Advocates for the diet recommend that it be seriously considered after two medications have failed, as the chance of other drugs succeeding is only 10%.[9][30][31] The diet can be considered earlier for some epilepsy and genetic syndromes where it has shown particular usefulness. These include Dravet syndrome, infantile spasms, myoclonic-astatic epilepsy and tuberous sclerosis complex.[9][32]

Jalali recommends that her clients work with a medical professional who is familiar with the diet to get the best results. "I do not think most of the general population would benefit from a ketogenic diet, although it can be very beneficial for some. The diet can be extremely challenging to stay compliant on long term so I find that clients who are very motivated and have a strong support system seem to be most successful."
There are three kinds of ketones, and the urine is only tested for acetoacetate. As you switch to the more efficient fat-burning process, you convert that acetoacetate to beta-hydroxybutyrate. So, yes, your test can show negative or zero ketones. Look at other factors. Are you losing weight? Are you feeling good? If you’re doing 20 grams net carbs a day or less, you’re going to be in ketosis, no matter what.
Normal dietary fat contains mostly long-chain triglycerides (LCT). Medium-chain triglycerides are more ketogenic than LCTs because they generate more ketones per unit of energy when metabolised. Their use allows for a diet with a lower proportion of fat and a greater proportion of protein and carbohydrate,[3] leading to more food choices and larger portion sizes.[4] The original MCT diet developed by Peter Huttenlocher in the 1970s derived 60% of its calories from MCT oil.[15] Consuming that quantity of MCT oil caused abdominal cramps, diarrhoea and vomiting in some children. A figure of 45% is regarded as a balance between achieving good ketosis and minimising gastrointestinal complaints. The classical and modified MCT ketogenic diets are equally effective and differences in tolerability are not statistically significant.[9] The MCT diet is less popular in the United States; MCT oil is more expensive than other dietary fats and is not covered by insurance companies.[3]
Hi Mel, Assuming that your ranch dressing doesn’t have sugar added, you don’t need to worry too much about limiting it, but within reason. This is my homemade ranch dressing recipe, which has 0.9g net carbs per 2-tbsp serving. It would be hard to find a store bought one with much less than that, even though some round anything less than 1g down to 0g, which isn’t truly accurate. Also, keep in mind that if weight loss is your goal, some people find that too much dairy can cause a stall. Finally, make sure you aren’t using all your “available” carbs on ranch dressing – have it with some low carb veggies!
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"Since many of these foods are the primary source of fiber in our diets, many people that start the keto diet will notice constipation as a side effect of eliminating those carbohydrate-rich foods," Fillenworth says. "Fiber is crucial to maintaining consistent bowel movements, helps to keep our GI system healthy, and creates a feeling of fullness when eating." Women should aim for 25 grams of fiber per day to keep things ~regular~.
Achieving ketosis is a pretty straightforward, but it can seem complicated and confusing with all of the information out there.4If you want to learn more about ketosis and the scientific process around it, you can visit a very in-depth discussion about on Dr. Peter Attia’s website. Here’s the bottom line on what you need to do, ordered in levels of importance: