Worried about electrolyte and kidney on keto

#1

I am bit worried about my kidney functions on keto as I am a struggling to keep my electrolytes intake, I didn’t realise but my protien intake was also too much, I have reduced it now.
Last time checked my creatinine was 0.6 and perfectly healthy kidney. I am having some back pain and leg pain lately after 16 days in keto. I tried taking electrolytes but that didn’t suit me I felt my heart racing on it, so stopped.
I do take lemon once in a day. Please suggest how get electrolytes without supplements.
Thanks.

Do blood electrolyte tests have any value?
(Bacon is a many-splendoured thing) #2

A diet consisting of fresh whole foods, plus such choice additions as bacon, pepperoni, etc., with a liberal application of salt, should meet all your needs, unless you have a specific problem with a particular micronutrient.

Remember that getting enough salt helps keep the other electrolytes balanced. You are likely to be getting enough, even on an all-meat diet, so supplementing should not be an issue unless, as I said, you have a specific problem. Good luck and let us know how you are getting on.

(Michael - When reality fails to meet expectations, the problem is not reality.) #3

Real Salt, NoSalt, Epsom Salt in these proportions: 15 : 35 : 4. A reasonable ‘dose’ is 1-2 grams per day dissolved in a liter of water.

(Michael - When reality fails to meet expectations, the problem is not reality.) #4

Sodium, no problem; it’s in pretty much everything. It is difficult to eat sufficient potassium without supplementing and potassium salt is the easiest, cheapest and most convenient way to do so. You could pick and choose foods carefully, I suppose. Some nuts are pretty good, but carry a high carb price. For carnivores, notice that various meats are not particularly good sources for potassium.

http://apjcn.nhri.org.tw/server/info/books-phds/books/foodfacts/html/data/data5b.html

Not so difficult to eat Magnesium because the daily optimal requirement is pretty low.

http://apjcn.nhri.org.tw/server/info/books-phds/books/foodfacts/html/data/data5d.html

@Keto12 You don’t mention your age so I don’t know specifically about your situation. Calcium is also a nutrient important for electrolytes, but is easily obtained from food, particularly dairy, but also bone meal if you don’t eat dairy. As we age, the need for calcium increases because we tend to lose it from bones especially women. That’s why osteoporosis is a big issue with seniors. I recommend dairy and more of it if you’re older unless you have some specific issue with dairy. Most issues with dairy are due to lactose intolerance, which if you eat only zero carb cream, cheeses, etc should not be cause for concern.

(Michael - When reality fails to meet expectations, the problem is not reality.) #5

The proportions are important, since electrolytes perform optimally only when in correct proportions to one another. I should mention that the RDA for these minerals are ranges and my proportions are based on the minimum values of those ranges. So if you wanted to increase the absolute amounts, maintain the same proportions. In particular, potassium should be slightly more than 2x sodium. Magnesium should be a little less than 1/4 sodium. BTW Real Salt contains a slew of trace minerals many of which are quite beneficial to consume and some of which I have no idea.

This is NOT an issue peculiar to keto by any means. Most people on whatever diet are potassium deficient and sodium overloaded.

(CharleyD) #6

Welcome aboard Keto12! Yeah, those first few days were a trip.

What kind of leg pain are you feeling? Is it muscle pain like a bruise or soreness, or a sense of impending cramp, or pain in the joints?

Any other worrisome signs of Kidney function in your labs? I had a downward trending eGFR I was concerned over for months, but quitting my high coffee intake for a few days for the Feldman Protocol tests brought that value into normalcy…

As @PaulL mentioned cured meats are generally heavily salted, also try out dry roasted keto freidnly nuts like macadamia’s, pecans, brazil, almonds.

Doing Taekwondo, I’m also keen to keep Magnesium high. But not so high I need to wear my brown pants to class :rofl: I supplement with Mag Glycinate after every class, but I also get a monthly 2lb bag of Sunflower kernels, as they’re high in Magnesium. Walnuts, Almonds, and Cashews (a treat for me) are also decent sources of Mg. Magnesium is also the central mineral to chlorophyll, so eating greens will bring some in…

Keeping those two electrolytes high make it possible to spare the others, so I don’t make any special effort to eat foods high in them. I do eat a sashimi plate and a pound of calf liver a week. That’ll cover iodine, another mineral lost to sweat.

(CharleyD) #7

I would quibble about this point just a little. The current medical teaching is to minimize salt intake to, what is it, 2.5 g/day or something else ridiculous? The DASH diet is the go-to for nutritionists and dieticians. A carb-burner’s high insulin will have them hold on to more of the sodium, but unless you are sensitive to sodium, there’s no need to worry as a ketonaut that anything under 10g/day will harm you.

(Michael - When reality fails to meet expectations, the problem is not reality.) #8

I agree there is little need to be concerned about sodium overall. My reference to it being overloaded in pretty much everyone’s diet is in reference to electrolytes specifically. If you consume 5-10 grams of sodium per day the sodium per se is not going to hurt you. But you will put yourself in a situation where your electrolytes are way out of balance because you would be very hard pressed to consume sufficient potassium in any form. May not be an issue until you get to my age or may be a complication to other issues younger. I don’t know.

#9

I am 28, I don’t take dairy instead take almond milk and sometimes tofu for calcium. I avoided dairy because it was creating lot of mucus.
I eat lots of meat and fish and green veggies but seems to be lacking somewhere.
I also eat one tablespoon of chia, sesame, sunflower, pumpkin, almonds daily too.
Tries electrolyte drop with calcium, mag, potassium felt my heart beat got faster, so had to stop that.

#10

No other warning, all labs were good, got tested in last September. I kind of have had little bit of soreness before then muscle pain started and now little joint pain in wrist.
I get fresh meat from local butcher and try to do clean keto.
I do eat handful of mostly all kind of seeds allowed in keto.
I don’t want to quit keto and enjoy the clarity of mind I get in this diet and lots of other benefits too. Just not able to figure it out what to do about the electrolytes and this body pain.

#11

FWIW I was able to eat tofu for years with no problems but in the last year or so appear to have developed an intolerance to it - manifested as a bit of muscle lethargy & joint pain.

#12

How long the lethargy lasted? I eat once a week not much.

#13

I stopped eating tofu & it went away - haven’t tried eating it since. It could of course be coincidence but just another thing to consider :woman_shrugging:

(Michael - When reality fails to meet expectations, the problem is not reality.) #14

My goof. :woozy_face: A reasonable dose is 5-6 grams per day, which works out to 1500mg sodium, 3500mg potassium and 400mg magnesium.

(Bacon is a many-splendoured thing) #15

My understanding is a bit different from what you lay out here. Several studies published within the past few years show a J-shaped risk curve for sodium intake, with the lowest part of the curve between 4 and 6 grams of sodium/day. That translates to 10-15 g/day of table salt (sodium chloride), including salt already present in food. Since people on a low-carbohydrate at a faster rate, it could be argued that the healthy range is actually a bit higher, since the study participants (in the PURE study for sure, and most likely in the others, as well), were presumably eating the standard diet (these were observational studies).

Additionally, my understanding is that the regulation of sodium in the human body is interlinked with the regulation of potassium, magnesium, and calcium, and that sufficient sodium intake is therefore key to keeping the others in balance. In other words, on a low-carbohydrate/ketogenic diet in which salt intake is properly maintained, dietary sources of the other electrolytes are sufficient for most people.

I am beginning to think that the low levels of serum glucose and serum insulin, coupled with the presence of ketone bodies, changes the rules sufficiently that a lot of our ideas about what the body does or does not need are inaccurate. We already know, for example, that the body’s built-in defenses against oxidation are restored on a ketogenic diet, rendering exogenous anti-oxidants such as Vitamin C unnecessary. Likewise, people on a ketogenic diet have very little or no need for dietary fiber, since the ketones provide the colonic benefits that dietary fiber is supposed to provide. My speculation is that the same sort of thing could also be true where electrolytes are concerned.

(Michael - When reality fails to meet expectations, the problem is not reality.) #16

@PaulL Yes, it certainly is currently. I’ll investigate to see what I can determine. Thanks. I’ve got interested in electrolytes in an attempt to control and/or eliminate night cramps in my calves, ankles and feet. They occur any time during the night, but most frequently upon awaking in the morning.

My current formula has helped significantly over the past week or 10 days. But I still get cramps, just not every day now. I am switching to Real Salt in a few days and will up the dose to report on whether that does better or not.

(Michael - When reality fails to meet expectations, the problem is not reality.) #17

@PaulL
As a beginning base line re keto, here’s what Phinney has to say:

https://blog.virtahealth.com/sodium-potassium-magnesium-ketogenic-diet/

“In short, 3000-5000 mg of sodium and 3000-4000 mg of potassium on average are needed as part of a well-formulated ketogenic diet. For sodium and potassium (aka electrolytes), rather than trying to track them directly (which is frustrating at best), we recommend salting food to taste, adding 2 grams of sodium as broth or bouillon, and eating 5 servings of non-starchy vegetables daily. For magnesium, 300-500 mg is an initial recommendation.”

(John) #18

@keto12 Go get a Comprehensive Medical Panel (CMP) blood test. It will tell you whether your electrolytes and kidney functions are normal.

(Michael - When reality fails to meet expectations, the problem is not reality.) #19

@JohnH. At the time the blood is sampled. I am probably healthier overall than 99% of people my age. Whether it’s due to the genetic luck of the draw, pure chance or some good choices of my own, I am very grateful for it. I have no particular issues other than the night cramps which started a few years ago and seem to be getting more frequent and severe. From all I’ve read over the past few years in my attempts to deal with it, the most likely culprit seems electrolyte imbalance. As I mentioned previously, my first simple electrolyte formula has helped more than anything else I’ve tried so far. I’m confident that getting the proportions and daily dose right for me is the best way to go about it.

(John) #20

@amwassil I was intending to reply to @Keto12, the thread starter. Sorry if it appeared I was directing my suggestion to you.

I like knowing the underlying numbers before I start supplementing things.