Any major dietary and lifestyle change is liable to completely mess you up, and the “flu” phase is one of the most common phases during which people will quit, many people simply feel they are unable to function without significant carbohydrates and snacking all day, so in this chapter we’ll discuss the major downside of getting on-board the keto train, and hopefully how to minimise its effects and push through.
Like most people you’ve probably spent 20-60 years feeding your body a significant amount of carbohydrates – and much of them from poorly chosen over-processed sources – your cells and organs and central nervous system and brain have all adapted to the hormonal responses and energy conversions that usually go on, so switching fuel sources is likely to throw your body and brain for a loop.
BTW the “keto flu” label is a bit of a misnomer, it’s more like carbohydrate withdrawal symptoms from altered hormonal states and the electrolyte imbalances that come with it.
The trials people encounter during the induction phase are unpredictable, it can range from nothing at all, to mild discomfort and fuzzy-headedness, through to full blown flu-like symptoms – eg nausea, fatigue, mental fog, headaches, cramps, diarrhea, etc. In severe cases high blood pressure and arrhythmia.
Also note that we have a diverse population of intestinal flora and bacteria and whatnot going on inside us, and so any major alteration to dietary intake is almost certain to result in short to medium term gastrointestinal and defecation issues.
There appears to be a reasonable correlation between the dieter’s previous lifestyle and the flu-like symptoms, unsurprisingly – the higher the fat content and lower the carbohydrate content of your current diet, the more likely it is you can take on keto with little fear of consequences.
The induction phase typically lasts a few days to a couple weeks, at which stage the symptoms dissipate and energy levels return – usually with a vengeance.
No need for hyperbole here, the point is recent studies are comparing the effects carbohydrates (typically processed/sugar-laden) on the brain to various stimuli which are addiction and dependence forming. We won’t go into that stuff here, just understand that you may be fighting what seems like unconquerable urges and cravings to start with.
There are a few different ways to approach carb restriction/induction to get over the addiction:
Self-explanatory really, jump in the deep end and learn to swim – just drop carbs to as low as possible (0-50g a day) and eat as much fat to quell hunger.
Also, cold turkey is great by itself, no need for it to be on a sandwich.
Depending on your current lifestyle, you might choose to drop the carbohydrates by 10g a day and increase the fats to satiety.
Each week remove another carbohydrate source, eg:
Week 1: Best place to start is soda, switch out for sugar-free diet versions, also halve the sugar you add to your coffee/tea.
Week 2: Then remove any of the daily desserts and sugary snacks – typically cakes, muffins, pastries and chocolate bars.
Week 3: Say goodbye to big starch – pasta, pizza, packets of crisps, and most stuff that comes in packets and boxes.
Week 4: Killer time – no more bread, no rolls, no potatoes.
Week 5: Hopefully by now most of your sugar cravings have subsided and you’re down to <100g of carbs a day, if you are significantly overweight it’s half likely you’ll have spontaneously dropped anywhere from 5-20lbs without much issue.
Next step is to see if you can go close to completely zero carb for a week to really kick off ketosis – this will mean eliminating whatever minor “healthy” sources might still be lingering like fruit and juice, and “sneaky” carbs such as in sauces etc.
On a “normal” diet there are many people who eat a lot of processed foods which by and large are fortified with salt. A ketogenic diet tends to centre around fresh meat and vegetables, and so when transitioning from a normal diet to keto – people spontaneously radically reduce their salt intake which reduces water retention. Also, lower insulin levels/increased sensitivity can signal the kidneys to discard excess water. For this and other reasons you also tend to increase your water consumption, end result is that lower water retention combined with increased fluid intake can be a big fat double-whammy on flushing electrolytes out.
Electrolyte imbalance – particularly sodium and potassium and magnesium deficiency – is the most common factor in the transitory flu-like symptoms. There is a laundry list of dozens of symptoms that deficiencies are associated with – all the way from sneezing to death – so it’s important you keep these levels in check.
Don’t worry though, your body is extremely good at letting you know when something’s up, it’s not like you’ll develop some lifelong debilitating critical organ damage because you didn’t pay attention to a muscle cramp or mild headache one day. Basically, don’t obsess, the stress will wear you out more than a mild short-term deficiency.
To mitigate these symptoms it is usually recommended to increase salt intake, this will help to counteract the initial water weight loss that occurs at the start of a low carbohydrate diet. It can be exciting for a first time keto’er to see up to 5kg/10lbs just disappear off the scale in the first week despite eating possibly even more calories than before due to more energy-dense foods, but if it’s at the expense of feeling like crap then it’s best to slow things down and let your body adapt.
Now that you’ve got your fluid management sort of under control the other electrolytes/minerals aren’t as big an issue in the short term, however it’s still worth supplementing potassium and magnesium – at least in the first months. You can either seek out supplements in the form of tablets etc, or you can acquire it in the form of a boullion/broth.
How Much Supplement Stuff?
It’s not really difficult, we won’t go into huge detail here (there are entire books dedicated to this), so the general consensus among low-carb experts is you’re aiming for something like this:
5g of sodium (salt)
1g of potassium (use “Lo Salt” etc which is ~2/3 potassium ~1/3 sodium)
300 mg of magnesium
In practical terms this just means lightly salting your meals and making sauces with generous helpings of sodium and potassium, and taking a magnesium tablet with or after dinner.
The best natural way to obtain these is in a cup of bone broth, which is dead easy to make – it’s little more than simmering beef/lamb/chicken/fish bones for 12-24 hours, and drinking it as a soup. Bone broth delivers these and many other great nutrients in plentitude, and in a readily bioavailable form – plenty of recipes/methods available by searching. Otherwise the soup section of your supermarket should have stocks and boullion cubes available – but you’ll have to check the yields and see what other preservative and “flavour” nasties might be in there.
Pro-tip: potassium and other important nutrients are lost in the water of boiled veggies and drippings of cooked meat, so remember to use them in your sauces.