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Old 07-19-2013, 09:59 AM   #1
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Trying this again after palpitations -- need advice!

Hi everyone. I was on here last November, but I discontinued my attempt after I started having pretty severe palpitations that were waking me up in the middle of the night, along with lightheaded/dizziness. I'm not sure it was the ketosis because some other things were going on at the time, but I decided that it was not the right time to put my body through the stress of keto-adaptation.

Now I'm back for another try (I was inspired by JM's recent podcast on the cognitive benefits of ketosis). I was wondering if anyone has any advice on how to avoid the possibility of palpitations because of electrolyte issues.

I am trying to cut the carbs down sort of gradually, and I am having the cup of salty broth every day as recommended. I am not sure if I should take potassium, because I don't want to upset my electrolyte balance.

If anyone has any thoughts on other things I could do to make sure my adaptation goes smoothly, I would greatly appreciate hearing them!
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Old 07-19-2013, 10:31 AM   #2
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The advice is for 2 cups of salty broth and that is as a minimum. Congrats on your return to ketosis!!! You are about to get smarter!
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Old 07-19-2013, 10:38 AM   #3
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Anjikun, another vote here for salty broth. I make bone broth, and find I really notice that I feel better when I drink it every day, or use it for cooking broth.

Also, if you can pick up a copy of Dr. Atkins', Vita-Nutrient Solutions, he has some good recommendations for supplements for keeping the heart rate steady and normal.

I take a pinch of L-Carnitine and of Acetyl-L-Carnitine in the morning, and also EPO, E, as well as taurine and magnesium. Those all help keep the heart rate steady and even for me.

You could eat avocados for potassium, if the bone broths are not enough.

I cut out things gradually, and found that worked well for me. I wish you all the best!
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Old 07-19-2013, 12:35 PM   #4
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Originally Posted by Anjikun View Post
Hi everyone. I was on here last November, but I discontinued my attempt after I started having pretty severe palpitations that were waking me up in the middle of the night, along with lightheaded/dizziness. I'm not sure it was the ketosis because some other things were going on at the time, but I decided that it was not the right time to put my body through the stress of keto-adaptation.

Now I'm back for another try (I was inspired by JM's recent podcast on the cognitive benefits of ketosis). I was wondering if anyone has any advice on how to avoid the possibility of palpitations because of electrolyte issues.

I am trying to cut the carbs down sort of gradually, and I am having the cup of salty broth every day as recommended. I am not sure if I should take potassium, because I don't want to upset my electrolyte balance.

If anyone has any thoughts on other things I could do to make sure my adaptation goes smoothly, I would greatly appreciate hearing them!
My advice is to keep your carbs under 20 grams, don't eat too much protein, and add your calories into your diet in the form of fat. Also add extra salt to your diet. I use Hymalayan salt.
Carolyn
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Old 07-19-2013, 01:32 PM   #5
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Magnesium. RDA is 320 mg for women, 420 for men.
I supplement 250 mg daily.

Also, potassium balance supports magnesium levels AND can impact heart rhythm, so I'd supplement for that. Mayo Clinic advises getting 1600-2000 mg from all sources (food and supplements). Since it appears in a lot of foods, about 400 to 500 mg per day from supplements is good for most folks. If you skip your veggies and/or don't eat seafood, you need more supplementation.
And since potassium levels are impacted by salt, I shoot for at least 3000 mg sodium and feel that 4000-5000 mg is better for me.

If you're a heart patient or are on blood pressure meds, talk to your doctor first.
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Old 07-20-2013, 05:06 AM   #6
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Thanks everyone for your advice.

I am nervous about supplementing potassium because I know the balance is important. I'm afraid that I could get too much. Does anyone know if too much potassium causes palpitations, or just not enough?
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Old 07-20-2013, 05:34 AM   #7
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WebMD has a good write-up on excess potassium.
google it by searching for excess potassium symptoms

And here's a snipped version of what Phinney and Volek say about this stuff--this book is worth a read and is affordable in both paper and kindle formats.

Quote:
For nerves, muscles, and other cellular functions to work right, neither sodium nor potassium can deviate much from that of the other. With severe sodium restriction (like 1.3 grams per day, combined with the natriuretic effects of carbohydrate restriction), the body responds first by mobilizing any excess extracellular fluid (which is why bloating disappears) and then by contracting its circulating volume. It is this contracted circulating volume that causes dizziness, headache, and ease of fatigue. At some point, when confronted with this low sodium intake plus carbohydrate restriction, most people’s defense mechanisms can’t maintain normal mineral balances. So the body’s next level of defense is for the adrenal gland to secrete the hormone aldosterone, which makes kidney tubular cells excrete potassium in order to conserve sodium. That is, the body wastes some of its intracellular potassium in order to cling to whatever sodium it can. However unless there is copious potassium coming in from the diet, this excess urinary potassium comes from the body’s potassium pool inside cells. Two things then happen. First, nerve and muscle cells don’t work well, leading to cardiac dysrhythmias and muscle cramps. Second, because potassium is an obligate component of lean tissue, the body starts losing muscle even if there’s plenty of protein in the diet.



Phinney, Stephen; Volek, Jeff (2011-07-08). The Art and Science of Low Carbohydrate Living: An Expert Guide to Making the Life-Saving Benefits of Carbohydrate Restriction Sustainable and Enjoyable (pp. 149-150). Beyond Obesity LLC. Kindle Edition.
So the suggested potassium supplementation (400-500 mg daily, which is about 20% of RDA), is to prevent leeching potassium out of the muscles in case you get low on sodium (if you're out of sodium, the body robs potassium from the muscles).

And...
Quote:
When the human body adapts to a low carb diet, the kidneys fundamentally change how they handle sodium. Removing most carbs from the diet causes your kidneys to aggressively secrete sodium (and along with it, extra fluid). This is why many people experience a dramatic early weight loss with carb restriction. But this means that a continuous moderate intake of sodium is necessary to keep your circulation adequate to handle ‘heat stresses’ like hot weather, endurance activity, or even a hot shower. If you are eating less than 60 grams of carbohydrate per day, you need to purposefully add 2-3 grams of sodium to your daily intake (unless you are still taking diuretic medication under a doctor’s direction for high blood pressure or fluid retention). And if you do hard or prolonged exercise (enough to make you sweat), one of those ‘grams’ needs to be consumed within the hour before you start. At or above 60 grams per day of carbs, this prescription becomes optional. However if you go out planning to exercise for 30 minutes, but find you have to stop after 15 because you feel lousy or light-headed, try it the next time with a cup of broth within an hour before exercising and see how things go. Practically speaking, the easiest way to get this sodium is to buy standard bouillon cubes and consume 2 per day. They are cheap, compact, last months without refrigeration, and hot water is easily found. A more traditional path is to make your own meat or vegetable broth containing 1 teaspoon of salt per quart.

Phinney, Stephen; Volek, Jeff (2011-07-08). The Art and Science of Low Carbohydrate Living: An Expert Guide to Making the Life-Saving Benefits of Carbohydrate Restriction Sustainable and Enjoyable (pp. 240-241). Beyond Obesity LLC. Kindle Edition.
And magnesium is important.

A distressing number of otherwise healthy people have frequent muscle cramps, and in the worst case, a muscle cramp of the heart equals sudden death. Physicians don’t like to deal with muscle cramps because the only effective medication we had to stop them was banned in 1992 due to unacceptable side effects. Muscle cramps are the end result of many contributing factors, including overuse, dehydration, and mineral inadequacies. Low serum potassium is not uncommon in people with frequent cramps, so physicians often try potassium supplements. However there is a daisy-chain leading back from muscle cramps to low blood potassium to intracellular magnesium depletion. Low carbohydrate diets don’t cause muscle cramps per se (meat and leafy greens are good sources of magnesium), but neither do they miraculously get better on low carb regimens unless the underlying problem is dealt with. This is just one more reason why leafy greens and home-made broths (good sources of magnesium) are desirable components of a healthy low carb diet. So here’s the shortcut to ending most nocturnal or post-exercise muscle cramps. Take 3 slow-release magnesium tablets daily for 20 days. The proprietary brand-name product is ‘Slow-Mag’®, but there are a number of equally effective generics at a fraction of the brand-name price (e.g., Mag-64® or Mag-Delay®). Most people’s cramps cease within 2 weeks of starting ‘Slow-Mag®’, but you should continue to take the full 20-day course (60 tabs per bottle at 3 per day lasts 20 days). If the cramps return, do it again, and then continue taking one tab per day. If the cramps return, take 2 tabs per day. Most people can be titrated to remain crampfree by this method. Why use a more expensive slow-release magnesium preparation like Slow-Mag®? Because magnesium oxide preparations like ‘milk of magnesia’ cause diarrhea, passing through the small bowel before they can be effectively absorbed. WARNING: The only contraindication to oral magnesium supplements is severe renal failure (e.g., a GFR < 30). If you have any history of kidney problems or known loss of kidney function check with your doctor before taking Slow-Mag® or its generic equivalents.

Phinney, Stephen; Volek, Jeff (2011-07-08). The Art and Science of Low Carbohydrate Living: An Expert Guide to Making the Life-Saving Benefits of Carbohydrate Restriction Sustainable and Enjoyable (pp. 243-244). Beyond Obesity LLC. Kindle Edition.
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Old 07-20-2013, 10:19 AM   #8
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Originally Posted by Anjikun View Post
Thanks everyone for your advice.

I am nervous about supplementing potassium because I know the balance is important. I'm afraid that I could get too much. Does anyone know if too much potassium causes palpitations, or just not enough?
Potassium supplements only give you a little potassium. You get about 3 percent of your potassium needs per pill. Really a better way to add potassium is to eat a little bit of avocado each day. It is very high in potassium. If you need magnesium, and little cooked spinach or other leafy green will supply you with that.
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Old 07-21-2013, 06:43 AM   #9
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Emel, thanks so much for including excerpts from the book--this really clarifies things! I can see that as long as I keep my sodium intake up, I shouldn't have a problem (I usually eat lots of avocado). If I start having palpitations/lightheadedness, I will up the sodium even more and add potassium.

I have put the book on reserve from the library, so I should have it in a few weeks.

Thanks again!
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Old 07-22-2013, 09:36 AM   #10
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Originally Posted by Anjikun View Post
Emel, thanks so much for including excerpts from the book--this really clarifies things! I can see that as long as I keep my sodium intake up, I shouldn't have a problem (I usually eat lots of avocado). If I start having palpitations/lightheadedness, I will up the sodium even more and add potassium.

I have put the book on reserve from the library, so I should have it in a few weeks.

Thanks again!
I strive to get at least 3000 mg sodium from all food sources. I'm fine with 4000. I believe there has been no demonstrated benefit of more than 5000 mg.

Table salt, broth, pickles--lots of foods have salt in them, but we have to be mindful to include them daily because we rip through salt on this eating style.

Suggest you track sodium on an online food tracker until you get the hang of how much 'super salt' foods to have.
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Old 07-22-2013, 10:13 AM   #11
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I strive to get at least 3000 mg sodium from all food sources. I'm fine with 4000. I believe there has been no demonstrated benefit of more than 5000 mg.

Table salt, broth, pickles--lots of foods have salt in them, but we have to be mindful to include them daily because we rip through salt on this eating style.

Suggest you track sodium on an online food tracker until you get the hang of how much 'super salt' foods to have.
I am sure that homemade broth is good for adding salt and minerals, but pickles and olives have carbs that we must count. Cheese also has quite a bit of salt in it. But of course we have to limit that as well, because it also has carbs. How I add salt now, is to put a pinch on my hand and eat it. Then I drink some water. I do that about 3 times a day. Then of course I salt my food. A new study just came out that said people can eat up to 3 tsp of salt a day. And that limiting salt does not improve health. In fact diabetics need more salt than average to balance their blood sugar.
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Old 07-22-2013, 01:57 PM   #12
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I am sure that homemade broth is good for adding salt and minerals, but pickles and olives have carbs that we must count. Cheese also has quite a bit of salt in it. But of course we have to limit that as well, because it also has carbs. How I add salt now, is to put a pinch on my hand and eat it. Then I drink some water. I do that about 3 times a day. Then of course I salt my food. A new study just came out that said people can eat up to 3 tsp of salt a day. And that limiting salt does not improve health. In fact diabetics need more salt than average to balance their blood sugar.
Carolyn
I respect your right to do that, and I've been known to drink salted water when I was way below my sodium goals. But it was more of a medicine than a food that way. If I want a pickle, I'll have a pickle. I don't eat much cheese, cream, artificial sweeteners,nuts, flax, almond meal, breakfast meats or other non-veggie sources of trace carbs except for eggs and my beloved 1-2 tbl of soy-free ranch dressing. So there's room for a pickle in there because I am very rarely at my carb limit with my usual foods.

(I'll eat from the listed foods occasionally, but I don't pile a bunch of them onto one day's plan, other than eggs and my dressing. And sometimes cottage cheese gives me a higher daily carb count, but that's fine because I'm in OWL, not induction. I'm usually at about 18 total carbs per day).

Last edited by emel; 07-22-2013 at 01:59 PM..
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Old 07-23-2013, 06:23 AM   #13
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I am kind of splitting the different . . . taking some of my salt medicinally, so to speak, and incorporating more into the foods I eat. I am mindful of the carbs in broth, olives, pickles, etc. so the salt water supplementation is something I will continue as needed.
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