In the final part of this series, we’ll explore some common “side-effects” of a ketogenic diet, and how you can combat them. You can view previous parts here: The Ketogenic Diet Part 1: What is Keto?, The Ketogenic Diet Part 2: Sugar, Insulin, and Inflammation, The Ketogenic Diet Part 3: How to Become Fat Adapted
Side-Effects and Dampers of a Ketogenic Diet
People who follow a low-carb diet often complain of unpleasant side effects. In this section, I will explain what causes these side effects, and how to prevent them. I call my approach to the ketogenic diet a “well-formulated keto-adapted diet,” because it maximizes the benefits while minimizing any unpleasant side effects.
Carb Quantity and Food Quality
Low-carb diets often get bad press, and many times studies show that they “don’t work.” Why is this? Let’s dive into the so-called “low carb” studies. In these studies, the participants were reducing their carbohydrates to 150 grams per, didn’t eliminate gluten, and often didn’t eliminate dairy. Sure, reducing their carbohydrates from 300 grams a day makes 150 grams look like low-carb, but it isn’t! A well-formulated keto-adapted diet will be closer to 30 grams of carbohydrates per day. Cutting out these “complex carbohydrates,” as well as gluten, is essential in order for you to become the keto-adapted fat burner we all strive to be.
One of the best side effects of becoming keto-adapted is the disappearance of the desire for carbohydrates and sugar, but it can take some time. If you find yourself indulging in carbs on the weekends, whether it is a beer or a piece of pizza, these indulgences will throw you out of ketosis. This is why I often discuss with my clients the possibility of adding specific supplements: bifido bacteria, 5-HTP, magnesium, and liquid zinc, to help deter those nasty cravings.
Sodium and Electrolytes
Some other common and bothersome symptoms experienced by my clients just starting a keto-adapted diet are headaches, dizzy spells, light-headedness, fatigue, and cramping. These symptoms aren’t experienced by all of my clients, but when they do happen, there are some nutrients that can help. This is a problem that can be remedied with better salt and mineral intake.
When you have metabolic syndrome, it means you have a lot of insulin circulating in your blood. You don’t need to be overweight for this to happen. I have had clients who were underweight and still had extreme blood sugar issues. This excess insulin does many wicked things to your body. In the book Why We Get Fat, Gary Taubes demonstrates how excess insulin makes you store fat in your fat cells. We focus on that one undesired side effect because we can see its results externally, but the more harmful effects are actually happening internally. Excess insulin also activates the kidneys to retain fluid. I had one client who was extremely obese and would fluctuate up to twenty pounds daily because of water retention. Yep, twenty pounds of water retention! She was experiencing pitting edema in her lower legs.
To test if you also have pitting edema, press your finger into the tissue of your shin bone. If your finger leaves an indentation (basically your finger print), you have pitting edema. Most obese clients complain of this sensation late in the afternoon or after being on their feet all day. What’s happening is the excess water retention gathers in the lower legs and soaks into the soft tissues. During sleep, when the body is horizontal through the night, the fluid is redistributed into the upper body. Come morning, the pitting edema has gone away, but then returns as the day goes on. This happens to anyone with insulin issues — it is just more noticeable in those who are overweight.
When clients first adapt to the keto-adapted lifestyle, one of the first side effects is a rapid improvement in insulin sensitivity. Eating low-carb causes insulin levels fall quickly, and your body starts to banish insulin resistance. As insulin levels fall, the kidneys begin to promptly release fluid. One common complaint I get from clients when they first adopt this lifestyle is that they are up in the middle of the night urinating more than usual. This will go away eventually, which is a good thing, but there is also some bad news that comes along with it.
The good news is that when you release that excess fluid, fat oxidation becomes easier. The bad news is that as the extra water goes, it also removes essential sodium and electrolytes. When sodium levels fall below a certain level, which can happen quite fast, there are some undesired side effects such as headaches, low energy, dizziness, and cramping.
When you first start your well-formulated low-carb lifestyle, you might notice that if you stand up quickly, you get dizzy or feel faint. This is because you are dehydrated! Just drinking water isn’t going to work like it would with a high-carbohydrate diet. You need to add more sodium. You can add more salt to your food, drink bone broth, or take sodium tablets. Salt is not the evil nutrient that your doctor warns you about. You’ve got to start thinking differently. Just like understanding that eating more fat lowers your risk of heart disease, it is important to understand that a well-formulated low-carb diet requires a more lot more sodium.
My favorite way for clients to get more sodium is to consume homemade bone broth. It is so easy to make — you can even do it in a slow cooker! Bone broth not only helps with getting sodium, but you also get a ton of minerals and electrolytes. Commercial broth will not have these benefits. It takes a few days to make, but I will often make a huge batch in the pot that Craig used to make home brew in (this was years ago … yes, we have come a long way in our journey).
I hope this series has encouraged you to at least try a ketogenic lifestyle! If you’re ready to start, get your camera out and take a “before” photo because in a month, you will be shocked at the difference in your body. If you need meal ideas, check out the Ketogenic Cookbook. Please let us know your keto experiences in the comments!