Metoprolol or beta blockers on keto

(Lisa Stevens) #1

Can anyone share their experience with taking beta blockers on keto? I was reading it does have an effect on sodium and potassium levels. I’ve been keto since October 2017. I’ve had a lot of trouble with high blood pressure, especially when fasting, even IF. It just got worse. I tried playing around with my electrolyte supplements. I don’t know if I should ask for tests on why my adrenals are so overactive (high BP, sweating, anxiety) because I suspect it’s from longterm use of tramadol. I haven’t lost any massive amounts of weight, just inches, look leaner, more energy. I became more concerned with high heart rates and hypertension so I’m trying this medication.

(Bob M) #2

I’ve been taking a beta blocker for about 5.5 years, carvedilol. I do not have high blood pressure (have idiopathic dilated cardiomyopathy, an enlargement of the heart). I cannot tell whether it has an effect on sodium and potassium levels, though I do take quite a bit of sodium (don’t take potassium except rarely, as I’m on an ACE inhibitor, which supposedly raises potassium levels).

I have the opposite effect when fasting – my blood pressure drops. I had to quit the longest fast I’ve done (5.5) days because I was getting dizzy when I stood. I do take sodium (pickle juice, salt) when fasting now, which has alleviated some of these symptoms.

(Lisa Stevens) #3

I’m one of those oddballs who have seen BP rise on keto. I’ve tried everything. My metabolism is just messed up I guess so I’m waiting it out.

(Pam ) #4

Been on Metoprolol for 10+ years and Keto for 7 weeks. I’ve not noticed any issues. I do also take prescribed Potassium with my Lasix in the evening. I eat the same amount of salt as before keto and my blood pressure stays in the same normal ranges.

(Bob M) #5

How “high” is “high”?

The problem with blood pressure and particularly medication for blood pressure is that (a) what’s considered to be “high” keeps getting lower (just like cholesterol) and (b) drugs may lower your blood pressure but might not increase your lifespan.

Here’s an article about blood pressure that might interest you:

I’ve taken L-arginine and L-citrulline, but have ceased taking them, as my blood pressure is too low already, and these cause it to go lower. In my case, these work too well.

And for any men reading this, L-arginine and L-citrulline increase NO (nitric oxide) synthesis…in a similar manner to Viagra.

(Lisa Stevens) #6

I’ve been as high as 180’s over 90’s. I’ve fought the fight to stay off of meds for over a year as readings just got higher at home as well as at my doctor’s office.

(KetoQ) #7

I’ve been on metoprolol for 11 years and low carb since May 2018.

My last full metabolic panel was in September and both sodium and potassium were stone cold normal. BP normal at 120/76.

Since going low carb began adding salt to my food on a regular basis. I don’t go crazy with it though. Probably add more salt in the summer when I am out doing stuff and losing sodium through sweating. Do eat pickles and sauerkraut on a regular basis.

I track my meals on Cronometer and usually get more than enough sodium, but usually not enough potassium, so I try to be aware of that and get more potassium rich foods in my diet. But from what I read, its is hard to get enough potassium in a normal diet.

Cronometer is good at tracking sodium/potassium balance, which is a useful metric. And taking magnesium can help with better absorption and movement of potassium in your body.

So in my experience, beta blockers have not been an issue.

(KetoQ) #8

I’m curious, why do you want off BP meds when you have a BP problem?

I know it’s politically incorrect on this board to advocate for pharmaceuticals. But until you can get the problem under control with diet or other behaviors, it’s a wonderful thing to have and it may be saving your life.

(Lisa Stevens) #9

This is my first experience with any BP meds. Other than chronic pain I’m pretty healthy. I’m postmenopausal. I’ve been keto since Oct 2017. My new doctor knows a little about keto and seems supportive. I just wanted to know if this drug would interfere with keto. Until recently I really only had white coat hypertension.

(Bacon is a many-splendoured thing) #10

If you need a blood-pressure medication, by all means take it! But keep an eye on your BP, because a lot of people find that theirs comes down. We are usually in the position of warning people that their dosage may need to be decreased, but there are always outliers such as yourself, and we always need to bear that in mind.

One consideration that may be relevant, however, is how much sodium you are getting per day, since that has implications for blood pressure.

Several recent studies have shown we are at our healthiest when getting between 4 and 6 grams of sodium a day, which translates to 10 to 15 g/day of table salt (NaCl). People with high blood pressure should work to stay within that range, as I understand it, because too much or too little sodium can greatly increase their risk of cardiovascular disease (for people with normal blood pressure, the risk from getting too much sodium rises more slowly; the risk from not getting enough is the same for everybody).

Here is a presentation given by Prof. Andrew Mente of McMaster University, one of the principal investigators in the PURE study, talking about this issue:


I find this thread really helpful. I have been taking the beta blocker bisoprolol for, gosh, more than 20 years and always tolerated it well.

But since going low carb, then Keto and then Keto/EF I have a lot of problems with light headedness especially so when going from seated to standing or bending over to do a chore. Also, when I go for long walks I am fine until I get home and slow the pace or sit, then I get light headed again until I drink a ton.

On my eating days the problem eases significantly but does not go away totally.

My blood pressure is normally kind of low at 110/72 and I have bradycardia — a slow heart rate so I know the systemic source of my light headedness. On top of that I take flecainide with is an anti arrhythmia drug. I’m lucky I have a pulse at all with Keto adding in its benefits.

I take a lot of Himalayan pink salt during the day and it helps but not much. I have a cardiologist appointment in three weeks and my dosages will be a primary topic.

(Lisa Stevens) #12

I bet you get to reduce your meds. Way to go!


My meds have not been adjusted in nine months and I have since lost 68 pounds. Surely something must change.

(Lisa Stevens) #14

Your symptoms sound like hypotension to me. Be careful in the meantime not to get up too quickly because you could easily pass out.


I haven’t passed out yet but a couple of times required an immediate sit down — had heavy legs and was seeing spots.

(Bacon is a many-splendoured thing) #16

So obviously, your ketogenic diet is making a difference with your blood pressure and your dose of bisoprolol needs to be reduced. I’m glad you’ve got that appointment coming up.


Thankfully I have a low carb-friendly cardiologist. But having had a heart attack 15 years ago he is very protective of my health and meds. Wonder how he’s gonna react when I tell him I’ve totally shelved my statins.

(Bacon is a many-splendoured thing) #18

Duh-duh-Duh-duh-DAH! Good luck! :grin:

(Paul Devery ) #19

New to the board. Started the Virta keto diet 5 weeks ago and lost 11 lbs.
On Eliquis (5mg twice daily) and Metoprolol Succinate 25 mg twice daily. History of tachycardia and AFiB with blood clots in my legs and lungs twice before Covid.
Was just in the ER last night due to upper right chest pain and rapid pulse, like Metoprolol was turned off. Turns out my sodium is low but chloride okay. Pulse takes off when standing like just after my pulmonary embolism lung clots 7 years ago. Hospital doctors said I should be on Weight Watchers, not keto with my heart condition, even though I have the heart of an 18 yr old with no coronary blockage at 56.

(Geoffrey) #20

I have paroxysmal atrial fibrillation and I’ve been fortunate that becoming carnivore has done wonders for me. My BP got so low that my cardiologist took me off of Metropolol because it was bringing it down to low artificially. Just last week my cardiologist cut my dosage of Flecanide in half and if I keep doing well he may take me off of it completely in six months.
Prior to carnivore I was had four serious AFib attacks that put me in ICU and the last attack was a year after I had a cardiac ablation. Now instead of having heart palpitations six or seven times a day along with PVC’s I now only feel a mild flutter maybe once a week. Even then, it’s so mild that I have to stop a think about it to make sure I’m feeling what I think I’m feeling. Unfortunately none of us are the same and I know a couple of carnivores that haven’t had the success that I’ve had. Of course just because I’m doing much better it certainly doesn’t mean I’m healed. There could be another attack waiting for me right around the corner.