‘Keto’ Diet May Ease Cushing’s Symptoms, but Delay Diagnosis

A young man switched his standard diet to a ketogenic, or “keto,” diet that’s low in carbohydrates and high in fats to lose weight, and saw some of his symptoms of Cushing’s disease ease, according to a new report.

But he wasn’t diagnosed until his symptoms came back or worsened over time, suggesting that a special diet may mask a disease’s symptoms to a point where it could delay or prevent a diagnosis.

“Diseases typically associated with poor lifestyle choices, like obesity and hypertension [high blood pressure], can often have alternative causes,” the researchers wrote. “Assuming that they are due to poor dietary adherence, can allow them to go undiagnosed.”

The report, “Ketogenic Diet Initially Masks Symptoms of Hypercortisolism in Cushing’s Disease,” was published in Metabolites.

Cushing’s occurs when the body has too much of a hormone called cortisol. This condition, called hypercortisolism, results in symptoms such as weight gain and fat accumulation, fragile skin, and high blood pressure.

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Masking Cushing’s with ketogenic diet

When paired with other treatments, a special diet that’s low in carbohydrates can help limit or counteract some of these symptoms.

A research team in the U.S. described the case of an Asian man in his 30s who saw some of his symptoms ease with the help of a ketogenic diet that limits the amount of carbohydrates (or “carbs”) eaten in a day to less than 30 grams, about the amount present in one medium ripe banana or two tablespoons of white sugar.

The man had a history of easy bruising, blood in urine (hematuria), headache, and high blood pressure. He also had excessive amounts of fat around the waist (central obesity). In 2015, he was at his heaviest weight at 179 pounds. His body mass index, a measure of body fat, placed him within the overweight range.

He ate a standard American diet and was active. A typical standard American diet includes a high intake of pre-packaged (processed) foods, refined grains, and high-fat dairy products.

Diseases typically associated with poor lifestyle choices, like obesity and hypertension [high…

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