I’m barely two weeks on keto and am having some serious side effects along with gaining 4 pounds. I can be patient about weight though that is my motivator, but I need to feel better. I’ve been keeping my carbs around 20g and targeted a ration of 5/20/75 c/p/f. I’m using My Fitness Pal for tracking and am mostly eating around 1600c per day. I’m 61, female, postmenopausal and fairly sedentary. I’m in ketosis according to the strips. I’m also going over recommended salt intake per my app because I’ve read here that it will help. Here’s my problem: Brain fog and confusion, dizziness, shaky hands and severe diarrhea. I’m dropping things and kinda concerned about driving since I can’t focus or concentrate. Im not ready to quit but I can’t keep going like this. Happy to provide more info as needed. (Also 2L water per day)
Help a Newbie - Advice and Support
What are you eating daily? Are you taking any other supplements besides added salt? For instance, magnesium can cause diarrhea if you are taking a lot. Hitting the coconut/mct’s super hard right off the bat can cause diarrhea.
A lot of severe diarrhea can cause an electrolyte imbalance.
Give us some more information on what you’re eating and has it been this way since you started or is feeling this bad a new thing?
Thanks! Sample of a typical day: 2 eggs fried in butter and 2 coffee with HWC
Lunch - 2 oz chicken, 2oz cheddar, 1/4-1/2c almonds, 1/4 bell pepper, a couple radishes
snacks - cheese and almonds
dinner - roast chicken wi olive oil, spinach sautéed in butter, salad with olive oil, vinegar and parmesan cheese
I do take magnesium (glycinate not citrate) and have been for years at bedtime because it helps me fall asleep. I’m concerned about potassium but haven’t supplemented since I take lisinopril for blood pressure and it contra-indicated.
My hidden carbs are from nicotine gum (xylitol) and I AM tracking. I seem to be getting too much protein vs fat. I don’t normally feel like this. At all. Also, I’m good on tracking. Ex-WWs dieter.
I’m 5’10 and about 200lbs. Open to change because I really want this to work.
Hmmm…chicken, almonds, chicken, almonds. All high in poly-unsaturated fatty acids.
Personally, I’d drop the chicken, nuts and cheese (dairy) and find food that you can eat, preferably beef and maybe fish.
About 6 months ago and everything fine except my BP. I can’t really go right now because of end of year insurance switchover (never need a doctor in the middle of shifting health plans). Including thyroid, VitD blood sugar.
And steak or salmon is my alternate meat. Cheese was my way to get more fat vs protein but I can change that. Didn’t realize it mattered!
https://blog.bulletproof.com/definitive-guide-to-conquering-keto-flu/
The keto flu, aka carb withdrawal, generally kicks in at the 24- to 48-hour mark. Symptoms typically last from a few days to two weeks, and up to a month at most. Whether you experience its symptoms – and to what extent – depends upon your metabolic flexibility, meaning your ability to adapt to different fuel sources ( sans uncomfortable symptoms).
SInce you are getting plenty of water and sodium and supplementing magnesium, it sounds like your body is just having a difficult time switching from carbs to fat. My advice is to try some MCT or coconut oil in your morning coffee.
https://drjockers.com/coconut-oil-brain-health/
The human brain needs a continual supply of fuel. When this continual supply is interrupted brain cells begin to die. In the short-term, this can cause symptoms such as headaches, brain fog, & tiredness. Long-term exposure to environments that deplete sources of brain fuel from effectively getting into the cells leads to neurodegenerative diseases.
New research is showing that coconut oil can supply the brain with a very clean source of energy that prevents unwanted short-term symptoms and is effective at preventing and treating neurodegenerative disease states.
Good luck and welcome to the forum.
Thanks again! I will eat more fatty beef and fish, and get coconut oil. I lurked a lot of forums before choosing this one and appreciate your feedback. I look forward to venturing out of the house without fear. I expect the comment about taking longer to adjust has truth in it. My weight has been a yo-yo for decades as I try eating styles and I think my body fears starvation every time I make a change.
This sounds just like my experience. I rode it out and the fog lifted. Every fart was a gamble for the first month for me. Keep calm, keto on. Eat less than 20g carbs and everything else will work itself out.
Kris86 - Truer words… Recently sacrificed underwear to science (I’m a volunteer beach surveyor for my local marine sanctuary)
Quick update and thanks. I got coconut oil and added it to coffee, along with using it to cook for the rest of the day yesterday. It’s made a huge difference. I still have symptoms, BUT they are manageable and I can function, in addition, my macros were the best yet yesterday.
When I posted yesterday I was pretty frantic. I was so foggy I was afraid to drive, so shaky that stairs were making me nervous. I was a day away from quitting. I’m back to ‘I can do this’.
So THANK YOU to all of you for taking the time to answer with good and helpful info.
Have you been supplementing salt? I had keto flu for four days when I started and washing down 3 grams of Himalayan Pink Rock salt with a big glass of water helped relieve the symptoms. I only had to do it for a few days but it really relieved my headaches and spasms/cramping.
I second on cutting out cheese and nuts until you’re doing better and then gradually add them back in much smaller quantities. Think of them as treats and not staples. 1/2 cup of almonds is way too much. I assume after years of dieting you own a kitchen scale, after you cut those out and try eating them again limit you quantities to 1 - 1 1/2 oz of each per day. That should give you weight loss a boost. I believe plenty of low carb veggies are also key, and fermented veggies are a plus in my opinion which is at conflict with many of the ZC people on this forum but it works for me.
I’m getting plenty of salt 
. My headache is better (? less achy?) no muscle cramps or spasms. The spaced out/stupid feeling is waning. GI issues TBD. I couldn’t agree more about the veg. Fermented veg is my SO’s favorite food and he’s doing great. I just don’t like them so I’m going to pass for now. Who knows? Maybe I’ll learn to like them. And yes, less cheese and nuts, along with the coconut oil is making a difference. I’m not even 2 weeks in and I’m expecting some bumps in the road. My goal is to lose some weight and to NOT be hungry all the time because that’s not sustainable as a lifestyle.
I know you said you are getting plenty of salt, and maybe you are, but to most people this just means more liberal use on regular foods. When battling keto flu 1-2 additional teaspoons of salt can be necessary. And many people continue to supplement some additional salt, often in broth, even post keto flu.
My husband had one of the worst cases of keto flu I’ve ever heard of. He vomited over and over until I gave him some Gatorade. His second attempt had him eating a 1/4 tsp of salt four times a day in addition to regular salt use on his food and he never suffered the slightest symptom.
I’m salting everything. Except bacon. I do track on MFP so that I’m sure I’m meeting the daily recommendation with what is naturally in my food and then adding additional salt on meals. It’s hard! Didn’t quite get there yesterday but I’m adding salty broth to make it easier. Thanks! It is easy to forget but I’m learning.
I use Morton Lite Salt (potassium + sodium + iodine), 1/2 tsp in a glass of water flavored with a little lemon juice, plus I take a 300mg Magnesium supplement pill.
Potassium is one of those things that too much of is bad for you, as is too little. It is one of those things that shows up on blood work. When I had mine tested, 6 weeks into keto, it showed I was towards the lower end of normal.
I don’t always drink the salted water, but I do take the Magnesium pill daily.
What does MFP recommend? I’d be surprised if it’s what is often required on a keto diet. Remember, keto makes your body flush salt so you need WAY more than people on the SAD. My guess is MFP is recommending the RDA for salt which is 2300 mg, but people on a ketogenic diet are told to get 3000-5000mg of salt/per day, and low salt is the main cause of keto flu symptoms.