Diets Low-Carb What to Know About Medications and Low-Carb Diets By Laura Dolson Laura Dolson Laura Dolson is a health and food writer who develops low-carb and gluten-free recipes for home cooks. Learn about our editorial process Updated on December 01, 2021 Medically reviewed Verywell Fit articles are reviewed by board-certified physicians and nutrition and exercise healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Barbie Cervoni MS, RD, CDCES, CDN Medically reviewed by Barbie Cervoni MS, RD, CDCES, CDN Facebook LinkedIn Twitter Barbie Cervoni MS, RD, CDCES, CDN, is a registered dietitian and certified diabetes care and education specialist. Learn about our Medical Review Board Print Hero Images/Getty Images Table of Contents View All Table of Contents Specific Conditions Diabetes Medications Blood Pressure Medications Psychiatric Medications You've heard it a million times: "Before you start a new diet or exercise program, check with your doctor." Before starting a low-carb diet, it's important to discuss your plans with your doctor—especially if you are being treated for certain health conditions like diabetes and high blood pressure. Why? When you make changes to what you eat, how much you eat, and when you eat, your medications may be affected. Additionally, some medications are prescribed based on the amount of carbohydrates that are being consumed. As long as your doctor is aware of the changes you intend to make, they can help ensure your medications remain safe and effective. The dosage of some medications may need to be changed, or your doctor may want you to take it at a different time of day. In some cases, it may be best for you to stop taking certain medications—but only if your doctor instructs you to. Low-Carb Diets and Specific Conditions If you have certain medical conditions, your doctor may suggest a low-carb diet to help control your symptoms or prevent the condition from getting worse. Conditions Positively Affected by a Low-Carb Diet In people who have these conditions, a low-carb diet may help (but always check with your doctor first): Obesity Type 1 and type 2 diabetes Elevated blood glucose or prediabetes Non-alcoholic fatty liver disease Metabolic syndromes (high cholesterol, high blood pressure) Glycogen storage disease Glucose transporter 1 (GLUT1) deficiency syndrome (a rare genetic condition) Conditions affecting the brain, including epilepsy, Parkinson's disease, and Alzheimer's disease Some research explores whether low-carb or ketogenic diets may be beneficial for people with certain types of cancer. Several studies have investigated whether reducing insulin levels could help slow the growth of cancerous tumors or keep cancerous cells from spreading, with promising results demonstrated in animal studies. More human studies are necessary to determine the efficacy of low-carb diets for cancer. Discuss the option of diet changes with your oncologist before adopting a low carb or ketogenic diet. Conditions Negatively Affected by a Low-Carb Diet In these cases, a low-carb diet may not be beneficial and may even be harmful. Ask your doctor before starting a low-carb diet if you: Are underweight or malnourished Have a history of disordered eating Are pregnant or nursing Are very physically active Are recovering from surgery, injury, or serious illness, or are immunocompromised Have chronic medical conditions affecting your heart, kidneys, or intestines, or other major organ systems Diabetes Medications If you're taking medication to treat diabetes, such as insulin, you're already aware of the direct relationship between carbohydrates in the food you eat and how much insulin your body needs. It's imperative to notify your doctor of dietary changes if you're taking insulin. Major dietary changes need to be coordinated carefully with your physician and/or dietitian. Insulin If you have diabetes and are taking insulin your doses may need to be adjusted if you are making drastic changes to your diet. This will depend on the type of diabetes you have, the type of insulin regimen you are on, and whether or not your change in diet causes weight loss. Do People With Type 2 Diabetes Have to Follow a Low-Carb Diet? Hypoglycemic Agents Many other medications for diabetes (particularly Type 2 diabetes) are intended to help control blood glucose. Three of the most commonly prescribed are: Glucophage (metformin)Avandia (rosiglitazone)Januvia (sitagliptin phosphate) If you have been eating a higher-carb diet and switch to a low-carb one, you will likely need to change how much medication you take. Over time, some people with diabetes eating a low-carb diet find they are better able to control their blood glucose with diet and exercise alone. In some cases, you may be able to stop taking medication. In fact, continuing to take the same dosage could result in hypoglycemic episodes. For example, metformin, which should not cause hypoglycemia, has been known to affect some individuals with diabetes when they change their diet. How to Balance Blood Sugar on a Low-Carb Diet Blood Pressure Medications High blood pressure can sometimes be partially treated with a low-carb diet. If you're already taking medication for hypertension, making changes to your diet (such as reducing your salt intake) could cause your blood pressure to go too low. There are different types of medications used to treat hypertension. They are divided up into many drug classes, including: DiureticsVasodilatorsBeta-blockersAlpha-blockersACE inhibitorsCentral agonistsCalcium channel blockersAlpha-2 receptor agonistsAngiotensin II receptor blockersPeripheral adrenergic inhibitorsCombined alpha and beta-blockers Here are the brand names of the commonly prescribed blood pressure medications. While not an exhaustive list, talk to your doctor before you make changes to your diet if you're taking these or other medications to treat high blood pressure. LasixDiurilLopressorToprol-XLLevatolLotensinMonoprilDiovanVasocorMinipressTenexApresoline Psychiatric Medications Drastically reducing your carb intake, like on a keto diet, has a profound impact on your brain chemistry. In some cases, conditions like epilepsy are treated with very low-carb diets. If you are taking any medications for depression, anxiety, or other mental health conditions, talk to the doctor who prescribes your meds before making changes to your diet. Specific psychiatric medications that may be affected by a low-carb diet include: Risperdal, Abilify, and Seroquel, and other antipsychotic drugsPossible increase in side effects if taking LithiumAnticonvulsants, including Depakote, Zonegran, and Topamax A Word From Verywell Everyone's unique experience with low-carb diets, medical conditions, and medication will be different. For your safety, always enlist support from your doctor, and your therapist or dietitian if necessary, before making any changes. Reducing Carbs Gradually on a Low-Carb Diet 24 Sources Verywell Fit uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Kelly T, Unwin D, Finucane F. Low-carbohydrate diets in the management of obesity and type 2 diabetes: a review from clinicians using the approach in practice. Int J Environ Res Public Health. 2020;17(7). doi:10.3390/ijerph17072557 Murdoch C, Unwin D, Cavan D, Cucuzzella M, Patel M. Adapting diabetes medication for low carbohydrate management of type 2 diabetes: a practical guide. Br J Gen Pract. 2019;69(684):360-361. doi:10.3399/bjgp19X704525 Curless J. Medication management on the ketogenic diet. CHOC Children's Hospital. Spritzler F. A low-carbohydrate, whole-foods approach to managing diabetes and prediabetes. Diabetes Spectrum. 2012;25(4):238-243. doi:10.2337/diaspect.25.4.238 Watanabe M, Tozzi R, Risi R, et al. Beneficial effects of the ketogenic diet on nonalcoholic fatty liver disease: A comprehensive review of the literature. Obes Rev. 2020;21(8):e13024. doi:10.1111/obr.13024 Hyde PN, Sapper TN, Crabtree CD, et al. Dietary carbohydrate restriction improves metabolic syndrome independent of weight loss. JCI Insight. 2019;4(12). doi:10.1172/jci.insight.128308 Olgac A, İnci A, Okur İ, et al. Beneficial effects of modified atkins diet in glycogen storage disease type iiia. Ann Nutr Metab. 2020;76(4):233-241. doi:10.1159/000509335 Sandu C, Burloiu CM, Barca DG, Magureanu SA, Craiu DC. Ketogenic diet in patients with glut1 deficiency syndrome. Maedica (Bucur). 2019;14(2):93-97. doi:10.26574/maedica.2019.14.2.93 Ułamek-Kozioł M, Czuczwar SJ, Januszewski S, Pluta R. Ketogenic diet and epilepsy. Nutrients. 2019;11(10). doi:10.3390/nu11102510 Włodarek D. Role of ketogenic diets in neurodegenerative diseases (Alzheimer’s disease and Parkinson’s disease). Nutrients. 2019;11(1). doi:10.3390/nu11010169 Li J, Zhang H, Dai Z. Cancer treatment with the ketogenic diet: a systematic review and meta-analysis of animal studies. Front Nutr. 2021;8:594408. doi:10.3389/fnut.2021.594408 Watanabe M, Tuccinardi D, Ernesti I, et al. Scientific evidence underlying contraindications to the ketogenic diet: An update. Obesity Rev. 2020;21(10). doi:10.1111/obr.13053 Desrosiers TA, Siega-Riz AM, Mosley BS, Meyer RE. Low carbohydrate diets may increase risk of neural tube defects. Birth Defects Res. 2018;110(11):901-909. doi:10.1002/bdr2.1198 Mujika I. Case study: long-term low-carbohydrate, high-fat diet impairs performance and subjective well-being in a world-class vegetarian long-distance triathlete. Int J Sport Nutr Exerc Metab. 2019;29(3):339-344. doi:10.1123/ijsnem.2018-0124 Chung JW, Hartzler ML, Smith A, Hatton J, Kelley K. Pharmacological agents utilized in patients with type-2 diabetes: beyond lowering a1c. P T. 2018;43(4):214-227. Bolla AM, Caretto A, Laurenzi A, Scavini M, Piemonti L. Low-carb and ketogenic diets in type 1 and type 2 diabetes. Nutrients. 2019;11(5). doi:10.3390/nu11050962 Wang L-L, Wang Q, Hong Y, et al. The effect of low-carbohydrate diet on glycemic control in patients with type 2 diabetes mellitus. Nutrients. 2018;10(6). doi:10.3390/nu10060661 Lichtash C, Fung J, Ostoich KC, Ramos M. Therapeutic use of intermittent fasting and ketogenic diet as an alternative treatment for type 2 diabetes in a normal weight woman: a 14-month case study. BMJ Case Rep. 2020;13(7). doi:10.1136/bcr-2019-234223 Unwin DJ, Tobin SD, Murray SW, Delon C, Brady AJ. Substantial and sustained improvements in blood pressure, weight and lipid profiles from a carbohydrate restricted diet: An observational study of insulin resistant patients in primary care. Int J Environ Res Public Health. 2019;16(15):2680. Published 2019 Jul 26. doi:10.3390/ijerph16152680 American Heart Association. Types of blood pressure medications. McGhee B, Katyal N. Avoid unnecessary drug-related carbohydrates for patients consuming the ketogenic diet. J Am Diet Assoc. 2001;101(1):87-101. doi:0.1016/S0002-8223(01)00021-9 Zhang Y, Xu J, Zhang K, Yang W, Li B. The anticonvulsant effects of ketogenic diet on epileptic seizures and potential mechanisms. CN. 2017;16(1). doi:10.2174/1570159X15666170517153509 Ebrahimpour-Koujan S, Keshteli AH, Afshar H, Esmaillzadeh A, Adibi P. Adherence to low carbohydrate diet and prevalence of psychological disorders in adults. Nutr J. 2019;18(1):87. doi:10.1186/s12937-019-0513-8 Sarnyai Z, Palmer CM. Ketogenic therapy in serious mental illness: emerging evidence. Int J Neuropsychopharmacol. 2020;23(7):434-439. doi:10.1093/ijnp/pyaa036 By Laura Dolson Laura Dolson is a health and food writer who develops low-carb and gluten-free recipes for home cooks. See Our Editorial Process Meet Our Review Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit