Ask Leyla: How can I survive the keto flu?


| By Leyla Muedin MS, RD, CDN

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How can I survive the keto flu?

Q: I’m on a very low carb diet and my question relates to my feeling of weakness and lethargy recently.  I’ve read about the “Atkins Flu” or “Keto Flu.”  Is this what I’m experiencing?  What can I do to feel better?

A: First, I congratulate you for embarking on a low carb diet. Whether you’re doing it for weight loss, health optimization, or to combat metabolic abnormalities like insulin resistance and type 2 diabetes, or even to reduce neurological disorders like Alzheimer’s disease, you are on your way to what I would describe as “metabolic bliss”—once you recover from the initial “keto flu.” 

During the first few days of a very low carb diet (ketogenic diet),  feelings of fatigue, weakness and lethargy are often reported. What you’re experiencing first is carbohydrate withdrawal, and then a metabolic shift from primarily burning blood sugar (glycolysis) to burning fat for energy (lipolysis/ketosis). 

During the first two to three days of the diet, some dehydration will occur due to the burning up of glycogen (stored carbo–‘hydrate’) in muscles and liver. Adding a couple of mugs of moderately salted broth to the diet is helpful as is taking a glass or two of tomato juice or V8 juice per day (if you’re not avoiding nightshades). For many, this alone takes care of restoring some electrolytes. 

Also helpful is taking in additional fats such as coconut oil and avocado. Use good quality olive oil or flaxseed oil in your salads too. To help your metabolism shift to lipolysis/ketosis, supplemental carnitine is advised because it helps to usher the fatty acids into the mitochondria for energy. The mitochondria are the powerhouses or furnaces of your cells. Increase your fish oil dose too. 

Hang in there and you will feel the merits of your perseverance when, by the end of five days or as much as a week later, the “keto flu” will lift and you’ll start to experience renewed energy and mental clarity. By maintaining your new fat-burning metabolism, you are cranking out over three times as much energy (ATP) as you were when you were burning primarily blood sugar. Your mitochondria are increasing and becoming bigger and healthier! 

When we’re burning our body fat for energy (and losing weight—yay!), toxins are being released into circulation too since that’s where they’re stored. It’s important to take a good multivitamin/mineral formula containing the necessary antioxidants to keep you healthy as you rid yourself of these toxins. 

To your health! 

Leyla Muedin, MS, RD, CDN 

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