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First, start slow

The effect can be prolonged by lower gut bacterial action on fermentable fibers (see below) to produce short-chain fatty acids (propionate, butyrate, etc.) Healthful naturally-occurring animal fats such as tallow, lard, butter, and schmalz, the oils of fatty fish (salmon, mackerel, sardines, trout) and fruit and nut oils (coconut oil, olive oil, avocado oil, macadamia nut oil) activate free fatty acid receptors on Lcells to stimulate the release of GLP-1 from the gut and prolong its activity.There was early research that seemed to indict a diet high in saturated fats (what a surprise) as potentially toxic to the L-cells over time, but all that research was done in isolated cell models or high-fat/high carb rodent diets, not in a ketogenic diet context in humans

Monitor Your Symptoms: If you experience severe pain, inability to keep fluids down, or signs of low blood sugar, seek medical help immediately

However, certain foods are fortified with vitamin B12

Your doctor may need to assess your blood pressure (both lying and standing), review your current medications for potential interactions, check electrolyte levels and kidney function, and evaluate your hydration status and nutritional intake