Frequently Asked Questions

Why Visit Dr. Berkowitz?

Dr. Berkowitz, is board certified in internal medicine and has attending privileges at Beth Israel Medical Center in Manhattan, giving him expertise in both conventional and complementary medicine. He was the Medical Director of the Atkins Center for Complementary Medicine, an attending physician at Lenox Hill Hospital and a clinical instructor at the New York University School of Medicine.

How is Keith Berkowitz MD PC different from other medical practices?

Patients are our priority. Many people have symptoms from an underlying medical condition that has not been diagnosed by other physicians. Our advantage is that our staff is experienced in both conventional and complementary medical approaches. We are able to interpret tests and accurately diagnosis conditions, which interfere with weight loss and quality of life, such as: insulin resistance, an under active thyroid, hormonal imbalance and yeast overgrowth.

The basis of our treatment includes a controlled carbohydrate nutrition plan and exercise, along with nutritional supplements. We find that our approach to medical care can decrease or eliminate the need for prescription medications.

Does Dr. Berkowitz use the Atkins' diet for his patients?

Dr. Berkowitz and his staff were personally trained by Dr. Atkins. Like Dr. Atkins, Dr. Berkowitz believes that reducing carbohydrates low enough for the body to switch from a carbohydrate metabolism to a fat metabolism will help with weight loss, the treatment of typical symptoms and the prevention of many medical conditions. Dr. Berkowitz also uses Dr. Atkins medical philosophy of using nutritional supplements when appropriate as first line therapy instead of prescription medications.

Last time I did the Atkins diet, my cholesterol increased. Why should I try it again?

Guidance by a properly trained health care professional should help ease your concerns and help you prevent an increase in cholesterol. If cholesterol is an issue, we will tailor the types of carbohydrates and types of fats to ensure you get favorable cholesterol results. Nutritional supplements can also improve cholesterol levels.

Total cholesterol is not as important as the results of HDL, LDL and triglycerides. Current research suggests that the further breakdown of HDL and LDL are important factors that help determine heart risk. For example, we screen for increased amounts of small dense LDL particles and low levels of HDL 2b. Individuals with this breakdown are at higher risk of heart disease than those with large LDL particles and higher levels of HDL 2b.

I have heard that people on a low carb diet suffer from bad side-effects such as: constipation, muscle twitching, decreased energy levels, and bad breath. Does this happen to everyone?

No it doesn't. These symptoms can be avoided through the guidance of a properly trained health care professional. We can help prevent these symptoms through proactive measures. For people on medications, it is especially important to work with an experienced physician who can adjust your medications appropriately.

Why should I limit bacon and cold cuts?

These products are often processed with nitrates and/ or sugar. Nitrates or Nitrites can yield byproducts such as nitrosamines which have been implicated in higher rates of gastric and colon cancer in animals.

My mother and grandmother developed diabetes by age 55. I am not overweight. How can I prevent this from happening to me.

Your family history puts you at risk for diabetes. You are wise to be concerned. Establishing a healthy controlled carbohydrate plan and staying active will not only help prevent diabetes but also minimize the risk of many other health conditions such as: heart disease, blood sugar and insulin disorders and high blood pressure all of which are associated with aging and lifestyle.

I have always had difficulty losing weight. Is there a way to find out if my metabolism is slow?

Yes, a simple 10 minute breath test, allows us to measure exactly how many calories you burn. The result is compared against normal values based on your height, weight, age and gender to determine if your metabolism is normal.

Patients and scheduled walk-in visitors can benefit from a metabolic measurement of resting energy expenditure. This measures your individual calorie needs; there is no guessing or estimating calories.

Causes of slow metabolism include insulin resistance, an under active thyroid, hormonal imbalance and yeast overgrowth. We will treat the underlying cause and will partner with you to achieve your weight loss goals.

I have been gaining weight even since I started on a birth control pill. Can using this medication contribute to weight gain?

Yes, the birth control pill, hormone replacement therapy and steroids are examples of prescription drugs that interfere with weight loss or cause weight gain. Others include medications for diabetes, high blood pressure, arthritis and depression.

My 16 year old son insists that the fruit drinks he gets from the vending machines at school are healthy because they say "natural" on the label. Is this true?

Just because a product label says its natural, it does not mean that it is healthy. Fruit drinks contain large amounts of sugar and excessive calories. Over consumption of sugar-laden products can lead to obesity, dental caries and excessive gas and bloating. We educate patients on how to read labels and increase awareness about healthy food choices.

I cannot lose weight despite eating very little and exercising very often. I am healthy and take no medications. Why is this?

There is likely an underlying reason preventing your weight loss. Based on the results of your questionnaire and your history and physical, we will test for specific conditions that can interfere with weight loss such as: high insulin levels, an under active thyroid, a hormonal imbalance or yeast overgrowth.

Why is caffeine bad on a low carbohydrate diet?

Excessive amounts of caffeine are not healthy on any nutritional plan. Caffeine can impair glucose uptake and decrease insulin sensitivity, lead to increased blood pressure, sleep disturbance and contribute to dehydration.

My husband suffers from heartburn, headaches, excessive gas, and bloating as well as always being tired. What can be the cause of these symptoms.

Based on the symptoms you mention, yeast overgrowth is the likely culprit. A weak immune system, use of antibiotics, or a high carb diet provides an environment for yeast to thrive. Treatment requires restricting foods that contain yeast or are fermented as well as the use of a "probiotic" to inhibit yeast and to restore the normal bacteria.


My doctor told me I have the "metabolic syndrome." What is this, and how is it treated?

The metabolic syndrome is a cluster of risk factors:

  1. Central obesity
    1. Waistline greater than 40 inches in men and 35 inches in women
  2. Insulin Resistance
    1. Fasting blood sugar greater than 100 mg/dl
    2. Elevated insulin levels
  3. Low HDL (good cholesterol)
    1. HDL less than 40 mg/dl in men and 50 mg/dl in women
  4. Increased triglycerides
    1. Triglycerides greater than 150 mg/dl
  5. High blood pressure
    1. Blood pressure greater than 130/85 mg/dl

You can reduce these risk factors with lifestyle changes. At Keith Berkowitz MD PC, we treat the metabolic syndrome with a combination of diet, exercise and nutritional supplementation.