The ketogenic (keto) diet has surged in popularity due to its potential for weight loss, among other perceived benefits such as mental clarity and increased focus. It involves drastically reducing carbohydrate intake and increasing fat consumption to shift the body's primary fuel source from glucose to ketones. However, this dietary change can lead to electrolyte imbalances, particularly concerning sodium. Ignoring electrolytes is probably the biggest mistake people make on a low-carb or low-processed-food diet. Unless they fix their electrolyte deficiencies or imbalances, these folks don’t tend to stick with keto for long.
Understanding Electrolytes
Electrolytes are minerals that carry electrical charges and are essential for various bodily functions. They literally prime the machinery that keeps you thinking, breathing, and moving. They play a crucial role in nerve impulse firing, muscle contraction, maintaining optimal fluid balance in the blood, brain, skin, and organs, and regulating blood pressure. Key electrolytes include sodium, potassium, and magnesium, along with calcium, chloride, phosphorus, and bicarbonate. Hydration isn’t just about drinking water. It’s also about getting enough electrolytes.
The Keto-Electrolyte Connection
When following a ketogenic diet, inadequate mineral replacement can become a significant issue. Insulin, a hormone that helps the body retain sodium and water, is significantly reduced due to the low carbohydrate intake. With less insulin circulating your body, your kidneys start to release excess water, instead of retaining it. This leads to the kidneys releasing more water and minerals, especially sodium, potassium, and magnesium. This isn’t a coincidence. The consequence of inadequate salt is keto flu, and eating a ketogenic diet is a contributing factor to sodium deficiency.
Why Sodium Matters on Keto
Sodium is vital for maintaining fluid balance, regulating nerves and muscles, and keeping the liquid portion of your blood intact. When you don’t get enough salt, you release aldosterone, epinephrine, renin, and other stimulating and blood-pressure-elevating hormones in an attempt to spare your body the loss of sodium. Inadequate electrolyte intake also impairs bone health. Why? Because bone is your primary electrolyte reservoir.
People often blame high sodium diets for high blood pressure, but this claim doesn’t hold up to scrutiny. The body’s hydration system operates on a ratio basis; not on a basis of absolute intake quantities. Thus, when it comes to something like blood pressure, the total amount of sodium you consume matters less than the amount of sodium relative to potassium. As SaltStick CEO Jonathan Toker, Ph.D. wrote about in a recent slowtwitch.com article, in attempts to lower blood pressure, it is often as effective to increase dietary potassium as it is to reduce sodium, because it is the balance that matters more. This same ratio-based lens is necessary when analyzing the effects of a ketogenic diet on the body.
Read also: Comprehensive Guide to Sugar on Keto
Salt Sensitivity
14% of Americans are salt sensitive, which means that too much salt increases their risk of cardiovascular disease. If you know that you are salt sensitive, you can control this condition through lifestyle modifications or therapeutic interventions. But if you don’t know your salt sensitivity index, you could potentially reduce your lifespan by as much as 20 years.
The "Keto Flu" and Sodium
Low electrolyte levels, particularly sodium, are often linked to the "keto flu," a cluster of symptoms experienced when transitioning to a ketogenic diet. Symptoms may include low energy levels, mental cloudiness, headache, fatigue, nausea, dizziness, brain fog, GI distress, decreased energy, faintness, and changes in heartbeat. These symptoms typically start within several days of beginning keto, peak after one week, and diminish after four weeks.
The standard advice for keto flu? This may be okay for a period of days, but what if you’ve been in keto hell for weeks or months? Something else is wrong, and it needs to be addressed.
There’s no downside to starting with electrolytes. That often solves the problem, right then and there.
Recommended Sodium Intake on Keto
Many ketogenic diet experts recommend consuming 2 to 4 grams (2000-4000 mg) of sodium per day to counteract the increased sodium excretion. Some recommend getting at least 4-6 g of sodium per day. More if you’re sweaty and active. This can be achieved by liberally salting food, incorporating sodium-rich foods, or using electrolyte supplements.
Read also: Troubleshooting Carnivore Diet Diarrhea
It’s important to note that, while “sodium” is often used as a synonym for salt, they are not the same. Salt, in the form that we typically consume, is sodium chloride plus small amounts of other minerals. By weight, 1 gram of salt is about 40% sodium. This lesser known fact is one big reason that people don’t get enough sodium.
Sources of Sodium
- Salt: The most obvious source. Try weaving in an extra 1-2 tsp of salt throughout your day. Sea salt is just that - evaporated sea water. You’ll also notice this type of salt is usually sold in grinders or in bulk at the supermarket.
- Broth or bouillon: Drinking a cup of broth or bouillon once or twice a day can help replenish sodium levels.
- Salted butter: Incorporating salted butter into your diet is another way to increase sodium intake.
- Himalayan salt: Many keto enthusiasts add Himalayan salt to their meals.
- Packaged keto foods: If you’re eating these, check the sodium content on the label.
- SaltStick Caps: Each capsule delivers 215 mg of sodium, along with other key electrolytes.
Other Important Electrolytes
Potassium
Some of my recommended sources for potassium are raw spinach, avocado, mushrooms, salmon, steak, pork loin, and coffee.
Magnesium
Synthesizing DNA. Growing muscle. Building bone. Maintaining your heart beat. What do these functions have in common? That’s right, they all depend on magnesium. Because magnesium does just about everything, magnesium deficiency can be tricky to diagnose. Nuts, seeds, and dark chocolate are also rich in this mineral. Assuming you have healthy kidneys, there’s no downside to getting a little extra magnesium.
Calcium
To keep your bones strong, aim for 1 gram of calcium per day. That means eating calcium-rich foods like dairy, soft bones (i.e., canned sardines), and cruciferous vegetables. I recommend avoiding large calcium supplements. However, if you’ve done a dietary analysis and determined that you aren’t getting enough calcium, my favorite pro tip is to save your egg shells, clean them, pulverize them, and then add them to a shake or beverage of your choice. A single egg shell contains about 3,500 mg of calcium.
Chloride and Phosphorus
Chloride always comes with sodium in salt. If you’re getting enough sodium, you’re likely getting enough chloride. Phosphorus is abundant in the food supply. It’s not an essential mineral. Bottom line? Focus on sodium, potassium, and magnesium.
Read also: Aspartame and Ketosis
Avoiding Common Keto Mistakes
- Cutting Carbs and Increasing Fat Too Quickly: Consider easing in. “Prior to starting a keto diet, individuals may benefit from tapering down their carbohydrate intake, instead of reducing carbs cold turkey,” says Lara Clevenger, a ketogenic dietitian-nutritionist with a private practice in New Smyrna Beach, Florida.
- Not Drinking Enough Water: Drink up. Tucci recommends waking up to a large glass of water and sipping regularly throughout the day to reach a goal of consuming half of your body weight numerically in ounces of water daily.
- Not Preparing Yourself for the Keto Flu: If you’re not prepared for this feeling, you may think something is drastically wrong and give up on the diet completely.
- Forgetting to Eat Foods Rich in Omega-3 Fatty Acids: When choosing yours, aim to include healthy sources such as more anti-inflammatory omega-3s, particularly EPA and DHA, the type of fat found in salmon, sardines, oysters, herring, and mussels, says Clevenger.
- Not Salting Your Food Enough: Chances are if you’re following a ketogenic diet you may need to prepare most, if not all, of your own meals and snacks from scratch, so simply season with salt,” says Tucci.
- Going It Alone and Not Clearing the Diet With Your Doctor: If that’s you, talk to your doctor first and make sure they’re on board with your plan - especially if you’re also taking medication, says Clevenger.
- Not Paying Attention to Your Veggie Intake: On the other hand, you may be skipping veggies altogether if counting every baby carrot is getting too complicated.
- Getting Caught Up in Carb-Counting and Forgetting That Food Quality Matters: “Reducing your carbohydrate intake is great, but higher-quality products, when your budget allows, will help improve your health, too,” says Clevenger.