Burn Ketones or Use Steroids for Inflammation Relief: You Choose

With the cost of healthcare topping record highs, patients come to the clinic with a list of concerns for each visit. Seventy-five percent of the time pain ranks first or second in their rankings

When helping patients deal with pain, I can always pull out the big hammer for cutting through a patient’s pain. The big, in this case, refers to narcotics like morphine or Oxycontin. This hammer comes with the severe drawback of addiction. Patients surrender years of their lives to the setbacks of chronic pain.

Opiate treatment provides relief of their distress but can coax their brain into the swamp of addiction. This sets patients and their families back many years. To avoid this possibility, physicians prescribe anti-inflammatory medications instead.

Anti-inflammatory medications do just what their name says: they work against inflammation. The most potent medicines to remove inflammation: STEROIDS.


Steroids win the medication contest to reverse inflammation. Got a lousy knee filled with arthritis? Nothing changes that chronic inflammation better than a shot of steroids into the knee joint. Got a hot and angry looking rash? Nothing cools down the flames bubbling inside your skin better than a cream filled with steroids.

Doctors use the power of steroids to put out the flames of many medical problems. These medications arrive onto the scene of inflammation like a bucket of water to a firepit. Splash! The jobs’ done. As with most miracle cures, there’s a catch. These medications work great for the “flash and dash.”

But if you use steroids for too long, you will weaken your immune system, increase your blood sugars, thin your skin, soften your bones and hijack your mood with a surge of hormones.

The substitute medications for steroids when fighting inflammation: Non-Steroid Anti-Inflammatory medications. You have seen this abbreviated as NSAID–Non-Steroidal Anti-Inflammatory Drugs. Typical examples of NSAIDs are ibuprofen, naproxen, or aspirin.

You don’t need my prescription pad to get these medications. Just hop over to your local pharmacy or gas station and find these on the shelves. These medicines are safe enough to use without the close monitoring of a doctor.

NSAIDs won’t shut down your inflammation as fast or as powerfully as steroids, but they are cheap and readily available.

When I instruct someone to take ibuprofen for an ache or a pain, I teach them that the medication will help their pain for eight hours. When setting expectations about how much improvement they should expect, I tell them it’s like a nickel. Yep – a coin.

They can use that ibuprofen every eight hours and expect a nickel’s worth of improvement. If they need more help than ibuprofen can deliver, we prescribe a steroid such as prednisone. Prednisone lasts for twenty-four hours, and it’s worth fifty cents.

Steroids are ten times more potent than NSAIDs like ibuprofen. NSAIDS wear out after 8 hours and steroids last a whole day. If you take that prednisone several days in a row, it increases in value.

The first day it helps the inflammation by fifty cents. The second day it helps a little more, about fifty-two cents. If you stack prednisone day, after day the power to reduce inflammation keeps rising until about day 10. After that, it steadily sinks back to about twenty-five cents.

The moral of this story is that ibuprofen is a safe, yet mild anti-inflammatory. Prescription steroids are much more powerful, but after time they lose much of their power and have massive consequences on your body.

Interestingly enough, ketones are estimated to be ten times more powerful than steroid medications. Produce ketones for a month, and the anti-inflammatory effect is worth nearly $5.00!! Let’s put it this way, going keto is 100 times more effective in reducing inflammation than using ibuprofen. Produce ketones for a year, and estimated that it’s worth $25.00!!

How is this possible?
When your body has excess water, your cells get inflamed they balloon up. On a carb-heavy diet, your system fills up with lots of water molecules. The carb-derived glucose molecules in your system naturally grab onto water molecules. Just how much water are we talking about here? Hundreds of water molecules per glucose molecule!

Think of each glucose molecule as a sponge bouncing down the stream of blood coursing through your veins. Before starting keto, it’s not uncommon to find an average blood sugar to be 105 mg/dl. Within two weeks their average sugars are in the 90s, and they are down over ten pounds. Much of that initial weight loss is from the extra water hanging onto those additional glucose molecules.

That’s a lot of water. Where did they put it all? Squeezed into many cracks and crevices.

No wonder, arthritis patients tell me that once they’ve gone keto, they would never go back.

When your system stops carrying around extra glucose, it let’s go of the water too. Remove that water in someone with arthritis and their joints hurt less. Stiffness is reduced.

Additionally, steroids are naturally made within your body. Steroid prescriptions remove inflammation because they mimic the steroids your body produces. Cortisol is one of your self-made-steroid hormones that eliminates inflammation.

Your cortisol hormones began as fat. Nutritional ketosis boosts hormone production overall. Sustained ketosis improves your body’s production of fat-based hormones across the board, including testosterone, estrogen, cortisol, and aldosterone.

Today if you present to my clinic with chronic pain, I will look to find the source. Quite often the pain comes from some part of your body that holds onto extra water. Could be a strained back muscle, a bulging disc, arthritis in your back, a kidney stone, a tumor, a pinched nerve or a list of other options.

The one thing all of those concerns have in common: they all hold onto extra water. While I try to figure out the exact cause of that pain, I tell patients to pee ketones. By the time we get two weeks into the testing and imaging, they are two weeks into ketosis.

That is when most pain patients turn the corner. They are amazed at how much better they feel with this new bath of chemistry.

Now, no matter what the cause of their back pain, I have the best chemistry set present to fix the problem.

To learn more about the ketogenic diet, check out the book I wrote ANYWAY YOU CAN.

Here is another story about an UNDERWEIGHT patient filled with inflammation. What should we do to help? Listen and find out.


  1. Cassiday, Laura. “Big Fat Controversy: Changing Opinions about Saturated Fats.” INFORM: International News on Fats, Oils, and Related Materials, Jun. 2015, pp. 342–377.
  2. Castaldo, Giuseppe, et al. “Very Low-Calorie Ketogenic Diet May Allow Restoring Response to Systemic Therapy in Relapsing Plaque Psoriasis.” Obesity Research & Clinical Practice, vol. 10, no. 3, 2016, pp. 348–352., doi:10.1016/j.orcp.2015.10.008
  3. Feinman, Richard David PhD. The World Turned Upside down: the Second Low-Carbohydrate Revolution. Nutrition & Metabolism Press, 2014
  4. Forsythe, Cassandra E., et al. “Comparison of Low Fat and Low Carbohydrate Diets on Circulating Fatty Acid Composition and Markers of Inflammation.” Lipids, vol. 43, no. 1, 2007, pp. 65–77., doi:10.1007/s11745-007-3132-7

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