Following a ketogenic diet can provide you with many health benefits, including weight loss, reduced cancer risk, protection of brain function and improved cardiovascular functioning, according to Medical News Today. However, getting the right balance of macros and electrolytes can be challenging when you're first beginning the diet, and an imbalance can result in uncomfortable side effects such as leg cramps.
What Causes Leg Cramps on Keto?
Sudden leg cramps can be unpleasant, especially if they wake you up at night or occur suddenly during athletic performance, literally tripping you up.
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Increased urination as you lose weight on the diet can set the stage for painful cramping as you lose fluids and electrolytes. The balance of magnesium, potassium, calcium, sodium and other minerals gets disrupted, with leg cramps resulting. A deficiency of vitamin E can also be a contributing factor.
Getting Hydration Right
Dehydration is one of the primary sources of leg cramps. As your body loses water, electrolyte levels fluctuate, setting the stage for leg cramps. Check the color of your urine. If it is dark yellow, you're dehydrated. If it is brownish, you're severely dehydrated.
You can also pinch the skin on the back of your hand between your forefinger and thumb for about five seconds. Release it and watch what happens. If it remains "tented" and retracts slowly, you're dehydrated. Well-hydrated skin will snap back into place quickly.
By the same token, you could suffer leg cramps from an electrolyte imbalance if you are overly hydrated. Your urine will look clear or very pale yellow. Drinking too much water contributes to a potentially dangerous condition called hyponatremia, in which you have too little sodium in your system.
Get Your Minerals
Minerals affect the balance of electrolytes in your body. When electrolytes are deficient, leg cramping results. Although there are many trace minerals you'll get in your diet, there are four you'll want to pay particularly close attention to if you're suffering leg cramps on the ketogenic diet.
The human body can't exist without any sodium intake for more than a few weeks, advises Virta Health. Getting too little on a ketogenic diet contributes to feelings of fatigue, achiness and other symptoms associated with the "keto flu."
Eating too little salt causes your kidneys to secrete a hormone known as aldosterone that conserves sodium in your body. Unfortunately, this hormone causes your body to waste precious potassium that is needed to make your heart, nerves and muscles function optimally.
Make sure you consume 3,000 to 5,000 milligrams of sodium per day, says Virta Health, when you're eating a ketogenic diet. Salt your food to taste, and add an additional 2 grams of sodium by drinking bouillon or broth.
However, be aware that excess sodium in your diet may contribute to your an increase in blood pressure. Before attempting a keto diet and adding more sodium, consult with your doctor for advice on how best to go about your weight loss plan.
Eating 3,000 to 4,000 milligrams of potassium daily in your diet is key to balancing your potassium-sodium electrolytes. Get the potassium that's crucial to your muscle, heart and nerve function through five servings of nonstarchy vegetables per day, in addition to bouillon, broth or keto-friendly sports drinks.
White mushrooms prepared in the microwave are among the foods naturally highest in potassium, at 488 milligrams per 100 grams — about 1/2 cup. Or throw some portobellos on the grill for even more potassium — 521 milligrams. There's no sugar or starch, making them ideal for a keto diet.
Cook up the same amount of mustard greens to eat 202 milligrams of potassium, or get 293 grams from 1/2 cup of cooked broccoli. Mix up 1/2 cup of cooked spinach in a keto dip and nosh on 302 milligrams of potassium with only 1 carb gram. Have an avocado, and you'll reap 980 milligrams of potassium, 400 milligrams of sodium and roughly 30 grams of fat.
Although you only need 400 milligrams of magnesium daily, most people don't get enough. The good news is that your keto diet doesn't cause depletion of magnesium, so if you're ingesting the right foods, your body will have the right level.
There are many delicious ways to add magnesium naturally to your diet. A dark chocolate bar with 70 to 85 percent cacao, for example, has 70 to 90 milligrams per ounce. Or add a few teaspoons of cocoa powder to a smoothie — the Amazonian superfood has about 215 milligrams per half cup.
Whip up some chia seed pudding. Not only does it combat keto constipation, but you'll take in 95 milligrams of magnesium per ounce. Almonds, pumpkin seeds, pine nuts and avocado are other magnesium-rich snacks.
Beware of getting too much magnesium, however, especially in the form of supplements. Side effects can include loose stool, nausea and even heart palpitations. A slow-digesting form of magnesium chloride known as Slow-Mag and magnesium glycinate are the least likely to cause digestive issues; however, the body can also absorb magnesium citrate and the faster-digesting form of magnesium chloride.
Read more: The 12 Most Overrated Supplements
Make Your Own Electrolyte Drink
In a two-liter bottle or pitcher, mix up:
- 5 cups purified water or herbal tea (noncaffeinated)
- 1/2 cup lemon or lime juice
- 1/4 teaspoon pink Himalayan salt, or to taste
- 2 tablespoons powdered magnesium supplement
- 1/2 teaspoon potassium chloride powder or cream of tartar
- Keto-friendly sweetener to taste, such as 1/4 cup erythritol (Swerve) or 20 to 30 drops of liquid stevia
Eat Your Veggies
If your hydration and electrolytes are on point but you're still suffering from leg cramps, it's time to look to your vitamin E intake — specifically, a lack of the E-2 fraction of the vitamin E complex, according to Dr. Eric Berg, DC, an advocate of the ketogenic diet.
The E-2 fraction is responsible for increasing oxygen flow to the muscles via red blood cells. The vitamin is often used for angina — basically a cramping of the heart muscle — and acclimating to high altitude athletics without cramping up.
Berg advises that the best way to get vitamin E is from natural food sources, such as leafy greens, avocados, asparagus, and raw sunflower seeds and almonds. If you do need to pop a supplement, opt for all natural. The ingredient list will read "d-alpha-tocopherol." Vitamins that contain "dl-alpha-tocopherol" are synthetic and don't contain the full fractions needed to prevent muscle cramping.
- Virta Health: What Causes Muscle Cramps on a Ketogenic Diet?
- Slideshare.net: The Art and Science of Low Carbohydrate Performance (Jeff S. Volek)
- Virta Health: How Much Sodium, Potassium and Magnesium Should I Have on a Ketogenic Diet?
- Diet Doctor: Low Carb and Keto Side Effects – Leg Cramps
- YouTube: Dr. Eric Berg – Taking Minerals Yet Still Having Leg Cramps
- Medical News Today: Keto Diet Benefits
- SELFNutritionData: Foods Highest in Potassium and Lowest in Sugars and Starch
- University of Michigan Health System: Potassium Content of Foods
- USDA Food Composition Database: Avocado
- Diet Doctor: Do You Need Electrolyte Supplements?
- Diet Doctor: Six Ways to Kick Nasty Leg Cramps
- Keto Diet App: Beat Keto Flu With Homemade Electrolyte Drink
- Now Foods: Vitamin E
- Centers for Disease Control and Prevention: Study of U.S. Adults Finds Strong Association Between Higher Sodium Excretion and Higher Blood Pressure and Association Between Higher Potassium Excretion and Lower Blood Pressure
Is this an emergency? If you are experiencing serious medical symptoms, please see the National Library of Medicine’s list of signs you need emergency medical attention or call 911.