I receive a lot of email and Facebook messages with questions about keto, so I thought I’d share them here with you. Because if one person is asking, likely 100’s (or more) have the same question.
**This information is for educational purposes only. Before beginning any supplements or dietary changes, consult your doctor or qualified healthcare professional, especially if you are taking any medications.
Do I Need to Supplement with Potassium or Magnesium on a Keto Diet?
“I have used potassium for years to avoid the dreaded low-carb leg cramps, but I heard somewhere that magnesium was another option. I was wondering what your experience has been?”
Leg cramps can be caused by either low potassium or magnesium. Some people on a low carb, Atkins, or ketogenic diet experience leg cramps and this is most often because they don’t know about the requirement to supplement with sodium. Low carb diets are very diuretic (makes you pee a lot!) and with this, it can cause your kidneys to lose too much sodium. With the loss of sodium, it can also cause an imbalance in potassium and other electrolytes.
One of the things I cover in my 90 Day Keto Challenge Program are various micronutrients (vitamins and minerals), that are important for long-term health and how to get enough of them on a keto diet. Along with the importance of sodium supplementation, two of the minerals I cover are magnesium and potassium.
Sodium
I think of sodium as our master electrolyte. Always start here with supplementation before considering adding magnesium and/or potassium. When you are consuming adequate sodium, it preserves potassium and magnesium in the body.
When you are consuming less than 60 grams of carbs per day, it is essential to supplement your diet with 2 – 5 grams of sodium, which is equal to 1 – 2.5 teaspoons of of table salt or sea salt. Just salting your food liberally will not get you there! I have my clients measure out at least 1 teaspoon per day (I do this, too) and do 1/2 teaspoon of sea salt in water in the morning and repeat again at the end of the day.
Magnesium
The Recommended Dietary Allowance (RDA) for magnesium is 310 mg (women) or 320 mg (men), however under certain circumstances, like stress or illness, some people may need as much as 900 mg per day. The best sources of magnesium on a low carb or keto diet (per 100 grams):
Hemp Seeds 489 mg
Almonds 276 mg
Fish, salmon 122 mg
Spinach 80 mg
Avocado 30 mg
Broccoli 20 mg
Potassium
There is no RDA for potassium, only a suggested Adequate Intake (AI). Most of the U.S. population consumes about 2,500 mg of potassium per day, but the AI is set at 4,700 mg per day. The recommended amount was set based on reduction or elimination of sodium sensitivity, high blood pressure, and minimize kidney stones. However, since these symptoms go away for almost everyone following a ketogenic diet, I wonder what the adequate or optimal intake of potassium is for someone following on a keto diet. For this reason, I recommend that my clients start with sodium supplementation, then add magnesium if they are still experiencing muscle cramps, and then add potassium as a last resort (or if they aren’t eating anything green, no nuts or seeds, nor any fish or seafood).
A cheap form of potassium supplementation is Lite Salt or Nu Salt. It is about 50% sodium chloride and 50% potassium chloride, so by supplementing 2 teaspoons of this per day, you get sodium and potassium.
Best sources of potassium on a low carb or keto diet
1 avocado 689 mg
150 g salmon 658 mg
1.5 cups chopped broccoli 431 mg
2 cups spinach 334 mg
1 ounce hemp seeds 253 mg
1 ounce almonds 202 mg
Do I Need a Probiotic or Resistant Starch Supplement on a Keto Diet?
Supplementing with probiotics and/or resistant starch on a keto diet, for most people, is unnecessary. We do have a lot to learn in this area though, because the field of research about probiotics is relatively new and we just don’t have a large enough body of research specific to a ketogenic diet and the microbiome of our guts to draw upon.
There are tremendous changes that occur in the body as a person adopts a very low carb, moderate protein, high fat diet, and many of those changes happen in the gut. It is surprising to a lot of people who embark upon a gut healing protocol that it takes at least a year, and up to two years or more, to fully heal the gut. Most people on a keto diet experience various symptoms of digestion and elimination as their body adapts to the diet and begins to heal the gut, including diarrhea and/or constipation. While there are things that can help short-term with these symptoms, I encourage my clients to be patient with their bodies and allow it the time it needs to reorganize, recolonize, and regenerate the tissues.
I asked Dr. Adam Nally about his experience with and opinion of probiotic supplementation for people on a ketogenic diet when I recently sat down with him for a Keto Chat:
One of the key messages he gave us was that if you are eating plenty of saturated fat (which feeds the small intestinal bacteria) and leafy greens (which feeds the bacteria of the colon), then for most people, supplementing with resistant starch or a probiotic is not necessary.
What Resource Do You Recommend for Ketogenic Diets for Children?
The first place to look is The Charlie Foundation. They offer information and support for ketogenic diets for Alzheimer’s, autism, brain tumors, cancer, epilepsy, Lou Gerhig’s disease (ALS), mitochondrial disorders, Parkinson’s, traumatic brain injury, and more.
Do seasonal allergies torment you? Are you hyper-reactive to bug bites? Do you have chronic nasal congestion? After eating, do you need to clear your throat, have heartburn, a headache or feel tired? You may be experiencing histamine overload.
Signs and Symptoms
The following are common signs and symptoms of histamine overload:
Itching – especially of the skin, eyes, ears, and nose
Hives
Swelling – especially of the face and mouth and sometimes the throat, the latter causing the feeling of “throat tightening”
Drop in blood pressure
Increased pulse rate, “heart racing”
Anxiety or panic attack
Chest pain
Nasal congestion, runny nose, seasonal allergies
Irritated, watery, reddened eyes
Headaches
Fatigue, confusion, irritability
Digestive upset, especially heartburn, “indigestion”, and acid reflux
What is Histamine and Why is it Making Me Miserable?
We get histamine from two sources: 1) our bodies make it and 2) from food.
#1 Histamine has several essential functions in our body. It is a neurotransmitter (sending messages between nerve cells) and it is necessary for proper stomach acid production. It is also involved in blood vessel and muscle function. And probably it’s most well known role is as part of our immune system.
#2 Normally food histamine is not a problem for people, however there are certain circumstances when histamine from food will cause someone problems. As food ages, a naturally occurring compound (histadine, an amino acid) gets converted into histamine. The longer a food ages, the higher the histamine content.
When does histamine become a problem? Our bodies have two mechanisms for breaking down histamine so that we don’t get overloaded with it. Some histamine is good, but too much causes the symptoms listed above that make you feel miserable. Histamine intolerance generally develops over time due to an impairment in the way our body breaks down histamine; our body literally gets overloaded with too much. In order for your body to be able to clear out this overload and allow it time to empty this overflowing cup, you will need to give you body a break from food histamine.
What Foods to Avoid
For anyone experiencing histamine overload symptoms, strict adherence for 4 weeks to a low-histamine diet is necessary since it takes time for the body to clear the excess and to determine if the symptoms they are experiencing are related to histamine. After 4 weeks, small amounts of histamine may be tolerated depending on the person, but individual sensitivity varies. Additional measures, such as healing the digestive system may also be necessary for symptom relief.
An important thing to understand when you want to reduce food histamine is that most fresh foods have very little or no histamine. However, as food ages, histamine is created as the proteins begin to change over time. Therefore, you will want to eat only freshly prepared foods; avoid anything aged, cultured, fermented, canned, bottled, smoked or leftover. Freezing halts histamine production, so if you have leftovers, freeze them immediately. This means you will need to prioritize time to prepare fresh food at each meal and/or prepare meals and then freeze them for later.
AVOID the following for 4 weeks:
Cultured and aged dairy products – yogurt, buttermilk, kefir, all cheese
Processed, cured, canned, pickled or smoked meat, fish or seafood
Egg whites (egg yolks are OK)
Fruit – Citrus (oranges, lemons, limes, grapefruit); Berries (blueberry, blackberry, raspberry, cranberry); Stone Fruit (apricot, plum, peach, nectarine, cherry, prune); Other Fruits (banana, pineapple, dates, grapes, currants, papaya)
Vegetables – avocado, green beans, eggplant, pumpkin, spinach, sweet potato, packaged salad mixes, pre-cut or peeled vegetables, tomatoes
All of the following foods are low in histamine and/or contain special compounds that reduce histamine production in your body. Eat them freely for 4 weeks.
Fresh or frozen fish, poultry, beef, seafood (must be freshly caught and cooked, or prepared from frozen)
In addition to modifications to your diet for 4 weeks, your healthcare practitioner will likely work on supporting healthy digestion and may recommend the following supplements. Consult your healthcare provider for dosage.
