Children with drug resistant epilepsy are at risk of insufficient vitamin D status prior to
starting ketogenic therapy (3) and although levels can be normalised with vitamin D supplementation, a decline in both whole body and spine bone mineral content while on the ketogenic diet has been reported (4) despite reduction in anticonvulsant medication.
In this 2017 study of epileptic children, 20 out of 120 subjects (over 16 %) developed hypothyroidism within 6 months of
starting a
ketogenic diet
therapy and were treated with synthetic T4 thyroid hormone (7).