I think this observation of change is an important point for those of us who get heart arrhythmia while pursuing a ketogenic lifestyle.
The changes that trigger arrhythmia may be imperceptible or they may be on purpose.
Some information that stuck with me was Dr. Adam Nally’s observation that his ketogenic eating patients who developed atrial fibrillation were the ones who were in the process of change after falling out of keto due to emotional eating, a holiday change, or other reasons. This observation would correlate with an increased incidence of arrhythmia in people using a cyclical approach to keto. But I haven’t come across that phenomenon as yet.
The other information and personal observation is the higher likelihood of electrolytes being a primary factor and their role in electrical conductivity in the heart. And how electrolytes are affected by the change to a lower insulin metabolic state, if a person can maintain the ketogenic eating groove.
When the conditions change in the body the adjustments to those changes can trigger an arrhythmia.
If ketogenic eating also unmasks an underlying disease, that will be important to investigate and diagnose. For example as some differentials, may be:
- a mild key electrolytes deficiency
- gut dysbiosis resulting in poor mineral absorption
- healthier keto or carnivore eating releases stored toxins from body fat that affect the heart
- (as above) oxalate shedding hypothesis, where a change from a high oxalate diet to low oxalate (carnivore) releases bound oxalate from affected body tissues that then binds electrolyte minerals in the blood as the oxalates are being excreted (can result in kidney stones), bound up blood minerals result in deficiency symptoms of heart arrhythmia
- an imbalance in electrolyte supplements e.g. too much calcium, wrong combinations, mistimed dosing
- a genetic susceptibility to arrhythmia (atrial fibrillation)
- due to a previous injury e.g. myocardial scarring after a flu infection
- persistent dehydration resulting in low blood pressure e.g. a symptom of kidney dysfunction especially in type 2 diabetes
- kidney disease resulting in electrolyte loss e,g. specific magnesium losing nephropathy
It means that people who get heart arrhythmia need to record their food, timings, supplements, and especially, any changes made to a routine previously working.
My latest observations of a return of heart arrhythmia were: new, mildly stressful job, change in eating toward carb cravings and increased coffee consumption, increased chocolate consumption, less activity, more time at a computer, and a cessation of surfing. Throw in a few minor surgeries for skin cancer and a bad leg injury (from surfing) that left me very lame for a month. Rapid healing from the surgeries however. I saw the slippery slope, so did that human thing of determining a change. I maintained my magnesium supplementation and switched to carnivore. 21 days into that change, and with the underlying changes as listed, I had a return of atrial fibrillation, one episode.
I’ve changed back to keto, which means some leafy greens, some fermented foods, potassium rich avocados daily, some seasonal berries, seaweed every breakfast, some non-sweet fruits such as pumpkin and olives. And it’s back to the beach daily this week, before work. I had another episode of atrial fibrillation. But I treated it at home with 20 minute sequential dosing of magnesium with water, topical MgCl, 100mg aspirin (vs the stroke risk during a bout), 1/4 teaspoon of pink salt, 90 minute meditation with an eye pillow. My heart rate flipped back from 150bpm for 5 hours to its regular 60bpm. Quite a work out. It was a risk and not recommended to try at home. The arrhythmia could be a ventricular tachycardia and that can result in death. But I am sick of hospitals.
I monitor my heart and can hear the occasional skip or extra beat, which is closer to what is considered normal. I went and got a blood draw yesterday to investigate and have a cardiologist appointment in two weeks.
We can see that heart palpitations and muscle cramping are common for people changing to ketogenic eating for the first time. That is a big clue. It is usually associated with electrolytes.
But for those of us who get heart arrhythmia severe or concerning enough that it sees us in a hospital emergency department, we have some extra learning to do.