Quick answer: On keto, lower insulin makes the kidneys release more sodium and water, and potassium and magnesium can fall too. Low electrolytes contribute to keto flu symptoms like fatigue, headaches, dizziness and cramps. Eating electrolyte-rich foods, using broth or an electrolyte drink, and staying hydrated help. People with kidney disease, heart disease or high blood pressure should get personal advice.
Why electrolytes matter
Electrolytes are minerals that control fluid balance, nerve signals, muscle contraction and heart rhythm.
Electrolytes on keto
As glycogen is used and insulin falls, the kidneys excrete more sodium and water, pulling potassium and magnesium with them. This can cause keto flu symptoms.
Food sources
- Sodium: sea salt, broth, pickles, olives, cheese
- Potassium: avocado, spinach, kale, almonds, salmon
- Magnesium: spinach, almonds, pumpkin seeds, chard, dark chocolate
Electrolyte drinks
I often suggest an electrolyte powder without added sugar or a little coconut water as an easy option. Check labels for sugar.
How much?
NIH provides general daily intake recommendations for adults, and needs on keto can differ. Reference ranges vary by lab, age and sex. Your provider interprets your result against the lab’s range and your overall picture, rather than chasing a single number. Extra sodium or potassium can be harmful with kidney disease, heart failure, high blood pressure or certain medications.
Healthy aging lens
Electrolyte balance supports heart rhythm and muscle function at every age. See hydration and electrolytes.
When to see a naturopathic doctor
- You have diabetes or take insulin, sulfonylureas or SGLT2 inhibitors (risk of low blood sugar or ketoacidosis)
- You take blood pressure medication or diuretics
- You have kidney, liver, gallbladder or pancreas disease, or high cholesterol
- You are pregnant, breastfeeding, or have a history of disordered eating
- You want a keto plan tailored to your labs and goals
See a medical provider promptly for nausea and vomiting, abdominal pain, confusion, fruity-smelling breath with rapid breathing, or very high blood sugar or ketone readings, which can signal ketoacidosis.
Want a keto plan that’s safe for your health?
A free 15-minute consultation with Dr. Kneessi. No cost, no obligation. In-office in Odenton, MD or by telehealth.
Frequently asked questions
Why do I need more electrolytes on keto?
Lower insulin makes your kidneys excrete more sodium and water.
What are signs of low electrolytes?
Fatigue, headaches, dizziness and muscle cramps.
What foods are high in electrolytes?
Broth, avocado, leafy greens, nuts and seeds.
Who should be careful with electrolyte supplements?
People with kidney or heart disease, high blood pressure, or on related medications.
Sources
This article is for educational purposes only and is not medical advice. It does not replace an individual evaluation. Talk with your healthcare provider before starting supplements or changing medications, especially if you are pregnant, nursing, or managing a health condition.
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