Bad knee pain since ketosis

(Diane ) #1

Hi this is my first post on here. I am having quite a bit of pain and inflamation in my knees. One whole leg is swollen but the other hurts worse. It feels like I have been doing heavy weight squats in the muscles around the knees and also like Ive hyper-extended them. All weird. No recent trauma, no squats etc. However, if I were to say what was the weakest thing on me it would be the knees. But nothing diblitating.

This all began when I cut out all sugar in my diet. I IF keto diet and have lost 6 lbs since 1/2/17. All good right? I have always eaten pretty clean. No bread, potatoes, rice, pasta… I eat a portion of protein and a LOT of salad and some cooked veggies. The only thing I have changed is no sugar and the frequency of eating. From 3 meals a day to 1.

Since I have been seeing this problem, I have not eaten nuts, dairy or anything mentioned here to cause inflammation. I don’t drink sodas. I haven’t introduced any new food. I’m baffled. Today, I had Xray & Ultrasound on knees and it shows fluid. Go figure.

I use sea salt. Take mineral supplements, nutriional yeast for B vitamins…I’ve tried pumping up the volume on Potasium and Magnesum. Drinking bone broth to help. Cartlidge supplement. I was fortunate and never had keto flu, cramps etc. I feel great, it’s just this darn joint and muscle pain.

Hard to negotiate stairs, toilet etc. I’m only 20 lbs overweight. I did this to get healthy. I figured getting the weight off would help my knees- not make them this painful.

Has anyone else experienced this? If so, what helped?

Thanks in advance!

(Courtney Travis) #2

If there was no injury it is probably a chronic knee issue that you have just noticed!


Did they test your uric acid level? The early months of ketosis can elevate it and cause gout or kidney stones in susceptible individuals (my husband and me, respectively). Gout crystals will not necessarily show on any imaging, and it can occur in any joint.

(Diane ) #4

I think you are both right. I think I have high levels of Uric acid. I ate organic cherries every morning before I started this new program. Perhaps, they were keeping my levels at bay. I’ll never know.

However, in my search I found out that fasting and ketosis can elevate Uric acid levels. Dr. Berg says to use Potassiun Citrate for this. ACV helps, lemon water etc. I’ll let you know if that what works for me. Thank you for responding!


Ketones compete with uric acid for excretion, so yes, both low-carbing and fasting can elevate UA. The “official” position on this in the keto community is that it resolves after several weeks, but that assertion is based on a single study done on highly trained athletes. For the rest of us, it can take much, much longer. For my husband, his uric acid never went down, and he continues to take medication (allopurinol) for it. Mine took 10 months to go down, and it’s still a little elevated.

Taking lemon juice, citrate, etc. can potentially lower your risk of the UA forming kidney stones, but I don’t believe it actually helps lower UA.

But UA might not even be the problem in your case, so definitely get it tested.

Activism in reverse?
(Diane ) #6

Koda, Thank you for the information. I will ask to be tested for sure. I am really hoping I get a handle on this soon and I had high hopes that it “usually resolves itself in a week no matter the treatment” as I read so many places online. From you and your husbands experience, that very well may not be the case. I will let you know if I find the cure or at least anyting that helps relieve the symptoms.

It is a shame it is a side effect as I really feel great other than the hurting, swollen knees ;-(

Thanks again.

(Emma) #7

Hi :grinning:. You say that the weakest thing on you is your knees? Did they hurt at all before keto, any twisting or injury, even mild? Keto lowers inflammation and repairs old injuries. The increase in pain could be because of this? I only say this because I have been having bad shoulder pain during my fasting window. I also think that the Uric acid is worth a look too. I understand why you can’t eat cherries anymore, but what about trying a cherry extract tab in tablet form? I’ve no idea of the carb content though. I wish you a speedy recovery and a solution to ease your pain.

(Diane ) #8

Thanks! Yes, to old injuries. One had meniscus clean up surgery a long time ago. The knees continue to feel tight, somewhat swollen and pain in stabilizer muscles when trying to bend. X-ray showed fluid. Hard to get under covers because of pain when bending them. Stairs are difficult but not impossible. Walking doesn’t hurt per se but I don’t want to aggravate the problem whatever it is. They are not real hot or red like gout but who knows. But maybe that is it. I’ve basically been trying any and everything to treat that if that is what it is. I’ve put cherries in kale shake, cherry concentrate. ACV, potassium citrate, celery seed extract, lemon juice water…avoidance of meat…nothing has eased it up. I’m still losing even adding cherries that is a plus. However, I’m puzzled about this problem. I have appointment with doctor Monday. I’ll see what she thinks.

(Rob) #9

I have a history of gout and a swollen painful knee right now so I am interested in what your doctor had to say. Any update?

(Diane ) #10

I did go back to the doctor yesterday and she ordered blood work. They are definitely looking at my Uric Acid levels among other things. I go back Thursday for results.

She did tell me that she had another patient and his wife that had put themselves into something like this with a low carb diet. He was there for a follow up to check his levels since treatment. However, she didn’t tell me what the treatment was for him or his wife.

Whatever I have is strange. The knees are not red but they are warm. My quad muscles feel as if I have done heavy squats and the soreness one feels the next day. They are swollen but one is far larger than the other. But it is the less swollen one that hurts more. If I bend my leg too much like to get under covers etc the quads scream. The knees themselves feel like when you put your feet up on a table for a long period of time stretched straight out. When you get up they hurt like they have been overextended too long. They feel like that without doing anything.

I have read a lot since this has happened to me. While limiting high purine foods is recommended a lot of places on the internet to help, a scientific study I read said that doesn’t matter as much once you have it. I’m not so sure about that. I have been eating mostly huge salads with a protein (fish, chicken etc) and a kale shake that now I am adding frozen cherries to so I am not in ketosis for sure.

I’ll let you know when I find out anything helpful. I hope you feel better!

(Rob) #11

Thanks for all the detailed info. The descriptions of the pain definitely rung some bells. Mine is swollen, painful, stiff and your mentioning of the quads being sore is something I have but hadn’t really though of before.

An indomethacin and some ACV took the edge off. allowing me to walk and sleep well enough so I am keeping up with that as it fades away. My gout attacks (usually feet) are more frequent but less severe since keto, though this is the first knee pain since I started this WoE. I’m still sure it’s the price for releasing all those stored toxins rather than a reaction to the yummy foods I am enjoying under Keto. That would just be too much to bear. :frowning_face:

(Basmah Othman) #12

I have the same knees and muscles hurt a lot, especially when I sleep. I had to stop Keto diet for two days hoping this will help. I will go for blood test next Tuesday.
What is ACV?
Any update on that please?

(Diane ) #13

I’m very sorry to hear that you have had the same problem. I can’t swear the ketosis brought mine on as I was instinctively? eating cherries every day for breakfast. Perhaps, I was staving off gout but I guess I’ll never know for sure.

ACV is apple cider vinegar. I took a spoonful every day as well as ACV capsules. Those things might have helped but I finally went on medication. I was prescribed allopurinol. It took a little time but I did get relief.

I have since stopped taking it and have not had a flare up. Even though I have continued ketosis.

I have the medication now as my go to if I start to feel the beginnings of inflammation in the knees.

I LOVE eating this way and have had wonderful success (lost 26 lbs) without any energy dips or cravings.

It is the easiest thing I have ever done. I feel I will continue to eat this way the rest of my life.

I watched “The Magic Pill” on Netflix the other day and it confirmed a lot of my beliefs that this is the way we should eat.

I hope you feel better soon. Please don’t give up because of this setback.

My Best!

(Darlene Horsley) #14

ACV = apple cider vinegar

(Kaiden) #15

My first dislocation was at age 15, but I didn’t have another until I went ketogenic. I’m operating on the assumption that my patellofemoral dysplasia has little to nothing to do with ketosis. If I’m wrong, I’d like to know. Finally, I can stop looking like a madman who proclaimed that ketosis is good for everything.

(Basmah Othman) #16

Thank you Na2rt. I am glad to hear that your gout is relieved. I did uric acid and inflammation markers test and everything was normal, but I still have the knee and muscle pain and I cannot think of any reason. I am taking ACV daily.
I do like Keto diet and I enjoy eating this way, so I will stay on it.
All the best

(serena carli) #17

I buy SERRACOR all the way from america, and its great for inflammation and pain and also the arteries and the heart… my sprained ankle inflammation went down on doing ketosis plus these tablets… helped a lot of my friends as well. Good thing about it it is also not a drug… just looking to get potassium citrate for the occasional leg cramps and protecting my kidneys as well as AVC thanks

(mags) #18

I suffered much more with knee pain when I started this WOE. I searched for solutions and bought several things that were recommended. Vitamins, turmeric, ginger, ACV etc. I’m hopeless at remembering to take stuff so most are still happily sitting in their containers. Then after about 5 months I realised my knees don’t hurt any more. Success!! Just KCKO worked for me :grinning:

(john) #19

GUYS i also have the quad and knee pain and hot knee caps. but it only comes at the fourth day of a fast. it gets so bad that i have to quit my fast at day 5. if i do a three day fast and stop i have no pain. i also have a hard time bending my legs and then after a while straighten them out hurts real bad. i also have had the gout but i do not get it eating keto, only fasting after 3 days. i have tried all the things that you guys have mentioned. i think that it is the uric acid that is the problem. i have been looking for a cure for a long time but i think i am going to have to ride it out for as long as i can to see if i can get past this! if you guys come up with anything please post. good luck

(john) #20

[Basmah_Othman check your potassium and sodium daily intake to eliminate them for your muscle pain. you need at least 4700 mg -7000 mg of potassium and 5000 mg a sodium a day. if you are deficient in them they will give you muscle pain and crams. hope this helps.