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My issue with keto is when protein and carbs are both kept really low. Even though you can mostly run on ketones, your brain still needs some glucose. Thyroid studies suggest that minimum level is around 50 grams a day. If you drop your carbs below that, you have to make up the difference through glyconeogenesis (converting protein to glucose). It takes roughly two grams of protein to make one gram of glucose. This means if you only eat 20 grams of carbs a day, it will take 60 grams of protein to make up the difference. If you don't also eat that much protein, then where does the glucose come from? Hint - your lean tissue.
Speaking of those thyroid studies, the studies show a consistent intake of under 50 g/day of carbs can (and probably will) lead to a depressed thyroid output, called Euthyroid Sick Syndrome.
My personal experience with it was doing a very low calorie keto diet for a year. Towards the end, I was cold all of the time, gained weight despite eating the same as when I was losing, chronic fatigue. My thyroid levels did not come back up when I added carbs back in and I have been on Levothyroxine for the last three years. It makes losing weight a bitch. I'm pretty pissed at myself for not considering that maybe doing a diet that mimics starvation might just have hormonal consequences.
People need to make their own decisions but it seems like a lot of people jump into keto with no idea what they're doing just because it's a hot diet right now.
One other thing to consider is that fat has almost zero nutrients in it so if that makes a big part of your diet, make sure you eat a lot of veggies to get some vitamins and minerals.
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