I hear about the great benefits of a 5 day fast, but then again hear how it might put a lot of strain on a women’s hormones… I’d really like to give it a go, but don’t want to do myself any harm.

    I’d also love some more guidelines on having our little ones following a more primal lifestyle, my daughter will be turning 4 later in this year.

  103. I love keto. It’s been a huge help with my diet restrictions. I feel amazing and so much healthier.

  104. I just ordered your Keto book! My doctor recommended a Keto diet to get back on track, and I’m so excited that you have researched how to do it with real food.

  105. Wow so much great info! I am currently struggling with my energy levels. I’ve never had this issue while on keto before and I am getting the same amount of sleep I’ve always had so I’m not sure if I’m lacking in something or what!

  106. Greetings! I have been following a keto diet for nearly three months. I never thought I could give up the vast amount of carbs I was addicted to. I am losing weight and feeling great . I would love to get more information on a keto vegetarian lifestyle. I presently have type 2 diabetes. I want to learn more. Thank you so much for all you do.

  107. Thanks, for the info. I have nut allergies and my hubby is dealing with GI issues. He was told to try low fodmap/ gluten-free, but has difficulty complying. Hoping keto can help.

  108. I’ve been doing Keto combined with intermittent fasting for a year (a few weeks off for the holidays) and now I’m on day nine of what I hope will be a 12-day water fast. I am not interested in this eating plan for weight loss as I am already on the low end of my normal BMI. I have found relief from an inflammation issue that is causing serious symptoms in the Keto diet and now hope the extended fasting will kick in some autophagy to heal my nervous system. So far, I’ve seen positive results. Thank you for all the information and the recipes you share with us. Every day I look forward to see what your post will be about and what I will learn from you.

  109. Thank you so much for focusing on dietary restrictions. It’s difficult to get consistent information on the topic in relation to the ketogenic diet. Early on I was diagnosed with Graves disease and I’m now relying solely on synthetic thyroid supplements, is it still okay to consume a significant amount of cruciferous vegetables on the keto diet? I would also like to ask if it’s necessary or even beneficial to take a kelp based iodine supplement? Any information on thyroid issues and a sluggish metabolism would be a big help!

  110. Thank you for bringing your wisdom to us! I’ve had fibromyalgia for years and decided to go paleo but in the last three years have also gotten chronic fatigue syndrome and so I’ve decided to take it a step further and try going keto! I really hope it helps with this as I’ve been quite debilitated with both conditions. Keep up the excellent work you are doing in order to help keep us healthy!

  111. Love your post. I’m new to the keto lifestyle and to have more options and put in such an understanding way and broken down the way you do is fantastic! Thank you for your knowledge!!!

  112. If life were a true lottery, my name would’ve just been called to go to the island. (Like the movie). I am the progeny of two of the most disease ridden family trees coupling. Yay me. I exercise daily. I eat really really well considering what little i can afford. I have tried keto and must’ve been doing it wrong despite following every recipe i could afford in every keto cookbook my library has. I try to get outside but i live in western oregon. I see sun only july-september. Maybe. Huge maybe. All my cholesterol labs had even my naturopath nervous. Which made me nervous. I dont need to lose weight really. I need the great health a young looking girl of 38 SHOULD have. I am envious of those with great health that barely try if at all. I need tutelage above all i believe. But honestly i don’t know what i need. *sigh*

  113. I like this was written. I battle multiple road blocks, but am making my way to a healthier me. I have fibromyalgia, and just had a hysterectomy on Nov 30 because of Endometriosis, fibroids, unknown cause of pain (think from previous surgery), PCOS, and family history of cancer. I have some restrictions still from surgery and complications when it comes to exercises because of not only the fibro but lax ligaments, hypermobility syndrome (and complications from the combination of them all). I am currently being tested for MS. I have also developed over 70 total allergies since being diagnosed with fibromyalgia. 40+ are environmental, 26 are foods, and the rest are medication. On top of those I have chemical sensetivities as well. The more under control I get my allergies the better my pain is and less flares I have. Keto has helped me the most. I’m planning on making this a life long journey and not a fad crash diet.

  114. I really loved your suggestion of the Turkish breakfast. There is a good blogger, Maureen Aboud, who reminded me of this blast from my past. Geek yogurt with mint, red pepper flakes and olive oil surrounded by cucumbers, olives, peppers and maybe some chicken for dipping? Definitely breakfast tomorrow for me!

  115. My husband and I jumped on the Keto wagon in October 2017 and have never felt better. We are still learning new techniques and experimenting with new recipes to keep us in ketosis. Thank you, Mark, for introducing us to this delicious world!

  116. We just found out our daughter has Celiac disease, so we have become so much more aware of what we are eating. We think dairy might be an issue for her as well, so these substitutions are great!

  117. How about a post on dysautonomia conditions and diet? Or casein and mental health? This last one is why I don’t eat dairy (except for ghee). It makes me anxious/depressed/obsessive and paranoid.

  118. I just started learning about KETO I love the benefits for the brain. I have multiple sclerosis and I am looking for ways to help get through this. I would love to read anything you may know in that area. 🙂

  119. I’d love to win this, battling an autoimmune disease…thank you

  120. I am thinking about inflammation now in middle age. I’ve read so much about its being a component in many chronic conditions. Food seems to be the best way to control it. Keto FTW! Great giveaway- thanks for the chance!

  121. This is great information. I’m just starting my keto journey. I’m 56 and have not been able to lose weight once my thyroid died and menopause hit. I’d love to feel good about my body in this phase of my life.

  122. Mark, can you recommend foods that will heal nerve damage from a stroke? I have also lost much of my gains as well, should I increase my protein intake?

  123. What do you believe about raw dairy products, namely milk? I’ve read that raw milk contains the enzyme Lactase because it hasn’t been pasteurized, which then transforms into Lactose. Supposedly those with a lactose allergy are able to easily digest dairy that isn’t processed/pasteurized.
    I fear that I rely on nuts too easily since I’ve shifted my nutrient intake towards Paleo/Keto. With the added nut butters, but milks, nuts, nut flours, the calories add up quickly and maybe hindering weight loss. Have you found this to be true or a concern of others?

  124. Am I too late, or has the US/UK time difference given me the slimmest of chances? A fine post, Mark.
    I have never tried your produce but have supped from the cup of your wisdom and found it enriching. I hope I will get the chance to see if your mayo matches.

  125. I am fairly new to the Keto way of eating and am learning as much as I can. I have enjoyed your articles and look forward to learning more.

  126. Sounds really amazing! I am fairly new to this, less than a month, and am blown away by the good things that this change of eating is doing for me. Can’t believe I am not hungry/eating all the time and carb cravings ate gone. Can’t get enough new recipes.

  127. I’ve been wanting to go keto but my need to go dairy free has stumped me plus the ratio of magnesium plus potassium confuses me. This article answered a lot of questions for me.

  128. Thank you so much for the great article! I just found you, and you sound great! I’m interested in thyroid/autoimmune helps w/keto as I have Hashimoto’s thyroiditis. My husband also seems to have a lot of general inflammation. I’d love to win as I’ve heard of the whole 30 but don’t know how to do it and would love a cookbook to help us! Thank you so much!

  129. Hi I used 3 day water fast to transition from primal to keto. Has been really easy so far (1week). Does potato starch carry a carb load, does anyone know?

  130. In the UK we have had a lot of headlines recently about transgender children. This seems much more of a problem than it was when I was young (I’m 69). Do you think this is diet related?

  131. I’m trying to lose weight and gain mobility following a stroke, and Primal seems like the best option for me.

  132. I have been reading up on the Keto diet for a while now. I’m very interested in starting it to lose weight. My only concern is that I’m about 90 pounds overweight and I have high blood pressure. Is there anything to watch out for at first?

  133. Stevia with coffee and cream! I knew i was doing it right . . .

  134. “How To Replace the Easy Breakfasts?
    Eat some combination of bacon, smoked salmon, olives, cheese, Greek yogurt. ”

    Is it realistic, honestly, smoked salmon is always farmed, isn’t it? At least the brands you see in stores in France (monoprix, carrefour, leclerc etc.) are. I mean, there are probably some brands of PCB free wild caught smoked salmon but I Wonder how much this stuff costs 😉

    What I mean is that you must take MDA with a pinch of salt and take a critical look at the advice… But I’m still in love with that website 😉 🙂

  135. Thank you for the information. I’m going to have to look into AIP. I have multiple autoimmune diseases, and I need to get a handle on them.

  136. I’d love to see more information regarding Lyme and dietary protocols in order to heal from it!
    But of course that can be difficult, since the disease is so vast in symptoms and bacteria.

  137. So -I’ve just been diagnosed with Hashmito’s Thyroiditis… I’d like to go Keto but have heard from Elle Russ and others that with Hypothryoidism one shouldn’t try to go to keto until it’s under control… I’m not quite there yet… are there risks of going keto? I looked at the paleo AIP diet and man that is really restrictive!

  138. Thanks for these suggestions. I’ve managed to work my way to things that work for me but more options are always welcome.

  139. My teen was just diagnosed with thyroiditis nodules, hypo, and thyroiditis Shortly before had been diagnosed with generalized epilepsy and POTS so her health is all over the place. Looking for a healthy diet for her to help multiple symptoms.

  140. Thanks again for all of the information. This week I used the Primal Kitchen Chipotle mayo and mixed it with an avocado/cilantro sauce that I made. It was an amazing chipotle/avocado/cilantro aioli that the people in my office enjoyed (I had it on a burger smothered with onions and peppers), and when I told them it was a healthy mayo that was used they were all surprised and a couple got the recipe.

  141. Great post! Though it isn’t physiological, I’ve won my wife over to the primal side after lots of initial resistance, but she just can’t seem to shake an aversion to egg yolks. I love them (especially in soft-boiled eggs), but she’ll only consider egg whites.
    I’m convinced she could like them, but it seems hard-wired into her brain that yolks are untouchable (maybe from past conditioning that whites are the “healthy part” of the egg).

    Any suggestions on how to introduce yolks to non yolk-eater? She’s missing out!

  142. Great info!!!! Dairy products definitely bother me, and for about 10 years I’ve been using supplements to make up for the calcium. I also learned to love spinach!!!!

  143. This was really helpful, as I have an allergy to both eggs. I’m thankful for the supplementation ideas you suggested.

  144. My husband and i have been together for 9 yrs. He is a huge meat eater and im into veggies, we have each put on 40 pounds since we met. I was thin and toned but then we began eating more his style. Im not happy with my current state of circumstances he keeps feeding me even when i tell him no. Allot of girls at work are going keto, this sounds like something id love to try. I just dont know how to introduce it into our lifestyle and help my hubby help me.

  145. I’m very interested in the keto diet, and have recently started making kidney stones (yay!!….) so may have further diet restrictions once the stone analysis comes back. Very insightful and useful info as usual. Thanks Mark.

  146. I sometimes have trouble with eggs when I eat a lot of them (a few times a week is fine, but daily is too much). So I came up with a delicious breakfast (which also works as lunch or dinner): avocado, bacon, tomato and arugula, tossed with bacon fat and a bit of lemon juice or vinegar. It’s such an amazing combiation – creamy, crunchy, juicy, sweet, salty, peppery, all at the same time. And the bacon still makes it feel like breakfast somehow. You’re welcome 😉

  147. Ive recently found out I have high estrogen, low progesterone and low testosterone. I’m a 35 year old female with 2 kids, not overweight and fit. I also have hypothryoid as per those same blood tests. I’ve read that they are related but I’m not sure what all to do about it? Thanks so much Mark – you are the best!

  148. I thought one of your closing food comments was interesting… “Gluten…You’re not really worrying about this, are you?” In my practice as well as many doctors that practice functional medicine, we see a lot of patients with gluten and gluten cross reactivity issues. Many say it’s not a real problem, however when all else is ruled out and specific laboratory testing is done, often gluten is a problem. It is a common problem, more common than people realize. I’ve had tons of patients diagnosed with Hashimotos that have never been told to be on a gluten free diet. I was kind of hoping you were not part of the “gluten is a non-issue” crowd. The proof is in the blood tests. Other than that little comment, excellent article and, I have to say, I love the recipes you’ve posted over the years. Great stuff, keep it up! Miamibeachdoc

    1. Todd M Narson, let me clarify. I made that comment tongue-in-cheek because it’s known I don’t support grains or gluten in the diet. For folks who are living the Primal diet, gluten isn’t an issue because they’ve already cut it out of their diets. Glad you’re here!

  149. I would be so happy to win your new book and all of your primal kitchen foods!! I love to eat healthy so these products and new recipes would be perfect for me.

  150. How often do you see food allergies subside after spending a while going Primal? I used to have an unpleasant reaction to raw carrots and apples, but recently I realized I’m totally fine with them. Macadamia nuts really bothered me too, I should try them out again, knowing how much Mark loves them.

    I just got my Primal Kitchen cookbook, it’s phenomenal, and I don’t use that word lightly. We are going to be eating new recipes for months, and start making mayo again!

  151. Great article. Thanks a lot for sharing the insights. I just would leave a notice on the vitamin D part which for some people may not be a good idea to supplement. Being better to stay in the sun if you didnt have your lvls checked.

    Do you have info on that?

  152. I’m currently waiting on my third bowel resection of the small intestine due to Crohns Disease. I’m very close to losing the last metre. At that point I fear malabsorption of vitamins and minerals will become an issue. A healthy diet will not be enough. I currently take a good multivitamin, good quality fish oil, probiotics, turmeric and vitamin d for winter. After the op in two weeks i’m like to tackle whats left of the inflammation. Can you focus on primal healing foods? I realise there are plenty of articles and i am working my way through them.

  153. I am new to Primal eating. I have avoided dairy and grains for about a year to help heal my thyroid issues. Now I know I can add dairy back in, but will continue to limit grains. Thank you Mark, for the valuable information you continue to share with us.

  154. I don’t want to throw a fly into the ointment here but James Krieger (of ‘’ fame) recently posted some links to a couple of very thought-provoking studies apparently showing deleterious effects of butter consumption:

    Firstly a study contending that what makes butter particularly harmful, compared to other types of dairy fat, is that it is low in milk fat globule membrane content. This study shows how butter increased LDL, but whipping cream (also dairy and high saturated fat) did not:

    Secondly, a 2015 study showing that even a moderate intake of butter increases LDL: although of course that may not be a negative thing in and of itself (depending on the LDL particle size):

    I’ve also heard the well-known keto advocate Dominic D’Agostino mention a few times in various podcasts that he significantly cut down on the dairy fat in his diet (switching more to coconut oil), and his raised LDL went down very significantly as a direct result. Coincidence?

    Any thoughts on those studies Mark: time to call time on your love affair with pastured butter?

  155. It’s a challenge trying to follow a keto diet as a family. At least our family anyway. A daughter with nut allergies and a son with autism that we are having good results with by avoiding dairy. It can still be done though!

  156. Keto diet restricts few nutrient-dense fruits and food like legumes, and whole grains. It might not be able to provide the required vitamins and minerals to the body. The keto diet doesn’t provide phosphorus, vitamin D, and calcium. Over time, this shortage leads to nutrient deficiency.