Can Keto Really Help With Diabetes, Gut Issues, Iron Deficiency, and Autoimmune Disease? Here's What I've Learned.

By Augustine, Founder of The Larder

I get asked a lot of health questions (probably because I've been a health care provider for 25 years).

But as the founder of The Larder, I answer these questions from a different place. In fact, the Larder exists specifically because food healed me in ways that doctors, supplements, and years of careful eating simply couldn't. When you've been through what I've been through — the collapsed immune system, the iron infusions, the diagnoses that stacked up like unpaid bills — you develop opinions about food that go well beyond recipes (or lab results).

So I want to address the health questions I get most often. Not as a doctor. Not as a nutritionist. As someone who has lived in a failing body and watched it rebuild itself one ketogenic meal at a time.

These are the questions I wish someone had answered for me.

"I have diabetes and insulin resistance. Is this safe for me?"

This is the question I care most about answering well, because it's the one with the most at stake.

The short answer is: yes - low-carb, ketogenic eating is arguably the most logical dietary intervention for blood sugar issues that exists. 

Type 2 diabetes and insulin resistance are, at their core, conditions of carbohydrate intolerance. The body has lost its ability to manage glucose effectively. Insulin — the hormone that clears glucose from the blood — stops working as efficiently as the cells become resistant to accepting the glucose. Blood sugar stays elevated. The pancreas works harder. The cycle worsens.

When you remove carbohydrates from your diet, you remove the primary driver of blood sugar elevation. Glucose stops spiking. Insulin stops having to work overtime. The metabolic stress that drives the condition reverses.

I have seen this in my own blood work. I have seen it in the people who message me through The Larder community. And I have seen this in my own patients. The results are often faster and more significant than people expect.

That said — and I want to be very clear here — if you are on medication for diabetes or insulin resistance, you need to monitor your blood sugar carefully when changing your diet. Ketogenic eating can lower blood sugar substantially and quickly. If you are on insulin or medication that lowers blood sugar, your dose may need adjusting. Please work with your doctor. This is food is medicine, and it is powerful enough to require attention.

"I've been told I'm iron deficient. Can this help?"

Yes. And this one is personal.

I received eleven iron infusions before I found animal-based eating. Eleven. My iron levels were so depleted that my body couldn't stand, couldn't regulate temperature, couldn't think clearly. I tried every supplement, every dietary tweak, every recommendation.

While iron infusions (and iron supplements to a small degree) do increase the bodies iron stores (called ferritin), they do not KEEP iron stores up. Iron is a core nutrient for all living beings - its so important cause the 4 heme iron cells in the haemoglobin are what actually move oxygen in our bodies. Almost all iron issues are either 'access, absorption or loss' issues. This is obviously a huge topic and if you're a health care provider yourself, Ive created a 4 hour online course about iron metabolism, but the simple truth is that a diet based in animal protein and fat solves all three issues.

Not all iron is the same. Plants contain non-heme iron, which the body absorbs poorly — somewhere between 0.5 and 5 percent, depending on what else you're eating. Animal foods contain heme iron, which the body absorbs at rates of 15 to 35 percent. Red meat, organ meats, and shellfish are among the most iron-dense foods on earth, in the form your body is actually designed to use.

If you've been told to eat more spinach for your iron, I understand the frustration. The iron in spinach is largely inaccessible because of oxalic acid (one of the most destructive plant defence chemicals. However, the iron in beef liver is perfectly bioavailable.

I am not saying ketogenic eating will cure iron deficiency quickly. What I am saying is that building your diet around animal foods gives your body the most bioavailable iron possible, in a context where it can actually absorb and use it, without the nasty defence chemicals.

"I have IBS and digestive issues. Will this make things worse?"

In my experience — and in the experience of many people I've spoken with — it often makes things dramatically better.

I had IBS symptoms for thirty-five years. Thirty-five years of unpredictability, discomfort, and managing my life around my gut. Within weeks of removing plants and carbohydrates from my diet, those symptoms resolved. Not improved. Resolved!

I don't say this to oversell it. Individual responses vary and I know that. But the mechanism makes sense: many digestive issues are driven by fermentation in the gut, where bacteria feed on undigested plant matter and produce gas, bloating, and inflammation. Remove the plant matter and the fermentation slows. The gut quiets.

Animal-based foods — meat, animal fat, eggs, dairy — are almost completely absorbed in the small intestine. Very little reaches the colon and there is no sugar to ferment. For a gut that has been chronically irritated, this is a significant relief.

If you have gut issues, I would start simple. Carnivore is the solution with minimal seasoning. Give your digestive system time to adjust. The first few weeks can be a transition, but what comes after is often worth it.

"I have an autoimmune condition. Can this help?"

This is the question I am most careful with, because autoimmune disease is complicated and individual.

What I know is this: my own autoimmune picture — MCAS, the chronic infections, the systemic inflammation — improved significantly when I changed how I ate. Not cured. Improved. Quieted.

The proposed mechanisms are reasonable. Autoimmune conditions are often characterised by gut permeability — a compromised gut lining that allows partially digested food particles into the bloodstream, triggering immune responses. Many plant compounds are known to contribute to gut permeability. Removing them reduces the antigenic load — the number of things your immune system has to react to.

Ketosis also lowers insulin and reduces systemic inflammatory signalling. For a body that is chronically inflamed and overreacting to everything, lowering the baseline inflammatory load can provide meaningful relief.

I have heard from people with rheumatoid arthritis, Hashimoto's, lupus, psoriasis, and Crohn's disease who have found significant symptom improvement on ketogenic or carnivore-leaning diets. I have also heard from people for whom it made no difference. The body is not a single thing.

What I would say is this: if you have an autoimmune condition and you haven't tried removing carbohydrates and plant foods for a sustained period — at least sixty days — it is worth trying.  Your body's response will tell you something.

Have questions? Join The Larder WhatsApp community — Augustine answers personally.