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In a 12-month study, a classic ketogenic diet resulted in higher levels of BOHB (and acetoacetate) over all time periods (three, six, and 12 months) but this was only statistically significant at three and six months (p Neal et al., 2009). Huttenlocher first observed higher BOHB levels in children with epilepsy aged 2–9 years, at up to one month on an MCT ketogenic diet, and marginally lower after this time, when compared to a classic ketogenic diet, although these differences were not significant (Huttenlocher, 1976). There is a paucity of studies on time to NK and mitigation of symptoms of keto-induction an as data related to the effects of various supplements on time to induction of ketosis and on symptoms of keto-induction are limited, and there is a lack of homogeneity between study objectives, outcomes, and measures, a narrative review style was chosen. There have been several methods suggested to reduce symptoms of keto-induction and to reduce the time taken to achieve NK, including the ketogenic amino acid leucine, short chain fatty acids, medium chain fatty acids, and exogenous ketones. Several studies have described adverse effects during ketogenic diets but to our knowledge, no studies have specifically described symptoms of keto-induction in the short time between commencing a ketogenic diet and the achievement of NK. Very-low-carbohydrate ketogenic diets (VLCKDs) are becoming increasingly popular for mainstream and athletic use for a range of outcomes including weight-loss and maintenance (Bueno et al., 2013), improved satiety and a reduction in hunger (Paoli et al., 2015; McClernon et al., 2007; Johnstone et al., 2008). Few studies have specifically evaluated symptoms and adverse effects of a ketogenic diet during the induction phase. First, a distinction has to be made between studies using low-carbohydrate diets and studies using ketogenic diets aiming to achieve nutritional ketosis. ΒHB, beta-hydroxybutyrate; g, grams; GI, gastrointestinal; HR, heart rate; KDT, ketogenic diet therapy; kg, kilogram of body mass; MAD, modified Atkins diet; Obs, observational study; Pts, participants; RCT, randomized controlled trial; RER, respiratory exchange quotient. A Spanish randomized study evaluated the effect of an 8 week hypercaloric ketogenic diet (39 kcal/kg/day, 11]. Of 11 participants assigned to the ketogenic diet group, two did not achieve ketosis and were excluded from the analysis (18% attrition). The most common reported adverse effects were exacerbated tremor or rigidity in the ketogenic diet group. You can choose a light dose for a mild enhancement to your road trip or go all out with a higher dose for a more profound, introspective journey. 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