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Let me introduce myself. My name is Mark Sisson. I’m 63 years young. I live and work in Malibu, California. In a past life I was a professional marathoner and triathlete. Now my life goal is to help 100 million people get healthy. I started this blog in 2006 to empower people to take full responsibility for their own health and enjoyment of life by investigating, discussing, and critically rethinking everything we’ve assumed to be true about health and wellness...

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June 04 2019

Electrolytes and Keto: Why They Matter for the Transition

By Mark Sisson
26 Comments

The one piece of advice all newcomers to the ketogenic diet receive is to “get enough electrolytes.” It doesn’t matter what flavor of keto diet you’re talking about—paleo, carnivore, Primal, standard, clinical, mainstream, salami-and-cream-cheese. They all mention the importance of getting your electrolytes, particularly during the transition from a higher-carb diet.

I’ve said it. I say it. It really is important. Heck, a major part of the much-maligned “keto flu” can be directly attributed to inadequate intake of sodium, potassium, and magnesium. Oftentimes, increasing your electrolytes stops the flu from happening in the first place.

Why, though?

Why Do Early Stages Of a Ketogenic Diet Trigger an Increase In electrolyte Requirements?

One of the first things that happens when you go keto is you lose a bunch of glycogen from almost everywhere. For one, depletion of liver glycogen—the storage form of carbohydrates in the body—is the trigger for the liver to begin producing ketone bodies. It can’t make ketones if it’s full of glycogen. And, two, since you’ve just removed virtually all the digestible carbohydrates from your diet and your body hasn’t adapted to burning fats directly, it’s going to burn through the stored muscle glycogen and ramp up ketone production to make up for the rest of your energy requirements.

If you’re going keto (and doing it right), you’ll be depleting your glycogen stores. It’s totally normal, but there’s a side effect: water loss.

Each gram of glycogen in the body is stored with four grams of water. Every time you lose a gram of glycogen, you lose four grams of water and a bunch of sodium, magnesium, and potassium. When sodium drops, your kidneys start shedding potassium to maintain the right sodium:potassium ratio. But even though the ratio might be “right,” the absolute amounts of sodium and potassium are inadequate for optimal function.

As you get better at burning fats directly and your body gets acclimated to utilizing them for energy, you won’t have to maintain empty liver glycogen to stimulate massive ketone production. You can use fats for the majority of your energy requirements and can begin storing more glycogen rather than shedding it instantly. As a result, you won’t shed as much water or lose as many electrolytes.

Another factor is that going keto lowers insulin, and low insulin levels reduce sodium retention. This is one reason why low-carb diets are so good for people with salt-sensitive high blood pressure—they help you get rid of excess sodium.

A Few Signs of Low Electrolytes During the Keto Transition

Headaches

When sodium gets too low, your body will reduce water stores to maintain proper sodium ratios. This creates a vicious cycle of dehydration that can trigger headaches. Luckily, salt repletion will fix most keto headaches.

Postural Hypotension

If you’ve ever felt dizzy and unsteady upon standing up from a seated position, you’ve experienced postural hypotension. Blood pools in the lower half of your body while sitting and the blood pressure is inadequate to adjust in time. Without enough blood in your brain, things don’t work so well. It only lasts for a second or two, but it’s no fun.

Sodium depletion—as occurs in the early stages of keto—is a major risk factor for postural hypotension. Eating more salt is a quick fix. This isn’t keto broscience, either. Standard medical treatment of postural hypotension is to have the patient consume up to a tablespoon and a half of extra salt per day.

Poor Physical Performance

When you go keto, you might notice a drop-off in your physical performance in the gym or on the field. Part of this is a transitory effect of your tissues adapting to a new energy source. But another explanation is that you have low potassium levels.

In the muscle tissue itself, potassium acts as an electrical conduit during muscle contractions—and muscle contractions are what make a muscle “go.”

Low Energy

To some extent, low energy is part and parcel of the keto transition. You’re not great at burning fat and ketones yet. You’re still missing carbs. That’s okay, that’s normal. It’s a necessary evil, and it will pass.

But low energy can also be a symptom of low electrolyte status, as potassium and magnesium are all important co-factors in the production of ATP, the body’s energy currency.

How To Re-establish Optimum Electrolyte Balance During Keto Transitions

The fix is simple. Eat more sodium, potassium, and magnesium. 

For sodium:

  • Salt your food to taste (your salt appetite is a good barometer of your sodium requirements).
  • Drink salty broth (true bone broth is ideal, but good bouillon or store-bought is also acceptable).
  • Aim for 3-5 grams of sodium on top of a reasonable

For potassium:

  • Eat zucchinis, avocados, leafy greens, and medium-rare steak with all the juices (the juice contains tons of potassium).
  • Use potassium citrate.
  • Aim for 3-5 grams of potassium.

For magnesium:

  • Eat leafy greens, halibut, dark chocolate, nuts.
  • Consider hemp seeds. They’re incredibly high in magnesium, low in phytate, and a little bit goes a long way.
  • Use magnesium supplements. The chelated magnesiums (those ending in “-ate,” like citrate, glycinate, or threonate) tend to be the best absorbed. Another option is to use topical magnesium chloride oil.
  • Aim for 500 mg of magnesium.

My favorite way to get a big dose of these electrolytes in one fell swoop is to pour a big glass of sparkling mineral water (I like Gerolsteiner) and add juice from 2 limes or lemons, a teaspoon of salt, and a scoop of magnesium powder. Great and incredibly refreshing. Sip on that twice a day, and you’ll be fine.

In my experience, electrolyte loss is the biggest stumbling block for people new to keto. It’s also one of the easiest to avoid. So get after it!

What’s your favorite way to get enough sodium, potassium, and magnesium? Got any great no-sugar electrolyte drink recipes you’d care to share?

Thanks for reading, everyone.

TAGS:  Keto, prevention

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26 thoughts on “Electrolytes and Keto: Why They Matter for the Transition”

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  1. I salt my coffee and water (and any food that needs it of course) and use magnesium oil spray after my shower, and I will probably add in zucchini for the potassium …… Thanks for the tip on that!

  2. I am on a doctor-ordered high-salt diet for a condition similar to orthostatic hypotension, and a medication known to deplete potassium. I use either a DIY Pedialyte-like drink or Trioral oral rehydration salt packets.

    DIY drink = 1/4 tsp regular salt, 1/2 tsp low-sodium salt, enough juice for 20 grams of carbs, and enough water to make 1 quart. Either way, this method works well for me.

  3. Don’t think that drink gives 3-5 g of potassium? And the potassium citrate capsules would require 30 per day. How do we really get the recommended amount of K? It’s a big problem for me. Tt.

    1. You can buy potassium citrate powder on Amazon.com from Bulk Supplements. Same company for Magnesium Glycinate. Stay away from Magnesium Citrate, because that is the one that causes “disaster pants”. I take a bottle of cold San Pelligrino mineral water, add a teaspoon of each, plus pink Himalayan salt, lemon juice and 2 packets of stevia and ice cubes. I do this twice a day and its amazing!

  4. Every other day an article about how to biohack yourself to counteract some potential pitfall of a Keto diet. It’s becoming somewhat amusing. “Hey, you can prop up this house of cards if you use the following special varnish on the bottom three rows!”

    Friendly ribbing aside, a great list for getting more electrolytes into your system, and I have been adding a tad more fats to my diet.

  5. I gradually transitioned to Keto from Primal/Paleo so never dealt with most of those symptoms. However, my blood pressure has always been low and I’ve found that I need to consume plenty of salt to feel my best. I salt my food to taste with Redmond Real Salt. I use Natural Calm at night for magnesium but would caution anyone using a magnesium supplement to start off very slowly or it can cause major digestive upset. I honestly haven’t given much of a thought to potassium but maybe I should:)

  6. ‘Postural Hypotension’ used to be called ‘gravity shock.’ Associated with poor body mechanics and general unfitness. One experimenter found that Zulu laborers just didn’t experience it under the test, while the other groups all could have it induced by hard physical activity followed by standing still.

  7. I’ve struggled with postural hypotension since childhood, but it used to be caused mainly by excessive heat. Recently I made the connection that if I don’t drink caffeine, it goes away completely. Soon as I drink it I’m lightheaded again, *especially* if I’m also pregnant. I could probably benefit from increasing my salt intake dramatically. I find that if I add 1/4tsp sea salt to a cup of water it tastes amazing, so that probably indicates I need more salt. I heard an interview where someone recommended adding salt to water especially if you drink coffee, and they said it tastes gross like you’re drinking sweat, but I really think it tastes delicious. Also he recommended adding salt to coffee, which I tried, and found it absolutely disgusting. Takes away the bitter taste which is what I like most about coffee. Anyway, good stuff here, Mark, as always.

  8. A question that is less related to this post, but then again maybe.
    I’m on Metformen, and fat adapting/Keto. Is there anything else I should be aware of.
    Thank you for this post, really helps.

  9. I suffered from depleted electrolytes for years causing terrible muscle cramps . Coffee made it worse and sadly I had to give it up. I tried lots of different brands of electrolytes but found that hydro surge worked so well I could resume my one cup a day. It is not expensive as many of them are
    And taste is ok. I highly recommend.

  10. Does anyone make a “sole” by diluting pink Himalayan salt, Red Hawaiian Alaea, etc. into water?

    Any success with that method?

  11. What I do often is have a couple of mugs of black coffee in the morning with the last one having butter and coconut oil in it.
    Then walk 18 holes while drinking a couple of bottles of spring water each with a pinch of Himalayan sea salt.
    Seems to work for me

    Thoughts?

  12. Better to add salt, potassium and magnesium powders to lemon water to get the daily recommended doses.

    Good article.

  13. I must say, this post has come just in the right time for me.

    I switched to primal a year and a half ago. After the initial hiccup, I felt great for a good 10-12 months. I lost all my excess weight(I wasn’t obese to start with). After which I started feeling the effects of chronic dehydration. Most common symptoms were postprandial hypotension, rapid heart beat, even occasional blackouts. Alarm bells rang when my kidney gFR levels dropped below 80.

    I stopped primal/keto/paleo for about 3 months, and things started coming back to normal. But I hated that phase. One thing about primal/keto/paleo is, if you do it correctly and diligently for a few months, it’s hard to get back to any other diet.

    I’ve recovered fine. I am back to primal since last couple of months. I haven’t checked my gFR, but I feel OK. I do make sure I have electrolytes regularly.

    In India, an ORS drink called Electral has a good balance of sodium & potassium, but lacks magnesium. I’ve been keeping a sachet or two handy. Only downside is high amounts of dextrose. For magnesium, I have a few almonds and bananas daily. But may be its not enough. Will follow this post’s recommendations.
    Mark, thanks a lot for your tips.

  14. Thank you so much for this articles, Mark. You are the first keto expert I have read who says to add electrolytes “for the transition”! I am no longer in the transition period…but I still take all my electrolytes daily. Is a person who is fat-adapted supposed to wean themselves from supplemental electrolytes?? I’ve been keto for over 18 months, and I really do not think I have heard that particular advice before. Could you clarify? Thank you again!

    1. Gjeanieg, thanks for your message. Most people find the need to keep their electrolyte intake higher long-term while keto (so, yes, it sounds like you’re doing the right thing for your body’s needs), but that doesn’t mean it always needs to be as high as when they transition to ketogenic eating. It’s not an exact science, and much depends on your own self-experimentation. Enough folks had questions about electrolytes that I’ll be doing a Dear Mark follow-up next week. Stay tuned for more. Best — M

  15. Not currently Keto but I make an electrolyte concoction similar to yours!! In a large mason jar: juice of 4 limes, a teaspoon or so of solé (salt water), a teaspoon of trace mineral liquid and top off with H2O. I’ll have to try it with sparkling water! I drink this almost daily, especially when it heats up and I’m outside sweating more.

  16. My wife suggests dining pickle juice for electrolytes. Dues that work?