Keto flu sucks.
It’s like having a cold, but without the infection. You get the cough, the runny nose and sneezing, the headache and scratchy throat. I also got blocked ears, but you don’t get the fever and the urgh-I-have-a-cold yucky feeling. The symptoms are bad enough though. The first time I experienced keto flu was on the last day of my keto phase. I phase my diet between keto and mostly vegetarian on a monthly basis. The reason for this is that, just like with exercise and calorie alterations, your body adapts to things. So you need to change things up to keep it on its toes. On the last week of my keto phase I do some kind of fast. This time was a 3 day water fast, which is not as bad as it sounds!
For the month before this, I has been dipping in and out of ketosis. I hadn’t fully gotten there as I would just get in and then have cake club and get kicked out again. I wasn’t so dedicated I guess to miss out on the only social event of the week at work. And that’s ok. I made my decision to go to cake club knowing the consequences. I knew that I had eaten well enough through the week that one cake incident wouldn’t harm me. But during my fast (during which time the new PhD student in my lab baked my favourite raspberry and cream cheese cake, there was a cancer research bake sale, 2 people brought sweets back from foreign countries and cake club occurred, all in just 3 days!) I abstained. I very quickly then moved into full ketosis and on day 3, keto flu struck!
Screw This, Bring On The Carbs!
For most of that last day of my fast, I just told myself that it was one more day and had a mini celebration in my head for making ketosis fully. However, towards the end of the day, my view changed. Had I been at the start or middle of my keto phase, I would have sucked it up and waited it out. Then I would have been extra careful to stay in ketosis for the rest of the month and not go through this again. As it was, it was my last day day and by 6:30pm, I’d had enough. Since it was only for a few more hours, it wasn’t worth suffering through. So I went in search of carbs to put an end to it. Turns out, there were none in the house!
Eventually, I managed to find some microwave popcorn and carefully ate some of that. Coming out of a fast is a delicate process. You have to be careful how you refuel your body. When there were no adverse effects, I finished the rest of the bag. This is now where I let you know that I do not advise this as a treatment if you are trying to get into ketosis. Firstly because if you do, you’re starting all over again and you’re currently doing well so don’t put yourself backwards. Secondly, because it didn’t work. On the second day I woke up and the first thing I became aware of was feeling really crap. I still had keto flu.
At this point, I briefly considered giving up on ketosis forever so as not to go through this again. Then I decided that a better idea would be to find out how to get into ketosis without keto flu. Here’s what I found.
Avoiding Keto Flu
Often the cause of keto flu is due to an imbalance of your electrolytes. I did already know this, but my research put it in such a way that made perfect sense to me and a lightbulb went off in my head. When you go into ketosis, you are reducing your insulin response by eliminating carbs. This is how your body starts burning fat instead of storing it.
However, insulin is also the hormone that tells your kidneys to store sodium. Without this, your kidneys go into diuretic mode, causing them to excrete sodium, potassium and magnesium by making you pee more. I did notice this when I started and remember that I was peeing way more than the extra water I was drinking justified. What really made me take notice though was discovering that your kidneys do the same thing when you exercise.
I’ve mentioned in previous articles that when I change my workout and increase the intensity I tend to come down with some kind of cold. I know I’m not sick because there’s no fever, it’s just the superficial symptoms (sound familiar?). I just said today that this keto flu feels like the “flu” I get when I work out too much. Then I discovered it feels like the same thing because it is the same thing! **lightbulb**
So how to avoid it. Basically, add salt to your diet. This is maybe a hard thing to take in for some people. We’ve all heard how salt is bad for us and causes high blood pressure and heart attacks, etc. I was always told as a child that your food has plenty of salt in it, you don’t need to add salt. To some extent this is true and if you’re eating a highly processed diet, you probably are getting too much salt. But for those of us who eat pretty clean and then add a diuretic element on top of that, we need that extra sodium.
If you’re going into ketosis, add at least a teaspoon of salt to your diet each day, or around 5-7g. This is twice the recommended amount of salt, but don’t stress about this. It’s short term and your body does need it. You can do this easily by dumping a spoonful of salt into your vegetables while you cook or by add bone broth into your day. Either buy it or make your own by keeping your beef and chicken bones and boiling them. You can leave them simmering for up to 12 hours, but I usually call it done after 1 or 2. Then store it in the freezer until you need it.. You can drink it straight up or make soup out of it.
Balance Your Potassium
Potassium and sodium create a concentration gradient in your body. They move in and out out your cells in relation to each other through an ion exchange channel in your cell wall membranes. This process does many things within the cell, such as regulate its volume and act as a messenger for certain pathways and it’s dependent on the concentration gradient of the sodium and potassium in the cell and its immediate surroundings. The lowered sodium puts this gradient out of balance, but so does the lowered potassium and your kidneys excrete it in urine so you need to increase it as well.
The best place to get it is from leafy green vegetables like kale and spinach as well as avocado, which has 3-4 times more potassium than bananas, but without the sugar. Fish is also a good source of potassium. You can supplement your potassium, but this isn’t a good long term solution. The best thing to do is make sure you incorporate it into your diet well. Signs that you’re low in potassium include muscle cramps, fatigue and weakness.
This is a mineral that isn’t talked about much, but that is really important in our bodies. It’s involved in over 300 biochemical processes that take place in our bodies, including sleep regulation and the production of ATP that we use for energy at a cellular level. It’s low levels of magnesium that cause the flu like symptoms of keto flu. As with sodium and potassium, magnesium is regulated by the kidneys, so when they go into diuretic functioning, they flush out the magnesium with the other electrolytes.
To make sure that your magnesium levels stay high as you go into ketosis, you should add a good amount of nuts and seeds to your diet. Cashews and almonds are great sources of magnesium along with sunflower seeds, pumpkin seeds and hemp seeds. You can also absorb magnesium topically with magnesium enriched creams or through using epsom salt if you have the luxury of a bath. There are ingestible magnesium supplements like magnesium citrate, but be careful with these. An overdose can cause loose bowels and some unwanted accidents.
Along with all the electrolytes, you also need to replace the water that you’re losing. Water is incredibly important just for your body to function so you should be hydrating anyway, but it’s even more critical during your transition to ketosis. If you really can’t stomach just drinking tonnes of water, add some flavours to it. My favourite is lemon and mint, but I have a few other suggestions here.
If It’s Your First Time, Go Slowly
A lot of the symptoms of keto flu are brought on by your body adapting to your new diet. If you’ve had a diet that’s highly carb based and highly processed, it will be adapted to function like this. So suddenly removing all the things that it’s used to is like taking a drug away from an addict. Your body will rebel, but it’s just going through withdrawal. If this is your first time trying out ketosis and you’re concerned about keto flu, go slowly. Reduce your carbs by 10g a day rather than suddenly dropping them straight away. Try eliminating carbs one group at a time, for example, cut out fizzy drinks one week, then bread the next, etc.
The other thing to try is intermittent fasting. This way your body dips in and out of ketosis just a little bit each day. It gets used to the change over before you start altering your macronutrient proportions. Take your time and let your body adjust. This is a lifestyle change, not a race to completion. You have all the time in the world to get there and you’re more likely to if the journey is less painful.
Now that I understand the biological basis of keto flu, it’s obvious that popcorn was not going to save me. The salt upped my sodium levels so that helped, but it was magnesium that I needed in order to get rid of the flu like symptoms that were killing me. I am now off to eat some quinoa and kale bake and hope that the magnesium from the kale will help.
The reason that I got hit so hard with this was that I got into ketosis during a fast. This is one of the quickest ways to induce ketosis. You’re not feeding your body any carbs, not just low carbs, so you get there in 24 hours. However, I was also not feeding my body anything at all so I didn’t regulate the electrolyte levels. After my research, I feel a lot more confident that during my next keto phase I'll be ok. As long as I get into ketosis while I’m still eating, I can manage my electrolytes to avoid keto flu. Then when I hit the fast, my body will already have adjusted so won’t try to kill me in rebellion.
If you’re struggling with keto flu, or want to avoid it altogether, I have a special gift for you. I’ve created a PDF with the best foods you can eat for each electrolyte in order to keep the levels balanced and high. Just click the button below to get instant access to it. And if you have anything to add, leave a comment sharing your keto flu remedies!
P.S. If you’re interested in ketosis, but you don’t even know where to start and you want to get through it without the dreaded keto flu, I have something coming that will take you through it step by step. I’ll be there with you at every stage and we’ll go through it together. It’s not quite ready yet, but you can find out more about it and sign up for the waiting list by clicking here.
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