I was terrified to tell my doctor I was doing keto.

I’d read the internet. I’d seen the articles about keto being “dangerous.” I expected a lecture, a shake of the head, maybe a disappointed sigh.

Instead, I got something much better: a real conversation with a medical professional who listened, asked good questions, and gave me honest, balanced advice.

Here’s how that conversation went — and how you can have it with your own doctor.

Why I Was Nervous

Before keto, I had a complicated relationship with my doctor. I’d gained weight with each pregnancy. Each annual visit, the scale showed a higher number. Each time, we had The Talk — “you should eat less, move more.”

I’d tried. I’d failed. I felt like a disappointment.

I was scared that telling her I was doing keto (a “fad diet,” in her eyes, maybe) would get me another lecture. Or worse — that she’d tell me not to do it.

But I also knew that if I was going to change my body this drastically, I needed medical supervision. I’m not a doctor. I don’t know what my blood work looks like. I needed a professional in my corner.

How I Prepared

Before the appointment, I did three things:

1. I Wrote Down My “Why”

I wrote a paragraph explaining why I wanted to try keto:

“I’ve struggled with my weight for 5 years since my third pregnancy. I’ve tried calorie counting and low-fat diets without lasting success. I’ve researched the ketogenic diet and believe it may help me address my weight, energy levels, and blood sugar. I’m asking for your guidance, not your permission — but I want to do this safely with your help.”

Having this written out helped me stay calm and clear during the appointment.

2. I Asked for Baseline Blood Work

I requested a full panel before starting:

  • Lipid panel (cholesterol)
  • Fasting glucose
  • HbA1c
  • Kidney function (BUN, creatinine)
  • Liver function
  • Thyroid panel (I have a family history)

This gave us a starting point to compare against in 3 months.

3. I Brought Research (Respectfully)

I printed 2 articles from reputable medical sources (not blog posts — actual studies and medical reviews). I didn’t bring a stack. I didn’t argue. I just said: “I’ve read these and they seem balanced. Would you be willing to look?”

She did.

The Conversation

Here’s roughly how it went:

Me: “I want to try a ketogenic diet. I’ve struggled with my weight for years, and I’ve done my research. I’m not asking you to approve it — I’m asking you to help me do it safely.”

Doctor: “I appreciate you coming to me with this. Let me ask you a few questions.”

She asked:

  • What exactly are you planning to eat?
  • How long are you planning to do this?
  • Do you have any history of kidney or liver issues?
  • Are you breastfeeding? (I wasn’t — Mason was weaned)
  • What medications are you on?

Then she said something I wasn’t expecting:

“I’ve seen patients do very well on keto. I’ve also seen people do it badly — not enough vegetables, too much processed meat, no electrolytes. The diet itself isn’t the problem. Execution is.”

She gave me three pieces of advice:

1. “Focus on Whole Foods, Not ‘Keto’ Foods”

She said the people who do well on keto eat real food — meat, vegetables, eggs, healthy fats. The people who struggle eat “keto” versions of junk food — keto cookies, keto bread, keto candy.

This was validation of what I already believed. I don’t buy keto packaged foods — and she confirmed that’s the right call.

2. “Get Blood Work at 3 Months”

She wanted to see my lipid panel and kidney function at the 3-month mark. She said:

  • “Your cholesterol may go up initially, then stabilize or improve. We need to see the trend, not just one number.”
  • “If your kidney function changes, we need to know — but keto doesn’t cause kidney problems in healthy people.”
  • “Your fasting glucose should improve. That’s one of the main benefits.”

3. “Don’t Restrict Calories Aggressively”

She said: “Keto works because it changes how your body uses energy. You don’t need to starve yourself. Eat when you’re hungry, stop when you’re satisfied. If you’re losing more than 2 lbs per week after the first month, we need to check that you’re eating enough.”

This was reassuring — I’d been worried that keto required calorie counting. She said it didn’t, as long as I listened to my body.

The 3-Month Follow-Up

Three months later, I went back. I’d lost 22 lbs. My energy was better. My sleep was better. My joint pain was gone.

Blood work results:

  • Total cholesterol: Up slightly (as expected) — 210 → 218
  • HDL (good cholesterol): UP — 45 → 58 (this was great news)
  • LDL (bad cholesterol): Basically unchanged — 130 → 132
  • Triglycerides: DOWN significantly — 145 → 78 (huge improvement)
  • Fasting glucose: DOWN — 98 → 85
  • HbA1c: DOWN — 5.6% → 5.2%
  • Kidney function: Normal, unchanged
  • Liver function: Normal, unchanged

My doctor’s response: “These numbers are good. The triglyceride and glucose improvements are significant. Keep doing what you’re doing. Come back in 6 months.”

She was genuinely pleased. Not every keto story goes this way — some people see cholesterol rise significantly — but my results were positive.

What I Learned From This Experience

  1. Most doctors aren’t anti-keto. They’re anti-bad-science and anti-people-doing-it-unsafely. If you show up informed and respectful, most will support you.

  2. Bring data, not opinions. Saying “keto works, I read it on a blog” doesn’t help. Saying “I’d like baseline blood work and a 3-month follow-up to monitor my health” shows you’re serious.

  3. Ask for their guidance, not permission. You’re an adult. You’re allowed to make your own choices. But framing it as “help me do this safely” makes the doctor your partner, not your gatekeeper.

  4. Get the blood work. If you’re going to change your diet this dramatically, you should know what it’s doing to your body. Baseline + 3 months + 6 months.

  5. If your doctor dismisses keto without discussion, find a new doctor. I’m not saying your doctor should prescribe keto. But they should be willing to engage with you, monitor your health, and adapt their advice based on your results.

What to Ask Your Doctor

If you’re preparing for this conversation, here are the questions to bring:

  1. “Can we do baseline blood work before I start?”
  2. “What should I monitor specifically?”
  3. “Are there any reasons this might not be safe for me based on my health history?”
  4. “How often should we follow up?”
  5. “What changes would make you concerned?”
  6. “If my cholesterol goes up, what would you recommend?”

A Note on Medical Disclaimers

I’m not a doctor. I’m sharing my experience, not medical advice. Your body is different from mine. Your health history is different. Your medications are different.

Please talk to your own doctor before making major diet changes. This post is about my personal experience — not a prescription for you.

If you have:

  • Type 1 diabetes
  • Kidney disease
  • Liver disease
  • A history of eating disorders
  • Are pregnant or breastfeeding
  • Take medications that affect blood sugar

…you absolutely need medical supervision before trying keto. Not optional. Required.

If you’re starting keto and want a beginner’s guide + weekly support, subscribe to my email list. I’ll send you my free starter guide, and you’ll get my weekly meal plan every Sunday.