Do you have the Ketosis Flu?

This topic contains 26 replies, has 17 voices, and was last updated by  ClaiduaG 7 years, 4 months ago.

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  • I wasn’t sure which section I should post this in, my strategy is what I call the 4–2–1 plan, I fast 2 day non consecutive days a week, eat a low carb but not calorie restricted diet 4 days a week to keep the fat burning benefits of ketosis going and then I give myself 1 day a week to indulge and eat whatever I want, usually a Saturday pasta dinner and wonderful dessert. I also walk 4 to 6 miles a day during the week and 10 to 12 miles on Saturday.

    Low Carb plans such as Atkins can be very effective for some people including me, many people who start a low carb diet experience get what’s called the “ketosis flu” or the “induction flu” in the first few days while the body is adapting to burning ketones instead of glucose.

    The basic symptoms are:
    – Headaches
    – Nausea
    – Upset stomach
    – Lack of mental clarity (brain fog)
    – Sleepiness
    – Fatigue

    It’s called the “ketosis flu” for a reason: you feel sick. I’ve gone through it and it wasn’t a pleasant experience. Fortunately it only lasted 2 days but then suddenly I woke up feeling much better, less hungry and my energy level was really high and consistent throughout the day!

    The first time I thought to myself: “What the heck am I doing? I feel like I’m going to die!” but I persevered and when it was over I didn’t regret a thing because what I had gained mentally and physically was 100% worth it.

    For those of you that are going through the ketosis flu, don’t give up! I know you feel like it’s never going to get better but stick with it and you´ll be so happy you did! I’m telling you, waking up refreshed for the first time in years, not getting the afternoon “blah” feeling and stuffing my face with carbs to try to boost my energy is the best side effect of the low carb diet I’ve experienced. Okay, losing weight while eating good food, feeling full and satisfied is great too.

    First you have to understand why your body is reacting this way. Your body’s been burning glucose for energy so it’s basically full of enzymes that are waiting to deal with the carbs you eat, but now the body needs to make new enzymes that burn fat for fuel instead of carbs, and the transition period causes the flu-like symptoms.

    There are some things you can do to lessen the symptoms of the ketosis flu and to make it go away sooner (to force the body to transition sooner) Ok, let’s get to the good part – what to do:

    First of all – you’re probably dehydrated. Drink PLENTY of water while you’re on a low carb diet, and then drink some more.

    Watch your electrolytes. When the body is getting rid of excess insulin from your former carb-crazy diet you´ll lose lots of fluids that have been retained in your body. This causes the rapid weight loss most people see in their first few days of ketosis, it’s mostly water, sorry. When you lose all the retained water you also lose electrolytes like sodium, magnesium and potassium. When you’re lacking them you´ll feel like crap so when you’re feeling really ill on the ketosis flu try things like chicken/beef broth and look for foods rich in these minerals. Take a multi-vitamin and a multi-mineral.

    Ok, here is where people throw the red flag – Eat more fat – Yup, I said MORE fat. Have some butter, just not on a roll, eat some bacon and eggs for breakfast, just skip the potatoes and toast. This will force your body to hurry up the transition. You´ll think this is crazy and think you´ll never get lose weight eating this way, but you will.

    Don’t eat too much protein – The body can transform protein into glucose so if you eat too much of it in the first days it will slow down the transition. Go for fatty meat and cheese if you can, add fat to protein shakes etc.

    Drink water, replenish electrolytes (sodium, magnesium, potassium) with food and supplements, drink broth, eat fat and not too much protein.

    I hope this helps, and have a great day


    ” Take a multi-vitamin and a multi-mineral.”

    I have been forgetting to take a multi-vitamin on fast days. Thanks for the reminder.

    “Eat more fat – Yup, I said MORE fat. ”

    I will have avocado more often.

    Thanks for that info, very interesting

    Please help!! I am a newbie on this site, but I have been doing the 5 2 for 9 weeks.
    I have lost nearly 4 inches off my waist and 4 off my hips. I dont weigh myself often but I am at 71 kgs now. I am post menopausal, and I couldnt loose weight with any other diet, so I am delighted with this. But I have one big problem….exhaustion! I am so so tired even on feast days. I am tired all day. In the beginning I had lots of energy.
    Whats going on? I thought I was supposed to burn fat for energy? On non fast days I eat up to a max of 1850 cals which is my allowance at 5 ft 4 ins. I stick to 500 on fast days and distribute the cals through out the day. I eat mostly low carb healthy stuff on feast days. I cycle a couple of times a week for one hour. I get loads of sleep. Am I doing something wrong? Others report a boost in energy on the 5 2!! I am a bit worried now!!

    Oh by the way my 2 fast days are non consecutive!!

    I suggest a trip to the doctor and perhaps get your thyroid levels checked.

    I am always more tired on a fast day and usually go to bed early, but feel fine the rest of the time. I have never had this surge of energy on a fast day either.

    Thanks Annette. Exhaustion would suggest hypo active thyroid and weight gain? Yes maybe you are right. But I had my thyroid checked about 9 months ago. Maybe it should be checked again. The problem is that I am away in SE Asia, and I dont want to get checked here due to language difficulties. I can wait till I go home in July I guess. I will have to be exhausted till then! Ha!
    Its understandable that someone could be tired on 500 cals, but exhaustion on non fast days dosent seem right.
    I have always been healthy and Im not taking any medication , so medication is not a factor. It would be nice to feel that surge of energy they talk about, wouldnt it?

    Try to get some iodine and tyrosine in your diet daily as well. They both help with thyroid health. Also if you’re feeling a bit weak, try some salt (preferably iodised sea salt) to regulate your blood pressure when in ketosis.

    So I believe that everyone here has all the correct tools for a strong keto diet. Blood sugar tester and strips blood ketone tester and strips and keto sticks. You probably already use lots of coconut oil and or MCT oil. You have a multi mineral and multi vitamin and a pack of your favorite bullion flavor: chicken, beef or vegy.
    Now for folks that are new to this life style you will not be able to jump into a 5:2 or CKD Cycled Ketogenic Diet until your body fully adapts. This means getting over the keto flu. If you start a CKD format right away and you never get flu chances are you were never in ketosis to begin with. The average person can get into ketosis in about a week however fully adapting can take about three months.

    Being keto adapted is a state where the person can start to cycle in a meal or a day of carbs and be able to successfully enter back into ketosis quickly within 24 to 48 hours. The return time to ketosis is very different from person to person and it is based on a number of physical and physiological points. This brings light to the fact as to why folks here fast for two days. Fasting plus an explosive physical workout will lower blood sugar very quickly.

    If you are getting keto flu for the first time stay with it, it will pass after about 3 to 4 days. If you are using CKD and continue to get the flu when returning to ketosis you need to take a closer look at your diet. Before you go jumping into thyroid meds and treatment witch can be very dangerous and you should follow your doctor’s direction not the folks here. Before you panic about your thyroid look for issues with simple corrections; things like electrolytes, vitamins and minerals are very important because the flush AKA diarrhea will strip you of the nutrients you need to make it through the day. I think you should keep the carbs low and up your fats i.e. coconut oil. In addition one of the sugar / carbs you are eating on your “cheat day” could be sending you back to square one.

    Using your blood glucose meter will tell you what foods push you too far out of ketosis on your cheat day. I find that french-fry’s blast me to a glucose level of 100 – 105 and it takes 3 days to recover I repeat all the flu symptoms and feel like poopoo. Note it is proportional I can eat some fries like 3 steak fries to stay under 95. I find that if I pass a level of 95 I get the short I cycle over one meal with a (1) small sweet potato. If I want the carbs over several meals I cut the sweet potato into thirds or I have 3 meals with a ¼ cup of sticky rice. My blood sugar never goes over 88 if I follow this to the ‘T.’

    The definition of ketosys is to burn b-hydroxybutyrate-acid as your body’s main source of fule rather than glucose. That said a person who is not keto adapted will experience a blood sugar spike after an intense workout almost exactly like having a full meal. This is sugar stored and produced in the liver. Folks like to believe that it is there muscle wasting away however this is simply not true. In order for muscle waste to happen you have to have experienced concentration camp style starvation or have muscular diseases. This means that during your diet days “70-80% fat, 3 -5% carbs you should actually experience the paradox you sugar should fall and your b-hydroxybutyrate-acid should spike after your workout.

    I really hope this was helpful for you I know it’s coming in a year late. I went through the same thing when I started the keto life style and its many flavors. I was zonked by 2pm. Coffee was my only hope to drive home before catching nearly 10 hours of sleep. This went on till I upped my salts and potassium and minerals. Most of which can be found in a simple bullion and spinach or supplement.

    Good luck!

    I heart this entire article!!
    I’ve been looking for an explanation and this is exactly how I got thru this and will never go back!! I have happy euphoric energy everyday all day, sleep about 6 hrs a night and have been symptom free from fibromyalgia, IBS, PMS, chronic fatigue syndrome and virtually pain free from my discs fusions a few years ago.
    I lost over 40 lbs but the health benefits are so much more important to me. So many friends have told me this is unhealthy lol but all my micronutrients are met thru supplementation and my macros are point on. I have the best cognitive function of most people I know, memory is incredible. Again, I love this encouraging post to keep moving forward.
    Thank you for this response!

    Hey I want to thank you all for telling me about the flu. I feel awful. I am disabled and I have been in the hospital a lot last year, I gained a lot of weight. I need to fit back into my clothes so I started low carb. I’m not taking any days off, however I have never felt so bad in my life. I stay on methadone and morphine for my disability. So much for my muscle spasm. But those all together if that will knock a person down. But is not helping the flu. Lol lol my stomach hurts I’ve got a raging headache and I’m so tired. But I want to say thank you all I already feel much better. Will I get the flu if I don’t take days off? Will this continue? I didn’t read all of the posts, cuz I have a bad headache. But I found you by asking the question why does low carb make you feel so bad. I was wondering if I don’t take the days off will I still have this blue? And why do you take the days off? I like this because you can’t cheat because if you do you go out of Kinesis don’t you? Anyway. Thank you again. Julie

    Hope you are feeling better Julie5600! Stick with the low carb to get through the flu faster, I don’t take any days off but will relax on the carbs a bit once I get to my goal weight. Once your body happily starts burning fat as fuel you will feel great!

    Very well written article, have been looking for this everywhere. Maybe one could answer a few questions, but I hope it will be one who’s experienced and knows.

    I do sports, I’m a dancer, I move a lot. I need food all the time. All symptoms explained- I’ve got them all. Not only once, every time I get in this ketosis state. I don’t know why I’m in it, I don’t see the point of being in it and I don’t know what to do about it.

    – What should I eat to get out of it.
    – I exercise a lot, should I do less or more when in ketosis, because I’m losing muscle very fast each time it’s happening and I don’t like it at all. It makes me crazy and I get negative and confused all the time. I don’t sleep because I worry about what’s going on with my body, I’m not doing anything on purpose at all and in my experience would not recommend doing it on purpose anyway, but that’s everyone else’s choice. Do I need more carbs, less protein and fat, or less carbs, more protein and fat, KNOWING that I don’t want to lose weight, but want to gain, muscle and fat. And never feel like this again.

    I am a 200lb phasic bodybuilder. I follow the ketogenic diet. My protein in take is 275 grams I keep my fat at 150 160 grams. I also use a potassium and salt blend on every meal. Totaling roughly 4 tea spoons a day. I find that if i go low on the potassium and salt I start to feel crappie. I also use 2 tablespoons of fiber 2 times a day as the additional protien makes your runny.

    Strong man John Anderson also uses keto to stay cut not ripped but cut and fit year round. Look him up on youtube it will motivate you.

    Good luck!

    I need to get out of this state, not stay in it and have diarrhea every day. But good that it works for you! And I’d like to use just food, no additives like extra protein shakes etc. My body wasn’t like this before, so I’d like to go back to “normal” and stay in a normal state where I can eat everything without being dehydrated every two weeks, loose so much water and muscle in my face and body- but whatever works for you is good and should stay like this

    Hi Molijer:

    Can’t even begin to help you unless you tell us what you are eating.

    Good Luck!

    Breakfast is pourridge, warm oats, apple, banana, fibers, flake seed, cinnamon, turmeric, honey and water, all in a pan or I warm up milk and throw everything in the blender and drink it. Lunch is steamed vegetables, whole grain rice or spaghetti or whatever whole grain pops up in my mind, cheese sprinkled, eggs, any Greek or Turkish yoghurt, herbs. Evening it’s meat (preferably not), fish or tofu, (sweet) potatoes, colored vegetables etc. When I’m in ketosis I don’t eat that much because I don’t feel like eating at all.

    Hi Molijer:

    If you are eating apples, bananas, rice and spaghetti it is doubtful you are in ketosis. But there is no good reason to be in ketosis anyway, so you have to answer why you want to do it.

    If you feel so terrible, just go back to what you used to eat before you started feeling so bad. Why eat a diet that makes you sick?

    Good Luck!

    Yeah, if only I knew where it started. First ‘episode’ was three years ago after a lot of stress. Last year I had three surgeries where after the last one I started feeling weirder and weirder. This is what I always have been eating with lots of variations in products. When I noticed I lost a lot of weight, I started eating more fat. Lots of peanutbutter and butter on bread, but it didn’t help.
    Why I want to be in it? No no, I don’t want to be in it at all, but since I’m in it every two/three weeks, don’t know why I’m in it and don’t know anyone around me who has ever experienced this, I’m stuck to Internet and articles and do my own research. I’m not using or doing any special diet. I prefer eating healthy over fried and candy.

    I have been to my doctor many times, I made another appointment just now again.
    My suggestion to anyone is to go check your blood as a reference for what you should or could eat, less or more. Mine was perfect except for a little high natrium, so it’s all very confusing. I peed on those sticks to see what will happen- nothing. Didn’t chance in color. I take magnesium to relax my heart- it doesn’t. My body is probably decomposing or something, hahah, that’s how it all feels.

    Anyway, thanks for your time. I’ll continue this journey open minded, because I’ve got no idea in which direction I should look.


    Hi Molijer:

    Only a guess, but given the high volume of grains and the fruits you mentioned you might look into a low FODMAP diet:

    Good Luck!

    Hi Molijer,

    I understand how frustrating this must be for you! It sounds like you’re eating an incredibly healthy diet but perhaps it doesn’t make up enough energy to sustain the amount of exercise you do. It sounds like you are a lot more active than the normal office worker gym goer and so you need a lot to fuel yourself.

    In short, insulin is the most androgenic hormone found in the human body – the more you have floating around, the easier it is for you to gain weight. Thats bad news for anyone looking to lose weight, but for someone looking to gain, you should use it to your advantage. Carbohydrates produce the most insulin, then proteins and fat produces a minimal amount if any. Everyone needs an essential amount of fat and protein in their diets, and for you, because of the amount of exercise you do, the amount of protein you’ll need is higher than the normal person. So you want to be aiming for around 1.5-2g of protein per kg of body weight. Fat you’ll want to get about 30% of your total caloric intake from, and the rest should be carbohydrates (if you’re super active and looking to gain weight). To work out how many calories you should be eating in a day, consider using a calculator like iifym (it’s a website that should have a free calculator that considers your daily activity levels, age, weight etc).

    If after eating enough calories per day to maintain/gain weight, you’re still struggling with these episodes, then see your doctor about gastrointestinal problems such as Small Intestinal Bacterial Overgrowth, or even a worm that could be stealing all of your energy.

    (p.s. the FODMAP diet that simcoeluv suggested is a way of treating some gastro issues!)

    I hope this helps!

    Hi and thanks. It surely helps, as well for my knowledge. I think I might have found the reason of my strange symptoms in combination with the thought that it could be something with or in my colon. It could be that my thyroid is overworking, for years and actually got activated during the recovery of my surgeries. I used to dance 10+ hours a day and my body was used to a certain rhythm. When you suddenly quit to rest, your immunesystem reaxts, because you keep on eating, the histamine in your body thanks to the anesthetic is enourmous and the liver is overworking. I’m running some tests at the moment if it’s hyperthyroid. I don’t have another explanation or really should full multi culti super detox everything. Hahah maybe I should anyway.

    Thanks for your words, ill read them again and the fodmap ill take with me too.

    Warm regards,

    So if the body reacts this bad on the transition from glucose to ketones, Wouldn’t you have the Keto Flu every Sunday transitioning back in after cheat day burning back glucose?

    Very curious to know your thoughts.

    Kind regards,

    Ryan Tozer.

    Dear Ryan

    It’s a medium to long term bodily condition (unless of course you are literally being starved) It’s like a ship – it used to takes 3 – 5 miles in reverse to stop a ocean cruise liner! Minor adjustments in your daily food intake – your body just levels out ….. It takes typically 1-3 months or more of low carbing before this Ketosis condition arises but daily tweaks do nothing or little in the overall condition but can level out the bodies condition and how you feel …

    Dear Martin (Molijer)

    Being someone who periodically on a low carb diet suffers from Ketosis Flu I wonder how you conclude you suffer from Ketosis? Further and more relevantly how does somebody who doesn’t want to lose weight keep losing weight?

    Ketosis Flu only results from a bodily position where the net carb intake (over time – usually over 1-3 months) is insufficient to power the daily energy needs of the body thus ‘forcing’ the body to process its fat reserves. Your base point is to monitor and cross check your Calorific intake. Today you can more easily get smart phone aps to do this. In your case I would definitely spreadsheet it and monitor it over a long period of time only to rule out and concur your facts with how you feel.

    Assuming your Calorie intake is below the daily norm for a male of your height and weight and activity levels you should raise both your fat and carb intake. If you do not like food or can only tolerate low carb foods I would suggest you supplement your diet with a natural organic ice cream product. Two scoops at lunch time. It is important as an active person during the day that you load your carb fat intake at lunch time and do feed your body energy at breakfast. Adding the ice cream to a milk shake or body builder protein shake could be good for you. In addition try supplementing your diet with B12 energy complex vitamins. People over a certain age or with weak stomachs or diet can suffer from poor food absorption. Martin don’t expect immediate responses to your Ketosis state – your body got there in longer term and it will take or can take time for it to react or stabilise.

    If you read the original authors comments you will decipher that the bodies reactions to resorting to fat reabsorption as energy intake is something it resists initially (these are like our gold reserves – precious and we don’t give them up easily – which is why true dieting can be sluggish). Once the body starts to give up those fat reserves its in that ‘mind set’ and it’s not like a Tap you can just switch on or off!! It will say to itself – “hey lets stop burning carb sugars for a while let’s burn fat instead or at least until we see those carb sugars are back in ready stable supply” In a sense Ketosis Flu is like a shock wave to switching over to the the fat fuel. Its impact varies from individual to individual but it can be dramatic and leave about 20-30% of us feeling very ill. Once you get through the shock wave – about 1-2 months later the body tends to stabilise. It also adapts better to switching from one fuel to the other and more responsively so, although mini bouts of Ketosis flu can result getting lesser with time……

    Martin assuming your calorific intake is normal and your condition is not Ketosis Flu some other options for your condition are ;
    -.lack of Vitamin B12
    – Iron deficiency or too much iron (careful here)
    – low grade early stage cancers (blood tests)
    – stomach and colon complications (specialists)
    – toxic poisoning (check cooking utensils or sources)
    – cigarettes & alcohol (highly toxic with age – quit for good both!)
    – wheat intolerance (remove bread from diet)
    -.diabetes (insulin level problems)
    – tape or worm infestation
    – repetitive viral infection (clean home & everything)
    – thyroid problems

    You don’t say much about what your actual diet is, your age, whether you are a drinker or smoker and your background. A detox is essential every year as is a period of 2 – 4 week fasting. Foot patches for me work best as an effective detox and oral or diet detox work well as a kick start. As you state blood tests can pick up most things.

    Reading between the lines something doesn’t stack up for you but generally if you are eating well and to your correct calorific levels but you are still losing weight or going into Ketosis then the only other conclusion is that you are ill fighting something, have worms or you have so much nervous tension you are stressed – how’s your stress & sleep quota?

    Beyond this write down everything and go and see a medical specialist – ask for a referral from your GP. Don’t sit on it any longer – it’s a good indicator or possible sign of background illness!

    The main post above is a duplicate of one written five years ago, found at this website:

    This article was copied, without giving credit to the original author.

    Thanks MathWiz & others here.

    Well, it’s 6am and I’ve been awake for 4 hrs with a banging headache and awful nausea, again! So while I drink my water like a good girl (3 pints) and wait for the multi vits and salt to enter my blood stream, I thank God for this post!

    I initially found it a year ago, when I was going through the same awful type of ketosis flu night as tonight. I followed the instructions, thinking that “no way could water fix THIS,surely I need to be hospitalised?”, and of course it did work, totally.

    Sipping 2-3 pints patiently over half an hour did the trick, and put me on the path of loosing shed loads of weight. Now I’m back, I’ve decided to go all the way to as near to perfection as I can, obviously without loosing any important wobbly bits. Low carb works. Its not easy at first, there can be a few days over the first week or so where you seriously just want to die, but after that its amazing!!!

    I go low, stay low and work hard. If I have a carb day its never before 4 weeks in ketosis, and even then I dont overdo it cos it makes me feel sluggish. I take fiber for my bowel health, drink loads of water and make sure I take my vitamins ect.

    The rest? Your body does it all for you, you can not fail, its impossible. I am in my 40s and feel like a completely new person. My energy is high, blood pressure low and my figure is better than when I was in my 20s. If a lazy old cow like me can do this, anyone can.

    Good luck out there people! Snd thank you all for the much needed advice.


    Forgot to mention fasting, because really, when I’m in ketosis it just happens naturally. If I wake up not hungry, which is once, sometimes twice a week, I just go with the flow without even thinking about it.

    It feels natural. I have a black coffee if I need a boost and drink plenty of water, but my energy and feeling of wellbeing doesn’t decrease. I find it helps aid weight loss and my digestion gets a break.

    It’s not weird at all and actually seems to help. I think the key thing with fasting is to not force it or think about it and just let your body do its thing. It knows what to do already.

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