Should I take vitamins or supplements on a ketogenic diet?

‍‍It is well known that whole foods should be emphasized over dietary supplements because essential vitamins and minerals found in foods are usually better absorbed than those found in supplements (Lichtenstein, 2005). By nature, the ketogenic diet is best comprised mostly of whole, unprocessed foods that meet most of, if not all your nutritional needs. Thus, if you make the right food choices and eat an appropriate number of calories, you will be at a low risk of nutrient deficiencies.

As for others, here are a few nutrients that deserve attention to ensure you are adequately consuming them (Volek, 2012):

• Sodium: Unless a person has high blood pressure requiring continued medication, it is recommended to start right out consuming 4-5 grams per day to prevent symptoms of “keto flu”, and then continue this sodium intake as long as you are following a ketogenic diet. You can easily increase your sodium intake by salting your food and drinking 1-2 cups of broth or bouillon.
• Magnesium: An important mineral for nerve and muscle function that is found in meats, leafy greens and nuts. If you experience any muscle cramps, fatigue, and possibly an abnormal heart rhythm it may be time to add in a magnesium supplement.
• Potassium: An important mineral that is also an electrolyte, potassium has several functions including maintenance of blood pressure, fluid balance, muscle contractions, and nerve function. While potassium is notably found in bananas it is also found in meat, non-starchy vegetables, and avocados! Just be sure to keep the broth/drippings from your meat and to steam veggies rather than boil because potassium (and magnesium) can leach out into the liquid while cooking.
• Omega-3 Fat: This is an essential fatty acid that is required for normal well-being and function. Cold-water fish like salmon, tuna, herring, mackerel, and sardines are great sources of omega-3s, as are omega-3 rich eggs. It is generally recommended to consume fish 3 times a week or 2 omega-3 rich eggs daily. If you do not regularly eat fish or purchase these specialty eggs you may want to consider taking a fish oil or flaxseed oil supplement.

Dr. Phinney on supplements and vitamins on a ketogenic diet