Help please...Head and sinus pressure during exertion

#1

Hi,

I am not very sure where to put this, so I’m going to drop it right here. I was not able to find any similar posts.

I have been strict Keto for almost 5 months. I have frequently, almost daily since two weeks into this lifestyle, gotten head pressure around my forehead and sinuses. There is no pain or headache associated. It causes me to blink a lot. No change in vision. I visited my doctor about a month into the diet. She chalked it up to carb withdraw and said to continue with electrolyte replacement. However, this gets exacerbated by any form of exertion no matter the intensity or length.
I’ve been free from carbs other than incidental in nuts, dairy and veggies, since the beginning except for one cheat day on Thanksgiving. These symptoms went away for three days following. My ketones never dropped below 0.7 mmol. During the day of or days following.
I’ve been supplementing potassium, salt and magnesium as recommended by all Ketoers. 1/4 tsp salt and 1/8 tsp of no-salt in 32oz of water. I drink about 3 of these per day. I typically get the rest in my food. I tend to get really anxious when the pressure gets really bad. Every now and then I’ll be in pure panic. i do have anxiety.
I want to work out again but I am terrified of what I will feel like and the symptoms that will follow. The first time I tried to work out about 3 weeks in, my heart rate shot up to 150 after warming up with 5 reps of kettle bell squats (20lbs).
Any help at all is appreciated. I do have a follow-up appointment next week 1/23/19.

Jeremy

#2

Anytime I eat dairy I get all stuffed up with pressure and sometimes pain. Maybe it is something you are eating that you are reacting to?

#3

Thanks for the response! I’ve never had any issues with dairy. To clarify, I may have a few Tbsp of heavy cream in my coffee on some mornings but not everyday. Other than that, I eat butter and cheese on some days depending on what we have fixed for dinner. It just depends on what I fixed. Most of my fat comes from animal fat and good oils.
I do feel this way when I fast as well - 16-24 hours.

#4

I don’t have any ideas about the head pressure. However, your mention of heart rate going up high made me wonder about your magnesium supplementation. If you do a little research, you will find that it helps the heart relax. I had problems when I was supplementing with magnesium oxide which I found wasn’t helpful for anything except constipation. My problems were that my bp shot up as well as my heart rate. It was terrifying!

So the type of magnesium you are taking may be the issue, or you may not be getting enough. Do you track your food and supplement intake with an app? You might find it useful, at least for a short while if you don’t, in order that you might know if you are really low in something.

Hope someone else with more knowledge stops in to help you!

(Carl Keller) #5

Hello and welcome medichermie.

I agree with your doctor about it possibly being an electrolyte imbalance. While it doesn’t sound like a headache, it sounds pretty close to one.

I’ve heard some anecdotal evidence that people using no salt can have issues that resemble keto flu symptoms as well as heart palpitations and breathing issues. It might be worth trying to skip it for a week to see if the pressure receeds.

As for this, not all keto people believe in supplements, including myself.

@PaulL says:

" My understanding is that sodium, magnesium, potassium, and calcium are all regulated by interlocking mechanisms, and that the key is being sure to get enough sodium. It certainly seems true for me, because I don’t get cramps and the other symptoms of magnesium and potassium deficiency as long as I work to keep my salt intake up.

I suspect that things get handled better in the absence of carbohydrate, for a lot of people. I find the Stefansson experiment quite intriguing, for example. Here are these two guys who go a year eating nothing but meat, and they never develop scurvy or any other mineral deficiency.

We know now that vitamin C is unnecessary in the presence of β-hydroxybutyrate, because it restores the body’s built-in anti-oxidant mechanisms. I suspect that ketones may play a role in determining how much of other vitamins and minerals we need, as well. After all, our hunter-gatherer ancestors seem to have done just fine without supplements."

So you can take this with a grain of salt or not, it’s up to you.

PS, I used to have a lot of sinus issues before I started keto and now I don’t. I’m sure it is something processed food related.

(You've tried everything else; why not try bacon?) #6

Andrew Mente, the lead researcher on the PURE study, has an interesting presentation on YouTube (check the Low Carb Down Under channel) of the salt data from the study. Their study shows that consuming from 4 to 6 grams of sodium a day is the level with the best health outcomes. The health risk climbs very steeply as sodium consumption declines; it also rises, though less steeply, as the dose climbs above 6 g/day. Four to six grams of sodium translates to 10 to 15 grams of table salt (NaCl). In his presentation, Prof. Mente cites several other studies that confirm the PURE results.

#7

Thanks for helping! I’ve been on a Mag. Citrate 250mg supplement. Because to what you stated, the oxide is for constipation, I’ve been on the citrate form as recommended by others. It definitely helps with muscle twitching and cramps. I do track food very closely. I’ve been pretty religious on my macros. I’m down 47 lbs since Sept. 4th. 265 lbs to 218 lbs as of yesterday. I’m curious, since I already have anxiety, if the lack of carbs is causing a cortisol response in high stress situations likes exercise? But, at this point, 5 months in, how am I not fat adapted enough to get through with fatty acids for my muscles?

#8

So, today I have increased my sodium tremendously. I’ve had 1/4 tsp of sea salt in every 16 oz water times 6 today. My BP is way up. But I can’t determine if it’s up because up strenuous activity, anxiety or salt.

(Carl Keller) #9

With the amount of water you are drinking per day, that sodium is being constantly flushed out of your body. Plus, carbs help us retain salt and since we keep those low, salt is less inclined to hang around. I’m around 2 teaspoons of salt per day and some experts even recommend higher amounts.

I’ve heard anecdotal evidence from one person who had sodium sensitivity and tried a no added salt diet and measure his BP. His BP fell a bit in the beginning but after a few days it stabilized as he hypothesized that it took his kidneys a few days to adjust. I’m not sure if that’s applicable in your case but it does make me want to say, see if your BP changes in a day or two.

It could very well be the stress and exercise causing the issue, but I am no expert and I am just guessing.

#10

Whenever possible, I try to get most of my electrolytes from the food I eat, so I choose my food and plan ahead what I will eat.

Everyone’s body is a bit different. We are different sizes and some are more active then others and there are many other variables. But I find that I feel good when I get around 3000 mg of potassium, 500 - 600 mg of magnesium and at least 3000 mg of sodium daily from food and some supplements. I don’t take large amounts of any supplement at one time because I’ve read that the body just flushes it if you do.

#11

Dude, thank you for this. I think this may be the issue. I’ll update in a few days. I take mag citrate but not regularly because I get it from other sources. I’m going to start taking it regularly on top of other things and see where it leads.
I really think I am getting enough potassium and salt so I’m not going to change anything with that. Maybe cut down on the water a bit. I’m drinking it to drink it because I feel like I need to flush “stuff” out.

(Ce) #12

medichermie,
I don’t know where you live, but January is major barometric change month and that’s hard on Migraine sufferers. That being said, drinking Saltwater only dehydrates you. Salt all your food. But drink ONLY pure water.