New here and need some help troubleshooting

bloodpressure
(Henry) #1

I’m in my mid 40s and have been doing a keto diet for about 3 months now. I’ve taken breaks from it for a day or two about every 2 weeks. I’ve gone from 5’10" 206lbs to 176lbs in that time. I have a sitting job as a programmer, though I do get up and walk or at least stand every hour, usually more. I do about 20 flights of stairs a day as a result of where my office is. I do about 10 minutes of yoga stretching daily. Otherwise not much exercise lately.

The problem I’m having is that my heartbeat gets very forceful to the point of causing anxiety (making it much worse). This is causing me to sleep poorly even when not anxious. My heartbeat shakes my whole body and I feel it in my head and gut.

Background:
I’ve seen my PCP specifically on this issue. We’ve done full lipid and metabolic panels, as well as magnesium serum, thyroid stimulating hormone, and Vit D. All my numbers are in the “normal” range except my fasting glucose is 104 (normal is 74 - 100), and my LDL and HDL are high while triglyceride is low. Those abnormal results are all to be expected while losing weight in ketosis. So I try to not worry about them. But my doctor is pushing for me to ease up on ketosis because of the high LDL (197). He also pushed on starting me on statins; I pushed back hard.

I also got an ECG done and that came back with no problems detectable. Doctor listened to my heart for a while and didn’t detect any murmur or other problems. Steady pulse in all testing, including my own at home.

Unfortunately all of this was done on a day when I wasn’t having any symptoms. Symptoms were present for nearly 24 hours each day for the previous 5 days leading up to the appointment. But when I got there for tests, I was feeling pretty good… It’s like my symptoms turn to hypochondria when I’m at the doctor’s office (joke). A few years ago I wore a halter monitor for 3 days to try to detect a very different burning sensation usually accompanied by a skip in heartbeat I was getting sometimes. Again, no symptoms presented during the entire 3 days. Around that same time I did a treadmill test and scored well with no detectable issues. In summary, when I’m feeling good, my heart tests great. I’ve never been able to schedule a test at a moment I wasn’t feeling good.

I’ve been drinking a total of 2 liters water over the course of a day with the following:

  • Concentrace Trace Mineral Drops - Magnesium Chloride 125mg. I plan to switch to food grade epsom salt (magnesium sulfate) today.
  • Potassium Chloride 2.5g
  • Sodium Chloride 2.5g
  • Baking Soda 1g.

My macros have typically been

  • 20 to 50g carbs
  • 80 to 120g fat
  • 35 to 80g protein

This works out to about 1300 calories a day. I know that’s pretty low, but I’m not feeling hungry and am moving toward my BMI goal.

My typical day is a glass of water, 12 oz Coffee with Grassfed butter, MCT and coconut oil, possibly a low carb seeds and nuts cereal with 1/2 cup whole milk for a second meal. Snacking on nuts and seeds and dark chocolate (less than 1 oz chocolate). For dinner I usually eat with family, so carb content varies, but I try to keep it low by selecting carefully. I probably get up to 100g carbs sometimes. But then I don’t eat again until 12 hours later in most cases. Dinner is usually some protein like fish or chicken with veggies.

I have had similar feelings in the past where my heart would pound forcefully about 30 to 60 minutes after a meal with bread usually. It’s not a fast rate. Just a pulse that shakes my body and sometimes even blurs my vision a little. That was different primarily because it was usually accompanied by a feeling of overwhelming fatigue and brain fog. It also would only last a couple hours at most.

What’s happening now can last all day right through till waking the next morning. I feel normal energy and cognition levels the whole time.

My hands are also frequently cold lately. This isn’t very abnormal for me. But it might be relevant since circulation seems to be central to this effect.

I have been doing a blood pressure log and finding that my first morning reading after voiding and not having any food or water median is 108/73 with a heart rate of 60. But this has fluctuated without clear cause, sometimes giving me strange readings like 112/84 75. My highest reading over the last month was 137/88 - 69 about 30 minutes after finishing some queso and parmesan crisps while reclined watching TV, a couple hours after some dark chocolate too. I sat up for the BP test, but was still very rested.

My blood pressure seems ok generally, but the spikes in Diastolic give me some concern. My blood pressure and heart rate can be pretty much anything when I’m feeling the forceful heartbeat. Doesn’t seem directly related.

Potentially related symptoms:

I’ve have Restless leg syndrome for many years. It hasn’t been bad while in keto, but has come up a few times.

About 1 month into the diet I had the first serious leg cramp in my calf since I was a teen. It totally locked up for about a minute before I could stretch it out. Since this recent cramp I’ve noticed the feeling like my legs (and even to some degree my forearms) could cramp if I flex them too long. But so far I’ve avoided another such locked cramp. My toes cramp occasionally during yoga.

I also get Reflex syncope to a very minor degree (lightheaded, but not passing out) sometimes. Thinking about blood, my heart, or just about any illness can lead me to feel weak and anxious sometimes. This has made research on the current problem very uncomfortable. :slight_smile:

Maybe this is too much detail for a first post. But having gone to my doctor and received no explanation or instruction for how to deal with this, I’m hoping someone here can shed some light on why this is happening, and how I can stop it.

I’m open to questions and will monitor this thread and respond quickly.

My goals are to get rid of the forceful heartbeat, perhaps understand the high Diastolic pressure readings, and reduce the threat of cramping.

Thank you for anything you can offer.

(Bob M) #2

You might be a candidate for carnivore. Maybe something you’re eating is causing this? If so, eating nothing but meat for a while should help resolve this. If it does, then you could add things in and see what happens.

I would also try cutting down some of those minerals (and baking soda?) in your water. Truth be known, I have no idea how much water I drink. I drink when thirsty.

I take magnesium oil (spray it on me) and that’s about it other than Vitamin D. I will take fasting drops (salt, potassium, Mg), but only when I’m actually fasting.

You could get a better thyroid analysis done, but whether that is what’s causing your issues, it’s hard to tell. Too many things are going on.

As a programmer, you must know debugging. Basically, go to something you know works (or should work), and then build up from there. Otherwise, there are too many variables.

The other thing you could do is see if you can get a continuous glucose monitor for a while, say a month. This would help with determining whether it’s glucose (if you have heart pounding after eating, but your blood glucose is normal, it’s probably not glucose).

(Henry) #3

I’ve been testing different foods for reactions and so far I’ve only found wheat and products made with it (like beer) to be consistently problematic. Everything else so far can be totally ok one day, and seem like problems followed it another day. I’ve done a full allergen panel (needles poked into my back to check for rash) and no allergies were shown. But that test is not conclusive for some reactions that only happen indigestion. I am keeping a much better food diary starting yesterday, so hopefully will get some answers there.

The problem with starting with something that works so far has been the lack of consistent results. I can fast for 16 hours, then drink a glass of water and start having palpitations 5 minutes later! Or I can eat a few scrambled eggs and bacon and feel fine. I can be feeling fine, walk up a single flight of stairs and have to catch my breath. Other times I can bound up and down the stairs 5 times and feel fine.

I can do 35 minutes of cardio with my heart rate up to 155 for most of it and feel good. A few days later I do the same thing and my heart gets to 120 and I get a sudden feeling of lightheadedness.

I get that it’s all very complex. So I’m trying to narrow down the variables. Thank you for your feedback and ideas.

The CGM is a good idea and I’ll look into it.

(traci simpson) #4

So, I experienced this as well in September and October. Did the emergency room visit and the EKG, did the cardiologist and stress test and heart monitor just to hear that I just have an irregular beat. Had a lot of the same symptoms as you but they couldn’t find anything distinguishable so I’ve taken it upon myself to limit my caffeine (coffee) and see if things change.

(Henry) #5

I cut back coffee from about 20 to 12 ounces a day and haven’t seen a change in the week since doing so.

(traci simpson) #6

I had coffee just now but other than that the last time I had it was on Monday so I’m just starting this journey.

(Full Metal KETO AF) #7

I think it sounds like even though you’re doing electrolytes you might not be getting enough sodium. You really don’t need a lot other than sodium on KETO IMHO. That’s the key to balancing potassium and magnesium. Maybe you’re a little potassium deficient right now too. Eating an avocado or two weekly can help. I had restless limb for years. I used to have to eat carbohydrates to calm it. It got better on KETO. But when I do get it now I swallow about 3-4grams of salt with a large glass of water. It disappears in 10 minutes. You need 2-3 teaspoons/10-15g of salt daily. About 5000mg of sodium.

:cowboy_hat_face:

(Full Metal KETO AF) #8

Magnesium

(traci simpson) #9

My go to!

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F4A0C11C-33C3-4F8A-B2E0-55DDEAED4BF0.jpeg3024×4032 2.99 MB

(Michael - When reality fails to meet expectations, the problem is not reality.) #10

Check out this:

(Marianne) #11

Hello and welcome.

Did you have this problem prior to keto?

I don’t know but will offer a couple of things to consider. I think maybe you aren’t eating enough/getting enough calories, and then working out (cardio), on top of it is a lot. I think it can be a strain on your body, especially if you aren’t yet fat adapted. In spite of doing clean keto from the beginning with no cheating, it still took me over four months until I knew I was fat adapted. Before that, I didn’t have sustained energy, would get winded and I’d have a rapid heart beat with doing anything even mildly strenuous.

I would suggest increasing your calories. 1300 for a taller man is not much. Keto is not a diet, although what gets most of us here is the desire for weight loss. That happens because of ketosis, the process of burning fat vs. carbs - not from calorie restriction. You can eat more and still lose weight. It will be better for you metabolically if you do. If you continue, you risk slowing your metabolism because your body will start to think you need to preserve calories because you are eating so little. You can eat hearty, rich meals without needing to count calories or keep them as low as you are. You will still lose weight and I believe it is better for your body.

Good luck.

(Henry) #12

I’ve been trying to not take too much salt because I am still eating daily, not fasting longer than 12 hours. But I think you may be right that I could be taking more of each.

(Henry) #13

I would suggest increasing your calories.

Thank you for the reply. I do plan to increase my calories deliberately when I get closer to my body fat goals. I’m still about 20% fat, and while I’m very happy with the progress, I want to get to 12% and maintain that.

I haven’t been restricting calories at all since I started. I skipped a few dinners just to see how it felt, but generally I’ve been eating 3 meals a day, as much as I feel like eating. It just turns out that without carbs, I am having to make a lot of adjustments to how much of other stuff I eat. I’m sure a lot of people here have experienced the need to prepare a much larger % of their food since changing diet.

Convenience now takes a lot of planning and work. Too often I didn’t plan well in advance and my choices end up being “eat some nuts”, or sit around and think about doing some work to make something more interesting, then deciding to eat nothing because I’m not all that hungry anyway.

That I need to fix. I’ve expanded my keto snack selection a lot, but as for meals, it’s still a lot of work that I have to plan ahead for. As I get closer to my BMI goal, I’ll also be getting better at that preparedness since I’m doing more cooking all the time.

(Full Metal KETO AF) #14

What does this have to do with it? You need salt, eating or not. If you eat sodium rich foods you don’t need to eat that much extra salt. I honestly don’t measure but I Salt my food pretty well, more than most probably. And if I feel punk, Salt is my first go to to see if it helps. Usually it does. :cowboy_hat_face:

(Henry) #15

If you eat sodium rich foods you don’t need to eat that much extra salt.

Like you say, if I’m eating, I’m assuming I’m getting some electrolytes that way. So I try to not add too much supplemental salt with water. But it very well could be that I’m not getting enough in my food to start with.

(Full Metal KETO AF) #16

Extra sodium is lost through urination, you don’t need to be cautious about too much salt unless it’s a lot too much, then you get diarrhea. :frowning:

(Henry) #17

People seem to agree that most of us are magnesium deficient no matter what style of diet we are eating. It seems safe to go up to 1000mg daily of magnesium for a while, and back off to 500 or so.

I’ve read that too much potassium can cause immediate and serious heart problems. Usually only if taken as a supplement, not in food. I’ll need to look more carefully into what exactly is “too much”

Too much sodium can raise blood pressure. I’ve certainly seen my BP go way up after some meals. So I might be sensitive to this. But my typical pressure is so low that it probably isn’t much of a worry.

I once did a cleanse that involved drinking a quart of water with a tablespoon of salt all within 5 minutes every morning. I can attest to the effects of too much salt all at once.

Thanks for all the feedback! I increased my magnesium last night and felt better within an hour. I’ll keep increasing that plus potassium and sodium and report back on the results in a few days.

(hottie turned hag) #18

This intermittent pounding HR doesn’t sound cardiac in origin to me based upon the neg diagnostics you report.

It sounds more like a systemic reaction to something; the cardiac response is just that: a response. The heart itself functions properly and is sound.

A transient inflammatory response, perhaps?

Sodium can cause fluid rentention; THAT (increased fluid volume in the vessels) is what actually causes elevated BP. High carb intake can also cause fluid retention in some individuals; it does so markedly in my case whereas high sodium does not.

Because the symptom’s source isn’t cardiac nor vascular in nature.

Sounds benign and transitory; could be a food reaction as in ingesting something to which you have a sensitivity or actual allergy.

These are hardly “spikes” and are normal fluctuations

(Henry) #19

Thank you for adding that. I’m fairly confident that wheat products cause negative responses in me. Many beers (especially my favorite IPAs) often cause me to go into a sneezing fit in addition to making me feel fatigued.

But while doing keto, I’ve been avoiding wheat and everything made with it except for about once a week when I eat some bun with a burger or low carb tortillas with burritos. The symptoms described in the OP are present for days at a time. So I don’t think it’s that specific known thing.

I also suspect tomatoes may be a problem for me based on past reactions when eating SAD. But again, I’ve been eating nothing with tomato in it except about once a week when I make keto tika masala or butter chicken. Those meals don’t seem to cause me any change for me at this time.

The “spikes” may not be all that dramatic considering cardiologist (on youtube anyway) talk about people getting up over 200/90. Certainly I’m not worried about 137/88 taken by itself. But I guess I don’t know what normal fluctuations should be when I’m hydrated, but haven’t eaten in a couple hours, and am just siting at a desk. Should Diastolic rise by 12 points over 10 minutes for no clear and obvious reason?

Being able to measure things like BP or glucose is probably causing a lot of people to get worried about fluctuations unnecessarily because the measurement is far easier than understanding what’s ok and when. I personally feel like my lack of knowledge in this area has caused me anxiety over it, coupled with the heart palpitations.

I do think what I’ve been experiencing is food related, not a “mechanical” problem with my heart or vascular system. But if so, is it something I’m eating? Or something I’m not eating enough of?

(Failed) #20

You may find this discussion of potassium of interest. I did extensive research and posted my findings as well as my n=1.