Can keto help osteoarthritis? (Or could it hurt?)

#1

Hi all, I’m 60 years old, female and doing keto for about 10 months. I started for two reasons: 1. To control fibromyalgia pain (which is a separate issue from my osteoarthritis and its associated pain), and 2. To control a steady weight gain since menopause. I’ve lost about 10 of the 20 pounds I’ve gained in the last 10 years, and my fibromyalgia pain is better – although by no means gone.

What is definitely not better is my osteoarthritis. Based on my last week’s x-rays, it’s looking like I will need double hip replacements, and I have a deep pain in one of my hips that has definitely gotten worse over the past year. I know it’s unrealistic to expect a diet to increase joint space once it is gone, but I was hoping I might have at least stalled a worsening of my problem.

I’m also wondering if something about my diet could have actually contributed to a worsening of the problem. Is it possible a mineral imbalance – which is common on this diet without supplementation – could be making me worse? I do take magnesium but not a lot as I easily get diarrhea from it. I don’t take calcium because I eat plenty of cheese. Lately I’m taking more vitamin C than my multi vitamin contains, more vitamin D, and collagen (when I remember!). But I guess this is all too late. If there’s a way to delay the replacements for a few years, that would be ideal since I know they don’t last forever and I am only 60 years old.

Another thing to add is that I have some degree of osteoarthritis in many joints/spine so I guess I am predisposed. I’ve tried taking glucosamine, chondroitin, MSM on and off throughout the years, but given studies that have shown no benefit – and I can’t say my n of 1 has identified any great benefits either – I’m not inclined to continue with this.

All thoughts on this topic are welcome!! Thanks so much.

(Michael - When reality fails to meet expectations, the problem is not reality.) #2

75 years here. Keto a month shy of 4 years. I eat collagen every day in the form of gelatin, hydrolyzed collagen and/or powdered bone broth. Mostly hydrolyzed collagen which I add to my daily keto coffee. I also eat lots of dairy to maintain my calcium levels. Fortunately, dairy is fine for me and I eat lots of it every day. It’s my primary food group. I have a degenerated L5 disc due to most likely a childhood injury, but not known for certain. This has caused me problems my entire adult life since the age of 25, including serious lack of flexibility. I’ve never been able to touch my toes, for example. I don’t have osteo that I’m aware of, although I occasionally have joint pain in my fingers. I did a lot of hiking in the mountains for many consecutive years and have weakened my knees to some minor degree, but they don’t usually cause me any discomfort. I’m hoping collagen and calcium will keep me mobile. I see no reason to think keto would exacerbate anything. Why would it? I’m eating the healthiest diet ever in my entire life, getting all the nutrients I require plus the additional collagen to help ameliorate the decreasing production of my own body as I age. Best wishes.

#3

Thanks @amwassil. There are two reasons I worry that the keto diet could possibly not be good for osteoarthritis. There are the mineral deficiencies that it seems almost everyone experiences to some degree, and there is the fact that it is a more acid than alkaline diet. I don’t know that acid/alkaline matters at all, but there are groups who think keeping the diet more alkaline is “healthier”. I’m not sure there’s great evidence for this but I followed an alkaline (focus on fruits and vegetables) diet for a while — checking my urine ph as obsessively as I now check my ketones :smiley:, and I thought I felt better when I was more alkaline. But really, I have no idea…

(You've tried everything else; why not try bacon?) #4

There are a few issues here. The first is that a well-formulated ketogenic diet helps with inflammation, by reducing serum glucose and serum insulin.

Second, if you also avoid polyunsaturated fatty acids, replacing them with saturated and monounsaturated fats, you will also greatly reduce systemic inflammation. (In other words, avoid the seed oils in favour of butter, tallow, and lard.)

Third, so far as the bone damage involved in osteoarthritis is concerned, there is a point past which a ketogenic diet will not be able to help repair the joints. The diet can help enormously, and it can even reverse mild damage in some cases, but it is not a cure-all. (The same is true of keto and other conditions, as well.)

Lastly, there is absolutely no evidence to show that the acidity of food has any effect whatsoever on the acidity of the blood. Blood pH is tightly regulated, and no one whose pancreas is secreting even a modicum of insulin has any need to worry about ketoacidosis.

#5

Thanks @PaulL. Just to be clear – my reference to acid/alkaline diet was not meant to suggest any concern about ketoacidosis. I think the premise of those who promote the alkaline diet is that the blood will pull from whatever stores it has (i.e., bones) to keep itself in the necessary range of pH. So foods that generate more acid will pull more minerals from the bones. What is interesting in my case is that there is no doubt that I have much less inflammatory pain on the keto diet. Within a few weeks my fibromyalgia pain changed from being a throbbing pain throughout my entire body to being much more focused on my arthritic joints and not constant.

I’m reading about collagen as an OA treatment, and it sounds promising! I wish I had known about it years ago.

(Michael - When reality fails to meet expectations, the problem is not reality.) #6

@Wendy198 I don’t know about ‘acid/alkaline’. I eat what I think is a pretty standard ketogenic diet: 2:1 ratio fat:protein grams and sub-15 grams carbs per day, frequently sub-10 grams. I eat from a repertoire of foods that includes dairy, eggs, meat, fish and plant fats from coconut and palm. All carbs I consume are incidental to the other foods. I drink a liter of coffee every morning with a mix of fats/proteins to my ratios. I supplement sodium, potassium and magnesium salts, but otherwise my mineral intake is from foods. I work a full-time job at Walmart that requires standing at all times on the sales floor and lots of walking. Also, I expend lots of energy interacting with customers and other staff. I also have to lift and carry 20-50 pound weights frequently. I am generally exhausted by the end of my work shifts. Yet, at the age of 75 I think I’m doing well. :slightly_smiling_face:

(Gregory - You can teach an old dog new tricks.) #7

Are you saying a generic keto diet, which means keeping your carbs low enough that fats/ketones become your primary/energy source, is more mineral deficient than some other way of eating?

What would that be?

#8

@OldDog I was referring to the electrolyte loss that occurs with the water loss associated with the diet. It seems many people get muscle cramps and nighttime heart palpitations (I certainly did), which is helped by magnesium. Magnesium is also important for healthy bones and joints. It’s hard for me to know how much I might need to be supplementing.

(KCKO, KCFO 🥥) #9

This podcast might be helpful.

https://ketowomanpodcast.com/158/

(You've tried everything else; why not try bacon?) #10

Well, that makes a bit more sense than the stuff I came across the last time I looked this up. However, while the idea is somewhat plausible, I haven’t encountered any actual data to prove it. I don’t think you need to worry. Also, as long as we get enough salt, the other minerals are more easily kept in check, because the regulatory systems are all interlinked. Most people get enough calcium, magnesium, and potassium in their food and can keep them in balance as long as sodium intake is sufficient.

(Germaine M Schweibinz) #11

Hello Wendy198, do you drink alkaline water, I use willard water & it has helped me so much for the last 4 years. I have been Keto two of those years!

#12

@Gms, thanks for the tip – I will try that!

(Germaine M Schweibinz) #13

Wonderful