Ketones and heart arrhythmia/palpitations

(Tom Seest) #21

I would definitely check with your doctor.

The beta blockers vary in how they act on the heart. Arrhythmias are normally electrical problems caused by an electrical signal short circuiting. They often refer to these signals or circuits as channels. So, beta blockers can act by blocking sodium channels or calcium channels, and can also have other mechanisms of actions. Too much or not enough magnesium can also cause arrhythmias. As you can see, these are all important electrolytes. So, play it safe, gather more information, and feel better. As someone that spent 14 months with constant Atrial Fibrillation and heart failure, I understand how bad it can feel. So, best wishes and get well…


Thank you. I will.

(Anne Bliss) #23

This is interesting. I’ve been waking up shortly after going to bed, rarely, (once a year until recently, its happening more often), with irregular pounding heart beats and increased heartrate. It’s only happened if I’m on low carb, the first 2 episodes were exactly 1 year apart and I remember “oh maybe I didn’t drink much water that day?” and “oh i barely ate that day, was so busy etc” … then recent episodes 1-2 a month, similar, not eating much/very low carb and IFing. It started when I was 37 and I am now 38 and otherwise a healthy female who turns to low carb to lose weight (no other sickness or ailments, no medication, all bloodwork is healthy, no diabetes, etc). I’m trying to figure out the common factor with my episodes so I can avoid it - the only thing is low carb and IF combination. I do use keto aid (but perhaps not on those days) but the episodes started increasing after I added Mg (after seeing a cardiologist and wearing the monitor for 30 days this January, which confirmed afib - my Dr was surprised!). The recent episodes would happen within 30 min after I take the Mg vitamin at bedtime… I’ll be resting/half asleep and boom, heart wakes me up. The scariest episodes can last 1-3 hours, and I’ve had at least 2 episodes that were brief - I didn’t even notice/wake up for (monitor caught it). During the 30 days monitor, I specifically started it during high carb/holiday (NYE) and vacation timing as well as fasting and low carbing, to help pinpoint if it’s random or not. The afib episodes are never during the high carb standard american diet days. I’ve also fasted after carb heavy days (i.e. eat SAD diet sunday and eat again on Wednesday), and no episodes there. My cardiologist thinks it is environmental and it is not the same a-fib that our parents/70s+ yr olds get. It’s not sustained and I’ve had zero heart issues history wise - echo is fine, no heart disease risk, etc. This is something acute and can be reversed, she says. Anyway, the more I look into it, and with the recent Keto causes AFIB articles - I don’t think low carb is for me. I’ve turned to it for nearly 2 decades…and it’s been a way of life for me to buckle down and lose some weight, after childbirth or putting on extra, etc. I don’t tend to lose doing just low carb anymore, so I have to also IF and limit the hours. I’m fine eating 1 hour a day or skipping a day here or there, and that’s the only way I see progress these days unfortunately. I don’t know if it was lack of water or electrolyte imbalance - I am kind of sick of trying to figure out what the “right balance” is - who even knows? What if for me it changes daily, etc? If I eat carbs, I don’t have to worry about salt and potassium and keto aid and Mg supplements how many grams I’m getting of everything - for me, I never want another episode again so I’m trying to focus on the IF and hope I can make progress with just that. What I find most disappointing is that the keto brigade was so quick to say “fake news!” when the afib articles came out. Here I was thinking “man that is what I was suspecting for a year now!” I want to raise my hand and say, yeah that’s easy for YOU to say - here I am a healthy female (besides overweight) trying to lose 30lbs and now I have experienced AFIB on keto/low carb. It’s messing with me in some way and I think there is something to those studies being done. Maybe low carb isn’t for everyone. My genetic testing (23andme and FoundmyFitness/promethease) also didn’t recommend low carb in the manner I was eating it (bacon, beef, pork, sausage, cheese, etc). My various FTO geneotype makeup just so happens to repeatedly recommend I keep a high poly unsaturated fat vs saturated fat intake, so I have to focus on fatty fish (yuck) and nuts (I can eat a lot of nuts so I’m not sure that’s so good). Anyway, all this to say - I am not a professional in nutrition or medical field but I do know that something is off with lowcarb/IF for me so there might be more of you out there. Wishing you all the best of health, and listen to your body if something seems wrong like sudden onset of afib @ a young age during low carbing.


Same thing happened to me. I was so scared. I had palpitations and arrhythmia. I started taking potassium and magnesium supplements and the symptoms went away. You have to take a lot of potassium. And drink a bunch of water.

(Af F) #25

Yes I got lots of heart arrhythmia and I think it’s because the loss of salts and electrolytes by the kidney on a ketogenic diet.
It’s known that on a low insuline levels the kdneys will loose salts instead of recycling them.

Since I have started ketogenic diet I need lots of salts to cover up this loss of electrolytes, and still it’s not enough.

(Edith) #26

Unfortunately, nothing stays the same. What works now, doesn’t necessarily work in a few months. Currently, I take:

2 teaspoons Himalayan salt
3/8 teaspoon No Salt
800 mg Magnesium Glycinate

I take this every day like medicine and I don’t get the heart palpitations any more. I recently had to up my salt from 1.5 teaspoons to the 2 teaspoons. I don’t know why my needs changed. I haven’t been exercising lately, one would think I would need less salt, not more. :woman_shrugging:

(Af F) #27

I’m so glad to hear that. Maybe I need to increase my salt dose too, I feel palpitations all the time.

(Af F) #28

How do you eat/drink so much salt?


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.


Edith, @VirginiaEdie on your blood work, did it ever turn up low alkaline phosphase? ALP is a liver enzyme.

I had repeatedly low ALP on serial blood tests taken 4 months apart over the past year. It forms part of the magnesium deficiency diagnosis (and resulting AF root cause) made by my doctor.

Zinc is another rabbit hole to dive down. It takes us to selenium and Vitamin E as well. Where I live the soils are all deficient in magnesium, selenium and zinc. But are high in titanium, calcium and lithium. And also living next to the ocean provides natural sources of magnesium and manganese through seafoods. This soil profile affects the animals, plants and people grown on these soils.

(Edith) #31

I have a mix of 4 parts salt to 1 part No Salt. Three times a day I toss down 1/2 teaspoon of the mix with a glass of water. The fourth dose I put in 32 ounces of water and drink that during the morning or afternoon. Plus, I heavily salt my food.

(Jenni Kitterman) #32

I agree that is an electrolyte imbalance. Couple of things that could be hindering electrolyte absorption: 1) . If you have uncontrolled Celiac your small intestine is not absorbing nutrients properly (including electrolytes). 2). If you are taking an antacid (ESPECIALLY a PPI like Nexxium, Omeprazole and the like) you are also not absorbing nutrients property. I had both those issues, but finally got them lined out. :slight_smile:

(Edith) #33

Nope, neither of those are the case. I did discover years ago, like 22 years ago, that I had issues with gluten. I’ve been gluten free since then. I also don’t take antacids. I thinks it’s just my body, maybe my age.

I actually have a theory: my mother started having heart palpitations at about the same age I started having heart palpitations. The doctor put her on metatropolol (or however that is spelled) and she has been on it ever since. I also know of ladies my age who had palpitations and ended up on beta blockers. My theory is that because soil is depleted of magnesium, we naturally become more deficient the older we get, until finally the health problems of deficiency kick in and we (meaning people in general) end up going on medications.

Once deficiency symptoms kick in, I think we are pretty depleted. I’ve actually gotten to the point where I am going to try to dial back my Mg to 600 mg/day. I was taking 400 mg/day before I started keto, but that ended up not being enough.

(Edith) #34

Hi @FrankoBear, I will reply to your post when I have a little more time. Thanks for your response and inquiry.

(Af F) #35

How about more trace elements that might be lost in Ketogenic diet, do you add some?

(Edith) #36

Hi @FrankoBear, the last time I had a blood test done was a year ago when I went to the emergency room for the heart palpitations. Most of my blood values were within normal ranges except potassium was a little low and RDW SD (red cell distribution width) was borderline high. When this value is too high it can signal nutrient deficiency in iron, folate, or B-12.

I had been eating keto for over a year by that time, and I don’t think I had been eating enough nutrient dense food. I have no idea what those blood values might be now. I switched over to a more carnivore-like diet this summer and I take a multivitamin. Plus, like I mentioned previously, I really upped my Mg. That is what really seemed to do the trick for stopping the palpitations. (I have a lot of posts about palpitations on the forum, so I won’t rehash all the trouble shooting here.)

There are definitely foods that will up my heart rate and will give me some palpitations, but the palpitations are nothing like they were though April/May of this year. The food reactions seem to be related to high histamine foods, but luckily not all histamine containing foods.

I think for petite women, in particular, it is difficult to get all our nutrients with keto. We don’t need a lot of calories, so the few calories we eat that are not fat, need to be as nutritious as possible. My version of keto carnivore seems to be helping.

Currently, I’m eating meat (beef, pork, chicken, some liver, some fish), baby greens, and berries. I do season my meat. So far, I’m feeling pretty good with that

(Failed) #37

My husband’s heart skipped a beat every 20 or so beats for years. Dr said it was normal.
He started keto in early July. The other day, I listened and i stopped counting at 500 not-missed beats. Definitely an improvement.

(Edith) #38

When I started upping my Mg I was using ReMag, an ionic solution sold by Carolyn Dean that is supposedly 100% absorbable, along with her ReMyte which contains minerals along with Iodine. My hot flashes got way worse with the ReMyte. I think it was the iodine. Now, I just take my multi which has some minerals in it.

(Af F) #39

I tried this for two days and found myself exhausted, I could hardly walk and had palpitations as well. When I took the “salts tabs” I have, everithing became ok, so when I looked up for the differences I have noticed that by taking those pills, Calcium was added, which was not available when I took only salt and No Salt (Potassium).

(Edith) #40

Yes, Mg and Ca need to be in balance, so I also take CitriCal.