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The “Keto Flu” – How to Reduce Common Side Effects of the World’s Most Popular Diet

steak with blue cheese, keto flu

By Kelley Herring

The ketogenic diet is everywhere you look…

It’s on the cover of magazines in the checkout aisle. Athletes are touting the benefits it offers performance. Celebrities credit keto with helping to prepare for movie roles. And Silicon Valley millionaires praise its ability to improve mental performance.

In my previous two articles, we covered the basics about keto…

We discussed the metabolic state of nutritional ketosis and how it works to transform your body from a “sugar burner” to a “fat burner.” We also talked about how to accelerate your transition into ketosis.

Today, we cover the common side effects people experience on keto… and how to reduce or eliminate their impact.

If you’ve been following a reasonably low-carb diet for some time, your transition to nutritional ketosis should be smooth and painless. You likely won’t experience ANY negative side effects – while you do notice improved energy, greater mental clarity and accelerated fat loss!

On the other hand, if you have been eating a high-carb diet, filled with traditional bread, pasta, pastries and desserts… there may be a few bumps in the road as your metabolism shifts from burning glucose for energy (as you have been doing for decades) to burning fat.

During this transitional period, biological adjustments are taking place to increase fat breakdown and reduce insulin production. Your entire metabolism is being rewired to a “fat adapted” state.

But as this is happening, you might experience a few uncomfortable side effects, often referred to as the “Keto Flu”.

Symptoms of the Keto Flu

In your transition to becoming a lean, mean fat-burning machine, you might experience:

  • Mental fog
  • Low energy & fatigue
  • Shakiness, dizziness, weakness
  • Muscle cramps
  • Nausea, headaches & general malaise

If you do experience these symptoms – take it as a GOOD sign!

It means you are being disciplined enough to starve your body of the sugar it craves! These initial side effects are usually mild and short-lived, so stay the course!

Your body will rapidly transition to efficiently burn fat and ketones. Any uncomfortable symptoms will soon subside. In their place, you will experience profound health and brain benefits, expanding energy reserves and deeper, more restorative sleep.

As your fat stores are converted to energy, the results you see in the mirror alone will be worth it!

Now, let’s discuss how to alleviate the most common symptoms, without getting off track!

Cravings for Carbohydrates

If a low-carb or ketogenic diet is a new experience, you may notice increased cravings for carb-rich comfort foods like bread, chips, crackers and dessert. Often times our “cravings” are simply habits. See them for what they are and allow the feeling to pass.

However, there are also biological explanations.

The microbiome in your gut has grown accustomed to feeding on carbohydrates and you probably have an imbalance of species that demand these foods. Yes, it is true… the bugs in your gut can actually influence your brain to feed them what they desire! The good news is that your microbiome changes on a daily basis – and a positive change in your diet can quickly alter its makeup.

Also, if your body is accustomed to burning glucose for energy (as is the case for most people), it will cry out for glucose when it is suddenly no longer available. However, as your blood sugar metabolism stabilizes, your carbohydrate cravings will gradually decrease and then go away almost entirely.

steak with blue cheese, keto flu

Electrolyte Loss & Increased Urinary Frequency

Another common side effect of your transition into ketosis might include more frequent visits to the bathroom. And this is especially common during your first week.

As you produce less insulin, your body will begin dumping the glycogen (a form of stored carbohydrates) held in your liver and muscles. And for every gram of glycogen, you store about three grams of water. This water may come pouring out in a big “whoosh”.

As this happens, you should also experience a decrease in overall bloating and much leaner, less puffy facial features. Most people are very happy with the quick weight loss results and rapid positive change in their appearance!

But there is a downside…

Increased urination and the release of retained water can lead to dehydration (so be sure to drink lots of water). It can also cause a loss of critical electrolytes, including sodium, potassium, calcium and magnesium. And if you allow these critical minerals to become depleted, you will almost certainly experience the “keto flu.”

A general consensus among nutrition experts is to aim for the following daily amounts:

3,000 – 5,000 mg (3g – 5g)
Potassium1,000 mg
Magnesium300 mg

Here are a few recommendations:

  • Alternate plain water with Sole Water. It is pronounced “solay” and simply means that the water is fully saturated with high-quality mineral-rich salt (not table salt). You can Google the term for more information and instructions.
  • Sip on Bone Broth. Not only is a well-seasoned bone broth delicious… it is also packed with electrolytes!
  • Increase consumption of low-carb vegetables, rich in calcium, potassium and magnesium. This can include kale, broccoli, beet greens, spinach, avocado and mushrooms (Yes, we know “shrooms” are technically not veggies – but they are a good source of potassium!).
keto flu, homemade bone broth, bone marrow, broth, superfood

Make your own gut healthy bone broth from a trusted pasture raised source

Unusual-Smelling Breath

A few weeks into the ketogenic diet, you (or others) may notice a smell on your breath, reminiscent of turned fruit, baby’s breath or nail polish remover. This is due to the increased levels of acetone in your body.

Acetone is a ketone that is produced as your body enters ketosis. Smelling it on your breath is actually a good (if slightly awkward) indicator that your ketogenic diet is working.i

If you do experience this, pat yourself on the back that you have reached ketosis. And keep in mind that for most people the smell subsides after a few weeks. To reduce the odor in the meantime, rinse your mouth with coconut oil, chew on mint leaves or carry a container of xylitol mints (which have an added benefit of reducing oral bacteria and risk of cavities).

It is important to note that, while it doesn’t happen to everyone, a change in your breath is a normal and temporary aspect of nutritional ketosis.

Short-Term Fatigue

One of the many wonderful health benefits of the ketogenic diet is increased energy. However, as your body makes the switch from burning primarily carbohydrates to using healthy dietary fat, stored body fat and ketones for energy – it is not uncommon to experience fatigue.

Feeling sluggish is one of the primary reasons people abandon keto. But remember… this is NOT a permanent condition!

While it can take anywhere from a week to a full month for your body to reach a stable state of nutritional ketosis, the reward on the other side is incredible. Not only will your energy return in full – you will probably experience more energy, stamina and mental alertness than you have in decades!

That is because fat is a FAR MORE efficient fuel than sugar. Not only does it produce less metabolic waste when it burns – it also generates significantly more raw horsepower!

Adenosine triphosphate (ATP) is the basic unit of “energy currency” in your body. A molecule of sugar produces exactly 36 units of ATP, while dietary fat produces an average 155 units of ATP. In other words, dietary fat produces 330% more cellular energy than sugar!

But get this…

The fat stored on your body is in the form of triglycerides. And every TRI-glyceride holds THREE long chain fatty acids. So every molecule of body fat you burn produces 465 units of ATP! Compared to the measly 36 ATP you get from carbs, you produce 1,191% more cellular energy from body fat than you do from sugar!

It’s obvious why the number-one benefit cited by people who become “fat burners” is profoundly more energy! When your body is adapted to produce energy from stored fat…

  • You wake up feeling refreshed in the morning
  • You no longer crave a jolt of sugar or caffeine to fight afternoon drowsiness, and
  • You have all the energy you need for work… play… and exercise.

The more energy you have, the more success you will enjoy in every aspect of life!

So if you do make the decision to pursue the keto diet, I strongly encourage you to stick with it long enough to transform your body into a lean, mean fat-burning machine.

Once you do, you’ll never look back!

Read more of Kelley’s articles here.

kelley herring


Kelley Herring is the author of the brand new book Keto Breads – which includes more information you need to know about why it is so important to avoid wheat and grains in your diet, plus how to use healthy replacements for these foods to create all the breads you love… without the gluten, carbs and health-harming effects. Click here to learn more about Keto Breads


  1. Musa-veloso K, Likhodii SS, Cunnane SC. Breath acetone is a reliable indicator of ketosis in adults consuming ketogenic meals. Am J Clin Nutr. 2002;76(1):65-70.References