Feasibility and Safety of a Combined Metabolic Strategy in Glioblastoma Multiforme: A Prospective Case Series

Table 4

Adverse effects that occurred at any time during the fasts or ketogenic diet (including the level of certainty that patients and spouses attributed each adverse effect to either strategy).

	Definite	Probable	Possible	Unsure	Total
Fasting adverse effects
Increased fatigue	3	0	2	1	6 (60%)
Increased irritability	3	1	2	0	6 (60%)
Feeling lightheaded	2	0	3	0	5 (50%)
Increased limb or back pain	1	1	0	3	5 (50%)
Excessive hunger	2	0	3	0	5 (50%)
Muscle cramps	1	2	0	0	3 (30%)
Sugar cravings	1	0	1	0	2 (20%)
Constipation	0	2	0	0	2 (20%)
Nausea	1	1	0	0	2 (20%)
Diarrhea	1	0	0	0	1 (10%)
Insomnia	1	0	0	0	1 (10%)
Headaches	1	0	0	0	1 (10%)
Palpitations	0	0	1	0	1 (10%)
Disorientation	1	0	0	0	1 (10%)
Generalized seizure	0	0	0	1	1 (10%)
Food aversions	0	0	0	0	0
Heartburn	0	0	0	0	0
Excessive thirst	0	0	0	0	0
Total	18	7	12	5	42
Ketogenic diet adverse effects
Increased fatigue	2	1	0	2	5 (50%)
Increased irritability	0	2	1	1	4 (40%)
Feeling lightheaded	1	0	3	0	4 (40%)
Sugar cravings	1	0	1	2	4 (40%)
Constipation	1	2	1	0	4 (40%)
Increased limb or back pain	0	0	1	2	3 (30%)
Generalized seizure	0	0	0	3	3 (30%)
Excessive hunger	1	1	0	0	2 (20%)
Nausea	0	1	1	0	2 (20%)
Diarrhea	1	1	0	0	2 (20%)
Food aversions	1	0	1	0	2 (20%)
Insomnia	0	0	0	1	1 (10%)
Headaches	0	0	0	1	1 (10%)
Heartburn	0	0	0	1	1 (10%)
Muscle cramps	0	0	0	0	0
Palpitations	0	0	0	0	0
Disorientation	0	0	0	0	0
Excessive thirst	0	0	0	0	0
Total	8	8	9	13	38