High BP on keto



Hi all,

Ive been doing keto since July 2021 and I started at 288 lbs (6’2 height) and am now down to 225 lbs and still going.

My goal weight is 200.

I just had some bloodwork done and I was happy to see I’m not longer prediabetic, all my other markers were on point except for my LDL which was slightly higher than the norm.

From what I understand this is normal while losing weight on keto.

However, I get super nervous when visiting my doc as I used to weigh 370 lbs and have been worried about my health since losing a bunch of that weight. My BP was 158/101, I know this is high, I’ve quit smoking weed as of Jan 1st, and I do not smoke anything else or drink alcohol or take other drugs.

I totally thought keto helps reduce blood pressure? I’ve just purchased a new machine so I can begin tracking my blood pressure from home. I do use salt, and supplement potassium and magnesium, but this is concerning me slightly.

Mind you, I’ve only recently picked up physical activity as I was sidelined for a few months (since august 2021) with a torn muscle in my behind (has been rough)

I’m a 32 year old male.

Any suggestions or any direction I could take to help bring this number down?

Based on the doc’s numbers, I have a 0.4% chance to develop heart disease and a 1% chance to drop dead of a heart related issue in 10 years. That being said, I’m sure those numbers were way higher when I was an inactive, carb and sugar addicted 370 lbs person.

Also, the nerve on that man, instead of giving a pat on the back for dropping 145 lbs in the last 4 years, he didn’t even remember I was morbidly obese and scolded me for my slightly higher LDL and then told me to stop eating fat… -.-

(Bacon is a many-splendoured thing) #2

A high-carbohydrate diet promotes high blood pressure by interfering with the production of nitric oxide. Nitric oxide helps relax arterial walls and thus lower blood pressure, and once insulin drops on a ketogenic diet, nitric oxide production generally improves.

I assume you mean you’ve been keto since July 2021, which would make it about seven months. At this point you should probably be seeing some improvement in your blood pressure, but it could take even longer for it to normalise completely. Is it still averaging 158/101, or has it started to come down somewhat?

(Laurie) #3

I was a heavy cigarette smoker until age 39. In my mid-40s I met a doctor who said there was a 90% probability of my being already dead. (That was a long time ago, and I’m still pretty healthy.) At any age, I would have thought that a 1% chance of dying in the next 10 years was basically zero. I know you want to do things right, but maybe don’t take these numbers too seriously?

Congratulations on your weight loss and the other improvements you’ve made.

(Joey) #4

@deathwhistle Man, congratulations! And welcome to the forum.

Putting aside your “deathwhistle” handle, it sounds like you’re pretty motivated to live … and your progress thus far toward better health speaks volumes.

Yeah, your doctor was being a jerk to miss the chance to high-five you on your significant weight loss (and to have failed miserably to keep up with the research on LDL). For someone like you who is deriving all of his energy from fat/protein, of course you’d have elevated LDL.

Would be curious to know: How are your HDL and trigs doing at this point?

As for blood pressure, yes, yours is elevated. Interesting that your doctor had an issue with LDL but you didn’t mention whether he was interested in having you take BP meds?

Anyhow, two thoughts come to mind…

1 - You’re still in transition from obesity. If you stay the course, you should expect to continue seeing improvements in your health markers over time, including BP.

2 - Great to hear you got your hands on home sphygmomanometer (sp?) to test your blood pressure regularly yourself at home while relaxed. What kind of figures are you seeing at home?

FWIW, my blood pressure (which is fairly low) invariably skyrockets when measured anywhere but at home. “Lab coat” syndrome, no doubt? I’m always left trying to explain that I don’t have high blood pressure - or even “normal” - it’s almost always too low.

There are lots of resources (and conflicting opinions from seemingly reliable sources) on what makes for a healthy range both for the systolic and diastolic measures. Read up and draw your own conclusions. :+1:

Meanwhile, keep up the progress. Sounds like you’re doing awesome.


Might be time to look for another dr. ?

Congrats to you on all the improvements you have created for yourself, keep it up and welcome to our forums.


Thanks for your reply. I will begin the tracking tomorrow AM as my machine is only arriving then.

Thank you for the advice.


Hey, I love your reply, super informative.

I did have high BP when I was morbidly obese and was on medication.

I went from 370 - 250 exercising and eating SAD.

I felt like crap the entire time, and the BP medication was too strong, I was getting light headed, dizzy and almost fainting. I told the doctor this but he shrugged it off and kept me prescribed.

Once I started training more rigorously I dropped the medication myself.

Since April 2020 I’ve been injured and have been treating the injury with a lot of weed and Tylenol or Advil. My physical activity levels definitely decreased and my sedentary lifestyle increased, so that definitely doesn’t help with blood pressure.

I gained some weight back and since July 2021 I’ve been losing (225 as of this morning)

He didn’t mention getting me back on BP meds but he wants me to monitor it from home and ordered a 24 hour test, so whenever the hospital calls me I’ll get that done.

I’m going to begin testing and logging my new results and I’ve recently been cleared for physical activity by my physio from my injuries so in the last two weeks I’ve been back to working out again.

I also quit smoking weed at the beginning of January and iirc it takes time for the BP to regulate (correct me if I’m wrong)

I will keep doing what I’m doing despite what he says and monitor my BP in the progress because I know and it feels like I’m on a solid path.

Here are my cholesterol levels:

HDL 1.41
LDL 3.50 (0.14 over range)
Triglycerides 0.79

Any insight on those numbers?

(Joey) #8

Okay, so clearly you’re on top of much of this stuff and have been taking serious steps to get your health on the right track. Great to hear.

Are you sure about these figures? Are these mmol/L? I ask because the other measures you’ve mentioned above have been in USA-common units (like lbs, inches, feet) so I’m surprised you’re not reporting in mg/dL - which would be vastly different levels than these (i.e., bigger numbers)

Assuming they’re mmol/L then your HDL translates to 54 mg/dL and your trigs come out at 70 mg/dL … and that’s pretty darn good by most standards. Having a Trig/HDL ratio of <2.0 is considered good for reduced risk of cardiovascular disease when measured in mg/dL terms. Your ratio is around 1.3x – well below 2. Again, good news in terms of CVD risk.

Sorry to challenge your stats as written, but in fairness, twice above you’ve said you started keto in July 2022. It’s unusual to get such a strong headstart. :wink:


The 2022 was a clear typo lol

I started in July 2021

I’m in Canada and we have funky mix of using imperial and metric.

These measurements are in mmol/L

(Joey) #10

Ah, thanks for clarifying. Yes, then those conversions should stand.

Based on how some of my dear friends to the north denominate things, July 2021 could well be July 2022-Canadian. :wink:


Thank you sir, I feel more at ease with the results of my cholesterol and understand it better.

My anxiety is pretty up there tonight, I just tried measuring my BP but I could not calm myself down. I’m too worked up for the night, but I really do appreciate your insight.

And my bad about the July 2022 typo! I started on July 11th of 2021.

Taken maybe 2.5 weeks in total of cheats (1 full week during the holidays then a few days here and there before the holidays).

Tbh, I’ve never felt better on any other diet, and I’ve recently started working out after a looong healing process, mind you I’ve lost a lot of my shape, but already with my heart rate monitor i see the differences from my first workout last week to my most recent on Wednesday, baby steps to getting my shape back, and ultimately my health.

(KCKO, KCFO) #12

Tips for more accurate BP readings.
Sit on chair w/table to rest your arm on for at least 5 mins. Doing simple breathes, no need for fancy deeper ones.
Make sure your arm and your feet are as flat as possible and very relaxed.
Take reading 3 times in a row and average it out.

My last visit to dr. office I had a high reading, I went home and followed the protocol above, 112/69, instead of over 150/80ish. I check myself a few times a month, if my dr. ever wants to see what I am seeing I can easily print out my home results for her.

Congrats on your other results. You are healing yourself.

(Joey) #13

Excellent advice. I do roughly the same (except I accept the lowest reading :wink: )


Not all of us can overdo the salt and get away with it, I’m one of them. Also, depending on your size physically, many cuffs will give you wrongly high BP reading, including the ones at the doctors offices. My arms aren’t “big” as far as I’m concerned, but bigger than normal (lifting), if my BP is taken with the normal sized cuff I’ll be in the Stage 2 hypertension range, when they take it with the one for really obese people It’s fine. I have to deal with that every time I get my BP checked. Then they try to blame it on my weight, which I’m around 210-220 lately, so I then remind them my “obese” BMI is paired with around 10% bodyfat… then they shut up and go get the cuff I told them to get and my numbers are descent.

Another one is big veins, I have big veins which means the electronic BP stuff shows me higher because they “hear” it vs “feel” it. I’ve had to prove that one a few times as well. As long as you’re trending down I wouldn’t worry about it.

(Robin) #15

@deathwhistle… glad you found this forum. You are treading familiar ground for many on here with good information and experience.
You’re wise to look at the big picture. If everything that is “wrong” with you remains “unfixed”…. You are already far FAR healthier than your previous self. The rest is numbers and details that may provide insight of “trends”. But all measurements will fluctuate at times. Just keep working the plan. Your body will register the changes long before any machine or scale. You got this!

Also… love the death whistle moniker. That’s the ultimate (and last) version of tooting your own horn. Lol


Same here in the State’s, weird part is when that ever gets brought up I’ve found most don’t even realize how mixed our measuring is.

(Edith) #17

I don’t know if any of this advice will help you, but here it goes:

One more thought about taking your blood pressure. Don’t have the cuff too high up on your arm. When the cuff as more arm to squeeze, I believe that makes the blood pressure register as higher. We’ve seen that happen with our home monitor.

My body needs quite a bit of salt on keto, but that is not true for everyone. If I stop getting enough salt, my blood pressure plummets. I know that salt is only supposed to have a small affect on blood pressure, but there are people who are more sensitive. Maybe try cutting back on some of your salt and see if that helps bring your blood pressure down a bit.

And … congratulations on all that weight loss!!! Your doctor sounds like a di*k.


Hey! Thanks for the response!

I’m not sure if my arm is HUGE, but I do have a little loose skin in the bicep/tricep area from my weightloss.

I’ve been using a M/L sized cuff and at home my readings are still elevated but lower than the doctor’s office.

I go easy with my salt now, but I do eat it still and I also make sure to get some potassium in food and supplements to balance out. I’m going to watch it closer now with the elevated BP.

I JUST started exercising again last Saturday after 5-6 months of NO exercise due to an injury, so I lost a lot of fitness for sure.

Anyway, I’m going to keep monitoring myself, and if I absolutely need to be on meds, I will be open to it, but it has to be more controlled than the last time, because I felt TERRIBLE the last time I was on them and was able to bring it down.


Thank you for the advice! I appreciate it!

If it wasn’t for my increased salt, potassium and magnesium, I would’ve died and failed at the beginning of this diet. It’s helped SO much. I even started using some salt pre-workout and have been having amazing results so far.

Im going to be more careful with it moving forward and thank you for the kind words!

I’m going stick to eating keto and my fatty foods/meats because I literally feel the best i’ve ever felt on any diet before. I crave nothing, no sweets, no pasta or pizza (ok maybe a little pizza because I LOVE it haha) but I can go for extended periods without eating as well as I usually fast 16-18 hours every day and I’ll do a 24 or 36 hour one to challenge myself.

I know Im far healthier than I was 4 years ago, and my numbers are going to only improve because I am not done and not where I want to be just yet.


Haha! Thanks for the kind words, I’m glad I found this forum as well, and I needed to reach out to the experienced community for words of wisdom. I’m sure plenty of people have been in my similar shoes before, so it’s always good to get some insight.

That’s my plan, keep doing what I’m doing, I’ll monitor my numbers (though this could cause me anxiety as I’m prone to obsess over this stuff, terrible habit, I know) and just keep it going until I reach my goal. I dont see myself going back on a higher carb diet as I’m not an athlete and I wont ever need that much extra energy, plus, I’m never out of energy on this diet, even with the intense workouts i’ve been back doing.

Thanks for the comment on the name! It’s actually based on the Aztec Death Whistles, this carved piece of wood that the Aztec warriors would blow while descending on horseback towards their enemies. Pretty interesting stuff, but of course, it could very well mean exactly what you thought it did :stuck_out_tongue: hehehe