Keto And Muscle Pain: What's The Connection?

The ketogenic diet is a popular way to lose weight and improve overall health. However, it is associated with some unpleasant side effects, including muscle pain and cramps. This is often referred to as the keto flu and can also include symptoms such as headaches, fatigue, insomnia, and constipation. The keto flu is caused by the body adapting to a new diet consisting of very few carbohydrates. This drastic reduction in carbs can be a shock to the system, leading to withdrawal-like symptoms. In addition to the keto diet, risk factors for muscle cramps include age, BMI, cardiovascular disease, kidney disease, and cancer, among others.

Dehydration and the keto diet

The keto diet is a very low-carb, high-fat, and moderate-protein diet. While it is considered safe for most people, it is associated with some unpleasant side effects. One of the most common side effects is dehydration.

When you start a keto diet, your body rapidly sheds water stores, increasing the risk of dehydration. This is because glycogen, the stored form of carbohydrates, binds to water in the body. So when you reduce your carb intake, your glycogen levels drop, and your body excretes water. This can lead to dehydration, which can cause symptoms such as fatigue, muscle cramping, and headaches.

To combat dehydration, it is important to drink enough water and other fluids. Staying hydrated can help reduce these symptoms and ensure optimal health. It is also important to replace lost electrolytes, as the keto diet can lead to an electrolyte imbalance, which can further contribute to dehydration and muscle cramping. Electrolytes such as sodium, potassium, and magnesium are important for muscle function and can be obtained through dietary sources or supplements.

Additionally, it is recommended to avoid strenuous exercise when experiencing dehydration and keto-flu symptoms. Light activities such as walking, yoga, or leisurely biking may be more suitable during this time.

By staying hydrated, replacing electrolytes, and getting enough rest, you can help your body get through the transition period to a keto diet more easily and reduce the risk of dehydration and associated muscle pain.

Electrolyte imbalances

Electrolytes are substances that carry electrical signals between the body's cells. They include sodium, magnesium, chloride, potassium, calcium, phosphate, and bicarbonate. Electrolyte imbalances can lead to disrupted electrical messages that may cause muscle contractions and spasms, resulting in muscle pain.

When adapting to the keto diet, your body may lose more electrolytes through urination due to decreased blood sugar and insulin levels. This loss is typically greatest during the first 1–4 days of transitioning to keto, so muscle cramps related to electrolyte imbalances may be more severe during this period.

To prevent and treat muscle pain caused by electrolyte imbalances while on the keto diet, it is recommended to:

• Eat potassium-rich foods such as avocados, Swiss chard, spinach, onions, tomatoes, beet greens, and mushrooms.
• Choose magnesium-rich foods like pumpkin seeds, Brazil nuts, cashews, kale, arugula, broccoli, and oysters.
• Consider taking an electrolyte supplement, such as magnesium, potassium, or a multi-mineral supplement.
• Consume enough salt by salting your food or sipping on salted bone broth.
• Drink plenty of water to stay hydrated and reduce the risk of muscle cramps.
• Cut back on or avoid alcohol, as it is a diuretic and may worsen dehydration.
• Engage in gentle exercise like walking, stretching, and yoga, especially when first adapting to keto.

It is important to note that severe or persistent muscle pain may be a symptom of a more serious medical condition, and it is recommended to consult a healthcare professional in such cases.

Sodium deficiency

A keto diet can cause muscle pain due to sodium deficiency. Sodium is a key electrolyte, and a keto diet can lead to a deficiency for a few reasons. Firstly, when you consume fewer carbohydrates, your body produces less insulin as insulin helps regulate the glucose you get from carbohydrates. With lower insulin levels, your body signals to your kidneys that they do not need to absorb as much sodium, leading to increased sodium excretion in urine.

Additionally, a keto diet typically involves eating whole foods, which generally do not contain much sodium. As a result, you may not be consuming enough salt to compensate for the increased sodium loss through urination. This imbalance of electrolytes can cause electrical messages in your body to be thrown off, resulting in muscle spasms and contractions.

To address sodium deficiency while on a keto diet, you can increase your sodium intake by salting your food or consuming salty foods like pickles and olives. You can also drink bone broth or salt your water. However, it is important to listen to your body and not overdo sodium consumption, as overhydration can lead to hyponatremia, a dangerous condition of low blood sodium.

It is worth noting that muscle pain can also be caused by other factors, such as dehydration, certain medications, old age, and strenuous physical activity. Therefore, ensuring proper hydration, consuming a balanced diet, and consulting a healthcare professional if symptoms persist are recommended.

Potassium deficiency

Potassium is a vital nutrient for muscle function. Low potassium levels, or hypokalemia, can lead to muscle cramping, weakness, and fatigue. Potassium deficiency is a common issue, with 60-80% of Americans not meeting the daily recommended intake.

When following a ketogenic diet, it can be challenging to consume enough potassium-rich foods, as many of these are limited or restricted. For example, potassium-rich foods such as potatoes, fruits, and carrots are typically consumed in smaller quantities on a keto diet to maintain ketosis.

Additionally, a low-carb diet increases the loss of potassium through urine. This is due to the decrease in insulin levels that occurs when restricting carbohydrates, which in turn reduces the body's retention of sodium and leads to increased urination. As a result, there is a greater loss of potassium.

To prevent potassium deficiency, it is recommended to consume potassium-rich foods such as avocados, Swiss chard, spinach, onions, tomatoes, beet greens, and mushrooms. These foods are suitable for a keto diet and can help maintain adequate potassium levels.

It is important to note that people with kidney disease should be cautious about their potassium intake and consult a doctor or nutritionist for advice. While potassium supplements are available, there is a risk of consuming too much, which can cause health issues.

Overall, ensuring adequate potassium intake is crucial, especially when following a ketogenic diet, to maintain muscle health and prevent muscle cramps and other related symptoms.

Magnesium deficiency

Magnesium is a mineral that the human body needs for almost every biochemical reaction. It is involved in energy production, blood sugar control, blood pressure/heart rhythm regulation, bone health, and more. The average dietary intake in the United States falls short of the recommended daily allowance (RDA) for magnesium. Recent studies suggest that swapping out processed foods for nutrient-dense foods loaded with magnesium may be beneficial.

On a keto diet, many magnesium-rich foods are off-limits due to their high carb content. This includes cereal, beans, gluten-laden bread, potatoes, and rice. However, there are still some good sources of magnesium that are keto-friendly, such as cashews, dark chocolate, pumpkin seeds, avocado, and leafy greens like spinach.

Low magnesium levels can cause symptoms such as loss of appetite, nausea, fatigue, weakness, constipation, vomiting, and muscle cramps. Chronically low magnesium levels are associated with an increased risk of developing Alzheimer's disease, insulin resistance, type-2 diabetes, ADHD, hypertension, cardiovascular disease, stroke, and sudden cardiac death.

Supplementing with magnesium can be a good idea for those on a keto diet, but it is important to speak with a healthcare professional first as magnesium supplements may interfere with certain medications. There are also different types of magnesium supplements, and finding the right one may require some experimentation.

In addition to supplementation, here are some tips to increase magnesium intake:

• Eat baby plants like seeds, nuts, and beans, which are good sources of magnesium.
• Opt for baby greens over fully grown ones as they have more magnesium content per bite.
• Include magnesium-rich foods in every meal and snack.
• Try soaking in an Epsom salt bath, which may help relieve muscle tension and pain.

Frequently asked questions