The ketogenic diet, often referred to as the keto diet, has gained popularity as a method for weight loss and managing certain health conditions. This diet involves drastically reducing carbohydrate intake while increasing the consumption of fats. While many experience benefits from this dietary approach, some individuals report experiencing fatigue. This article explores the reasons behind fatigue on a low-carb diet, its symptoms, and how to alleviate them.
What is the Keto Diet?
A ketogenic diet is a dietary approach characterized by low carbohydrate, high fat, and moderate protein intake, with the goal of achieving a metabolic state called ketosis. In ketosis, the body becomes more efficient at burning fat for energy, converting fats into ketones, which then serve as the primary fuel source.
The keto diet shares similarities with the Atkins diet, but differs in its approach to fat intake. All variations of the keto diet involve carbohydrate restriction, generally limiting intake to less than 50 grams per day. The typical daily caloric breakdown consists of 70-80% from fat, 5-10% from carbohydrates, and 10-20% from protein.
The ketogenic diet has been associated with several benefits, including weight loss, reduced blood sugar levels, heart disease risk prevention, and diabetes management. Research has also indicated that the keto diet can effectively reduce seizures in children, leading to exploration of its potential benefits for other neurological disorders, such as Parkinson’s, Alzheimer’s, multiple sclerosis, sleep disorders, autism, and brain cancer.
Why Does Fatigue Occur on a Low-Carb Diet?
While the keto diet offers numerous benefits, it can also lead to negative side effects, including fatigue. Several factors can contribute to this fatigue:
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The Keto Flu
As the body adapts to lower carbohydrate intake, some individuals experience the "keto flu." This typically occurs during the first week of starting the keto diet and involves symptoms such as headaches, fatigue, tiredness, and nausea.
Carbohydrate Cravings
Intense cravings for grains and other carbohydrate-rich foods can also contribute to fatigue.
Insufficient Calorie Intake
The word "diet" is sometimes associated with low calorie consumption. However, the keto diet requires adequate calorie intake to maintain energy levels. Undereating can reduce the body’s production of thyroxine and other energy hormones, potentially triggering "starvation mode."
Inadequate Fat Consumption
On the keto diet, the majority of energy comes from fat calories, both from stored body fat and dietary fats. Avoiding fats, even healthy fats, deprives the body of its primary energy source.
Irregular Eating Schedule
Meal timing can affect energy levels, especially when starting keto. Eating regularly provides a consistent energy supply. Keto dieters should aim for at least three meals and a few snacks daily, spaced evenly to maintain stable energy levels and avoid energy slumps. Combining the keto diet with intermittent fasting, particularly when new to keto, can also lead to energy depletion.
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Insufficient Physical Activity
Lack of exercise or movement can also contribute to fatigue on keto. Regular workouts, including weight training and cardio, are essential.
Potential Long-Term Risks
The ketogenic diet, being high in fat, may increase the risk of health issues such as high blood pressure, high cholesterol, heart disease, and stroke.
Avoiding the Keto Flu and Maintaining Energy
To minimize the keto flu and sustain energy levels, ensure your diet includes healthy protein and fat sources. Avoid "dirty keto," which relies on processed and packaged foods lacking nutritional value. While dirty keto adheres to the macronutrient ratios of regular keto, the source of these macronutrients is crucial.
Supplementing with protein powder, particularly blends low in carbohydrates (1-2 grams) and containing 20-30 grams of protein, can provide additional energy.
Understanding the Keto Flu
The keto flu is a collection of symptoms experienced by some people when they first start the keto diet. These symptoms, which can feel similar to the flu, are caused by the body adapting to a new diet consisting of very little carbohydrates. Reducing your carb intake forces your body to burn ketones for energy instead of glucose. Ketones are byproducts of fat breakdown and become the primary fuel source when following a ketogenic diet. Usually, fat is reserved as a secondary fuel source to use when glucose is not available. This switch to burning fat for energy is called ketosis. It occurs during specific circumstances, including starvation and fasting. However, ketosis can also be reached by adopting a very low carb diet. This drastic reduction can come as a shock to the body and may cause withdrawal-like symptoms similar to those experienced when weaning off an addictive substance like caffeine.
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Symptoms of the Keto Flu
Common symptoms of the keto flu include:
- Nausea
- Vomiting
- Constipation
- Diarrhea
- Headache
- Irritability
- Weakness
- Muscle cramps
- Dizziness
- Brain fog
- Stomach or intestinal pain
- Muscle soreness
- Difficulty sleeping
- Food cravings
These symptoms typically last a few days or, rarely, up to several weeks.
How to Ease Keto Flu Symptoms
Several strategies can help reduce keto flu symptoms and ease the body’s transition:
Stay Hydrated
A keto diet can cause rapid water loss, increasing dehydration risk. Drinking enough water helps alleviate symptoms like fatigue and muscle cramping.
Avoid Strenuous Exercise
Rest is essential during the adaptation period. Light activities like walking or yoga may improve symptoms.
Replace Electrolytes
The keto diet can lead to electrolyte imbalances. Consuming potassium-rich, keto-friendly foods like green leafy vegetables and avocados, and salting food to taste, can help maintain a healthy electrolyte balance.
Get Adequate Sleep
Lack of sleep can worsen keto flu symptoms. Establishing a consistent sleep schedule and creating a dark, relaxing sleep environment are beneficial.
Ensure Adequate Fat and Carbohydrate Intake
Eating enough fat helps reduce cravings and maintain satiety. Gradually reducing carbohydrate intake may ease the transition.
Factors Influencing Adaptation
People adapt to ketogenic diets differently. Those who typically consume a lot of refined carbohydrates may experience more difficulty transitioning to a high-fat, low-carb diet. Genetics, electrolyte loss, dehydration, and carbohydrate withdrawal are believed to be driving forces behind the keto flu.
Long-Term Considerations and Potential Risks
Researchers do not know much about the long-term effects of the keto diet beyond the first 2 years. However, the potential risks of any restrictive diet include vitamin or mineral deficiencies. A person on the keto diet needs to monitor their carbohydrate intake from all potential sources, including fruits, vegetables, and whole grains. As a result, they may need to cut back on foods that previously provided them with beneficial nutrients. Vitamin and mineral deficiencies can cause a variety of symptoms, ranging from mild to severe. A person following the keto diet will need to ensure that they do not miss out on any nutrients as a result of changing their diet.
Other potential risks of a high fat, high protein diet include:
- Kidney stones
- Hepatic steatosis (fatty liver)
- Hypoproteinemia, or low levels of protein in the blood
Low carbohydrate diets, in general, may have adverse effects. For example, a 2016 study found that people following low carb diets have higher levels of low-density lipoprotein cholesterol, which is a risk factor for heart disease. Additionally, the authors of a 2012 review concluded that a low carbohydrate diet that focused on animal sources of protein and fat increased the risk of type 2 diabetes and death. Scientists will need to conduct more studies to understand the potential long-term side effects and risks of the keto diet specifically.
The keto diet has some other limitations that a person may wish to consider before they try it, such as:
- Varying results: In terms of weight loss, the keto diet may work more effectively for some people than others. According to the Academy of Nutrition and Dietetics, the rate at which people get into ketosis and start losing fat varies depending on several factors. Therefore, the diet will affect individuals differently.
- Difficult to follow: The keto diet strictly limits what a person can eat. As a result, it may be challenging to follow the diet for an extended period. If a person stops limiting carbohydrates, they may regain any weight that they had lost.
- Saturated fat: As a person can remain in ketosis regardless of the type of fat that they consume, this may lead to a heavy reliance on animal fats or saturated fats, which have associated long-term health risks.
Who Should Avoid the Keto Diet?
The keto diet may not be suitable for everyone. Individuals with pancreatic disease, thyroid conditions, liver conditions, gallbladder disease or removal, or a history of eating disorders should consult a doctor before starting the keto diet.