I started Keto last summer because I was pre- diabetic ( type 2) I am a 60 year old woman - 5-10 257 lbs. I used to have swollen ankles from sitting ( my work is desk work) and it went away after being on Keto for about 2 months. I fell off the wagon around Nov 2017 - and just started the diet again full blown about 3 weeks ago. I went to several websites - Ketokarma, Perfect Keto, ruled me. My recommended macros are all over the place. So I downloaded Keto app on my eye phone - selected the macros from Keto Karma calculator and started working out - eliptical 3 time a week for 35-40 minutes. Bottom line - Yesterday is day 18 - I started to blow up with swollen ankles and hands. I feel bloated. I drink much more than 64 oz of water per day. I cut back a bit on protein because I was afraid I was eating too much ( suggestions for me were between 80-100 grams per day. I am very upset with all this and I have no idea what is going on. I have air conditioning on constantly as it is getting hot in the NE. I have no trouble eating salt. Today I had 2 hard boiled eggs with avocado mayo, dinner was a veal chop “breaded” with flaxseed meal and sautéed in Ghee and avocado oil, with zoodles and home made pesto. I like seasoning. I am a very good cook which is why I got obese in the first place - well menopause doesn’t help either. Can someone help me?? I had a physical 2 months ago and I am fine - but I do feel very “off” yesterday and today - depressed and stressed and this is very uncomfortable as well as making me feel ugly. I would really like to know if this is normal because it is the exact opposite of my experience last summer. I really want to get this weight off, it is 3 weeks and I am dancing on the edge of ketosis - .03 my meter measured my blood and now I am blowing up like a Willy Wonka blueberry. Any advice? Is this normal? Thank you.
Swollen ankles, hands and body
Well, that could do it. Are you drinking that much because you’re thirsty or because you think you need to? Drinking that much water is likely also flushing your electrolytes right out, and that can cause all sorts of issues if you don’t replenish them.
I swell up in response to food sensitivities. Cow dairy, peanuts, It’s happened with peppers, avocados, you name it whatever the food sensitivity of the day is it can cause me to swell and gain 10-12 pounds in a day. I find, fasting and ginger capsules seem to help the best.
Thank you for your response. I have always been a thirsty girl. Before and after Keto. I am not diabetic either. I take a 32 oz bottle of water to bed every night as well. But that said - I did not experience these problems last summer - in fact Keto stopped my ankles from swelling for the first time in years - which I took as a miracle. So I am very confused by this. Back in the day I tried Atkins - followed that diet to the letter and after a month the scale did not budge. So now with all the new information out I figured - too much protein, not enough fat. So now just had some bone broth and put in a tbsp of salt. Now I’m thirsty again.
Thank you. I have been doing intermittent fasting - today and yesterday I was just not hungry at all. I had my first meal at 3 pm today- organic egg salad on 1 slice of 3 net carb bread. Made the salad with avocado mayo, mustard and cayenne and a little salt. So does this swelling thing go away? I have not added anything to my diet that I never ate before.
Cut down on the water, and make sure you’re taking in enough sodium - it’s hugely important.
Feeling “off” is so very often about sodium levels. Also, if you’re sweating on that eliptical routine you may be losing too much potassium.
For me personally, the mosquitos of late Spring through Summer are a big problem. I’m still pretty sensitive to the stings, and the stings happen on my ankles - which compounds any and all ankle swelling.
Remember that exercise can exacerbate swelling and slow the body’s fat-adaptation process if you haven’t yet reached 100% adaptation. With your pre-diabetes and female hormonal at age 60 - it may take you a bit longer to become 100% fat adapted - and the body’s recovery from forced exercise can be an energy drain. I’m 52 and metabolically healthy - but I didn’t feel 100% fat adapted until month 6 of lazy well-formulated ketogenic way of eating.
If you adjust the water and experiment with sodium/potassium/iodine and exercise and still have swelling issues/slow water cycling in the body, consider supplementing with 4 capsules of Ginger daily - its circulatory and anti-inflammatory actions are a boon for midlife and older women. It also helps rebuild enzymatic levels so that you can eat and digest enough protein - protein helps CVI 
Thank you Thank you Bless you! I will try this. You just gave me hope. Where do you get ginger capsules?
You’re very welcome!
I order Nature’s Way brand Ginger from Amazon - but nowadays the GMP high quality Ginger supplements are sold at many chain drugstores and supermarkets. And, 2 caps of Ginger is the same NSAID strength as prescription ibuprofin - so it’s an all-around friend for the kitchen and medicine cabinet. If you use the search bar here (upper right) on Ginger there’s many past posts around here on it.
Thank you so much. I just ordered on Amazon and something else which seems to have good reviews called Keto Vitals - which seems to be a sodium potassium electrolyte supplement. I also tried Puritan Pride 550 ginger root capsule because they had a twofer so i will give it a whirl. I so appreciate the support and also the idea that fat adapting will probably take more than a few months. As stated I was not hungry at all today - even a little revolted by the thought of food and fat. 
I guess this is full blown keto flu? Wait until I tell my husband exercise is probably not a good idea. But it is summer and I can swim instead. I will let you know if your suggestions help. God bless.