Keto Side Effects and What to Do

The side effects of following a ketogenic lifestyle are? Weight Loss, Normalized Blood Sugars, More Energy, A Feeling of Well-Being, Better Moods, Banished Brain Fog, and, of course, a Very Healthy Lifestyle! 

But, there are some TEMPORARY side effects that aren’t so happy! Read on to see what you MIGHT expect and what you can do about them (many people experience a few of these side effects, some have no side effects at all).

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LESSON 7 – KETO SIDE EFFECTS (This is taken from KetoSchool, a wonderful series of self-paced lessons on how to get into the Keto Lifestyle. (Great for those who are new to Keto, those who are experiencing problems on Keto, and for Keto group leaders who need a resource for members who are having trouble staying on plan. KetoSchool is not a group and does not take the place of a good keto/Low Carb/LCHF support group.)
To Join KetoSchool, Click here!

PLEASE be aware that these side effects are temporary. Changing your body from burning glucose (sugar) to burning fat is a major change. It will take a few weeks. (For some as little as one week, longer for others) Once you understand what causes them and how counter-act them, you’ll be feeling much better sooner.

The most common side effects when beginning keto are:


A. You are now burning up the extra glycogen (stored glucose) in your liver and muscles. Breaking down glycogen releases a lot of water. As these stores drop, your kidneys will begin to expel this excess water.

B. Also, as your circulating insulin levels drop, your kidneys begin to excrete excess sodium, which will also cause more frequent urination. And this is why, on Keto, you need more salt intake – more on that later. (This does not pertain only to diabetics, everyone has insulin circulating in their body.)

C.You should be  drinking more fluids than before as well.  You DO want to stay hydrated. How much water do you need? A good rule is simply to watch your urine. If it’s clear, you’re drinking too much, it should be just slightly yellow. (unless you’re taking a med that causes discoloration. For instance, Complete B Vitamin supplements turn your urine bright yellow!) Don’t try to drink all your water at one time, space it out over the day and slow down at night so you can sleep well. You don’t want to “slosh”.


A. As you dump excess water, you lose minerals such as salt, potassium and magnesium. Having lower levels of these minerals will make you feel tired, lightheaded or dizzy, cause muscle cramps, and headaches. You may also experience skin itchiness.

B. Fatigue and dizziness are the most common of the low carb diet side effects, and they can be avoided for the most part by making sure you stay ahead of mineral loss. You do this by eating more salt or sipping salty broth throughout the day, and eating potassium rich foods. (Dairy foods, green leafy vegetables and avocados are all high in potassium).
[If you take medicine for high blood pressure, check with your doctor. Although salt is blamed for high blood pressure, usually it’s not the culprit at all and most people on Keto see their blood pressure begin to normalize.
Blood pressure that drops too low because of medication can make you feel dizzy.(NEVER STOP TAKING MEDICATION WITHOUT YOUR DOCTOR’S HELP. SOME BLOOD PRESSURE MEDS MUST BE WEANED OFF.]

C. If you experience leg cramps, try taking 400 mg of magnesium every night before bed. Many people are low on magnesium today anyway because it has become depleted in our soil so it’s not getting into the vegetables we eat.  (CHECK with your doctor if you have kidney or heart health issues).
It’s also VERY important to eat at least 2 cups of raw green leafy vegetables every day. These vegetables provide potassium and vitamin K, and will also help with hunger in the beginning.

3. HYPOGLYCEMIA (Low Blood Sugar):

A. If you take insulin or any oral med or injectable med that causes your pancreas to push out more insulin, you need to watch for low blood sugars.
This means TEST, TEST, TEST! LESSON 6 regarding Diabetes medications goes into this more deeply, please read it.

B. Never use food (orange juice, candy, milk) to overcome a low. Use glucose tabs. Be sure you have them on hand (available at any pharmacy)

C. Please note, if you have not been diagnosed as diabetic: Most people who are significantly overweight, have some level of insulin resistance – the precursor of diabetes. Most people are insulin resistant for many years before it reaches the level where it’s caught on lab tests and the person is diagnosed as “pre-diabetic” or “Diabetic Type 2” (they both mean the same thing, pre-diabetic simply means your blood sugars are too high, but they want to break it to you gently by calling it “pre-diabetes”, in most scientific circles today the preferred term is “Diabetes – Stage 1”. At any rate, following a ketogenic diet will help get this in control.)


A. Not uncommon, although constipation is more common.

B. If you’re using coconut oil for the first time this may be the problem, START VERY SLOWLY! No more than 1/4 teaspoon a day at first! and work your way up slowly. Coconut oil is processed differently in your body from other oils/fats and your liver has to create an enzyme to handle it. Some people never do. (very very few) It’s ok! You do not have to consume coconut oil to follow keto.


A. If you take your multi-vitamin or B vitamin supplements before bed, they can cause you to be more alert – not a good thing for sleeping! Take these in the morning only. Check any other meds/supplements to see if they may have this effect!

B. Low carb diets are higher in histamine containing foods, and some people react to higher intake of these foods with anxiety and sleeplessness, this will pass, usually within a week or two.

C. You can also try eating a small snack which contains both protein and some slight amount of carbohydrate (1 or 2 grams) right before bed. The carbohydrate will increase insulin, which will allow more tryptophan from the protein to get into the brain.
Tryptophan is the precursor for serotonin which has a calming effect on the brain.


A. This is  a natural reaction from being in ketosis and eating less, which is what usually happens when you are keto-adapted and hunger is reduced. The same thing happens on any diet.

B. It’s also possible to become more sensitive to T3 when you are in ketosis, so you don’t need as much T3 to get the same job done. Dr. Ron Rosedale discusses this at his site.
If you have Thyroid issues you should tell your doctor you’re following Keto so he’ll know what’s happening if you have any issues.


A. Probable cause: nutrient deficiency. This is why a multivitamin containing the RDA for especially selenium and zinc, plus a magnesium supplement, broth or mineral water are strongly recommended. Again, much of this is caused because now the kidneys are working more efficiently and flushing out minerals along with excess fluid.

B. You may be insulin resistant and lowering carbohydrate intake can result in transient hypoglycemia (low blood sugar). Transient means it won’t last forever – when you’re insulin resistant, your blood sugars are always bouncing around, when you begin to fix insulin resistance with Keto, two things can happen:

a. your blood sugar may go lower than your body is used to – even though it’s not actually low, it will feel low.

b. your body becomes a little confused and your liver may not kick out glucose in time to keep you from feeling a low. It’s ok. Eat something from the food list and rest a few minutes and you’ll feel much better. This will pass within a week or two as your body adjusts.
[if taking insulin or other diabetes meds – see Lesson 6 and TEST, TEST,TEST. Treating a low without testing first is a bad idea, it may be a false low, see above, however if you are out somewhere without your meter, go ahead and use the glucose tablet(s).)

C. There may be an electrolyte imbalance OR you may be dehydrated. Getting enough salt, magnesium and potassium rich foods is your best defense. In addition, drink plenty of water.

D. Some people may feel palpitations due to excessive coconut oil or medium chain triglyceride (MCT) oil consumption. As you add these oils to your diet, start with very small amounts and increase over time. Don’t rely on coconut or MCT oil for your only fat intake. Be sure to include other fats such as butter, ghee, olive oil, and animal fats as well.

E. Even though a ketogenic diet does allow for adequate protein, if you are more athletic, you may have a need for a higher protein intake. Heart palpitations may be an indication of this. In simpler terms, protein intake may be too low for daily needs. Try adding 5-10 grams of protein to each meal IF you are doing a high level of sports/exercise.


A. Some people report accelerated hair loss on a low carb or ketogenic diet. This phenomena is not related strictly to a ketogenic diet, but with any major change in diet. It’s  called “telogen effluvium,” a medical term for hair loss due to a change in metabolism or hormone levels. [this happens frequently to women after pregnancy] Ketogenic diets lower insulin, one of the main human hormones, and hair loss may be one of the natural but TEMPORARY  side effects from normalized insulin levels.
You might try taking biotin or collagen if this occurs. Bone broth is easy to make and is full of collagen! You don’t have to buy expensive supplements.

UNLESS YOU’RE ALREADY ATHLETIC: don’t start to exercise in the first couple of weeks after starting keto. Concentrate on getting into keto first by following the food list. Once you get that rush of energy that keto gives when you enter fat burning, then exercise is great! But it’s not something you are required to do IF you have a condition that makes exercise difficult or impossible.
By this I don’t mean just sit in a chair all day. Light movement is fine – just don’t push yourself to become a superstar during these first couple of weeks!