Keto Diet: Save the Thrombos! – DocCheck

Thrombocytopenia is a common occurrence in cancer patients undergoing chemotherapy. Does switching to a ketogenic diet help? A study shows surprising effects.

If you want to eat keto, you consume very few carbohydrates, but much more fat and protein than with a normal mixed diet. In order to compensate for the long-term lack of carbohydrates, the body forms within the framework of the Ketogenesis Ketone bodies that are in the citrate cycle be fed.

This diet is already being used as a treatment method Epilepsy and obesity used – over the last few decades, researchers have also investigated their use in diabetes and cancer. In a recent study in Science Translational Medicine researchers now assumed that the keto diet and the resulting circulating in the body ketone bodies die platelet production on the On a megakaryocyte-affect metabolism in the bone marrow.

80 percent fat

To support their hypothesis, they studied platelet production in five healthy men who followed a strict keto diet for 7 days. The ketogenic ratio, i.e. the mass ratio of fat to carbohydrates and proteins in food, was 4:1. The researchers then took blood samples from the subjects at the beginning of the experiment and on days 3 and 7.

Similar to the results of a keto diet they previously tested in male mice, the participants’ body weight dropped, as expected. The concentrations of circulating ketone bodies in the body increased due to the strict diet; the amount of substance concentration increased from β-Hydroxybutyrate (β-OHB) averaged from about 1mM to more than 3mM by day 7. Compared to the start of the experiment, the number of blood platelets also increased, 1.1-fold on the 7th day. There was no change in the thrombocyte distribution width, the average volume of the blood platelets, or the erythrocyte count or the number leukocytes.

A detailed analysis revealed that the number of platelets increased for all participants, but still below a potentially damaging value of 400 x 109/L stayed. Further research also found that the strict keto diet had no effect on the coagulation cascade, platelet morphology, or their function. The diet resulted in only a modest increase in platelet count in healthy men over a 7-day period.

chemotherapy and keto diet

All well and good, but why is the number of platelets or the increase in them so relevant? It can occur during or after chemotherapy thrombocytopenia lead to an increased tendency to bleed and also to a limitation of the effectiveness of chemotherapy. Although a reduced dose of chemotherapy can alleviate chemotherapy-induced thrombocytopenia (CIT), it can also lead to a loss of therapy effectiveness and further complications – as well as to tumor progression. In clinical practice, the keto diet is therefore also used or tried in cancer patients. However, the study situation still looks relatively meager; the actual impact of diet in CIT is still unknown.

The researchers therefore retrospectively examined the influence of a ketogenic diet on CIT. 28 patients with cancer who received either only conventional chemotherapy or additional hormone or antibody therapy took part in their clinical study. 11 of these patients were on a ketogenic diet, while the remaining 17 were on a conventional diet.

The results were comparable to those of healthy men: those patients who followed a keto diet had significantly higher platelet counts than cancer patients on a conventional diet. The incidence of CIT in the latter group was 11.8% (2 of 17); in the keto group, on the other hand, it was 0%.

Inexpensive alternative

“Taken together, our results indicate that ketogenic diets contribute to thrombocytopoiesis and may have the potential to prevent CIT in patients undergoing oncology treatment,” the authors write. According to the researchers, the β-OHB circulating in the body have effects on megakaryocytes, which would drive thrombocytopoiesis via epigenetic processes. “This work paves potential avenues for the management of CIT and provides mechanistic insights into the metabolic regulation of platelet biogenesis.”

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Like many studies, this one also has its limitations, above all the small sample size and the retrospective nature. Nonetheless, a keto diet would be a cost-effective alternative in the treatment of CIT in comparison if it was effective for use von Thrombopoietin Receptor Agonists (TRA)which have already been used clinically as a previously unapproved therapy against CIT.

Image source: Nadine Primeau, Unsplash

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