Keto And Shakiness: What's The Real Connection?

The keto diet is a low-carb, high-fat diet that aims to induce ketosis in the body, which is a metabolic state where fat is burned for energy instead of carbohydrates. While this diet is popular for weight loss, it can also lead to some side effects, including fatigue, weakness, and digestive issues. One of the potential challenges of the keto diet is experiencing shakiness or tremors, which can be caused by decreased blood sugar levels and electrolyte imbalances. This is particularly common in individuals with type 1 diabetes, as they may be at a higher risk of hypoglycemic episodes, marked by symptoms such as confusion, shakiness, fatigue, and sweating. Additionally, the keto diet's restriction of carbohydrates can lead to a drop in basal insulin levels, which can further contribute to shakiness. However, it's important to distinguish between true hypoglycemia and pseudohypoglycemia, where the body panics due to a rapid decrease in blood sugar levels, releasing stress hormones like cortisol and adrenaline, resulting in shakiness. To alleviate shakiness, it is recommended to increase electrolyte intake, ensure adequate hydration, and gradually adjust to the diet.

Low blood sugar

Causes of Low Blood Sugar

• Insulin resistance or diabetes: People with type 1 diabetes do not produce insulin, while those with type 2 diabetes have become resistant to insulin.
• Ketogenic diet: Restricting carbohydrates can lead to low blood sugar levels, especially in individuals with type 1 diabetes who are also taking insulin.
• Prolonged fasting: Going for long periods without eating, especially when combined with dehydration, can result in low blood sugar.
• Kidney disease: The keto diet may worsen chronic kidney disease due to acid buildup in the blood.
• Alcohol intake: Alcohol consumption can contribute to low blood sugar levels, especially when combined with other factors such as dehydration and a low-carb diet.

Treatment of Low Blood Sugar

The treatment for low blood sugar is to consume sugar or carbohydrates to bring blood sugar levels back to normal. This can be done by eating sugary foods or drinks, such as juice. If the person is unable to eat or drink due to vomiting or other illness, they may require emergency medical treatment with IV fluids containing glucose.

It is important to monitor blood sugar levels, especially for individuals with diabetes or those following a ketogenic diet. Any symptoms of low blood sugar should be addressed promptly to prevent complications.

Adrenaline release

The keto diet is a low-carb, high-fat diet that is commonly used for weight loss. Restricting carbs and increasing fat intake can lead to ketosis, a metabolic state in which the body relies on fat for energy instead of carbs. While the keto diet is associated with several benefits, it also carries certain risks. One of the potential risks of the keto diet is that it may cause shakiness or tremors in some individuals.

One possible explanation for the shakiness experienced by some people on the keto diet is increased adrenaline release. Adrenaline, also known as epinephrine, is a hormone and neurotransmitter that plays a crucial role in the body's fight-or-flight response. It prepares the body for intense physical activity and increases heart rate, blood pressure, and blood glucose levels.

Several factors related to the keto diet may contribute to increased adrenaline release:

• Stress Response: Restricting carbohydrates can be stressful for the body, as carbs are a primary source of energy. This stress response may trigger the release of adrenaline, which can lead to symptoms such as shakiness, increased heart rate, and changes in blood glucose levels.
• Blood Glucose Changes: The keto diet can lead to significant changes in blood glucose levels. When carb intake is reduced, blood glucose levels tend to decrease. This can stimulate the release of adrenaline, which works to increase glucose levels by triggering the breakdown of glycogen and stimulating gluconeogenesis (the production of glucose from non-carbohydrate sources).
• Counterregulatory Response: Adrenaline is part of the counterregulatory response to low blood glucose levels, especially in individuals with type 1 diabetes. In response to low blood sugar, the body releases adrenaline, glucagon, and other hormones to stimulate glucose production and raise blood sugar levels. This counterregulatory response can result in symptoms such as shakiness, sweating, and increased heart rate.
• Interaction with Medications: For individuals taking stimulant medications, such as ADHD medications, the combination of keto and these drugs may lead to increased adrenaline levels. The keto diet increases adrenaline and noradrenaline, and the addition of stimulant medications can further enhance this effect. This interaction may result in side effects such as increased anxiety, tachycardia (rapid heart rate), and panic attacks.

It is important to note that while increased adrenaline release may be a contributing factor to shakiness on the keto diet, there are also other potential causes. These include electrolyte imbalances, dehydration, and withdrawal symptoms from reducing carb intake (often referred to as the "keto flu"). Additionally, individuals with type 1 diabetes on the keto diet may experience shakiness due to episodes of low blood sugar (hypoglycemia).

Insulin resistance

The ketogenic diet is a low-carb, high-fat diet that aims to induce ketosis in the body, a metabolic state in which the body burns fat for energy instead of carbohydrates. While this diet can be effective for weight loss, it also comes with certain risks and side effects that individuals should be aware of. One of the potential dangers of the keto diet is that it may cause shakiness due to insulin resistance.

The keto diet, by restricting carbohydrate intake, can exacerbate insulin resistance and lead to further health complications. When an individual with insulin resistance follows a keto diet, their body may struggle to adapt to using fat for energy instead of carbohydrates. This can result in a state of "pseudohypoglycemia," where the body panics and believes it is in a dangerously low blood sugar situation, even if blood sugar levels are still within a normal range.

During pseudohypoglycemia, the body releases stress hormones such as cortisol and adrenaline, which can cause symptoms such as a pounding pulse, increased heart rate, and anxiety. The release of adrenaline is what leads to the feeling of shakiness. This reaction is particularly common in individuals who have had moderate to high blood glucose levels and then suddenly restrict carbohydrates through a keto diet.

To manage shakiness caused by insulin resistance and pseudohypoglycemia, it is important to give the body time to adjust to the new diet. Gradually reducing carbohydrate intake over a period of several weeks can help minimize the severity of symptoms. Additionally, ensuring adequate electrolyte intake, particularly sodium and potassium, is crucial to maintaining a healthy electrolyte balance during the transition to a keto diet.

It is worth noting that not everyone who follows a keto diet will experience shakiness due to insulin resistance. Only about one-third of overweight individuals have insulin resistance, and the keto diet may still be effective for weight loss and blood sugar management in those who are insulin sensitive. However, it is always advisable to consult with a healthcare professional before starting any new diet, especially if you have existing health concerns.

Dehydration

• Glycogen, the body's primary fuel source before transitioning to keto, is stored with water. As your body runs through its glycogen stores, you will lose a lot of water.
• High-carb diets cause water retention by inhibiting sodium excretion. The keto diet lowers insulin levels, allowing excess fluid to be released.

These two factors combined can lead to dehydration, which may cause symptoms such as stomach pain, headaches, lethargy, nausea, brain fog, and low motivation. To combat dehydration, it is important to drink plenty of water and ensure adequate electrolyte intake, including sodium, potassium, and magnesium. Bone broth is also recommended as it supplies electrolytes and other important nutrients.

In addition to dehydration, transitioning to a keto diet can also lead to a drop in blood sugar levels, which may result in symptoms such as shakiness, lightheadedness, and sweating. This is more likely to occur in individuals with type 1 diabetes or those with type 2 diabetes taking insulin medications. It is important to monitor blood sugar levels and consult a healthcare provider if you are at risk of hypoglycemia.

Furthermore, the keto diet may cause an initial decrease in performance and energy levels due to the reduction in muscle glycogen stores. However, after several weeks, many keto dieters report that their energy levels and performance return to normal or even improve.

It is important to note that the side effects of transitioning to a keto diet, including dehydration and low blood sugar, are typically short-term and should resolve within a few weeks as your body adjusts.

Electrolyte imbalance

The keto diet can lead to an electrolyte imbalance, which is often referred to as the "keto flu". This is because restricting carbohydrates causes your body to process electrolytes differently. When insulin levels are low, the kidneys excrete more sodium, and since there is a delicate balance between sodium and other electrolytes in the body, the loss of sodium may disrupt levels of other electrolytes as well.

Symptoms of Electrolyte Imbalance

• Shakiness
• Headaches
• Weakness
• Fatigue
• Brain fog
• Heart palpitations
• Muscle cramping or twitching
• Difficulty concentrating
• Insomnia
• Constipation
• Diarrhea
• Increased thirst
• Irregular heartbeat
• Nausea
• Vomiting
• Loss of consciousness

How to Prevent or Treat Electrolyte Imbalance

• Consume more sodium, potassium, and magnesium.
• Eat more whole foods such as spinach, avocados, beef, chicken, eggs, nuts, and seeds.
• Take electrolyte supplements.
• Drink more water.
• Transition to the keto diet slowly.
• Consult a doctor, especially if you are taking any medications.

Frequently asked questions