The ketogenic diet is an effective, natural way to burn fat and achieve healthy body weight. This way of eating (best summarized as a low carbohydrate, high healthful fat, and moderate protein nutritional approach) has even proven to prevent and manage of a variety of chronic diseases.
However, oftentimes when people start looking into going keto, they can be dissuaded by the “keto flu”—a particularly ominous sounding side effect of the diet.
The keto flu is a constellation of symptoms, including fatigue, headaches, and muscle cramps, which are a direct result of reducing carbohydrates and transitioning your body’s primary fuel source from glucose to ketones.
Want to learn more about keto flu? Go here to read my full article on the keto flu—including symptoms, remedies, and how to avoid it
One of the most painful manifestations of the keto flu is muscle cramps, which can hit out of nowhere and even wake you up from a deep sleep. Some people push through only for the keto flu to make the first three to five days of the transition SO challenging that they throw their hands in the air and quit.
Even though leg cramps are a perfectly normal reaction for a body transitioning into ketosis, there are a number of steps you can take to prevent their onset or, at a minimum, mitigate their severity.
Electrolytes: The Missing Link
There are a number of chemical structures in the human body that are classified as electrolytes, including sodium, potassium, magnesium, bicarbonate, calcium, chloride, and phosphate.
Electrolytes play a vital role in human physiology, as they conduct electricity from one point in the body to another. This conveyance of electricity allows muscles to contract, synapses to fire, and damaged tissue to regenerate.
Electrolytes are so important that their imbalance can lead to death: hyponatremia describes the condition in which sodium is significantly decreased in the body, and can ultimately lead to heart attacks, while potassium can actually be used to stop the human heart, as is the modus operandi for executions by lethal injection.
While all electrolytes play their own important role in the body’s functioning, the three we are primarily concerned with today are:
These three electrolytes need to be consumed in a specific ratio to one another to ensure you maintain electrolyte balance.
Every day, in addition to what you take in from dietary sources, you should be consuming 5,000mg of sodium; 1,000mg of potassium, ideally in the form of potassium chloride or potassium sulfate; and 300mg of magnesium.
Drinking Water is Not Going to Help You!
There’s one thing that always shocks people when I discuss the topic of leg cramps and the ketogenic diet: drinking water is not enough to kick the keto flu.
In fact, overconsumption of water can actually exacerbate electrolyte imbalance even further. The only truly effective way to control leg cramps on the ketogenic diet is to properly supplement lost electrolytes as you transition into ketosis.
Short of emergency situations, virtually no one dies from a lack of hydration. However, hyponatremia, the condition in which your body is so depleted of sodium that it can’t function, is a major killer, and one driver of sodium depletion is overhydration with water.
The idea that water will help relieve muscle cramps is a long-standing misconception; most people have no idea that water can often times make cramping worse! A 2019 study published in the journal BMJ Open Sport & Exercise Medicine found that water consumption following intense exercise actually increased the muscles’ susceptibility to cramping, whereas an electrolyte replacement mixture decreased it.
It is thought that water on its own actually exacerbate the exercise-induced electrolyte imbalance by further diluting what few electrolytes are left.
How Can You Prevent Leg Cramps on Keto?
As mentioned above, water alone will not relieve keto leg cramps because it only further exacerbates the electrolyte imbalance caused by the ketogenic diet.
To get relief from keto leg cramps, get your electrolytes on point! Specifically, this means ensuring you get adequate levels of sodium, potassium, and magnesium. To that end, here are some simple ways to increase your intake of electrolytes on the ketogenic diet and fight off leg cramps:
1. Salt Your Food
Most foods on the ketogenic diet do not contain naturally-occurring sodium at adequate levels, so it is critically important for you to salt your food. Even if it is gustatorily challenging to salt a salad, I’d really encourage you to try it.
Ironically, many people are able to hit our recommended levels of sodium intake and avoid cramping because the processed foods we typically consume contain so much sodium. Transitioning away from these processed and preserved foods towards whole foods is absolutely the right move, but we have to keep in mind that this will reduce the amount of sodium we get through our diet.
So salt it! Any kind of salt will do…I don’t recommend one kind of salt (Himalayan pink, Hawaiian black, etc.) over the other. However, if you have a personal preference for one type of salt, that’s no problem! Just make sure you’re getting adequate salt into your diet to replace that which you’re no longer consuming through processed foods.
2. Consume Bone Broth
You’ve probably heard about the scientific research surrounding bone broth before and are familiar with its status as a nutrient-packed superfood; it is commonly promoted based on its benefits for the gut, joints, skin, and overall health.
Bone broth is made by simmering the bones and connective tissues of an animal for ten to twenty hours, which is what separates it from the standard broth or stock found in most grocery stores which is only simmered for a few hours tops. Cooking this concoction for such a long time allows the liquid to absorb all of the collagen, glutamine, and other minerals that give bone broth its nutrient density.
While bone broth is a decent source of sodium on its own, it’s very easy to add some salt, a bouillon cube, or Raw Unflavored LMNT to really turn it into a keto cramp-ending treat.
3. Mix Up Electrolyte Homebrews
One thing that I stress all the time is that you should never retreat to the sugary sports drinks of your youth to combat keto leg cramps. All of the mainstream “electrolyte-replacement” products on the market offer wholly insufficient levels of the electrolytes and are very high in sugar.
The overload of electrolyte-less sugar you consume with these beverages will only spike insulin levels and impede your ability to transition into ketogenesis. Despite the worldwide catchy marketing campaigns and sponsorships of virtually every visible sporting event, these drinks should be avoided–honestly, whether you adhere to a ketogenic diet or not.
4. Stay Salty with LMNT Recharge
The dearth of quality electrolyte replacement beverages on the market drove me to spend countless hours mixing up homemade concoctions with ingredients from my own pantry. After a ton of trial and error, I was able to nail down a few great do-it-yourself drink recipes for anyone who is inclined to mix up their own cramp-killing concoctions.
If you’d like to dive into some of my favorites, you can see a list of my best recipes here.
Additionally, after years of tinkering with these homebrew recipes—some of which were way off the mark—and waiting for someone to come up with a product that wasn’t full of sugar, I decided to take the matter into my own hands…
I’ve worked hard to develop LMNT Recharge, a new product that is precisely formulated to replenish the electrolytes your body will purge in the adoption phase of the ketogenic diet. If I can so say myself, it’s quite a tasty powdered mix full of everything you need–sodium, potassium, and magnesium–and nothing you don’t.
You can learn more about the ingredients here.
I often hear people who have tried and abandoned the ketogenic diet say that the keto flu—specifically the leg cramps—is what drove them away from the diet. It’s an easy process to understand: you start a diet and instantly feel awful instead of feeling energized and wonderful and quickly thereafter decide that the diet just isn’t for you.
It is my hope that a better understanding of the keto flu will help new adherents stick out the initial adoption phase—armed with all the electrolytes their body needs to push back the keto flu—and reap its long-term benefits.
Our bodies have everything they need to fuel themselves with ketones, but years of carbohydrate addiction has allowed them to “forget” how to burn fat for fuel.
All our bodies need is a little bit of time to relearn this natural process, and knowing how to handle the keto flu enables you to give your body the time to adjust without succumbing to cramps, brain fog, and exhaustion.
David A. says
Hello, I hope this question reaches you and thank you in advance for reading. I’m 46 years old and approx. 450 lbs. Every time I try and loose weight through a low carb or Keto style diet, I get severe cramps or spasms in my abdominal side region. Near my rib cage. I don’t get cramps in my legs like the article suggest. I have tried sugar free electrolyte drinks, powders and Nuun type water additive supplements. Usually around day 3-4 after I start is when they kick in. They can happen under various circumstances. For example: middle of the night while sleeping. If I bend over to long. If I try and push something or engage my core. Sometimes just standing there. Even while sitting on the toilet. This has been happening for about 10 years and has foiled any attempt to stick to a program out of fear there is internal damage going on. The spasms are violent and debilitating. They can last anywhere from 10-45 minutes of pure pain. My Dr. even did an abdominal ultrasound to see if it was gall stones with negative results and no other suggestions. I would greatly appreciate any suggestions on how to combat this. Its truly frustrating and down right scary. Thank you for any suggestions you can provide.
Connie Mae says
Same exact issue here! Did you find a cause?
Olivia Austin says
Hello and thank you for the article. Have been struggling with leg cramps for a while now, so this means a lot to me!
What is the reasoning behind your recommendations for the type of potassium? I have heard potassium citrate is the best form to use. Why do you advise against it? Thanks!
It doesn’t have to be potassium chloride, but it seems to be an effective form, and chloride is actually an electrolyte too.
Potassium citrate is more commonly used for kidney stones.
I keep hearing we need whole grains for overall health. I stopped long ago due to bloating at times and always having such a full feeling. The gall bladder was removed in 1999, so breaking some foods down can be terrible. I can become bloated at times with food that sometimes is ok
Without a gallbladder, some digestive support might be helpful for you. Something like Ox Bile, or something with it in it.