Keto and Arrhythmias

[Deleted member 106824]

I've been doing keto mainly for my IBD / gut issues and it seems to be helping in that regard quite a bit, otherwise I'd never bother with it. I'm not trying to cut, just maintain weight so I'm eating ~3500 calories.

It seems when I do keto though it really screws with my heart rate. My resting HR used to be ~50. On keto it's 60-75 but worse than that is these random periods where it's jumping up. I'll wake up and it's 80-100bpm. I'll get up from a seated position to get a drink or something and it feels like I just went up a flight of stairs and my heart is thumping.

Many people talk about electrolytes being off because of the diuretic effect of keto. I am loading up on salt though and drink a lot of water and it doesn't seem to be helping. I take an ARB (Valsartan) so I wouldn't want to take in a lot of extra potassium but I eat plenty of potassium containing foods (loads of spinach and avocado). Just started supplementing with magnesium as well but it doesn't seem to have made much of a difference.

I'd hate to stop the diet because it does seem to be helping me but this issue has been going on for over a month. It feels like my heart is constantly taxed and fluttery. Curious if anyone here has experience this and if they found a solution beyond just adding more electrolytes. I'm stumpted at this point and don't think it would be good to go on with it as is.

 

[Deleted member 106824]

For example sitting here on the couch right now after eating, barely moving at all, heart rate is 90bpm and I can very much feel it.

 

[M@NU]

i had something similar when i was put on TRT.
i did a lot of IF and as soon as i was put on TRT, i got these episodes.
I thouhgt that the cause might be a blood sugar drop due to Trt or something like this..
I stopped doing IF and after a while it went away

 

[jeroendebleser]

If your (out of the ordinary) diet is causing you these issues, I would be off of it asap. Just sayin'

 

[Stewie]

Try upping your hydration. Unfortunately, ketogenic dieting can lead to dehydration. Even mildly dehydration will increase HR. And in some cases, palpitations.

 

[Deleted member 106824]

If your (out of the ordinary) diet is causing you these issues, I would be off of it asap. Just sayin'

I don't enjoy doing keto, but it really seems to help my GI issues. If it didn't, I'd drop it right away but right now it seems to be helping control it and if I can't control it with diet then the next step is some really harsh medication.

Try upping your hydration. Unfortunately, ketogenic dieting can lead to dehydration. Even mildly dehydration will increase HR. And in some cases, palpitations.

Hey man. Do you think this is the only / most likely cause? It seems that's what most people say, dehydration and lack of electrolytes. I feel like I'm drinking a ton though and taking in a lot of sodium, as well as recently adding magnesium which hasn't seemed to help.

I would add potassium as well but am cautious about that since I'm on Valsartan.

 

[NEMSZ]

Are you having big meals? Having a large meal on its own can raise heart rate.. Your body has to digest all that and heart rate goes up when it goes to work... I used to eat HUGE meals in one sitting until I couldn’t fit another bite and then it actually started bothering me and feeding my anxiety and I had to look it up lol now with smaller meals and I don’t feel any raise in HR..

 

[BoredStiff]

It's actually quite common, you deplete a lot of water and in turn a lot of minerals. You drink your gallon of water, or whatever, a day and you deplete that even more. Salt is your friend on ketosis.
Try adding a teaspoon of himalayan pink salt and a 1/4 teaspoon of creme of tartar (loaded with potassium) to your large jug of water if you carry one, or you could buy electrolyte packets if you prefer.

I feel ya. I'm not a huge keto fan but it's the only thing my stomach seems to like, I don't tolerate carbs well at all.

 

[maldorf]

Are you having big meals? Having a large meal on its own can raise heart rate.. Your body has to digest all that and heart rate goes up when it goes to work... I used to eat HUGE meals in one sitting until I couldn’t fit another bite and then it actually started bothering me and feeding my anxiety and I had to look it up lol now with smaller meals and I don’t feel any raise in HR..

Very true. With my heart failure I am constantly fighting to stave off arrhythmias. It is a daily even for me. I find that eating a big meal can really mess me up bad. Another thing is taking in too much sugar. Too much salt is another big trigger for me.

The antiarrhythmic I take, Mexiletine, it works by blocking sodium channels. https://en.wikipedia.org/wiki/Mexiletine

Sometimes if I can myself into trouble by eating too much sodium in a meal I take a small bit of the powder under my tongue and let it absorb. Makes things better in under 30 minutes usually.

 

[Pissbrainiac259]

Try upping your hydration. Unfortunately, ketogenic dieting can lead to dehydration. Even mildly dehydration will increase HR. And in some cases, palpitations.

Not bad Stewie, not bad at all. In nutritional biochemistry, 1 gram of carbohydrate attracts ~2.7 grams of water by weight. Less carbs in the body = less total body water = varying levels of dehydration = [see below]

1) mild hypovolemia = some degree of electrolyte abnormalities = possible cardiac arrhythmia(s) +/- premature ventricular contraction(s) (PVCs)

2) increase cardiac output via increase HR to maintain adequate systemic blood perfusion

 

[Pissbrainiac259]

Hey man. Do you think this is the only / most likely cause? It seems that's what most people say, dehydration and lack of electrolytes. I feel like I'm drinking a ton though and taking in a lot of sodium, as well as recently adding magnesium which hasn't seemed to help.

I would add potassium as well but am cautious about that since I'm on Valsartan.

The following statement could potentially save your life one day: DO NOT blindly start ingesting or administering potassium supplements while on an ARB or an ACEI.

 

[maldorf]

Not bad Stewie, not bad at all. In nutritional biochemistry, 1 gram of carbohydrate attracts ~2.7 grams of water by weight. Less carbs in the body = less total body water = varying levels of dehydration = [see below]

1) mild hypovolemia = some degree of electrolyte abnormalities = possible cardiac arrhythmia(s) +/- premature ventricular contraction(s) (PVCs)

2) increase cardiac output via increase HR to maintain adequate systemic blood perfusion

Yeah, the response is very similar to when a person is loosing blood volume to bleeding out. Baroreceptors in the arteries pick up the change in pressure.

 

[Deleted member 106824]

It's actually quite common, you deplete a lot of water and in turn a lot of minerals. You drink your gallon of water, or whatever, a day and you deplete that even more. Salt is your friend on ketosis.
Try adding a teaspoon of himalayan pink salt and a 1/4 teaspoon of creme of tartar (loaded with potassium) to your large jug of water if you carry one, or you could buy electrolyte packets if you prefer.

I feel ya. I'm not a huge keto fan but it's the only thing my stomach seems to like, I don't tolerate carbs well at all.

Seems to be what everyone says. Like I said I use a ton of sodium and now add 500mg magnesium in addition to what I eat....but maybe I should try super loading sodium upwards of 10g for a few days to see what happens.

Again I'm hesitant to add anything with potassium due to being on the angiotensin receptor blocker

 

[Deleted member 106824]

Very true. With my heart failure I am constantly fighting to stave off arrhythmias. It is a daily even for me. I find that eating a big meal can really mess me up bad. Another thing is taking in too much sugar. Too much salt is another big trigger for me.

The antiarrhythmic I take, Mexiletine, it works by blocking sodium channels. https://en.wikipedia.org/wiki/Mexiletine

Sometimes if I can myself into trouble by eating too much sodium in a meal I take a small bit of the powder under my tongue and let it absorb. Makes things better in under 30 minutes usually.

See that's a concern of mine as well. I did keto in high school and college and never had these arrhythmias so the fact that I'm getting them now makes me wonder if it's related to my heart worsening. Though before I did a cyclical keto diet with big carb ups on Saturdays so I don't think I was nearly in the state of ketosis I am now if at all.

Also you say high salt does it to you but then the main suggestion when this happens on keto is to drastically increase salt intake lol.

It does seem to be more so after my meals (I have three 1000-1500 calorie meals per day but not always). The other night I woke up with ym HR around 100bpm.

 

[Deleted member 106824]

Not bad Stewie, not bad at all. In nutritional biochemistry, 1 gram of carbohydrate attracts ~2.7 grams of water by weight. Less carbs in the body = less total body water = varying levels of dehydration = [see below]

1) mild hypovolemia = some degree of electrolyte abnormalities = possible cardiac arrhythmia(s) +/- premature ventricular contraction(s) (PVCs)

2) increase cardiac output via increase HR to maintain adequate systemic blood perfusion

The following statement could potentially save your life one day: DO NOT blindly start ingesting or administering potassium supplements while on an ARB or an ACEI.

I agree of course, but what's your solution? More water and sodium?

 

[NEMSZ]

See that's a concern of mine as well. I did keto in high school and college and never had these arrhythmias so the fact that I'm getting them now makes me wonder if it's related to my heart worsening. Though before I did a cyclical keto diet with big carb ups on Saturdays so I don't think I was nearly in the state of ketosis I am now if at all.

Also you say high salt does it to you but then the main suggestion when this happens on keto is to drastically increase salt intake lol.

It does seem to be more so after my meals (I have three 1000-1500 calorie meals per day but not always). The other night I woke up with ym HR around 100bpm.

Do you have any anxiety/stress?

 

[Deleted member 106824]

Do you have any anxiety/stress?

Only around health issues like these

 

[NEMSZ]

Only around health issues like these

I mean, I wouldn’t consider anything you’re saying a health issue unless you actually know what’s going on...

If you have things in life that are stressing you out it could cause anxiety/panic regardless of how well you THINK you can handle things..

I’m saying this because it happened to me, I would get edgy and have raises in heart rate for what seemed like no apparent reason, after eating or just laying down watching TV and then it got to a point where I would get anxiety/panic attacks etc, (this started happening to me recently after about 2 years of business/personal life stress) and I couldn’t explain it until I got checked out..

Of course, you said you’re worried about your heart, do you have any underlying heart issues? Sorry if I missed it...

 

[Deleted member 106824]

I mean, I wouldn’t consider anything you’re saying a health issue unless you actually know what’s going on...

If you have things in life that are stressing you out it could cause anxiety/panic regardless of how well you THINK you can handle things..

I’m saying this because it happened to me, I would get edgy and have raises in heart rate for what seemed like no apparent reason, after eating or just laying down watching TV and then it got to a point where I would get anxiety/panic attacks etc, (this started happening to me recently after about 2 years of business/personal life stress) and I couldn’t explain it until I got checked out..

Of course, you said you’re worried about your heart, do you have any underlying heart issues? Sorry if I missed it...

I do yea, I have I guess what at this point would be called mild cardiomyopathy. I also have inflammatory bowel disease so over the years I've become somewhat neurotic when it comes to health issues.

And I agree with what you said above, though for me both times I've done keto in the past year it was accompanied by these bizarre increases in heart rate and bounding pulse.

 

[maldorf]

See that's a concern of mine as well. I did keto in high school and college and never had these arrhythmias so the fact that I'm getting them now makes me wonder if it's related to my heart worsening. Though before I did a cyclical keto diet with big carb ups on Saturdays so I don't think I was nearly in the state of ketosis I am now if at all.

Also you say high salt does it to you but then the main suggestion when this happens on keto is to drastically increase salt intake lol.

It does seem to be more so after my meals (I have three 1000-1500 calorie meals per day but not always). The other night I woke up with ym HR around 100bpm.

The trick is to have the Na level in your blood between a certain level I think. Too low or too high is just as dangerous. Same with potassium. They have to be in balance. With me if I get too much sodium then my heart cells seem to depolarize too fast and I start getting PVCs etc. Somehow it overpowers the mexiletine I am taking. A normal heart shouldn't experience it so easily. I think anyone though can have that trouble if the sodium gets high enough.

I used to do keto diets and never had any arrhythmia problems. I guess I never got dehydrated. Getting dehydrated could probably do it though, or if you aren't taking in enough sodium. I did a couple days fast a few times since my heart attack and made sure to drink beef and chicken broth for the sodium.