#124. Has anyone tried the ketogenic diet as a FIRST treatment before medications?

Full question: Has anyone tried the ketogenic diet as a FIRST treatment before medications? We are exploring this, but the everything I read talks about using this diet after no response to medication is seen.

Reply: This is an excellent question. I have a lengthy answer. In a 2008 medical article in Epilepsia comissioned by The Charlie Foundation, a group of experts recommended that the ketogenic diet be used first-line for two conditions; Glucose Transpoter Deficiency Syndrome and Pyruvate Dehydrogenase Deficiency. Both are rare metabolic conditions that are greatly improved by ketogenic diets and for which no other treatment is available. Aside from those 2 conditions, the group suggested that the ketogenic diet be considered after the failure of 2-3 anti-seizure medications (or if the medication caused adverse effects that could not be rectified).  Why is this?  Because 70% of people with epilepsy achieve control with anti-seizure medications. That leaves 30% of people with epilepsy that don't achieve control. HOWEVER, there are many very motivated people that wonder exactly what you are; if a diet could control epilepsy then why not try that first? In response to this we've created a simple 2-page guideine for anyone who has epilepsy that wants to try a preliminary diet which could help. It's called "Does what I eat affect my epilepsy": you may purchase it in our Keto Store ($2.50). The guideline outlines two steps, 1) eliminating sugars and 2) eating a whole foods diet with fat. I've had great feedback from people who have followed this strictly for several weeks and have had improvement in seizure control. If you find this difficult to follow, any of the ketogenic diets including Modified Atkins are more restrictive.   Beth Zupec-Kania, RDN, CD