[sradman]

Before the advent of anti-seizure drugs, the ketogenic diet [1] was an effective and widespread intervention used to treat epilepsy. The downside is the discipline required to keep intake of carbohydrates below 15 grams per day, especially in children.

[1] https://en.wikipedia.org/wiki/Ketogenic_diet

[shlant]

additional downsides include kidney stones[1,2,3,4], bone mineral loss[5] and a long list of other complications (including death):

https://www.thepaleomom.com/adverse-reactions-to-ketogenic-d...

1. https://pubmed.ncbi.nlm.nih.gov/11095028/

2. https://pubmed.ncbi.nlm.nih.gov/10893623/

3. https://journals.sagepub.com/doi/pdf/10.1177/088307380730192...

4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2852806/

5. https://pubmed.ncbi.nlm.nih.gov/19064531/

[PudgePacket]

Firstly those studies are all in children..

Study 1 doesn't actually show increases in kidney stones.

Study 2 has N of 4...

Study 3 looks reasonable, though they did note "use of oral potassium citrate significantly decreased the prevalence of stones" which is good news!

Study 4 has N of 25 & no info about what they actually ate other than macronutrient ratio.

[shlant]

> Firstly those studies are all in children

Your point? the OP ended his sentence with "especially in children" so I thought I'd share that which was relevant to children. If you are looking for information on adults, here are some possible clues:

https://www.nature.com/articles/pr19971830

It makes sense considering the increase in uric acid, but might only be a problem in children and those susceptible to kidney stones (although when it presents in children, that is some pretty important information in terms of holistic, long-term diet considerations). Still definitely worth mentioning and I'm sure we will get more information as more studies are done on adults (most are on children due to it being used as an epilepsy treatment)

[codeulike]

The NHS prescribe the ketogenic diet for some forms of epilepsy. That is, the UKs national health service prescribes keto as a treatment. And so the answer to the question posed by the OP "Can an extreme low carb diet be used as medicine?" is clearly Yes.

You get a diet plan, support, specialist foods and ingredients, ketone testing kits, etc, all on prescription.

There has been proper research into Keto as a treatment for some forms of epilepsy, and in some cases it performs as well as the best AEDs. See https://pubmed.ncbi.nlm.nih.gov/25524846/ and https://pubmed.ncbi.nlm.nih.gov/16146451/

[frereubu]

And still used in cases where drugs are not well tolerated: https://www.bbc.co.uk/programmes/m0002bnz This was for a child, and the parents talk about the difficulties in maintaining that diet that you mention.

[0-_-0]

It's still used for treating e.g. West syndrome which is similar to epilepsy.