Take it with a grain of salt: micronutrients and the Ketogenic diet

When following a ketogenic diet or experimenting with different fasting protocols, it is important to be mindful of micronutrient intake. Reducing or eliminating carbohydrate intake can lower consumption of micronutrient-rich foods such as fruits and vegetables. But that’s only part of the story. Fasting and ketogenic diets induce a fair amount of diuresis (peeing more often), which results in significant loss of electrolytes as you work of the that “water weight.” The effects can be felt in just a few hours of fasting, and with just a few days of keto eating. In this post we’ll examine the primary electrolytes in our bodies and ways to maintain optimal levels for performance and well-being.

Sodium is the principal electrolyte in extracellular fluid. Its functions are related to blood volume maintenance, water balance, and cell membrane potential. Sodium is also essential for acid-base balance and nerve conduction. Sounds pretty important, eh? Well it is. The human body closely regulates osmolality and achieves balance through complex physiologic signals including the anti-diuretic hormone AVP.

The level of sodium can fall at the start of a ketogenic diet. Adding extra sodium to meals (like adding salt or consuming bouillon/ bone broth) can reduce the chances of feeling the common side effects associated with low sodium like headaches and cramps.

Potassium is the principal electrolyte in the intracellular fluid. Its primary functions are related to maintaining cell membrane potential and electrical activity in cells such as neurons and cardiomyocytes. As with sodium, levels of potassium fall at the initiation of a ketogenic diet due to increased excretion. When starting a ketogenic diet, include sources of potassium like nuts, dark green vegetables, and avocados to avoid muscle cramps, weakness, and even cardiac arrhythmias that can accompany severe hypokalemia.

Magnesium is an essential element in biological systems, especially for nerve, muscle, and immune function. Levels of magnesium also fall at the initiation of a ketogenic diet due to increased excretion. When starting a ketogenic diet, include sources of magnesium like oily fish, dark green vegetables, and seeds to avoid serious muscle cramps that can accompany magnesium shortage.

Calcium has a role in muscle contraction and is important for cardiovascular and bone health. Calcium deficiency is less common during a ketogenic diet, as staples of the diet such as fish, cheese, and leafy greens are rich sources of the mineral.

If you’re just getting started on a keto diet, maintaining proper electrolyte balance is critical; symptoms like headaches, muscles cramps, and fatigue will easily derail your efforts and discourage progress. In fact, the lack of adequate micronutrients may even explain some of the “keto flu” symptoms commonly experienced when starting out with low carb. I for one strongly remember my first attempt at an intense workout after starting a carb-restricted Paleo some 8 years ago–I felt light-headed and could barely focus on anything other than wolfing down a bag of potato chips or a candy bar. I thought I was just craving carbs, but as it turns out, it was the salt my body was truly lacking.

After a few weeks of eating keto, you’ll find that your body adapts to the “cleaner-burning” fuels that are ketone bodies. As long as you maintain a diverse array of vegetables and protein sources you’re unlikely to encounter true electrolyte deficiencies. However, if you are into intermittent fasting electrolyte disturbances can be a real and serious concern. In my experience, it hasn’t been an issue when fasting for 24-48hrs, but anything longer I need to be very careful about sodium and potassium in particular. On several occasions I have been unable to sleep due to severe and relentless muscle cramps, particularly in the hips and quadriceps in the later stages of a 3- day water-only fast. Fortunately, they have responded well to things like Epsom salt baths and “rescue” supplementation with electrolytes like salt and magnesium. Now I always make an effort to drink unflavored mineral waters and preemptively supplement with salt during longer fasts.

Portions of this content was originally published at HVMN, but has been edited for content by OurHealthHabit.com. The original content can be accessed here.