low carb flu
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l3long
Posts: 153 Member
I had been doing keto for about 10 days. It took about 4 to get through my initial low carb flu and then I was going well. My son's birthday came and I eased up a bit. Not a binge but ate some extra chocolate and fruit. Definitely was not in keto. Yesterday as I tried to get back into keto, I was starving all day. Today I am back to my routine low carb and not feeling overly hunger but it seems the low carb flu is back. Is this how it works? Every time I ease up, I have to face the low carb flu again? For how long?
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The good news is that you don't have to experience it at all.
Let me introduce you to my friend, Sodium.
http://community.myfitnesspal.com/en/discussion/10321316/interesting-personal-discovery-about-sodium-long0 -
Interesting! I am taking magnesium but not sodium. in fact I was thinking that our lower sodium intake was good for hubby's blood pressure. I, on the other hand, have low blood pressure and love salty foods so, I will indulge myself :-)0
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Yo Yo low carbing is not fun... In, all in is the way this Way Of Eating grows wings.0
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Actually, once I get past the flu part, low carbing makes me feel great! No more blood sugar fluctuations, no more cravings, sleep better, more energy. It seems a good fit for me.0
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The "flu" is the result of some kidney shenanigans, and sodium will fix it. Ask for details if you're curious about mechanisms, but it can recur even if you're "all in," especially if you exercise a lot. More symptoms? More sodium!0
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Interested in hearing details :-)0
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The "flu" symptoms are typically some combination of light-headedness, headaches, and fatigue.
All of those are the result of poor blood perfusion to the brain. The poor perfusion is the result of low blood volume.
Note that I said nothing about low blood pressure. Your body can still regulate blood pressure via vasoconstriction, so your BP may be fine even as you experience these symptoms.
The low blood volume is due to sodium losses. Water (in blood) follows sodium. That great water-weight loss at the start of a low carb diet is mostly due to sodium losses rather than glycogen depletion that everybody seems to implicate. Your liver only stores about 100g of glycogen, and you probably only deplete about half of that. So with water:glycogen at 3:1, only about 200-400g of that weight loss is due to glycogen depletion. The rest is sodium, and the water:sodium ratio is over 300:1.
Your kidneys are responsible for regulating fluid, electrolytes, and the acid-base balance of your blood.
Ketones are acids. And when they lose the H+, they become negative ions.
You excrete ketones in your urine. Why? It hasn't been studied AFAIK, but probably to help regulate blood pH. The more ketones you make, the more you'll excrete in your urine.
(If you make too much, you exhaust your supply of pH buffer, and that's when you enter ketoacidosis.)
Since those ketones are negative ions, they get "covered" by positive ions. In the first week or so, sodium is the only available volunteer, so you lose a LOT of sodium during that period.
As you continue to restrict carbs and deplete your glycogen, your rate of gluconeogenesis increases. You convert protein into glucose. The waste produce of that process is ammonia.
Ammonia is toxic, and it's normally converted to harmless urea and excreted in the urine. But now the kidneys are running out of sodium to pair up with the ketone anions, so instead of converting ammonia to urea, it gets excreted as ammonium ions. Yay! Sodium is conserved, and flu symptoms resolve.
But that assumes everything is in equilibrium. As soon as you do something that causes a change in protein metabolism (like changing carb consumption) or an increase in ketone production (like fasting or exercise), then sodium has to be excreted again for a while until ammonium production ramps up again, and you may get "flu" symptoms again.
Frankly, I'm guessing about some of this stuff. But it should be pretty close. You'll only find this info here -- it's not yet an internet meme.
You can find some aspects in early studies of starvation, like this one:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC292366/0 -
I just wanted to add... The need for more sodium isn't just in the beginning. Wab did say that above in a different way, but I just feel like there is post after post after post describing symptoms of low sodium. It's a never ending subject of discussion on here. I don't mean to sound like I find it annoying or anything, that's not what I mean at all. My point is that as much as we are discussing the need for sodium, there still seems to be a lot of either sodium avoidance or ideas that the need is just temporary or that if you supplement magnesium and/or potassium that you don't need to make sure to get enough sodium then.
Sodium is first. Then supplementing the others can also be done. But keeping up sodium will help to preserve the magnesium and potassium you already have.
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Question: I had 6300 in sodium yesterday and woke up with a terrible headache ..Would that be due to ..too much sodium? I am fine now but I wasn't this morning when I woke up0
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The "flu" symptoms are typically some combination of light-headedness, headaches, and fatigue.
All of those are the result of poor blood perfusion to the brain. The poor perfusion is the result of low blood volume.
Note that I said nothing about low blood pressure. Your body can still regulate blood pressure via vasoconstriction, so your BP may be fine even as you experience these symptoms.
The low blood volume is due to sodium losses. Water (in blood) follows sodium. That great water-weight loss at the start of a low carb diet is mostly due to sodium losses rather than glycogen depletion that everybody seems to implicate. Your liver only stores about 100g of glycogen, and you probably only deplete about half of that. So with water:glycogen at 3:1, only about 200-400g of that weight loss is due to glycogen depletion. The rest is sodium, and the water:sodium ratio is over 300:1.
Your kidneys are responsible for regulating fluid, electrolytes, and the acid-base balance of your blood.
Ketones are acids. And when they lose the H+, they become negative ions.
You excrete ketones in your urine. Why? It hasn't been studied AFAIK, but probably to help regulate blood pH. The more ketones you make, the more you'll excrete in your urine.
(If you make too much, you exhaust your supply of pH buffer, and that's when you enter ketoacidosis.)
Since those ketones are negative ions, they get "covered" by positive ions. In the first week or so, sodium is the only available volunteer, so you lose a LOT of sodium during that period.
As you continue to restrict carbs and deplete your glycogen, your rate of gluconeogenesis increases. You convert protein into glucose. The waste produce of that process is ammonia.
Ammonia is toxic, and it's normally converted to harmless urea and excreted in the urine. But now the kidneys are running out of sodium to pair up with the ketone anions, so instead of converting ammonia to urea, it gets excreted as ammonium ions. Yay! Sodium is conserved, and flu symptoms resolve.
But that assumes everything is in equilibrium. As soon as you do something that causes a change in protein metabolism (like changing carb consumption) or an increase in ketone production (like fasting or exercise), then sodium has to be excreted again for a while until ammonium production ramps up again, and you may get "flu" symptoms again.
Frankly, I'm guessing about some of this stuff. But it should be pretty close. You'll only find this info here -- it's not yet an internet meme.
You can find some aspects in early studies of starvation, like this one:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC292366/
I like how you summed that up. Over the past year your input has been so helpful to me. I'm now wondering if the ammonia nose I get when really low carb could be helped by more sodium. I seem to be the only person that gets this side effect and I hate it so much I'd rather stay a little higher in carbs than experience it again.0 -
ms_smartypants wrote: »Question: I had 6300 in sodium yesterday and woke up with a terrible headache ..Would that be due to ..too much sodium? I am fine now but I wasn't this morning when I woke up
It could be. There are so many different causes for headaches, and kidney regulation is much more complex than I outlined above, so it's hard to say. But increased blood volume could cause increased intracranial pressure, I suppose. There's a lag between sodium intake and excretion of about 4 days, so any symptoms of too much sodium (like excess water retention) should resolve in about that time.auntstephie321 wrote: »The "flu" symptoms are typically some combination of light-headedness, headaches, and fatigue.
All of those are the result of poor blood perfusion to the brain. The poor perfusion is the result of low blood volume.
Note that I said nothing about low blood pressure. Your body can still regulate blood pressure via vasoconstriction, so your BP may be fine even as you experience these symptoms.
The low blood volume is due to sodium losses. Water (in blood) follows sodium. That great water-weight loss at the start of a low carb diet is mostly due to sodium losses rather than glycogen depletion that everybody seems to implicate. Your liver only stores about 100g of glycogen, and you probably only deplete about half of that. So with water:glycogen at 3:1, only about 200-400g of that weight loss is due to glycogen depletion. The rest is sodium, and the water:sodium ratio is over 300:1.
Your kidneys are responsible for regulating fluid, electrolytes, and the acid-base balance of your blood.
Ketones are acids. And when they lose the H+, they become negative ions.
You excrete ketones in your urine. Why? It hasn't been studied AFAIK, but probably to help regulate blood pH. The more ketones you make, the more you'll excrete in your urine.
(If you make too much, you exhaust your supply of pH buffer, and that's when you enter ketoacidosis.)
Since those ketones are negative ions, they get "covered" by positive ions. In the first week or so, sodium is the only available volunteer, so you lose a LOT of sodium during that period.
As you continue to restrict carbs and deplete your glycogen, your rate of gluconeogenesis increases. You convert protein into glucose. The waste produce of that process is ammonia.
Ammonia is toxic, and it's normally converted to harmless urea and excreted in the urine. But now the kidneys are running out of sodium to pair up with the ketone anions, so instead of converting ammonia to urea, it gets excreted as ammonium ions. Yay! Sodium is conserved, and flu symptoms resolve.
But that assumes everything is in equilibrium. As soon as you do something that causes a change in protein metabolism (like changing carb consumption) or an increase in ketone production (like fasting or exercise), then sodium has to be excreted again for a while until ammonium production ramps up again, and you may get "flu" symptoms again.
Frankly, I'm guessing about some of this stuff. But it should be pretty close. You'll only find this info here -- it's not yet an internet meme.
You can find some aspects in early studies of starvation, like this one:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC292366/
I like how you summed that up. Over the past year your input has been so helpful to me. I'm now wondering if the ammonia nose I get when really low carb could be helped by more sodium. I seem to be the only person that gets this side effect and I hate it so much I'd rather stay a little higher in carbs than experience it again.
I remember you had ammonia sweat too. How long did that take to go away?
Protein metabolism is the only source of ammonia, but protein is not the only fuel for gluconeogenesis. So it's a little counterintuitive, but you can minimize ammonia production by either increasing carbs or perhaps by increasing ketone production, which increases availability of the other GNG substrate -- glycerol.
This may be where the famous "20g carbs = ketogenic" comes from. Your brain requires a minimum of about 40g/d glucose. You can make about half of that from glycerol, so that leaves 20g that would need to come from your diet or other sources.
So if you go below 20g carbs, you'll have to burn more protein.
Between 20-40g carbs, you're able to meet your glucose needs by diet and glycerol, minimizing protein catabolism.
Between 40g-130g carbs, you're providing more glucose than minimal needs, so you're reducing ketone (and glycerol) generation and you may be delaying keto-adaptation, so your tissues require more glucose, and that will come from more protein catabolism!
At above 130g, you're providing all the glucose your brain needs, so you're again minimizing protein catabolism.
So there may be a sweet spot for minimizing ammonia production of between 20-40g/d carbs. and another one as you approach 130g and more.
I think Lyle McDonald has some information in his books on this stuff if you're interested.
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