Keto flu

Health and diet

written by Dr. Basudev Tewari | May 3, 2018

Ketosis and keto dieting is extremely popular for weight loss and also recommended in several diseases. If you have started this amazing diet pattern, there is a chance that you have experienced ‘keto flu’.

By the way, it is not a contagious disease like flu, nor a viral disease. The symptoms mimic flu (except fever, by the way) and hence given such fancy name. It commonly starts at 2 to 3 days of ketosis and hardly stays more than 2 weeks. But it is not universal, although most of the dieters experience it.

In normal cases our body is used to run on glucose. As carb intake is minimised body has to tap on alternate source for fuel, i.e. the fats. The body turns into a fat burning machine. You start burning fat like a furnace but can sometimes feel those ‘keto flu’ symptoms. Don’t worry these are temporary symptoms and can be minimised too.

The principal 3 causes behind the ‘keto flu’ symptoms are:

1.Fighting to become “keto-adapted.”
2. Electrolyte loss and dehydration.
3. Withdrawal from carbohydrates and sugary foods.

A few biochemical changes in the body are responsible for the reaction.

Beta oxidation of fatty acids are the chief biochemical process instead of glycolysis for energy. These produces ketones like Aceto acetate and Beta Hydroxybutyrate which can be utilised by the body instead of glucose. Body slowly gets more adapted to this alternate fuel and use fats as energy precursor instead of glucose. The body turns into a fat burning machine.
Your brain starts running on Beta Hydroxybutyrate instead of normal glucose as substrate. Initially that is not easily adjusted leading to confusion and brain fog. But as a fuel, it is a much cleaner option for the body than glucose. That is why several keto dieters enjoy better cognition and better clarity of brain as they get adapted.
During ketosis sodium and sugar rich foods along with preservatives, are drastically reduced which hampers fluid retention. Electrolyte imbalance and dehydration can occur easily if proper water and electrolyte intake is not taken care of.

Moreover carbohydrates, more so in case of sugars and simple carbs give us a pleasurable sensation. Its effect on brain is somewhat like that of substance abuse as its pathway by dopamine surge (the feel good of eating sweet!) for pleasure is same. That is why as you stop sugars and carbs, you get a feeling similar to withdrawal of substance abuse like cocaine, marijuana etc.

The keto flu is a natural reaction to our bodies are entering ketosis and switching to a state of glucose-burning to fat-burning.

But everybody is not the same. There is a term called ‘metabolic flexibility’. Those who had lesser amount of sugars and a better dietery pattern usually feel lesser symptoms. Also those who had exercises regularly, gets keto adapted much quicker and may feel less keto flu symptoms. Sedentary people or the cravers of sugar tend to be affected more.

Besides lifestyle, genes play important role as well. Few people can easily switch between keto and normal mode easily without much fuss. Anyway, none will have any permament symptom of keto flu.

Its common symptoms reported are:

Headache
Abdominal cramp
Brain fog and difficulty in focussing
Dizziness or confusion
Nausea
Irritability
Diarrhea or constipation
Muscle cramps
Lack of concentration
Poor sleep induction or maintenance
Sugar cravings
Heart palpitations

Symptoms of ‘keto flu’ can be controlled by following:

Keep yourself hydrated as much as you can. Drink plain cool water frequently and may be more than normal.
Salt intake should be maintained. Lime water with pinch of salt few times per day help. People have reported quick and significant improvement of symptoms by simply taking a little bit of extra salt. The stress on aldosterone pathway is quickly relieved by salt.
Intake of fats may be increased temporarily. I know, calorie restriction is there for most keto diets, but still you can do it temporarily. As body adapts, fat intake can return to original level. By ketosis your body will be a fat burning machine, anyway.
Little more carbs may be taken, if last point does not work, as a last resort till symptoms are relieved. But do not try it at first attempt and get kicked out of ketosis.
Supplement with magnesium and eat keto foods high in potassium like leafy green vegetables, salmon, nuts, mushrooms etc.
Adequate sleep and light exercises for 2 to 3 days a week, definitely helps in controlling symptoms (never heavy weight training or HIIT)
‘Bone broth’ and exogenous ketone intake has been advocated in some literatures to fight ‘keto flu’.