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Keto, high blood pressure, and the food you eat on Keto

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JerSchmare
JerSchmare Posts: 1,214 Member
in Social Groups
I'm new here. But, I have a question.

I have high blood pressure. I just started Keto today, so brand new.

Many of the foods that are ok to eat seem to have higher levels of sodium. I have concerns about this. On the other hand, everything I am finding on the internet, is suggesting that sodium isn't actually the problem.

My issue is that I can't find evidence of this, only blogs and opinions. Are there studies suggesting that sodium doesn't have much effect on blood pressure? And if so, what is a primary culprit?

Any links would be great. I went through the stickies before posting, but didn't find anything that directly answers my question. Also googled for a few hours and also couldn't find anything.

Thanks in advance.
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  • RalfLott
    RalfLott Posts: 5,036 Member
    edited July 2017
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    Here's a collection of resources on sodium in one of this group's sticky threads (just in case you missed it):
    http://community.myfitnesspal.com/en/discussion/10358179/low-sodium-and-keto-flu-electrolyte-imbalance-may-be-your-problem#latest

    As I recall, keto guru Dr. Stephen Phinney explained the BP issue something like this....

    A minority of people with HBP are sodium-sensitive, but they're pretty much what drove the FDA to set low daily sodium intake levels, in the 2000-2500mg range. However, for someone in ketosis (you'll be there soon!), and in fact for the general population, it is riskier to drop your sodium level from 5000mg to 2000g than it is to raise it from 5000mg to 8000mg. (!) I'll see if I can find the video where he lays it out.

    In the meantime, here's a summary:


    https://www.youtube.com/watch?v=WNV0GJcrqp4

  • RalfLott
    RalfLott Posts: 5,036 Member
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    There can be many culprits, including heart / circulatory system not efficiently getting blood around your body, hormonal issues, medications, heredity, age, obesity, stress, kidney issues.

    Oh, and kids, every now and then, and Xmas.....
  • RalfLott
    RalfLott Posts: 5,036 Member
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    There's some good stuff on sodium in this thread, including some discussion of a NEJM study by @cstehansen that Phinney refers to in one of the videos posted there.
    http://community.myfitnesspal.com/en/discussion/10498634/a-video-phinney-recent-developments-in-lchf-and-nutritional-ketosis/p1
  • Sunny_Bunny_
    Sunny_Bunny_ Posts: 7,140 Member
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    I'm just going to predict that your high blood pressure is mostly resolved within the week.
    Be in the look out for low blood pressure symptoms listed in the keto flu link already provided. If you take meds to lower it you'll need to be particularly aware.
    The body doesn't retain sodium the same on keto due to lower insulin levels. Insulin plays a role in sodium retention. Lower levels means less sodium.

    I remember someone previously going back to their doctor to have meds adjusted and the doctor telling them their new diet was making their blood pressure too low. Suggesting instead of lowering or quitting meds they should go. Ack to the diet that made them need the meds in the first place...
  • AlexandraCarlyle
    AlexandraCarlyle Posts: 1,603 Member
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    Honestly? I have no ways, means or mechanical devices to measure anything about myself, except a tape measure (100% reliable) and a set of bathroom scales (Dodgy). AFAIK, on nutrition, I'm on good levels of everything.

    I very much 'listen' to my body, and if it feels good, I do it, when in doubt, I don't.

    If I feel 'wavery', quivery, light-headed, headachey or simply out of sorts, it's water, mixed with ACV, Bicarb of soda, Cream of tartar and a nugget of Himalayan salt to crunch.
    Within minutes, I'm right as rain.
  • gymbunny09
    gymbunny09 Posts: 69 Member
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    TheDevastator wrote: »
    magnesium was the key to my high blood pressure. I take 400-800mg of it a day and my blood pressure is manageable without drugs. I also take 1/4 teaspoon of ancient sea salt every few days and that can actually lower it too.

    I'm going to give this a go, been on bp medication for years, enjoying the keto lifestyle and managed to lose 14lbs since the end of May so hopefully can get off they meds soon
  • gymbunny09
    gymbunny09 Posts: 69 Member
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    JerSchmare wrote: »
    I'm new here. But, I have a question.

    I have high blood pressure. I just started Keto today, so brand new.

    Many of the foods that are ok to eat seem to have higher levels of sodium. I have concerns about this. On the other hand, everything I am finding on the internet, is suggesting that sodium isn't actually the problem.

    My issue is that I can't find evidence of this, only blogs and opinions. Are there studies suggesting that sodium doesn't have much effect on blood pressure? And if so, what is a primary culprit?

    Any links would be great. I went through the stickies before posting, but didn't find anything that directly answers my question. Also googled for a few hours and also couldn't find anything.

    Thanks in advance.

    I've found dietdoctor.com really helpful loads of information and great keto recipes.
  • anglyn1
    anglyn1 Posts: 1,803 Member
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    Before keto my blood pressure wasn't super high but it was always on the upper end of normal or into the zone where it's technically above what they like but they usually give you a chance to correct it rather than push meds. Now it's rather low. Not too low just really low. Sometimes the nurse will take it more than once because she thinks it's an error. I eat tons of sodium btw!
  • kpk54
    kpk54 Posts: 4,474 Member
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    I was on meds for high BP. I lost weight and got more active (brisk walking mostly) and my BP went down and I was taken off the meds. A couple years later I ate keto for a year (for reason other than weight loss/maintenance) and had what seemed to be only a slight need for increased sodium over my norm. It was rare that I hit over 3500 mg per day though there were definitely days I would purposely eat a boullion cube or lick about 1/2 tsp of salt out of my hand because I was feeling a bit "clammy". Increasing sodium from "my norm" never seemed to increase my BP but I seemingly don't have the high intake/need many others have. I function fine.

    I think those of us who have been diagnosed with "the silent killer" and have been told to limit our sodium intake (right or wrong) have a little different perspective or caution regarding sodium. There are many "keto foods" that are not high in sodium. My "diet" was fairly simple: meat/fish/dairy/vegetables/nuts/seeds/eggs/oils. I was happy though to be able to eat shrimp/crab/kielbassi/sauerkraut and not worry about the sodium content as I did when eating <1500 mg/day while on BP meds.

    Because my BP has been fine since weight loss, I'm fairly certain mine was high due to excessive weight and lack of activity. My husband, who had been on a variety of meds for high BP for a few years with little effect, started walking a couple miles a few days a week. He's no longer on BP meds and his BP is AOK. (He's never been over weight. Not even close.)

    I'm aware though that weight loss and exercise of the "steady state" kind don't help reduce blood pressure for everyone.

    You didn't mention in your original post why you are eating keto or if you have been provided a reason why your BP is high so I'm just sharing my experience FWIW.

  • RalfLott
    RalfLott Posts: 5,036 Member
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    :o Refusing to take BP meds, not listening to anyone who's not a peer reviewed, doublie-blind, randomized study that applies specifically to your situation, and being angry about it is probably not helping.
  • baconslave
    baconslave Posts: 6,958 Member
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    Dragonwolf wrote: »
    Wab seems to be on vacation right now, so I'm going to address some of the points that I can.
    thubten1 wrote: »
    I am having a lot of trouble swallowing 20 gm sodium a day advice.

    Make sure to read through the whole thread, not just the first post. The 20g sodium thing is addressed in a later post, where Wab and the nurse conclude that he said salt, not sodium, putting the sodium intake at 8g.
    Is there something about your advisor being russian that is significant? Is he actually a board certified nephrologist?

    I can't speak for Wab on either of these, but knowing him, I suspect that if the doctor is not board certified, he's likely very highly qualified. Wab's not the kind of person to believe just anyone (as reading his posts in the archives will tell you).

    As for him being Russian, I suspect the largest significance is his mannerisms. If you've ever had an Eastern European or Asian doctor (or other service provider) -- and I'm talking "fresh off the boat" immigrant, here, not American with Eastern European or Asian ancestry -- there's a certain demeanor to them that makes them stand out. This isn't a bad thing by any means. It's just something that one happens to notice.
    Did he ever give you any references in the scientific literature on which he based his opinion?

    I can't speak for his references, but I found a few you can start with while we wait to hear back from Wab.

    http://healthland.time.com/2011/05/04/low-salt-diets-reduce-heart-disease-risk-right-a-study-disagrees/
    http://www.todayifoundout.com/index.php/2013/02/why-does-salt-raise-blood-pressure/
    http://www.kevinmd.com/blog/2013/07/salt-diet-high-blood-pressure-evidence.html
    http://www.scientificamerican.com/article/what-science-on-hypertension-really-shows/
    http://www.scientificamerican.com/article/its-time-to-end-the-war-on-salt/
    http://www.aafp.org/afp/2004/0115/p359.html

    Unfortunately, certain organizations have done a damn good PR job and it's quite difficult for the layman to find anything that contradicts the conventional wisdom. However, like most of the recommendations, the salt thing is an oversimplification of a more complex thing, and is based off of shoddy science (nutrition -- the only science field where uncontrolled population studies are treated as solid fact and correlation is treated as causation).

    What the above links state, at the very least, is that there is no actual correlation in the more strictly-controlled trials between sodium intake and blood pressure. Some of them also mention that increased sodium intake actually helps prevent death.

    The thing is, the body regulates sodium concentrations in the blood more tightly than it regulates glucose. As a result, the body will change blood volume and vasoconstriction in order to maintain a certain concentration. This also means that it will deprive the other cells of sodium in order to maintain said concentration.

    In other words, it's less about the raw intake numbers and more about the concentration levels in the blood.

    Finally, for a quick anecdote regarding blood pressure, I'll share my recent experiences:

    I by no means restrict my sodium intake. In fact, I salt damn near everything, in addition to eating a fair amount of cheese, and enjoy the occasional cup of salted broth. Hell, I even add salt to the "energizing hot cocoa" recipe that I recently found (milk of any sort, cocoa, teaspoon or two of coconut oil, dash of cayenne, salt, pinch of cinnamon, and a bit of sweetener of choice, heat, blend, enjoy). Right now, I'm donating plasma twice a week, and I get it measured every time. Yesterday's measurement -- 114/77 A previous measurement -- 114/65 And that's with a shoddy water habit lately (noontime measurements, and the only thing I've had to drink is coffee with a fair bit of cream; yeah...I'm a phlebotamist's worst nightmare, except I still manage to bleed well). Oh, and those numbers are a reduction since going low carb (which is another thing that throws off the studies -- because of the naturetic nature of ketones, our sodium needs -- and therefore intake tolerance -- goes up), my numbers have always been in that 120/80 "perfection" range.

    quoted from the thread:
    Sodium, Blood Pressure, and the Russian Nephrologist

    Hopefully the links will point you in the right direction.
  • RAC56
    RAC56 Posts: 433 Member
    edited July 2017
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    JerSchmare wrote: »
    RalfLott wrote: »
    :o Refusing to take BP meds, not listening to anyone who's not a peer reviewed, doublie-blind, randomized study that applies specifically to your situation, and being angry about it is probably not helping.

    That's not what I said. I am angry about my situation because I work hard. It's frustrating.

    I am not refusing to take meds. I take them. But, I don't want to take them. So, I am trying to get to a situation where I no longer need them. My traditional diet obviously isn't working. So, I am seeking an alternative.

    I don't not listen to people, but when it comes to health, I tend to base my beliefs on science. I like to find studies that suggest that I am heading in the right direction. This industry is full of opinions and quacks. I tend to disbelieve most things that do not have some basis in science. Anyone can make any claim. It's easy. And, it's easy to just say, eat this, buy my book, and you will live a healthy life. It's very easy to do, and many people are writing books and doing just that. But, anyone can write a book. Anyone can stand on a stage and talk. I want to see actual evidence that something works. I've read several studies on how the keto diet seems to help epilepsy patients. Also, seem to help those with diabetes. There seems to be some circumstantial suggestions that a Keto diet can lower BP for some that are obese.

    All that is good.

    Of course I want a study that identifies my exact situation. Why wouldn't I seek that out?

    I like information. I apologize if that offends you or rubs you wrong.

    I'm asking for studies that head in that area. And, I'm a little surprised that there aren't more since this diet has been around a very long time now.

    But, with that, I'll drop the topic and search on my own. Obviously, I've pushed the envelope here.

    Salt intake is a touchy subject here sometimes. Not everyone can take in a lot of sodium without having their BP go up. That happens to me. When I first started keto there were two members here who had lower amounts of daily sodium in their diet. One guy, under doctor supervision, was taking in less that 2000mg a day and was doing well. Another member started keto with higher sodium intake but found that an intake of around 2300/day was fine.

    I tend to stay around 2400mg/day. Sometimes I hit 3000 or more but most of the time I stay around 2400. For now….if I take in higher than that my BP will go up so it's something I tend to keep an eye on. Perhaps when I've been keto for a year or so it won't be an issue. Hope so.
    Let your own body be your guide and do what is right for you. :)
  • Sunny_Bunny_
    Sunny_Bunny_ Posts: 7,140 Member
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    Tim Noakes states "High blood pressure is a sign of insulin resistance"

    https://itunes.apple.com/us/podcast/the-ask-prof-noakes-podcast/id882524927?mt=2&i=1000384912381

    Reverse the insulin resistance and its symptoms will go away.
    High cholesterol, at least high trigs, is a sign also since it indicates an inability to access fat for fuel.
  • cstehansen
    cstehansen Posts: 1,984 Member
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    First, welcome, @JerSchmare

    I completely understand your frustration in regard to not having such diagnoses. I have worked out regularly (minimum 5 days a week) for about 30 of the last 35 years and have never been significantly overweight. I was all out pissed off when I was diagnosed at T2D almost 2 years ago being 6'1" and 195 lbs and appearing to be in far better shape than many if not most guys 10 years younger than me.

    That said, I have come to realize through much research that exercise can't save me from poor dietary choices and all those pizza buffets I frequented for years because I was "able to burn it off" came to bite me.

    This is a link to a more recent study on sodium and potassium which followed over 100,000 people:

    http://www.nejm.org/doi/full/10.1056/NEJMoa1311889

    Unfortunately, to see the entirety of the data, you have to have a paid subscription, but this is still quite enlightening. The one thing that is not in this version that I did see presented in a YouTube video which has subsequently been removed, is that there was one variation for those with high blood pressure.

    For those with normal BP, the was only a slight increase of mortality as the intake went over 6 g (6000 mg) per day but a very high increase of mortality when going below 3 g (3000 mg). However for those with high BP, the increase over 6 g was also pretty steep. The "sweet spot" of between 3 g and 6 g was the same regardless though.

    The reason I mention this is for those of us who do not have HBP, overdoing it is not a big deal. However, those with HBP need to be more careful regarding staying in that sweet spot.

    That YouTube video was from a large medical conference and was copyrighted which is why it was removed. This is where I am torn because I believe in the ability to have copyrighted material, but at the same point, I think it is vital that we all have the information available to us to make the right decisions. Personal responsibility can't be expected if people don't have the information to make informed decisions.

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