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    Other side effects of the keto diet

    Here are six additional side effects of the keto diet, which are commonly experienced by people starting the diet. Constipation Constipation is…

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    Other side effects of the keto diet

    Here are six additional side effects of the keto diet, which are commonly experienced by people starting the diet.


    Constipation is a common side effect, especially if it is your first time on a ketogenic diet. This is due to your digestive system needing to adapt to your dietary change. Here are three ways to address the problem:

    1- Drink plenty of liquids and have enough salt: The most common cause of constipation on a keto diet is dehydration, which leads the body to absorb more water from the colon, making your stool drier and harder. The solution is simple, have plenty of water and enough salt.

    2- Eat plenty of fibres such as vegetables: Good quality fibres are important in our body to keep the intestines moving and avoiding constipation. If you are feeling constipated, you could be eating too little vegetables. Try adding more green to your diet <link low carb vegetables>. Another great, carb-free source of fibre is <psyllium seed husks – link to product in e-store>, which can also be dissolved in water.

    3- If the above is not enough, try having some Milk of Magnesia.

    Leg cramps

    Leg cramps may happen when first starting on the keto diet. It is not a major issue but could be painful. It happens as a side effect of the loss of minerals (mainly magnesium) via urination. Here is what to do:

    1- Drink plenty of water and eat enough salt: This will help maintain magnesium levels.

    2- Magnesium tablets: If the cramps persist supplement the magnesium in your body with slow-release magnesium tablets.

    Bad breath

    On a keto diet it is common for some people to experience a characteristic smell in their breath resembling nail polish remover.

    The smell comes from a ketone body called acetone. This is a sign that you are in ketosis and that your body is burning lots of fat and also converting it into ketones. The smell may also show up as body odour when you sweat.

    This is not an issue experienced by everyone but those who do experience it will notice that these side effects go away after a week or two. Once the body has adapted to the state of ketosis it will stop “leaking” ketones through breath and sweat.

    In some cases however, the effects might persist and for these cases, here are some possible solutions:

    1- Drink plenty of water and have enough salt: during ketosis you will often have dry mouth due to the initial dehydration. A dry mouth does not have saliva to wash away the bacteria producing the odour, so make sure you drink enough water.

    2- Keep a good oral hygiene: brush your teeth at least twice a day. That won’t stop the acetone smell associated with ketosis (that smell comes from your lungs) but at least it will not be mixing with other smells.

    3- Use a breath freshener regularly: this should help mask the smell.

    4- Wait for the smell to subside: as mentioned, in most cases the smell is temporary and should subside after a week or two.

    5- Reduce the degree of ketosis: if the smell is not going away and you want to get rid of it, the alternative is to reduce your ketosis levels by introducing more carbs in your diet. You would probably be looking at 50-70 grams of carbs per day. Naturally this will throw you out of ketosis and you may sense an impact in your weight loss and other benefits, but for some this can still do the trick. Another option is to be on the 50-70 grams of carbs per day and add some <link intermittent fasting> to the mix. This could get you roughly the same results without the smell.

    Heart palpitations

    It is not uncommon to experience a slightly elevated heart rate or a stronger heart beat during the beginning of your keto diet.  This is normal and generally not a cause for alarm.

    Generally the cause for this is dehydration and lack of salt. With a reduced amount of fluid circulating in the body, the heart will have to respond by pumping blood a little harder or faster to maintain blood pressure.

    The quick solution is to drink plenty of water and to eat enough salt.

    If salt and water does not eliminate the heart palpitations it can be due to stress hormones released to maintain blood sugar levels. This is generally temporary and lasts while the body adapts to a lower-carb diet. It should subside in a week or two.

    Important note if you take medication for diabetes or high blood pressure


    The keto diet greatly reduces the intake of foods that increase your blood sugar and therefore reduces your need for medication. Taking the same dose of the medication as you did before adopting a ketogenic diet might result in low blood sugar, which has as a symptom heart palpitation.

    Frequently monitor your blood sugar when starting the diet and adapt your medication as needed. This should be done with the assistance of a trusted doctor.

    <link Learn more about diabetes and the keto diet>

    High blood pressure

    While on a keto diet the high blood pressure tends to improve. This reduces the need for medication and your current dosage may become too strong leading to low blood pressure. This has as a potential symptom increased pulse and heart palpitations. Contact your doctor before commencing the keto diet and ask for advice on how to proceed regarding the medication.

    <link Learn more about blood pressure and the keto diet>

    Reduced performance in physical exercise

    When starting your keto diet you might notice a significant reduction of your performance in sports and physical exercise. The two main reasons for this are:

    1- Reduced levels of fluids and salts: This is generally the cause of most negative side effects experienced when starting keto, but it is especially perverse when trying to exercise. Try drinking a large glass of water with half a teaspoon of salt at least 30 minutes before training.

    2- It takes weeks for your body to adapt to burning fat: The second cause is simply due to your body going through a process of adaptation to the new fuel source. It takes time for the body to transition from burning sugar to burning fat. There is no quick fix for this and waiting for the adaptation to happen is your only remedy. However, you can generally speed up the process the more you exercise while starting your keto diet.

    Increased performance in physical exercise

    While transitioning into a fat burning state often reduces your performance in sports in the early stages, increasing evidence shows that performance is measurably improved in the long term. Many elite athletes are trying the low carb high fat (LCHF) diet with some measurable results.

    Athletes in activities such as marathons and other endurance sports have seen the greatest benefits. The body’s fat stores are massive if compared to the minute storage of glycogen. This means that a fat-adapted athlete has access to a larger pool of fuel for its activities and can go for longer without needing to replenish energy. This enables the athlete to divert more blood to muscles rather than having to use that blood for activating digestive organs during the exercise. An additional benefit is the reduction in body fat, which makes the body lighter helping the exercise.

    Elevated cholesterol

    Good news: studies<link> have shown that a low-carb-high-fat diet results in an improved cholesterol profile, which is closely associated with a lower risk of hear disease.

    Usually on a low-carb diet such as the keto diet, the person will see a slight elevation on cholesterol levels. That is in part due to the elevation of the good HDL cholesterol, which is beneficial in reducing the risk of heart disease. The cholesterol profile also improves due to lower triglycerides and larger LDL particles.

    However, it is recommended that you run regular blood checks on your cholesterol levels. A small number of people (about 1-2% of the population) may see a worrying increase in LDL and total cholesterol probably due to genetics. It is always a good idea to monitor your cholesterol while on a keto diet.

    What you can do to improve your cholesterol:

    1. Stop drinking bulletproof coffee: stop adding butter or MCT coconut oil to your coffee.
    2.  Intermittent fasting: consider doing some intermittent fasting <link intermittent fasting>. It has been shown to consistently reduce cholesterol levels.
    3. Use more unsaturated fats: opt to eat unsaturated fats such as olive oil, fatty fish and avocados. This should help lower your cholesterol.
    4. If all of the above fail: then perhaps you need to consider whether to switch to a more moderate diet (e.g. 50 – 100 grams of carbs per day). This will likely lower your cholesterol. But remember to choose good sources of unprocessed carbs and avoid things like wheat flour or refined sugar.


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