I started Keto on August 13th, just about 4 months ago and have been struggling with headaches the entire time. To start I went way too low on my calories and completely neglected my electrolytes so with the exception of the first week I felt like garbage - fatigue, headaches all day, just miserable. Then about 3 or 4 weeks in I found this forum and realized I had to supplement my electrolytes. So I upped sodium and potassium intake to about 8000mg and 4000mg, respectively, and started taking 400mg of magnesium. I did that for over two months and the fatigue subsided but I was still getting horrible headaches all day. I’ve been keeping my macros at around 70-75% fat, 20-25% protein and 5% or less carbs. I track everything I eat with carb manager. 3 weeks ago I decided to reduce the potassium based on some of the posts on this forum and the 2 Keto Dudes podcast episode - The Salt Fix. So I cut potassium down to around 1000mg and my sodium ranges fro 6000 - 9000mg (higher on days I weight train). I also cut my net carbs from around 30g to 10 - 15g ( total carbs usually under 20g). The headaches have mostly subsided throughout the day, I still get a few in the late morning or early afternoon but salt water usually helps subside it. However, everyday shortly after I eat dinner (around 5pm) I get a horrible headache that lasts about 1 1/2 to 2 hours. They are so bad that it is hard to function and I just can’t figure out what I’m doing wrong. I typically eat between 10am and 6pm. My calories range from 1800 to 2200. I started at 274lbs and am now down to 227lbs (down 47lbs which is why I’ve put up with the constant headaches). I started weight training a little over a month ago and do 3 days a week in the mornings and feel the best after my workouts up until I eat my first meal. My typical meals are 2 to 3 eggs, cheese, bacon for breakfast. Coffee with almond milk, coconut oil, mct oil powder, butter and a low carb protein powder for lunch. 80/20 burger patties cooked in olive oil,cheese and 1tbs low carb sugar free ketchup or chicken thighs cooked in olive oil with primal kitchen dressing and a cup of broccoli for dinner. Snacks range from almond butter, pork rinds, nuts low in carbs and beef sticks. I know I am not yet fat adapted as my energy fades throughout the day and I certainly don’t experience much mental clarity (due to headaches) but I do feel like I could go all day without eating if I wanted. Any help would be greatly appreciated, I really don’t want to give up but I am so tired of the headaches.
Need help - still struggling after 4 months
It seems to me that you are fat adapted since you could go all day without eating. Maybe your headaches are a sign of an underlying ailment. Did you see a doctor for those?
Wow Dan, I can relate. I don’t have headaches daily but I started getting these brain shattering migraines since starting this woe so I started a headache journal. At first I assumed it would be the sweeteners but low and behold, it’s when I gobble down eggs. I posted earlier in my journey that I thought eggs were giving me diarrhea, so I stopped eating them altogether. Then I found a recipe for various shredded veg held together with egg and baked in the oven and ate them for lunch every day last week with bacon. Within an hour I’d have a headache, one which sent me home from work. They are accompanied by the worst nausea and I kind of just have to wait them out in the dark, not moving, like a migraine. (For the record, I have never had migraines)
This week I had left over eggs and made a six egg omelette after work and within an hour I had a headache and nausea so bad it made me cry. Almost like it’s getting worse every time it happens.
I’m not saying you are allergic to eggs, but I’ve learned even on a ketogenic diet there are still foods that can “hurt” me and I think eggs are one of them. And darn it too because I really like them!
Headaches are a sign of inflammation. Add in some more carbs a little bit and see where your headache stop also go and see your doctor to rule everything else out. Good luck and make job number one getting rid of your headache’s rather than losing weight for your health sake
I suffered with daily headaches for many years. Keto has, in my case, massively improved them. However, I spent those years trying to figure out triggers, so I’ll list the ones I’ve heard of that I see in your food list.
First of all, make sure you’re well hydrated. I definitely get headaches if I don’t drink enough. I can’t even sleep in, it’s too many hours without fluid and I’ll wake with a massive migraine that lasts the day long.
Similarly, a lot of salt intake must be accompanied by water. Salt is very dehydrating. I woke with headaches for two months on keto when I started having salt in the late evening but didn’t also have water because I didn’t want too pee all night. It took me forever to figure that one out and was at my wits end and worried that I’d have to give up keto.
Ok, on to the possible food triggers. From this list I’d initially concentrate on things that you weren’t eating as much as before the headaches started. However, don’t assume something is fine just because you ate it before without any issues, this diet does change how we respond to foods. Alcohol is a big example of this.
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The MCT oil and coconut oil causes many people various problems.
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Nuts are also a very common migraine trigger. If you are having much more, since starting keto, of nuts and nut butters, consider trying a week without them.
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You didn’t mention chocolate but this is also a major trigger in many people.
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I’d definitely try eliminating the low carb ketchup. Many artificial sweeteners are known headache triggers, as are tomatos.
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Ripened cheese. I know this one sucks on keto to give up, but if the others don’t work you should try it. It a big issue for many headache sufferers, and you may be eating much more than you used to.
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Proccessed meats. This includes the meat sticks, bacon, and deli slices. The additives in these cause issues for many, and again, you’re probably having more than you used to.
I know this includes a lot of what you’re currently eating but it may actually be more than one of these acting in concert. As my neurologist explained to me migraines are triggered when a threshold is reached. So any one might be ok, but a few in a day can trigger a headache.
What I’d recommend is that you radically eliminate the lot for a week and see how you are. If the headaches go away then you know that one or more items are triggering them and you can begin experimenting with reintroducing them one at a time. Reintroduce slowly though. Some things don’t cause instantaneous migraines but seem to add up slowly. I have that with wine. I’ll have a glass for a night or two and think “Yay! I’m cured!” and then they come back a couple of days later and never leave until I again ditch the wine. 
Anyhow, it’s not easy to figure out, but it will be some trigger and not ketosis itself that’s the problem, it’s just a matter of solving the puzzle.
I wish you luck. I know what total shit daily headaches are.
How much water so you drink daily? A lot of headaches are caused by not being properly hydrated, so maybe try that!! Congrats on the weight loss, that is great. Good luck getting to the bottom of the cause for these headaches!!
I think Ilana_Rose is on target here. It sounds like you eat a fair amount of things that have additives. The powders (protein and MCT) are quite “processed,” as is most almond milk. Beef sticks, pork rinds, etc, are not really “whole foods.”
Try switching to foods with just 2 or 3 ingredients and see if that eliminates the headaches. Look up Whole30. It’s an elimination diet that’s very helpful in figuring out where your sensitivities are. You don’t necessarily have to follow it, but the information is on their website for free.
I’ve always been a headache sufferer, but eating keto has actually helped, but that’s because, by eating this way, I’ve cut out all the processed snacks that I used to eat. It’s whole foods (beef, salmon, eggs, chicken) with vegs (salad mix, cauliflower, broccoli, cabbage, pickles, etc). I don’t take any supplements (those often have additives, too!)…so somewhere along the way, I’ve eliminated something that contributed to the headaches.
Good luck! I know it’s miserable to have a daily headache. 
You haven’t mentioned water! You may very well be dehydrated. I did notice that there is no mention of any greens. Salad vegetables, asparagus, avocado, kale etc are all good sources.
I drink at a minimum 80oz of water a day, a lot of which I add salt to, so I don’t think it’s dehydration. I was eating more salads but cut that the last few weeks to see if significantly cutting my carbs would help. But I think I could definitely do more greens.
I don’t feel fat adapted simply because I am not experiencing any of the benefits people talk about. I did see a doctor two months ago to do bloodwork and told him about the headaches, he said that he wasn’t surprised because the brain loves glucose and without it I was going to get headaches for a while. I am definitely considering go back soon though.
@Ilana_Rose and @cw2001, I think you both may be right. I think I could try cutting everything out that has more than a couple of ingredients and is processed to see how I feel. Then see if I have to cut out things like nuts and cheese, both of which I ate a decent amount of prior to this WOE. I will definitely look into Whole30, thanks for the recommendation!
I have to say this community is awesome, I never expected to get this many responses, so thank you to everyone! And I really appreciate the personal stories, it’s nice to know I’m not the only one who has struggled along the way.
I must confess, I’m 7 weeks into keto now and like you, not experiencing the benefits either… I heard someone say in a podcast that it can take up to six months to really feel the difference…Today I’m a bit discouraged and that’s how I read your post. I wish you the best 
@74Ann I heard the 6 month mark as well which gives me some hope. The crazy part is that my body feels so much better but my head feels so much worse. Good luck to you!
Sorry to hear it.
But not so much after breakfast and lunch, could your body be struggling to cope with a certain food you have at dinner?
I reckon you should definitely purchase a blood based keto meter, they are not that expensive, definitely more accurate than pea stix… The jab doesn’t hurt at all and it just takes a drop… I have the Abbott one …
If you’re producing ketones your brain and head should love them …
BUT - if this persists you should definitely seek out a doctor who understands low-carb diets like keto or Atkins (not many do they are decades behind) - they can then order some proper lab tests …
Maybe you are just allergic to some food, you mentioned a few which sound rather heavily processed to me …
Good luck