What is the keto flu?

The keto flu is a common occurrence for those that are starting the ketogenic diet.  It happens as your body is transitioning between eating carbs and sugar, to being able to process and use fats as your fuel source.  Some of the symptoms can include fatigue, dizziness, nausea, brain fog, confusion, muscle cramping or soreness, sugar cravings, heart palpitations, irritability and mood swings.  The keto flu can affect each person differently.  

Keto breath

One other thing that will happen as you convert to eating fats is the fact that you may get bad “fruity” breath.  While it has nothing to do with the keto flu, it is important to know that it is an indicator that you are in the process of converting to ketosis.  The bad breath will go away once you are fully fat adapted.  It is actually a good sign that you are on the right track. It is just frustrating in the interim.

An analogy that I use when I try to explain this to other people is to think an automobile.  Automobiles can run on either gasoline or diesel fuels.  If the engine normally runs on gasoline and you put in diesel fuel, you can ruin your engine.  That being said, your vehicle can run off of diesel fuel.  In order for that to take place, you will need to modify the mechanics of how your engine runs because gasoline and diesel engines run very differently.  So, to get your gasoline engine to run on diesel, you would need to remove parts, add parts and modify others.  As you make changes to your engine, you will discover that it is not running as smoothly as it should and you will need to make more small changes to get it to work.  

This adding, removing and modifying of parts is similar to what our bodies are going through when we begin ketosis.  Our bodies also will continue to make small adjustments until it gets the formula just right to run on fats. We are literally changing our fuel, and it does not change overnight. This change will require our bodies to increase or decrease hormone production (depending on the hormone) and a whole slew of other things just so that we can adjust to this new fuel.

Keep in mind that the keto flu is manageable, normal, and even sometimes avoidable. To understand how to manage it, you need to understand part of why it happens in the first place.

Some science behind the keto flu

Our bodies can generate energy in two main processes.  Glycolysis is the conversion of glucose (sugar) into energy and Beta-oxidation is the conversion of fats into an energy source.

As you cut out the carbohydrates and sugars from your diet, your body will be forced to make changes.  Here is a list of some of those changes.

1. Your blood sugar will drop causing hypoglycemia.  This is one of the big causes of the fatigue, brain fog and irritability.  As the glucose gets used up, which our brain functions on, our body has to transition to making glucose to keep the brain functioning as it is supposed to. 
2. As you use up the carbs and sugars in your body, your body will start the process of using fat stores.  As this happens, you will start flushing out excess water that is stored in fats.  This is caused by lower insulin levels telling your kidneys to store less water.  Along with the water that is getting flushed out, you will also lose electrolytes.  This can cause an electrolyte imbalance, which can also lead to dehydration. The main electrolytes that will be flushed are sodium, magnesium and potassium.  Others that can be affected are calcium and chloride.  These electrolytes are imperative to muscle and nerve function.  The lack of electrolytes can cause many of the flu like symptoms.
3. Between the low blood sugar and electrolyte imbalance, your hormones can get out of wack.  As your body transitions to being fat adapted, your hormones will get out of wack until it finds that equilibrium it needs.  This can be a big factor in the mood swings you may have. Another factor affecting hormones is the flushing factor mentioned above. As your body flushes out excess water from your cells, the water will also carry some hormones that are stored there. As those hormones are dumped into your system (when they aren’t needed), it will put your system into further imbalance. Until the balance is restored, it can affect your body in many ways. In women, the excess estrogen being flushed out can cause spotting, more frequent periods or possibly period like symptoms.
4. As a new type of fuel, our bodies will begin making ketones which are forms of fat that our bodies can use (oxidize) as our new fuel.  Our bodies prefer to use glucose as a food source because it is easier to process, so our bodies are not going to create ketones until there is a lack of carbs/glucose to use.  Using ketones are much better for our bodies to use because it is a “cleaner” fuel and will actually function much better once we are fat adapted.
5. There is a correlation between the lack of sugars and carbs having a “withdraw” that can affect people both physically and psychologically.  

Fun fact, for every gram of glycogen that is stored, your body will also hold 3 grams of water. Water weight…

So as your body uses up the stored glycogen, it will also dump the water that was stored.  This is why when you first start the keto diet that you will lose weight fairly rapidly.  You are losing water that was stored because of the glycogen.  As you remove those water stores, your waist will also get smaller because you are not holding on to that water.  On the flip side, if you eat carbs, those cells will fill right back up.

Many people get frustrated when after a few weeks or months of good weight loss, they slow down.  That is perfectly normal.  You most likely have just been flushing out water, which caused fairly quick weight loss.  Water is approximately 8 pounds per gallon. Once you use up the majority of the glycogen, you have also flushed the water.  The weight loss will most likely slow down, but if you stay true to the diet it will not stop if your body still has weight that it does not need.

*If you have stalled for several weeks, you may need to make adjustments on your caloric intake. Make sure you are not eating more calories than you are using (even if you are staying keto). Adjusting your calories can be tricky as your needs are constantly changing, but you can eventually find the right balance that works for you. Just keep with it.

Hormones

If your keto diet is too low in calories or if you are not eating foods that have enough nutrients, your body can trigger a starvation response.  Your adrenal glands will then increase the levels of cortisol (the stress hormone).  High levels of cortisol can have a negative affect on your body.  Cortisol is a vital hormone for our bodies, but high levels can be counter productive.  Cortisol in high levels can cause a stress response and throw your blood sugar out of wack by sending the wrong signals.  If you have a high stress job, you can also have a similar response, so try to not stress too much especially when you are transitioning to keto.

Once your blood sugar levels level out, your hormones will find their natural balance.  The keto diet has been shown to have a positive affect on hormone production and reduce the risk of autoimmune diseases.  One important factor when considering the keto diet is that eating a high quality fat diet will give your body the building blocks for nearly all hormones your body makes.  Cholesterol is one of the main building precursors of nearly all hormones. Yes, cholesterol is very important for your body, in fact you can’t survive without it. So cholesterol is not just a bad thing your doctor talks about, but more on that in another blog.

The two main ways that our bodies store energy for the future:

1. Glycogenesis.  This is the process where glucose is converted to glycogen and is stored in the liver and muscles.  Some researchers have found that an average person will remain approximately 2000 calories in the form of glycogen in the liver and muscles.  Assuming that you are in that range and you just started the keto diet, you should use up the stored glycogen within 24 hours. That is not including what is already in your blood or your food. (It can take some people weeks to get into ketosis, so please don’t misinterpret the above to mean that you will be in ketosis in 24 hours.)
2. Lipogenesis.  If your body has already stored enough glycogen in your liver and muscles, your body will convert any excess to fats through lipogenesis.  Our glycogen stores are somewhat limited, but our fat stores are virtually unlimited.  This is where our spare tire comes from.  Our bodies are converting the excess sugars into fats so that they can be used sometime in the future.  In our distant past, this was a great thing, when the winters hit and the food was not as abundant, we could use our fat stores to stay alive.  In the modern world, this is no longer needed since we don’t have those lean times where we use up our stores.  Since we don’t use up the stores, we just continue to add to our spare tires.

How our bodies use stored energy:

1. Glycogenolysis.  The process of using up stored glycogen.
2. Lipolysis. The process of using up stored fats.  (Where we really want to be if you are wanting to lose weight.)

How long will the keto flu last?

There are many factors that can affect how long you will have the keto flu.  Some people will not be affected by the keto flu at all.  Typically people get the keto flu from anywhere between 1 day to 2 weeks.  It is all dependent on what you are eating (did you cheat), how hydrated you are, and if you read below for some tips to minimize your chances of getting the keto flu.  

How to reduce your chances of getting the keto flu.

1. Stay true to the diet.  As you are in the process of becoming fat adapted (especially for the first time), if you eat any carbs or sugars, it will prolong the process.  Once your body has developed the necessary tools to create ketones, you will be able to switch between carbs and fats much easier.  I don’t recommend switching since it will just set your weight loss back further, but that is your individual choice.  Remember that there is a lot of misinformation on the internet, so do some research to make sure that you are correctly following the keto diet. My blog is as accurate as I can make it, but new information is continually coming out.
2. Stay hydrated!  As I stated above, you will flush water out of your system.  It is imperative that you drink plenty of water.  Your urine should be a light yellow color.  You should also be urinating several times a day.  If you are not, drink more.  Please use common sense though, there is such a thing as drinking too much water. Since you aren’t storing water, the water you do drink will also exit just as quickly. So keep your water glass handy.
3. Add salt to your foods.  You can also add salt to your water if you prefer.  Don’t use table salt, use a sea salt or pink Himalayan salt.  The table salt does not have any of the micronutrients or minerals that you need.  The salt is one of the electrolytes that are being flushed out. Your body will still need the salt, so you need to replenish it daily.
4. Eat foods that are high in magnesium and potassium.  If you know you are not going to get enough magnesium and potassium from your diet, then take a supplement.  The salt, magnesium and potassium will get flushed out with your urine, so you will need to make sure you are getting enough daily. Making sure you get enough of all three electrolytes is probably the best way of reducing the keto flu.
5. Get plenty of sleep.  Especially when you are transitioning between glucose to fats, getting plenty of sleep is very beneficial.  It allows your body to rest and recuperate. While you may not have run a marathon, your body has been figuratively, as it is making the changes needed to run on fats.
6. Exercise.  Exercise can help burn up the stored glycogen and speed up the process of converting to ketones.  You want to keep the exercise on the light side while you are in the conversion process. Too much exercise during the transition can deplete you body of your glucose too rapidly and may cause blackouts or injury.
7. Drink some bone broth.  Bone broth is a great way of getting sodium and potassium and some of the other health benefits of bone broth.
8. Eat enough fats.  If you are trying to get your body to burn fats, you need fats for your body to burn.  Eventually you will adjust your fat intake down so that you can burn your stored fats, but when you are converting over, try to get your fats from your foods. Just make sure they are healthy fats.