Signs Of Ketosis: How Your Body Tells You Keto's Working

Kasey Trenum, a proponent of the keto diet, has shared her journey and results after 100 days of being on the keto diet. She started her keto journey after seeing a friend's impressive transformation. In her first week, she searched for keto recipes and cooked them, and she lost 6 pounds. She also experienced the keto flu, which made her feel dizzy, nauseous, and tired. However, after six weeks to two months, she experienced a huge energy surge and felt terrific. She also noticed that she slept better and had more energy during the day. Kasey's results and experiences serve as an encouragement for those interested in trying out the keto diet.

Increased ketones in the blood, breath, or urine

Blood

Blood ketone levels can be measured using a specialised meter that calculates the amount of beta-hydroxybutyrate (BHB) in the blood. This is one of the primary ketones present in the bloodstream. Nutritional ketosis is defined as blood ketones equal to or above 0.5 millimolar (mM).

Breath

Breath analysers monitor acetone, one of the three main ketones in the blood during ketosis. This gives an indication of the body's ketone levels, as more acetone is released when in nutritional ketosis.

Urine

Urine tests can also be used to measure ketone levels. Urine tests usually involve dipping a test strip into a container of urine and waiting for it to change colour. The colour is then compared to a chart that indicates ketone levels. Urine tests can show ketone levels from the last few hours but cannot indicate the body's current ketone levels.

It is normal to have small amounts of ketones in the urine, and this is safe for people who do not have diabetes. However, moderate to large amounts of ketones in the urine can be dangerous and can lead to ketoacidosis, a life-threatening condition.

General signs of ketosis

Other signs that the keto diet is working include bad breath, weight loss, increased energy, and reduced appetite.

Weight loss

One of the main reasons people don't lose weight on keto is that they're consuming too many carbs. To reach the state of ketosis, where the body burns fat for energy instead of glucose, carb intake must be drastically reduced. Only around 5-10% of total calories should come from carbs, which is a stark contrast to the standard dietary recommendation of 45-65%. Tracking macronutrients through an app can help individuals stay within their carb allowance.

Another reason for a lack of weight loss on keto could be the types of food being consumed. Even if someone is sticking to keto-friendly foods, relying too much on processed options like snack bars, keto desserts, and other packaged foods can hinder progress. These foods tend to be high in calories but low in vitamins, minerals, and antioxidants. To optimise weight loss on keto, it's important to prioritise unprocessed, whole foods like full-fat dairy, eggs, fish, meat, poultry, and healthy fats such as avocado and olive oil. Non-starchy vegetables like greens, broccoli, peppers, and mushrooms should also be included to boost nutrient intake and fibre.

Creating a calorie deficit is crucial for weight loss, and this can be achieved by reducing calorie intake or increasing physical activity. Overeating, even if the foods are keto-friendly, can prevent weight loss. Paying attention to portion sizes and increasing physical activity can help create the necessary calorie deficit.

Undiagnosed medical issues could also be a factor in a lack of weight loss on keto. Conditions such as hypothyroidism, polycystic ovarian syndrome (PCOS), Cushing's syndrome, depression, and hyperinsulinemia (high insulin levels) can contribute to weight gain and make weight loss more difficult. Consulting with a doctor to rule out any underlying medical issues is important if weight loss is not occurring despite a person's best efforts.

It's also important to manage expectations and remember that weight loss can vary from person to person. While keto can promote weight loss when properly followed, the rate may not be rapid. Small, consistent changes are key to losing and maintaining weight in a healthy way. Instead of relying solely on the scale, taking weekly measurements of the arms, thighs, and midsection can provide a more accurate picture of progress.

Finally, stress and lack of sleep can also impact weight loss. Research shows that chronic stress and inadequate sleep can encourage the body to store fat and increase appetite. Finding ways to reduce stress and improve sleep, such as through meditation or yoga, can support weight loss efforts.

In summary, while keto can be an effective tool for weight loss, it's important to ensure carb intake is low enough to reach ketosis, prioritise whole, nutritious foods, create a calorie deficit, address any underlying medical issues, manage expectations, and reduce stress and improve sleep. Combining these factors with increased physical activity can maximise the chances of achieving weight loss goals on a ketogenic diet.

Dehydration and increased thirst

The keto diet is a high-fat, moderate protein, and low-carb diet. It involves cutting out carbohydrates and eating more fat, which puts the body into a metabolic state known as ketosis, where it burns fat instead of sugar for fuel. While this diet is generally safe and can be part of a healthy lifestyle, it can lead to dehydration, especially when first starting.

When you eat carbohydrates, your body converts them into glycogen, which is used for energy. Each gram of glycogen stores approximately three grams of water. So, when you drastically reduce your carb intake, your body burns through its glycogen stores and loses a lot of water in the process. Additionally, changes in insulin levels can also lead to dehydration. When you ingest carbohydrates and sugar, your pancreas releases insulin, which triggers your kidneys to retain water and sodium. However, when you eliminate carbs and sugar from your diet, your insulin levels drop, and your kidneys release this stored water.

Symptoms of Dehydration

Dehydration on the keto diet can lead to various unpleasant symptoms, including:

• Dry mouth and throat
• Fatigue and weakness
• Dizziness and lightheadedness
• Muscle cramps
• Headaches
• Keto flu
• Constipation
• Increased thirst and hunger

Preventing Dehydration on the Keto Diet

To prevent dehydration, it is crucial to increase your water intake and ensure proper hydration. Here are some tips to help you stay hydrated:

• Start your day with a glass of water, and aim to drink around eight glasses of water throughout the day.
• Keep a full glass of water nearby to remind yourself to drink.
• Purchase a tracking cup or download a water-tracking app to monitor your daily water intake.
• Consume other hydrating liquids such as low-sugar broths, juices, sports drinks, and popsicles.
• Eat whole foods like leafy vegetables, which have a high water content, and nuts and seeds, which are high in electrolytes.
• Aim to drink at least half of your body weight in ounces of water per day. For example, if you weigh 150 pounds, aim for 75 ounces of water.
• Set reminders on your phone to drink water every hour.
• Infuse your water with fruits or herbs to add flavour.
• Drink water before and after meals.
• Avoid sugary drinks, caffeine, and alcohol, as these can contribute to dehydration.

Muscle cramps and spasms

The keto diet may make you more susceptible to muscle cramps and spasms for several reasons:

• Electrolyte imbalance: Electrolytes are minerals that are essential for critical functions in your body, such as cell communication. They include sodium, magnesium, chloride, potassium, calcium, phosphate, and bicarbonate. 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 imbalance may be worse during this period.
• Dehydration: People transitioning to the keto diet often urinate more, which can lead to dehydration, another potential cause of muscle cramps and spasms.

To treat and prevent muscle cramps and spasms while on the keto diet, it is important to:

• Eat potassium-rich foods: Avocados, Swiss chard, spinach, onions, tomatoes, beet greens, and mushrooms are keto-friendly, potassium-rich foods that can help rebalance your electrolyte levels.
• Choose magnesium-rich foods: Pumpkin seeds, Brazil nuts, cashews, kale, arugula, broccoli, and oysters are low in carbs and high in magnesium to aid your electrolytes.
• Consider taking an electrolyte supplement: Taking a magnesium, potassium, or multi-mineral supplement may be beneficial when transitioning to a keto diet.
• Consume enough salt: Salt your food and consider sipping on salted bone broth to reduce the chances of electrolyte imbalance.
• Drink plenty of water: Staying properly hydrated may reduce your risk of muscle cramps and spasms, as well as other keto side effects such as headaches and constipation. Pale, yellow urine is a sign that you are adequately hydrated.
• Cut back on or avoid alcohol: Alcohol is a diuretic and may worsen dehydration, potentially leading to muscle cramps and spasms.
• Engage in gentle exercise: Try walking, stretching, and yoga when first adapting to keto. Avoid intense exercise for the first few days to reduce the chance of muscle cramps and spasms.

If you experience persistent or extreme muscle cramps and spasms, it is recommended to consult a healthcare professional to rule out any underlying medical conditions.

Headaches

Causes

Hypoglycemia

When you start the keto diet, your carb intake is drastically reduced and replaced with fat. This shift causes your body to rely on ketone bodies instead of glucose for energy, which can lead to low blood sugar levels. This transition into ketosis may stress your brain, resulting in mental fatigue, "brain fog", and headaches.

Dehydration

Dehydration is another common side effect of the keto diet. As your body shifts into ketosis, you tend to urinate more frequently, leading to water loss. Additionally, your body produces less insulin, which can affect electrolytes such as potassium and sodium, further contributing to dehydration.

Ketoacidosis

During the early stages of keto-adaptation, ketone levels can increase rapidly before stabilising. This short-term increase can disrupt the normal balance of acids in the body, leading to temporary ketoacidosis, with headaches being a key symptom.

Treatment and Prevention

To treat or prevent keto headaches, it is crucial to address the underlying causes of dehydration and low blood sugar levels:

• Drink plenty of water: Aim for at least 68 ounces (2 litres) of water per day to counteract the water loss during the initial phases of keto.
• Eat more low-carb, water-rich foods: Cucumbers, zucchini, lettuce, celery, cabbage, and raw tomatoes can help with hydration and are suitable for the keto diet.
• Avoid intense exercise: Intense workouts can further stress your body and increase the likelihood of headaches during the initial days of keto.
• Eat more electrolyte-rich foods: Avocados, spinach, mushrooms, and tomatoes are keto-friendly and high in potassium. Almonds, kale, pumpkin seeds, and oysters are good sources of magnesium.
• Salt your food: Lightly salting your food can help reduce the risk of an electrolyte imbalance.
• Try an electrolyte supplement: This may help minimise the risk of dehydration and keto flu symptoms.

If your headaches persist beyond a few days or weeks, consult a healthcare professional to rule out any underlying medical conditions.

Frequently asked questions