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Understanding the Keto Flu

What exactly is the “Keto flu”?

During the beginning stages of the ketogenic diet, its common to begin feeling “bogged down”. Due to ketogenic processes happening in your body, this abnormal feeling is to be expected. However, it must not be sustained due to prolonged exposure to circulating ketones.

The “keto flu” is a feeling of flu-like symptoms due to your muscles and organs not being able to function optimally due to circulating ketones generated by the ketogenic diet. Common symptoms include lightheadedness, nausea, fatigue, mental fogginess, abdominal cramps, headaches, and diarrhea. 

How long does it last?

It really depends. However, Keto flu symptoms can begin to appear as early as 1-2 weeks into the ketogenic diet and will remain as long as ketosis is occurring. If symptoms become uncomfortable or interfere with daily routines, the ketogenic diet should be stopped and carbohydrates are to be reintroduced.

What exactly is happening during the Keto flu?

When undergoing the ketogenic diet, your body does not have much, if any, carbohydrates in circulation. Therefore, your body uses its secondary source of energy, fat tissue. When fat tissue breaks down into useable energy, known as “ketone bodies”, and enters blood circulation, it brings along with it it’s acidic properties. Ketones are acidic in nature and will lower your blood pH. This acidic state will put strain on your organs as long as ketones are in abundant circulation.

What can I do about it?

The good thing about ketone bodies, is that they’re easily excreted through your kidneys. However, kidneys need plenty of water to do their job. If following the ketogenic diet, you will need to consume at LEAST 3 liters of water per day (4 liters if you exercise regularly). 

In general, the kidney does a fantastic job at regulating electrolyte levels in the body, provided it has enough water to do its job. However, drinking excess water to flush out ketones may result in loss of important electrolytes as well.

How do I replenish the electrolytes I lost?

Easy. Simply replenish what you lost. During kidney clearance, the most important electrolytes lost will be sodium, potassium, magnesium and chloride.

By adding a high quality sodium such as sea salt to meals, your body can replenish electrolytes.

It is important to only get potassium from food sources and not take any potassium supplements unless provided by your doctor.

The following foods are a great start to replenishing potassium levels:



-Avocados contain potassium, monounsaturated fats (known to lower LDL cholesterol levels), and vitamin C. They work great in salads, eggs, and as a substitute for butter if avoiding dairy.

Wild Salmon

-Wild salmon contains potassium and Is a great source of quality protein. Additionally, it’s loaded with omega-3 fatty acids, which can lower the risk for heart disease and stroke.


-Spinach is nutritious and versatile. Not only does it contain adequate amounts of potassium, but it’s also high in vitamins and K, as well as magnesium and iron. All of these components play an integral role in bodily functions.

Bok choy

-Bok choy is a type of Chinese cabbage that is low in carbohydrates and contains potassium, vitamins C and K, and insoluble fiber. It is versatile and used in a range of dishes from salads to stir-frys.

Most meals you prepare will likely require some form of salt, also known as “sodium chloride”. The ketogenic diet naturally produces diuresis (kidney excretion), so no need to severely restrict salt intake as long as water consumption is appropriate. Bone broth is a great way to add sodium to your system. Not only does it contain adequate amounts of sodium, and can include magnesium, but also tastes great and can be used in a variety of dishes. 

Who is the ketogenic diet NOT recommend for?

Before beginning any new diet or exercise regimen, always consult your local general practitioner.

Due to the effect of acidifying the bloodstream, anyone with the following conditions are advised NOT to follow the ketogenic diet: 

-Any stage of pregnancy

-Anyone with decreased kidney function

-All type 1 diabetics (recommended for type 2 diabetics without kidney damage and under doctor supervision)

-Anyone on medications that decrease kidney or liver function (i.e. metformin). Keto must be discussed with your physician if you are on any kinds of medications or drugs to ensure there are no contraindications with keto

-Women with irregular menses

-Anyone with a current or previous eating disorder

-Anyone with chronic respiratory conditions (COPD and other restrictive lung diseases) 


Those who experience the keto flu may believe they are doing something wrong. This is false. Keto flu symptoms are an indication that you are gaining independence from carbohydrates as an energy source and that ketosis is occurring. This should be immediately dealt with by consuming large amounts of water to flush ketone bodies out of your system and replenish lost electrolytes.


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