Ketones and heart arrhythmia/palpitations

(Edith) #1

Does anyone know of any scholarly papers or articles that discuss the affect of ketones on the heart, possibly causing palpitations/arrhythmias?

(Bob M) #2

It would probably be the other way around, as ketones are preferred heart fuel.

(Bob M) #3

See, eg.

I know I’ve found more than this for heart failure and ketones.

Interesting ketone, obesity study:

(Bacon by any other name would taste just as great.) #4

PubMed shows these studies:

(Edith) #5

The reason I am asking is because I have been having trouble with heart palpitations on and off since I started keto eighteen months ago. In the past few months they have gotten worse. I have been doing lots of trouble shooting, but haven’t come up with an answer, yet; and I ended up going on beta blockers. Even so, I am still getting palpitations. Yesterday, I went to the emergency room because they were so bad.

It turns out the doctor who attended to me also follows a ketogenic diet. He mentioned that ketones can cause heart palpitations and that it is really important to make sure I drink 3-4 L of water a day. Unfortunately, I don’t remember what his explanation was on how ketones cause the palpitations and why all the water helps. My potassium was low, just below the bottom of the normal range, and I have really been working on getting enough potassium this week. Anyway, that is why I was hoping to find some information relating to what the doctor had to say.

(Empress of the Unexpected) #6

Did your doctor do an echo?

(Edith) #7

Yup. Everything was fine. I seem to be in that 10% category where they don’t know what is causing the palpitations.

I’ve suspected it’s actually keto so when the doc last night mentioned needing to drink more water and the why (which is what I can’t remember) I got very excited. I may try upping my carbs for a while and see what happens if I can’t find anything else to solve them.

I just don’t believe they are happening for no reason.


I would suggest Keto Aide. KetoAide homemade Also Spinach salad, one whole avocado, almonds and pumpkin seeds daily.

(Empress of the Unexpected) #9

Ooohh - a pumpkin seed aficionado. Yes, I agree with everything you have said. I don’t think I will ever get tired of spinach, avo and almonds, and I grow my own pumpkins (season sadly over).

(Bacon by any other name would taste just as great.) #10

Make sure also to get enough salt, because it helps regulate your potassium and magnesium levels. It’s not the ketones causing the problem, it’s that your electrolytes are out of balance.

(Lynsey Cunningham) #11

I experienced scary irregular heartbeats after eating a ketogenic diet for around 3 months. Besides this I had energy and felt fine. But the irregularities we’re very noticeable and I could feel them. Initially they would come in the morning and evening, then continued in frequency throughout the day and would last for quite a while. I was eating well, salads, avocado, plenty of water, etc.

Immediately I began supplementing with additional magnesium, potassium and salt. After 2 weeks of supplementing and condition became worse, I saw the doctor. My labs were normal. No defiencies. The echo test showed abnormalities in rythym and I was on schedule to see cardiologist for further testing.

I figured I would eat carbs and the condition improved after another week. I have not had any heart issues again in the 4 months since. I did not see the cardiologist.

This was scary for me and if I do Keto again I will do more cyclical.

(Brian) #12

I had some irregularities before ever starting keto. And they did continue for the first couple of months of keto. But they’re pretty much gone away. I think (after 16 months of keto) my heartbeat is about as steady as it’s been in quite a long time and a little slower than I think it’s been in many years. It’s not uncommon for me to be laying in bed and normally find the resting heartrate in the 50’s. Before keto, it rarely went below the mid 70’s, at least in the years right before keto when I was 100 (?) pounds overweight. It’s amazing I didn’t have a heart attack or stroke. Thankful I didn’t. Very glad that keto has allowed me to heal in many ways and given me way higher quality of living in whatever years I have left. (At 50, before keto, I would have told you I didn’t think I had many left. I know it sounds weird but I had confided in a friend that I felt like I was dying. Had I not made a chance, I don’t think I would have lived that many more years. At 54, now, I feel like I might have another 30, maybe 40, maybe a few more, don’t know. Yeah, it made a difference.)

I still do skip a beat every so often. I’m not so sure that’s unusual. I suspect it happens more when I don’t get enough salt or OD on coffee or something like that. But so far, nothing dramatic (bad) has shown up and stayed a while.

(Edith) #13

Are you still low carb? If so, about how many grams of carbs do you eat each day?

(Lynsey Cunningham) #14

I have not gone back to very low carb. I don’t have a lot of carbs but Im guessing between 50-100 day.

I am healthy, active, don’t really need to loose weight and I’m 42 years old. So to me, the heart problems are not worth it. I have implemented IF.

When this started happening to me, I kept reading it was from some Mg, Sodium or potassium defiency, but with addition of plenty of those through, there was no improvement. I also had read that too much water can easily flush out the electrolytes so I took care not to overdo the water.

I looked for scholarly articles also but to no avail.

I think it’s worth it to add in some carbs for a month to see if it improves. It was a scary experience for me. Sounds like for you too.

I was so worried I would gain weight but I didn’t go overboard in the carbs and kept exercising.

Let me know how it goes as I’ve also tried to search on this topic.


I have had cardiac arrhythmias since I was a teenage (I’m 71 now). I started on the keto diet about 3 weeks ago. Last week I began having crazier arrhythmias than I’ve ever had before, really frightening. I figured at once it must be the diet, thought maybe my potassium was low. I always drink a lot of water, but drank even more, with no noticeable results. I also added greens and any other high potassium foods I could think of. But the next day, still feeling awful, I finally decided maybe I’d better eat some carbs - it was either that or go to the ER. I’m back on a fairly normal diet now - low carb but not really keto. Finally today, after 5 scary days, I feel more like my normal self, although still having some palpitations and wild fluctuations in my heart rate. I really want to keep trying to lose some weight - only 10 pounds or so, but still, I want to lose it! But now I’m terrified to try to do keto again. Anyone have any advice?

(Edith) #16

How much salt are you taking in? Low sodium could also contribute. We need about 5g of sodium a day. That’s a little over 2 teaspoons of table salt or almost 3 teaspoons of pink Himalayan salt.

(Bacon by any other name would taste just as great.) #17

This may be something you need to consult your physician about. We’d hate to have you come to harm, as much as we’d also love to see you eating keto. Please take care of yourself.

It’s possible that, if you are taking any drugs, for this condition, the dosage(s) might need to be adjusted if you want to eat a ketogenic diet. This is standard advice for diabetics and people on blood pressure meds and could well apply here, too.

(Brian) #18

There are people who are in ketosis at that level of carb intake. And even if you’re not in ketosis all of the time, with that low of an intake, there’s a good chance you’re going in and out of it quite often, perhaps even daily. I’m not sure that’s a bad thing at all. Maybe the metabolic flexibility is actually quite good. (?)

I have days when I’m down in the teens & 20’s (grams of carbs) and days I push towards 100, not many, but it happens. Mostly, I think I hang out in the 25 - 50 area without a whole lot of attention to it. It’s kinda of a habit.

But I’m pretty lazy keto. That doesn’t work for some. Just how it happens to work for me.


I always worry about eating too much salt, so it’s an adjustment for me to actually try to eat it. That said, I do think I was probably getting the equivalent of at least 1 teaspoon a day, and possibly 2. But thank you - if I go back on keto I will definitely keep your advice in mind.


OK. Thank you. I do take a beta-blocker for my arrhythmia. I’ll talk to my doctor.