Having learned this, I now have a big-ass salad daily, generally, and I take a probiotic supplement. (Organic spinach is just $2/bag at Trader Joe's!)
[0] e.g. if one subsisted on mostly processed food before keto, if they don't add some appropriate carbs (even ones they didn't previously eat with any frequency), the microbiome will suffer... and it is difficult to repair without carefully culled fecal transplants.
it's a difficult decision socially
This derails a number of people. Eating keto often means eating separate foods altogether from your family/peers, and your choices when eating out become limited and/or disproportionately expensive[0]. It also means that you are often put in a role of educating people (or trying to) about what you are doing, and why, and that can also mean overcoming skeptics.Generally, however, after a few months of showing continued positive results, the skepticism turns more to curiosity... and you find people coming to you for dietary advice and reference material.
[0] some restaurants will work with you on this, and it never hurts to ask. For example, I've eaten at multiple diners where they would make a larger omelet in lieu of potatoes and toast.