When it comes to diets, people swear by the amount of weight loss they get when they go on the ketogenic diet. While this diet is effective in burning fats and losing excess weight, your body takes its toll when you transition to a very low carb and high-fat diet.
Yes, there's such a thing. If you've experienced sudden and severe leg pain when you're on the ketogenic diet, don't be afraid. You're not alone. And the good news is, there are lots of things you can do to prevent it.
To know more about leg cramps while on keto, read this article!
Can Ketosis Cause Muscle Cramps?
We will make this short and simple for you—the answer is yes, the ketogenic diet may cause muscle cramps. It is one of the most prominent diet ketosis side effects.
It's easy to determine if you're suffering from leg cramps because it only comes with two symptoms—sudden and sharp pain and a hard lump of muscle underneath the skin. The good news is it usually goes away on its own. It will be over in less than a few minutes. (1)
But of course, the sudden onset of pain can be quite frustrating and bothersome, especially if you're experiencing it. If you want to understand why you experience this on a keto diet and how you can prevent it, keep on reading!
What Causes Leg Cramps on Keto?
The exact cause behind it is still not clear. However, there are still lots of factors that will increase your risk of experiencing it. When you're on a ketogenic diet, you're more susceptible to it for many reasons. These include:
At the start of the ketogenic diet, frequent urination and diarrhea ketosis are two things that you'll have to deal with.
Between these two, frequent urination is a more common side effect. This is because the first thing your body flushes out is your glycogen stores. Glycogen is made up of three to four parts of water, so water molecules go with it when it goes out of your body. (2)
Besides the fact that going to the toilet plenty of times in a day is bothersome, frequent peeing will also take a toll on your body. When you flush glycogen and the water that comes with out of your system, you get dehydrated.
Leg cramps are one of the most significant symptoms of dehydration. Intracellular water (the water inside your cells) has a substantial impact on your muscle function and capacity. When your muscles are not well hydrated, your muscles won't be able to function at an optimal level. It will also start to spasm from time to time. (3)
To determine if you're dehydrated, check your urine color. If it is dark yellow to brownish urine, you're dehydrated.
Another thing you can try is the skin turgor test. Pinch the skin at the back of the hand. You're dehydrated if it retracts slowly. (4)
Of course, electrolyte imbalance my happen when dehydration takes place. The fluids in your body contain various substances, and electrolytes are one of them.
Electrolytes are essential minerals that play a significant role in different bodily functions. If the electrolyte levels in your body are depleted, your nerve cells will become sensitive, which may pressure your nerve endings. This is what causes muscle spasms. (5)
Some of the common essential electrolytes that you will run low when you're dehydrated are as follows:
Your body needs this electrolyte for proper nerve and muscle function. A Magnesium deficiency will result in not just leg cramps but also cardiac arrhythmias, high blood pressure, and insomnia. (6)
Aside from the amount of potassium you lose with frequent urination, your potassium levels will also run low in keto diet because most of the potassium-rich food items are also rich in carbohydrates.
This is another electrolyte that is critical to the function of your nervous and muscular system. Studies show that not getting enough potassium will lead to leg cramps. (7)
This electrolyte is the main component of salt (Sodium Chloride). It is also the most prevalent electrolyte in the body as it makes up most of your organs and plays a vital role in the functioning of your cells, organs, especially your muscles.(8)
When you urinate frequently, you may feel thirsty a lot of times. To address it, you will surely drink lots of water.
While staying hydrated is a must, you should be careful in consuming too much liquids. Overhydration is a thing, and it is as dangerous as dehydration. It may even be worse. (9)
This is because drinking too much liquids can also flush out electrolytes from the cells. It may lead to electrolyte imbalance, the main culprit behind muscle cramping.
Too Much Caffeine
To address the fatigue that comes with a low carb diet, most keto dieters tend to drink too much caffeine to get the energy boost that they need. While it's useful in keeping you awake and alert, it may also cause leg cramps. There are a lot of ways why it happens.
Of course, drinking too much caffeine will cause you to urinate more, which may lead to dehydration and electrolyte imbalance, and ultimately—leg cramps.
Another possible reason would be too much caffeine makes your muscles sensitive, which may lead to excessive muscle contractions and leg cramps. (10)
Leg cramps are common during the early stage of the ketogenic diet. Once your body has adapted to a full-fat diet, all these symptoms will go away. If you're still experiencing leg cramps after a few months of the keto diet, it may not be diet-related. Here are some other possible causes that you may want to know about:
Overtraining or physical overexertion
High stress levels
Medications (birth control pills, diuretics, statins, albuterol, and Naproxen)
Medical conditions (kidney failure, thyroid issues, vascular diseases, Addison's diseases, alcohol use disorder, Parkinson's disease, type 2 diabetes, and sarcoidosis)
Muscle fatigue due to running, weight training, and sports
High or low blood sugar levels
How to Treat Keto Lego Cramps
What helps with muscle cramps on keto? If we know the causes of this ketogenic diet side effect, we can find out medically reviewed ways to address, treat, or prevent it, right?
Yes, of course! Here are some things that you can do to prevent or treat this side effect:
Since dehydration is one of the leading causes of leg cramps, you should make an effort to get your hydration right. You can do this by drinking 6 to 8 glasses of water. You can increase your water consumption if you work out or during the hot summer months.
In addition to water, you can also consume other liquids such as fruit juices. You can also try to consume more water-rich food like vegetables, fruits, and soup broths.
Limit your caffeine consumption.
While teas, energy drinks, and coffees are liquids that can aid in your hydration, you should limit your caffeine intake. This is because it will cause you to urinate more.
Additionally, sports drinks are a big no-no for a ketogenic diet since these contain high amounts of carbohydrates and sugars.
Create your electrolyte drinks.
Electrolyte drinks are the best way to boost and replenish your electrolyte levels. Unfortunately, most of the electrolyte drinks in the market are laden with sugar. Lucky for you, you can easily create your electrolyte drink.
Here's an affordable and healthy DIY sugar-free electrolyte drink recipe that you can try:
2 cups of water
1/8 teaspoon of salt
6 tablespoons of lemon juice
3 teaspoons of artificial sweetener (Stevia or erythritol)
Eat the right food.
If the reason for your leg cramps is an electrolyte imbalance, getting enough minerals is the best way to address this issue. The good news is you can get these from your diet. What foods are good for leg cramps? Read on to find out!
Get enough potassium.
According to studies, you need to consume 3000 to 4000 mg of potassium daily. (11)
You can get this amount by incorporating 5 servings of vegetables in your daily menu. It can be challenging to find non-starchy vegetables, but we have a few recommendations: (12)
White mushrooms (488 mg)
Mustard greens (202 mg)
Enoki mushrooms (368 mg )
Please take note that all of these values are for a 100-gram serving.
Consume magnesium-rich foods.
The medically reviewed daily recommended dietary Magnesium intake is 400 mg. This may seem a lot, but the good news is the keto diet doesn't restrict the consumption of magnesium-rich food. Because of this, you can easily incorporate the following food in your diet:(13,14)
Hemp seed (195 mg per 30 g)
Pumpkin seeds (150 mg per 30 g)
Mackerel (105 mg per 114 g)
Swiss chard (150 mg per 175 g)
You can also try taking natural mineral water, which contains reasonable amounts of electrolytes.
Increase your salt intake.
Are you not getting enough salt? You can easily take care of that by eating more salt. However, you must keep in mind that too much salt is also bad for you. The recommended dietary intake for sodium is no more than 1500 mg per day. (15)
To obtain the amount of sodium needed, add salt to your dishes or sip on bone broth from time to time.
Incorporate more veggies in your diet.
At times, your hydration and electrolyte levels are on point, but you'll still experience leg cramps. Well, you may also want to look at your vitamin E levels. (16)
To address this, try to consume vitamin E-rich foods like:
If you're having a hard time consuming all your needed electrolytes from food, the best thing that you can do is take supplements instead.
You can easily increase your sodium intake just by adding salt in your food. On the other hand, taking potassium supplements is pointless since the FDA limits the amount of potassium per supplement to only 99 mg per serving. This is because high amounts of potassium may lead to stomach problems and certain cardiac problems. (17)
For magnesium, you can go for magnesium citrate. But please bear in mind that this form may cause loose stools. If you can't tolerate its side effect, you can take a magnesium supplement in a slow-release pill.
Another great supplement would be an electrolyte supplement that already contains all of the electrolytes you need. The advantage of taking such a supplement is you only need to pop one pill, and you can get them all. The downside is the capsule contains only small amounts per electrolyte.
When to Go to a Doctor
As mentioned, this side effect goes away on its own. Sometimes, though, they are a sign that something isn't right. You should seek medical advice if:
The cramping is constant, too painful, or severe.
It lasts longer than two weeks.
You have a pre-existing medical condition.
You're pregnant or a senior citizen
You're experiencing other symptoms
You can't sleep at night because of "restless legs"
You're taking medications
Are Leg Cramps a Sign of Ketosis?
Leg cramps are one of the side effects from keto diet, just like ketosis diarrhea. While this side effect is bothersome, it is a sign of ketosis. It means that your body is starting to burn fats, and you may experience weight loss anytime soon. (17)
But of course, you don't need to suffer from leg cramps even if you're on ketosis. A few simple changes in your diet and the consumption of essential keto supplements can help put an end to your misery.