Ketogenic supplements — not the diet — may help scuba divers avoid seizures brought on by oxygen toxicity

Scuba divers and those with epilepsy who are following the ketogenic diet to help control or avoid seizures might want to try adding certain ketogenic supplements to a regular meal plan, instead.

Researchers at the University of South Florida found that boosting the level of blood ketones by using ketogenic supplements — and not the popular diet — may have provided increased resistance to seizures brought on by extreme levels of hyperbaric oxygen. The results were published this month in the journal Physiological Reports.

The keto diet is a very strict low-carb, high-fat meal plan that forces the body into ketosis, a process where the body burns ketones (produced by fat) instead of glucose (produced by carbs). The diet has helped people lose weight and is proven to improve certain health conditions including treatment-resistant epilepsy.

Exposure to high-pressure oxygen is a danger for recreational, technical or military scuba divers who use a mix of pressurized air, including nitrogen and oxygen, in their tanks.

The Florida researchers fed rats ketogenic supplements in addition to their regular high-carbohydrate rodent chow and then exposed them to pure oxygen in a small hyperbaric environmental chamber until they developed seizures as a result of oxygen toxicity.

The rats that were fed a supplement that combined ketone ester and medium-chain triglyceride oil experienced a delay in the onset of hyperbaric oxygen-induced seizures compared to rats that received other supplements. The severity of the seizures was also reduced in this group.

“As a scuba diver, I am very excited about the implications of these findings, since during 20 years of diving I have heard many stories about the dangers of being exposed to high partial pressure of oxygen and it is something that always has to be considered when planning a dive,” said lead author Csilla Ari D’Agostino, PhD, research assistant professor in the department of psychology at USF College of Arts and Sciences.

While previous studies have found that following a ketogenic diet may help control seizures for those with epilepsy and decrease central nervous system oxygen toxicity symptoms in divers, this study concluded that just by using supplements there is a protective effect against seizures.

Hyperbaric oxygen therapy has been used as an approved treatment for cases of air/gas embolism, decompression sickness, carbon monoxide poisoning, and diabetic wounds. It has also been used to treat other conditions such as Alzheimer’s disease, cancer, autism, migraines, stroke and diabetes where it has not been clinically proven to be effective, according to the U.S. Food and Drug Administration.

While generally safe, hyperbaric oxygen therapy is not without risks.

Besides the complication of seizures, sinus pain, ear pressure, and painful joints, more serious conditions such as paralysis or air embolism can occur.