10 Keto Diet Side Effects and How to Minimize Them

The ketogenic diet offers numerous health benefits, including rapid weight loss. However, there are some potential side effects you should be aware of. 

Thankfully, most of these subside in a few days once your body adapts to the fat-burning and learns to utilize ketones efficiently for energy production.

Planning and preparation are half the game. When you know what side effects to expect, you will be better prepared to deal with them in the right way and minimize their effects. 

With the right approach, you may be among the lucky ones who do not experience any keto side effects. 

1. Keto Flu

The keto flu is among the most common side effects experienced during the initial transition phase. When your body switches to burning fats for fuel instead of carbs, you may experience carb-withdrawal symptoms. 

Just like with any other addiction, your system protests when you stop giving it what it is used to. And in this case, that’s the carbs or primarily the sugar/glucose! 

You may have flu-like symptoms such as headache, dizziness, fatigue, irritability, nausea, etc. This usually lasts only a few days. So hang in there and don’t give up. Sadly, many people get discouraged and discontinue the diet before they start noticing the benefits. 

Read more: Keto Flu Remedies: Fastest Ways To Stop Keto Flu

2. Dehydration

On a low-carb diet, the initial weight loss comes from water loss. 

Your body’s preferred source of fuel is glucose. Once that’s used up, the next in line is glycogen. Fat burning starts only after your glycogen reserves are used up. Each gram of glycogen is stored with at least 3 g of water (1). Thus a lot of water gets released when glycogen is broken down as fuel.

If this fluid loss is not compensated, you can end up with dehydration. The symptoms of dehydration include increased thirst, dark-colored urine, dry mouth, dizziness, fatigue, etc. So make sure to drink plenty of water and keto-friendly electrolyte drinks.

Read more: Why am I Exhausted on the Keto Diet?

3. Electrolyte Imbalance

The water loss in the initial phase of a keto diet is accompanied by a significant loss in electrolytes as well. The imbalance in electrolytes, such as sodium, potassium, and magnesium, can cause dizziness, muscle cramps, etc.

To prevent electrolyte imbalance on a keto diet, drink plenty of electrolyte-rich (keto-friendly) fluids. Coconut water is a good choice, but be aware of its carb content and have it in moderation only. 

Avocados, spinach, broccoli, and lentils are rich in potassium while dark chocolate, pumpkin seeds, and almonds are rich in magnesium.

Read more: Can I Drink Coconut Water on a Keto Diet?

4. Digestive Issues

When you change your diet, you can naturally expect some digestive issues. Some people get conspiration while some others may have diarrhea. The sudden spike in high-fat foods and the lack of fiber or fluids in your diet can aggravate these issues.

Adequate hydration, increasing your fiber intake, and adding probiotic-rich foods such as sauerkraut and kimchi can help ease your digestive issues.

A healthy keto diet includes plenty of fiber from low-carb vegetables, especially leafy vegetables such as kale and spinach. Cruciferous vegetables are also a great choice. Berries and avocados are keto-friendly fruits.

Read more: Keto and Digestion: Everything You Need to Know

5. Fruity Breath

Once you are in ketosis, you may notice that your breath smells and feels different. People often describe it as a fruity smell with a slightly sweet feel. This is generally known as ‘keto breath’. 

The fruity smell comes from acetone, a byproduct of ketone creation. Acetone is that distinct smell you get when you open a nail polish remover.

During ketosis, as the acetone levels in your blood rise, some of it gets expelled vis your breath, urine, and even sweat. 

Staying hydrated and practicing good oral hygiene can help improve your breath. Fortunately, this unusual smell tends to vanish on its own within a couple of weeks of being in ketosis. 

Read more: What Is Keto Breath, and How Can You Get Rid of It?

6. Elevated Heart Rate

A racing heart or heart palpitations can occur in the beginning phases of a keto diet. This increase in heart rate can be due to multiple factors. Dehydration, low salt intake, and electrolyte imbalance can all trigger this condition.

Black coffee and high-fat bulletproof coffee help speed up ketosis. But too much caffeine in your system can spike up your heart rate as well.

If reducing your caffeine intake, increasing hydration, and balancing electrolytes are not improving your situation, you may need to increase your carb intake some more. Go slow and allow your body to adapt to a low-carb diet by gradually reducing your carb portions. 

Read more: Mediterranean Diet vs. Keto: Which Is Better?

7. Cholesterol Changes 

When you switch to a high-fat diet, your cholesterol levels will naturally fluctuate. Your LDL levels may spike quite a bit initially before settling down. The good news is that your ‘good cholesterol’ - HDL levels also improve. Triglycerides are also found to improve significantly on a low-carb keto diet (2).

Olive oil, fatty fish, avocados, nuts, and seeds are healthy fat choices that help improve your HDL levels. Avoid processed foods with rancid oils and trans fat.

Lowering your triglycerides helps reduce the risk of cardiovascular disease and contributes to a healthier heart. Following a healthy diet improves your blood sugar control and promotes weight loss. The combination of all these significantly improves your health and well-being. So don't let the fear of higher LDL levels scare you. 

Do your research and make informed choices. If you are already on cholesterol medication, please check with your doctor before making drastic diet changes.

Read more: Will a Keto Diet Cause High Cholesterol?

8. Vitamin and Mineral Deficiencies

Limiting any food group on a diet can result in nutrient deficiencies. Grains and high-carb fruits/vegetables are limited or eliminated on a keto diet to keep the carb intake as low as possible. 

Considering that these foods are rich in various vitamins, minerals, and fiber, nutrient deficiencies can be expected if you don’t plan your diet with care. Even milk and some milk products are not advised on a keto diet. 

Supplementation, especially of B vitamins, calcium, and iron can help ensure you get all the nutrients you need. Plan your diet with care, adding a wide variety of keto-friendly fruits, vegetables, nuts, and seeds. 

Read more: Essential Supplements for Keto Dieters

9. Muscle Cramps

Muscle cramps are a common side effect of the keto diet. You may wake up with a painful leg cramp once you enter ketosis. This is usually a sign of dehydration and/or electrolyte imbalance.

Muscle cramps on keto can be easily avoided by keeping yourself well-hydrated and taking electrolyte-rich foods. Physical activity is also important to keep your muscles active, strong, and healthy. 

Go for regular walks and do some strength training as well. Light to moderate intensity is adequate. Avoid high-intensity or heavy workouts till you have completely adapted to using fat for energy.

Read more: Leg Cramps on Keto: Causes, Treatment, and More

10. Kidney Stones

Keeping yourself well-hydrated on keto takes on even more importance when your kidneys enter the picture. Kidney stones are a risk factor to watch out for on a keto diet.

Fat metabolism and ketone production put a heavier load on your kidneys. The increased intake of animal foods can make your blood and urine more acidic. This increases calcium excretion in the urine. 

Another kidney stone contributing factor is the reduction of citrate in the urine, on a keto diet. The presence of citrate helps prevent kidney stone formation, by binding to the calcium in the urine (3).

To sum up,  the increased calcium levels, along with decreased citrate and pH levels can lead to kidney stone formation. To minimize this effect, drink lots and lots of water.

Read more: Keto Mistakes That Everyone Makes

Conclusion

The keto diet is healthy and safe for most people. It is especially beneficial for those with type-2 diabetes and/or obesity. However, you should expect some challenges when you begin your keto journey. 

Most keto side effects are temporary and they subside once your body gets used to the keto transition. Keto flu, fruity breath, digestive discomforts, and muscle cramps are some of the most common side effects of the keto diet. 

Keeping yourself well hydrated, having electrolyte-rich food and drinks, plenty of fiber, probiotics, choosing healthy fats, and avoiding intense exercises can help minimize or even avoid most of these keto side effects.

When starting a diet as restrictive as a keto diet, it is always best to consult your physician or a registered dietitian for personalized advice, especially if you have any underlying medical conditions.