Dizzy, Weak, Tired, Headaches, Cramping Muscles? Electrolyte Imbalance May Be Your Problem!

Yes. The keto-flu or low-carb flu IS a thing.
The first couple weeks, or even periodically thereafter, you may have bouts of feeling dizzy, tired, worn down, have headaches, an achy body, nausea, racing heartbeat, weakness, or have cramping muscles. Isn't low-carb supposed to be great? Why does this happen? One simple word is the answer: Electrolytes.

Electrolytes are important for keeping the body humming along.

According to Wikipedia:

Electrolytes play a vital role in maintaining homeostasis within the body. They help to regulate heart and neurological function, fluid balance, oxygen delivery, acid-base balance and much more. Electrolyte imbalances can develop by the following mechanisms: excessive ingestion; diminished elimination of an electrolyte; diminished ingestion or excessive elimination of an electrolyte ...

The most serious electrolyte disturbances involve abnormalities in the levels of sodium, potassium, and/or calcium. Other electrolyte imbalances are less common, and often occur in conjunction with major electrolyte changes.

Electrolytes are important because they are what cells (especially nerve, heart and muscle cells) use to maintain voltages across their cell membranes and to carry electrical impulses (nerve impulses, muscle contractions) across themselves and to other cells. Kidneys work to keep the electrolyte concentrations in blood constant despite changes in the body. For example, during heavy exercise, electrolytes are lost in sweat, particularly in form of sodium and potassium. These electrolytes must be replaced to keep the electrolyte concentrations of the body fluids constant.

https://en.wikipedia.org/wiki/Water-electrolyte_imbalance

Electrolytes are important no matter which WOE you follow. Low-carb diets pose a unique conundrum, however. As hormone and ketone levels change, we retain less sodium. The loss of sodium leads to a large loss of fluid, which can lead to symptoms of dehydration and low blood volume if the sodium isn't replenished. If sodium levels are too low for too long, the body will waste potassium in order to spare sodium, and then we end up potassium deficient as well.

To remedy this problem, we need to supplement electrolytes. There are multiple ways to do this.

• Every day low-carbers require:
• 3,000-5,000mg of sodium
• Potassium: as close to 2,000mg as you can manage
• Magnesium: a minimum of 300-400mg. Though many people require 600mg. YMMV.

How on earth are we going to get all this in? We don't have a whole bag of salty potato chips!
Sodium and potassium:
The easiest ways to supplement sodium is to take a sodium pill. They sell these supplements. No salty taste required. That isn't the only way, however. Another way is to liberally salt your food and drink salty broth or warm water with a bouillon cube dissolved within it. You can add a tbsp of HWC or butter to make it into a savoy fat bomb. What about potassium though? Potassium can be supplemented in a pill, however, the concentrations available are way too small. So we recommend eating potassium rich foods and investing in a bottle of a potassium salt, like No Salt, Nu-Salt, or Lite Salt. You can add this to your salty broth to achieve your potassium goal.

Sometimes we get sick of broth, but that's ok. Another way is to make what I call "ketoade." regular Gatorade or Powerade tastes nice, but they contain a pittance of electrolytes in them. You'd have to drink over a gallon of it. You can do that if you like, but that's going to get pricey. Ketoade is simply 8-12oz of water, flavored with a no-cal, no-carb flavoring (like Mio), and mixed with a 1/4 tsp of salt and ¼ tsp of potassium salt. For those who can't/don't use artificial sweeteners, squeeze some lemon juice (or soak berries) and add some stevia to your electrolyte water.

As long as you track your sodium, your potassium store will also be preserved as your body won't freak out and leech it. Hitting the potassium goal exactly is less important. Of course you should get as much as you can, but obsessing over it is less productive. Potassium is great for keeping muscle cramps at bay, but it IS preserved when we make sure we get enough salt. So we don't need to sweat it as much.

Those who remain on this WOE for a long period, or adopt it as their lifestyle, find that over time (usually once they become fully adapted to ketone production after 6 weeks or so) that their sodium needs decrease somewhat. They still require higher sodium intake, but require intake only at the bottom of the range instead of the max as they did when they first began.

But what about magnesium?

Symptoms of magnesium deficiency include hyperexcitability, muscular symptoms (cramps, tremors ... spasms, tetany, weakness), fatigue, loss of appetite, apathy, confusion, insomnia, irritability, poor memory, and reduced ability to learn. Moderate to severe magnesium deficiency can cause tingling or numbness, heart changes, rapid heartbeat, continued muscle contractions, nausea, vomiting, personality changes, delirium, hallucinations, low calcium levels, low serum potassium levels, retention of sodium, low circulating levels of parathyroid hormone (PTH), and potentially death from heart failure. Magnesium plays an important role in carbohydrate metabolism and its deficiency may worsen insulin resistance a condition that often precedes diabetes, or may be a consequence of insulin resistance.

https://en.wikipedia.org/wiki/Magnesium_deficiency_(medicine)

That sounds pretty dire. It isn't always so severe. And we see some of our undesirable symptoms in there, don't we? Cramps, weakness, fatigue, nausea, insomnia. Who knew mag was so important? Magnesium is in many foods, but as soil has been depleted, we get less minerals in our foods. So, like with the other electrolytes, we need to supplement. And like potassium, few people get enough daily. Any old supplement won't do for magnesium, though. NEVER ever take magnesium oxide, unless you just want to perch on the porcelain throne for a long period. It is poorly absorbed by the body, in addition to mainly being nothing more than a laxative. Other forms of magnesium may help in that regard if you have egularity issues, but the following forms are actually absorbed. Choose magnesium supplements whose second word ends in -ate: citrate, glycinate, malate, or taurate. You'll likely have to order these, but it's worth it.

Many low-carbers take theirs before bed, as mag supplements tend to fix problems with night cramping and insomnia. Be aware that some people experience vivid dreams as a result. That's not bad, just different. Also, you'll need to discover your personal need level. Some are good with only 300mg. But some people need more. Many recommend to increase your dose by 1 pill every night until you reach the point that you experience some gastric upset (yup-TMI-sorry. Loose stools.) At that point you back off one pill.
Another way to supplement magnesium is through the skin. Your body will absob the mag until it is full up, then stop. This way you don't need to worry about swallowing more pills or toilet troubles. You can do this by soaking for 30 minutes in a bath with epsom salts or by purchasing and applying pure magnesium oil to the skin.

Electrolytes are so important to our bodies. Keeping our electrolytes balanced is going to optimize our health, and keep us feeling on-par.

As with any other online advice you receive, if you are taking medication, please review this advice with your doctor if your meds may affect electrolyte metabolism before making any changes. You should always know what your meds do.