Keto And Muscle Twitching: What's The Connection?

The keto diet is a low-carb, high-fat diet that forces the body to burn fat for fuel instead of glucose. While it has been known to aid weight loss and treat certain medical conditions, it has also been associated with a host of side effects, including leg cramps, headaches, constipation, and fatigue—collectively known as the keto flu. One of the less common side effects of starting keto is muscle twitching. This is usually caused by a simple imbalance in the body, often due to a lack of electrolytes, and can be easily remedied.

Electrolyte imbalance

The keto diet is a low-carb, high-fat diet that forces the body to burn fat for fuel instead of glucose. This metabolic state is known as ketosis. While this can have many benefits, it can also lead to some uncomfortable symptoms, such as muscle twitching, as the body adapts to this new way of burning fuel.

Electrolytes are electrically charged minerals that play a crucial role in body function, especially nerve and muscle function. They are essential for critical functions in the body, such as neurological functioning and cell communication. Electrolytes include sodium, magnesium, chloride, potassium, calcium, phosphate, and bicarbonates.

When transitioning to the keto diet, the total volume of fluid in the body decreases, and as electrolytes are mainly stored in bodily fluids, this can lead to low levels of electrolytes. Additionally, when you restrict carbohydrates, your body will naturally produce less insulin, causing the kidneys to flush out excess water and sodium. To maintain a healthy balance, the kidneys will also release extra calcium, magnesium, and potassium.

Symptoms of Electrolyte Imbalance

An electrolyte imbalance can lead to a range of symptoms, including:

• Muscle twitches
• Muscle cramps
• Keto flu symptoms such as headaches, constipation, and fatigue
• Difficulty concentrating
• Weak and brittle nails
• Confusion or memory loss
• Irregular heartbeat
• Diarrhea or digestive issues

How to Address Electrolyte Imbalance

To address an electrolyte imbalance, it is important to increase your intake of electrolytes. This can be done by:

• Consuming more mineral-rich vegetables, especially leafy greens like kale, spinach, chard, and broccoli.
• Taking electrolyte supplements.
• Increasing your salt intake by salting your food or consuming salted bone broth.
• Drinking enough water to stay properly hydrated.

Dehydration

To prevent dehydration, it is important to stay properly hydrated by drinking plenty of water. However, it is also possible to drink too much water, which can lead to a condition called hyponatremia, or too little sodium. To check if you are well-hydrated, note the colour of your urine—if it is dark yellow, you may need to drink more water, and if it is extremely pale, you may be drinking too much. Another test is the skin turgor test: pinch the skin on the back of your hand between your thumb and forefinger for about five seconds. When you release the pinched skin, it should rapidly go back into place. If it stays "tented up" or moves slowly, you may be dehydrated.

In addition to staying hydrated, you can also try drinking mineral water with magnesium, as this can be a good way to increase your magnesium intake while also staying hydrated.

Nutritional deficiencies

To address this, it is important to increase your intake of important minerals like potassium, magnesium, and calcium. Leafy green vegetables like kale, spinach, chard, and broccoli are excellent sources of these minerals. Alternatively, you can take electrolyte supplements to ensure adequate intake.

In addition to electrolyte deficiencies, a magnesium deficiency may also contribute to muscle twitching on keto. Magnesium is a crucial mineral involved in muscle contractions and neuro-muscular conduction. While there is limited evidence to support this link, some researchers believe that most leg cramps are due to magnesium deficiency. Supplementing with magnesium or including magnesium-rich foods in your diet may help alleviate muscle twitching.

Dehydration is another potential factor that can contribute to muscle twitching. When adapting to the keto diet, increased urination can lead to dehydration, which in turn can cause muscle cramps and twitching. Therefore, staying properly hydrated by consuming adequate water is essential to prevent these issues.

Over-hydration

When transitioning to the keto diet, the body's total fluid volume decreases, and as electrolytes are stored in this fluid, it is easy to become deficient in these essential minerals. Electrolytes are electrically charged and play a critical role in the body, especially in nerve and muscle function. Therefore, it is important to increase your intake of electrolytes when starting the keto diet.

However, it is also important not to over-hydrate, as this can flush out electrolytes and lead to hyponatremia. A simple test to check if you are well-hydrated is to note the colour of your urine. If it is extremely pale, you may be drinking too much water. Another test is the skin turgor test: pinch the skin on the back of your hand between your thumb and forefinger for about five seconds. When you release, if the skin stays "tented up" or moves slowly back into position, you may be dehydrated. If it rapidly returns to its normal position, you are likely well-hydrated.

If you are experiencing muscle twitching, it is most likely due to an electrolyte imbalance, which can be easily fixed by increasing your intake of electrolytes and ensuring you are properly hydrated.

Situational risk factors

There are common situational triggers for leg cramps, and these are often referred to as the 'common triggering Ts'.

Taking Diuretic Medications

Diuretic drugs reduce blood pressure by flushing salt out of your body, and fluid along with it. These drugs can cause leg cramps as a side effect. A low-carb diet can improve high blood pressure for many people, sometimes enough for them to come off this type of medication. If you are still taking drugs for high blood pressure, switching to another type may help.

Too Much Sitting

Sitting for long periods without taking breaks to walk around can cause leg cramps. This includes long car rides or long-haul flights. Sitting for too long, especially with crossed legs, tightens the calf muscles. It is important to get up and move around and stretch throughout the day.

Too Much Exertion

Athletic exertion is a known trigger for leg cramps, although it is still unclear why this causes cramps in only some athletes. If you are planning to be very physically active, pay extra attention to magnesium and salt supplementation, stay well-hydrated, and stretch before working out and sleeping.

Too-Tight Leg Muscles

Tight calves and hamstring muscles may be more prone to cramping. Regular yoga, before-bed stretching, and foam rolling of the legs can help limber up the legs and may prevent cramping. A 2012 randomised trial of nightly stretching before bed found a reduction in cramping frequency in older adults who stretched.

Too Much Wine

Research in France has found that drinking alcohol once a week can increase the risk of leg cramps by almost seven times for adults over 60. Alcohol consumption, particularly red wine, is a known trigger for many people.

Travel

Travel often involves a lot of sitting, unusual periods of exertion, a higher risk of dehydration, and more alcohol consumption than usual. Paying attention to salt intake, magnesium levels, adequate hydration, and stretching may be especially key for avoiding leg cramps during travel.

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