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J Immunol 76:417, 1956

9 Systemic complications of KD The initial stage of KD is often accompanied by short-lived symptoms, commonly referred to as keto flu, including fatigue, gastrointestinal disturbances, and headache, which usually resolve within a few days (228, 229)

Over time this can reduce resting metabolism and impair function

Understanding the mechanisms behind this muscle loss, the factors that influence it, and evidence-based strategies to preserve muscle function helps patients and clinicians optimize treatment outcomes while maintaining strength and functional independence throughout therapy