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"Keto-flu" and Sufficient Intake of Electrolytes

|"Keto-flu" and Sufficient Intake of Electrolytes

People often ask me about potassium deficiency (or any other mineral deficiency) on a low-carb, ketogenic diet. I decided to summarise which minerals you should be aware of and what the adequate intake is...

To pin or bookmark an easy to follow guide to keto-flu remedies, have a look at this post!

What is "Keto-Flu"?

Electrolytes (sodium, magnesium and potassium) are often underestimated on low-carb diets. As low-carb expert and scientific researcher Dr. Volek suggests, mineral and electrolyte management is the key to avoiding side effects typically associated with low carb dieting. When entering the induction phase of a Ketogenic Diet (50 grams or less of total carbs - about 20-30 grams of net carbs), most people experience "keto-flu”. This often scares them off and they start to think that low-carb is not right for their body. The "flu" is nothing else than a result of starving your body of carbohydrates. Stay strong! You can easily counteract these effects by replenishing electrolytes. Make sure you include foods rich in electrolytes in your everyday diet and take food supplements (if needed).

Firstly, I would like to share my own experience with electrolyte deficiency. I have been really tired recently. It was actually so bad that I couldn't open my eyes and could barely get up even after 7-9 hours of sleep. Also, my energy levels at gym were very low. I woke up in the middle of the night and experienced heart palpitations (weird feeling that could be described as "heart beating too fast"). I knew what was going on: I was magnesium / potassium deficient. I have been on a low-carb diet for more than a year and always made sure I include food rich in these minerals in my diet. The truth is, I have been so busy recently that I didn't pay enough attention to my diet. Also, stress may have contributed to all this. Excessive stress usualy means you need more vitamins and minerals. So, I got some supplements - an easy way to boost your electrolyte intake. The one for magnesium was great: 400 mg which is 100% RDA (Recommended Daily Amount) per pill, while the supplement for potassium was not as good: 99 mg per pill (only 5% RDA). I understand that this is due to the risk of excessive potassium intake which may be as dangerous as potassium deficiency. However, I still prefer using lite salt (potassium chloride or potassium sulfate. 1/2 a teaspoon of lite salt (mixed in a litre of water) provides 750 mg of potassium! Now, let's have a look at why electrolytes are so important for us...

|"Keto-flu" and Sufficient Intake of Electrolytes

Potassium

The most commonly deficient mineral (not just on low-carb diets) is potassium. EDR (Estimated Daily Minimum) for potassium is round 2,000 mg for healthy adults. However, people on a ketogenic diet have special requirements on the top of this, which is round 1,000 mg more. There are a few ways how you can boost your potassium intake. Eat food rich in potassium or take supplements (if needed). Be careful about potassium supplements, too much of potassium can be toxic and as dangerous as its deficiency. AI (Adequate Intake) of potassium is stated to be 4,700 mg a day. There is no upper limit for healthy individuals and you shouldn't worry about eating too much of potassium, unless you take supplements. Some salt substitutes are very high in potassium while other potassium supplements like this one only contain 5% EMR.

Who should consult supplementation with his doctor: those with kidney disease or take medication for high blood pressure, heart failure or other conditions. Also, salt substitutes may interfere with some medications.

Why is potassium so important for us? Here are signs of potassium deficiency (hypokalemia):

  • hypertension
  • cardiac arrhythmia
  • muscular weakness and muscle cramps, weakness
  • constipation
  • depression and irritability
  • heart palpitations
  • skin problems
  • respiratory depression, heart failure (severe deficiency)

Unfortunately, many potassium-rich foods are not keto-friendly but here is a list of keto-friendly potassium-rich foods:

  • avocados (~ 1,000 mg per average piece)
  • nuts ( ~ 100-300 mg per 30g / 1 oz serving, depending on the type)
  • dark leafy greens (~ 160 mg per cup of raw, 840 mg per cooked)
  • salmon (~ 800 mg per average filet)
  • mushrooms (~ 100-200 mg per cup)

Magnesium

Magnesium is commonly deficient in modern diets, including low-carb diets. You should be aware of your intake, especially if you are an active individual like me. RDA for healthy adults is 400 mg a day. However, if you are suffering from magnesium deficiency, you may experience muscle cramps, dizziness and fatigue. Of course, severe magnesium deficiency can result in more serious problems.

Here is a list of foods rich in magnesium:

  • nuts (~ 75 mg per 1 oz of almonds)
  • cacao powder and dark chocolate (~ 80 mg per 1 tbsp cacao powder)
  • artichokes (~ 75 mg per average piece)
  • fish (~ 60 mg per average fillet of salmon)
  • spinach, cooked (~ 75 mg per 1 cup)
  • blackstrap molasses (~ 50 mg per 1 tbsp)

Who should consult supplementation with his doctor: those with kidney disease or taking diuretics (magnesium citrate has a diuretic effect).

Sodium

Sodium has always been advised against, especially for those trying to lose weight. The truth is that your body needs extra sodium on a low-carb diet. The reason is that insulin, which also has the effect of reducing the rate at which sodium is extracted through kidneys, drops and it can cause sodium levels to drop significantly, too. You should eat 3,000-5,000 mg of additional sodium occurring naturally in food. It's quite simple to get sufficient intake of sodium: Unless you have any medical conditions that restrict your sodium intake, don't be afraid to use salt, and even if you feel you need more, drink 1-2 cups of bouillon / stock / broth a day.

High sodium content is also one of the reasons bacon has gained such a bad reputation. To read more about bacon, check out my post: 3 Reasons Why You Shouldn't Fear Bacon. Keep in mind that sodium in bacon is very high and doesn't count as "naturally occurring in food."

You can make your own electrolyte drink in a few easy steps: Beat Keto-Flu with Homemade Electrolyte Drink

Who should consult supplementation with his doctor: those with heart failure or kidney disease.

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To find out more about the ketogenic diet and keto-friendly recipes, check out my apps KetoDiet, KetoDiet Basic and my new cookbook!

All electrolytes are tracked by KetoDiet for the iPad

All electrolytes are also shown in the recipe detail (iPad and iPhone)

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Please, note that I do not offer personalised advice. For personalised advice you can contact one of our experts.

Comments (125)

Do we continue to keep electrolytes high(6-7g sodium, 3-4g potassium and 400-500mg magnesium) after adapting  or just while adapting to the diet?

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Yes, ideally, you should be getting this much of potassium (minimum 2 g) and magnesium (minimum 3 g) every day. When it comes to sodium, 3-5 g should be enough.

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Just wondering about salmon.  Wild vs. Farmed.   Wild is really low fat and farmed is very oily. So which do we use for potassium etc. Or does it matter?

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When it comes to potassium, it doesn't matter. There is slightly more potassium in wild salmon but the difference is less than 10%. The problem is organic pollutants. If you can, go for wild salmon because farmed salmon may contain PCBs.

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Wow this has clarified so much. I was getting uncontrollable/paralyzing  swelling in my claves, and cramping all over my body - could barely move without cramping somewhere. I had twitches at night, tingling nerve pain, the works! I had been on keto for just under a year and for some reason wanted to amp it up and eat strictly 20g carbs/day.  I was eating mostly bacon (sodium through the roof) and by the look of things no potassium whatsoever...
I went off keto because I was freaking out about my symptoms. And of course the symptoms cleared up (potassium!).
But now I can get back on it and have clear amazing skin again and long lasting energy and less cravings.
So great, thanks.

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So, is potassium sulfate (E-515) safe? Better taken on an empty stomach or with food?
I'm all confused about this potassium conspiracy, and why 99mg is the upper limit for supplements. I already take magnesium (from Doctor's Best), organic sea salt, and sometimes sodium bicarbonate.
I have 1kg of potassium sulfate ("food grade") which I bought as a plant fertilizer some months ago. Would be wise to ingest it in small doses? Thanks!

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Yes, E-515 is safe for consumption and it's better taken with food. I don't think it's easy to get too much potassium - see Wikipedia: toxic dose is 2.5 g/kg (meaning that a lethal dose for 50% of people weighing 75 kg (165 lb) is about 190 g (6.7 ounces): https://en.wikipedia.org/wiki/Potassium_chloride
I don't usually take potassium supplements, I just include foods high in potassium such as avocado, salmon, mushrooms, etc. almost every day.
If you do, only use small amounts like I did in this recipe: ketodietapp.com/.../beat-keto-flu-with-homemade-electrolyte-drink

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Ive been in keto for awhile now and only experience lightheadedness in the mornings! Im looking into suppliments and wondered if anyone had any experience with potassium & magnesium aspartate 250??? Was on oxide yea that was a waste lol!!!

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I use ForzaOne BCAAs from Nutrishop (I'm sure many BCAAs on the market are great).  I had headaches last week, some crankiness, and fatigue, but none of the other "flu" symptoms.  This supplement has excellent electrolytes.  This week, I feel much better, and I was able to drop from 30 grams to 20.  
Good luck everyone!

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Reading about the increased salt intake on keto diet makes me wonder if this will be safe for me. I have highblood pressure and I've always been told to keep my sodium intake low. Any advice?

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Hi Samantha, to be safe, you may want to consult this with your doctor before you increase your sodium intake.

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I'm not sure if this is of help to anyone, but I use a zero calorie electrolyte drink called 'high 5 zero'. Not sure if it has all the right balances and it is quite expensive, but easy and convenient effervescent tablets to have with you as and when you need them.
I'm experiencing my first bout of Keto flu, it sucks. I don't have headaches (yet :s), but even though i'm not hungry, I just feel knackered all the time. I feel like this just shows how difficult my body is finding it to use its own fat source for fuel, so I'm hoping this diet is going to undo a lot of metabolic damage over time!

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Is getting all of your potassium from lite salt bad? And exactly how much sodium do you need? I thought it was like 2300mg?

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There is an increased demand for sodium on a keto diet (additional 3000-5000 mg) - if you experience headaches or any symptoms of keto flu, it might be worth adding some foods like bone broth or sauerkraut. Potassium: I'd personally mostly use whole foods like avocados, fatty fish, etc. You are likely getting most of your daily potassium from the foods you are eating but you can supplement your diet with some lite salt.

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Great. Info thank you!

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Hi! I'm staring Keto tomorrow, I'm taking herb tinctures to help balance my hormones
As you may know tinctures have alcohol ,the brand is Herb Pharm , I'm taking 3 diferents herbs
15 drops of each, 3 times at day. Should I cut them now that I'm going Keto????
I don't want to jeopardize my diet. Please help😁
Regards

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Hi Rita, such a small amount of alcohol won't have any impact. I personally use food extracts that are alcohol-based. Small amounts won't make a difference Smile

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thanks so much for this info, ive only been on this WOE for the past 2 weeks, and im feeling so dizzy and furry headed! with pains and heaviness behind my eyes, i was beginning to think i might be allergic to this diet lol! having read this im going to buy some supplements which hopefully will sort me out! i love your app, your blog, your recipes and i love you Smile x

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Thank you Carroll, I hope you feel better now!! Smile)

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Hi there.
My wife and I have just started our third week on Keto diet and for the last few days we have been having an increased heart rate and heart palpitations.
We got magnesium and potassium supplements, couple of days ago. Magnesium is ok, but potassium is just ridiculous, 99mg per tablet...
So we started taking LiteSalt (66% less sodium, 900mg of potassium per half tsp)
Is it ok to take half tsp twice a day? Just worry that it is too much salt.
Any general advice? My wife is quite concerned about heart rate...
I hope it will get better...
Thank you
Yevgeny

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Hi Yevgeny, if I was you, I'd try to get my potassium from foods like avocado (one avocado a day will give you 50% EMR potassium). I only take magnesium supplements because it's hard to get enough from a regular keto diet. Or you may want to try this instead: ketodietapp.com/.../beat-keto-flu-with-homemade-electrolyte-drink

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I have just started taking a ECA to help with total fat loss
All information on this supplement says that it will deplete potassium.
Since taking this supplement I have started getting muscle cramps late at night
I also donate plasma twice a week and I am unsure how this effect my electrolytes
I use Kale, Spinach, and avocado but do not seem to reach my goal of 3500mg of per day of potassium
If I take the lite salt with pink Himalayan how much do you recommend I should take ?  

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Hi Dennis, 1/2 teaspoon of lite salt will give you 750 mg potassium so you might want to try that - it should be enough. Eggplants, tomatoes, fatty fish like salmon, dark leafy greens and avocado will all help you get plenty of potassium.

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Hey there!
I have been following your blog since few days. Thanks for making this.
Quick question. I am deciding to go on Keto. However I am said to be having vitamin d and vitamin b12 deficiancy. I am taking supplements prescribed by my doc. Also taking vitamin b12 injections once a week. I have one injection left and prescription for 15 days more.. is keto safe for me? Frown
Thanks.

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Hi Ahmed, I myself had low vitamin D and I just take cod liver oil every day. I haven't had any issues with vitamin D deficiency since then. You should be getting enough B12 on a keto diet (lots of eggs, cheese, animal products in general) but if you still have issues with low B12, there may be another reason and your body may not be absorbing it well. I'd think that a keto diet / low-carb diet is a good option for you - make sure you ask your doctor to monitor your levels and you should be fine.

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I have tried on 2 separate occasions to take magnesium supplements. Each time after about a week, I got seriously woozy to the point I couldn't even stand up. I stopped taking them and got better in a few days. Now I eat avocados and bone broth. Do you think this is ok, and has anyone else ever had this problem?

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I'm not quite sure what was the reaction you has but there are so many different types of magnesium supplements... Have you tried Magnesium Glycinate? Avocados are great for potassium, bone broth for all electrolytes but mostly sodium and nuts are good for magnesium. Depending on your diet, you may still need to add extra magnesium, especially if you follow a very low-carb diet.

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I tried 2 different types of magnesium. One being magnesium citrate. Don't ever want to go through that again, so will have to stick to pink salt and nuts. I mainly eat very low carb. Thanks for your input.

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Barb, I experienced the same thing until I found magnesium potassium aspartate. I take like 1/2 of one vitamin per evening and it gives me what I need to keep the heart rate normal.  I also eat a lot of nuts- like a ton and try not to go lower than 15 net carbs for more than a few days. Water and sodium too are important!
~ Elle

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Thank you for this site. I did a high fat,zeroish carb years ago and lost alot of weight. I have had a fast heart rate for the last two years. Went to the cardiologists and did the full battery of tests. From a stress ekg to a CT scan. All normal.
I knew that magnesium was vital,so started taking it but really it did not help. I had all the symptoms of hypokalemia but did mot know it. Have started taking no - salt for three days and feel much better.
I wanted to mention something about avocados or beans that I believe needs to be addressed. A plant produces sugars,fats and proteins as well as vitamins and a host of other things. What no organism can do,is produce minerals. Meaning, while an avocado when tested had xx milligrams of K or Mg or whatever, you have no way of knowing if the plant you buy has that same amount. It is all contingent on the minerals found in the soil the plant grew in. After years of farming that avocado tree may have fruit with much lower amounts of K. Fertilizers may increase the mineral count but we do not know what the actual fruit or vegetable has as far as mineral content.
I fear that modern farming techniques will give us less mineral rich foods.
Maybe that is why things taste different now than when we were kids. Eat the avocado by all means. Just realize that it may not contain what we believe it should. I think going forward a potassium salt is going to be our best bet.
At the begining comments section a Dr commented on how too much K is deadly. It is true. But according to recent data most of us get nothing clse to the 4700 mg a day of K. Something like 90 percent get less than half that. The concept of selling supplements at 99 mg a pill is verging on the criminal imho.

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Thank you for your insights, Jim. I agree that modern farming changes the nutritional aspects of foods these days - foods contain less micronutrients and it it sometimes a challenge to find "clean" produce. Taste is also affected - nowadays I could never get the same tomatoes I used to eat from my father's garden. Yes, most people are truly deficient in both magnesium and potassium and some cannot get to even half of the recommended values.

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Quoting the article: "Be careful about potassium supplements, too much of potassium can be toxic and as dangerous as its deficiency. AI (Adequate Intake) of potassium is stated to be 4,700 mg a day. There is no upper limit for healthy individuals and you shouldn't worry about eating too much of potassium, unless you take supplements."
So... which is it?

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Hi Jules, unless you take supplements, you won't exceed a toxic level (toxic level of potassium chloride is about 190 grams / 6.7 ounces), so there is no way you can eat that amount (AI is 4.7 grams just for a comparison). In fact, it would be nearly impossible even with supplements as most contain small amounts such as 5% RDA per pill. Also, this applies to healthy individuals - others should consult this with a health professional (especially those with diabetes, kidney and heart disease).

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Does the sodium in sparking water count towards my daily sodium intake?

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Hi Kristina, yes, anything with sodium should be counted in your daily intake - including foods and supplements.

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Hi, great info thank you.  I am having half to a whole avo daily plus low carbs veges etc and a few nuts.  I'm eating a very low carb diet for cancer reasons but find I often get a racy heart after eating.  I certainly seem to be thirsty and drinking lots and going to the loo lots.  Don't like the idea of supplementing the potassium if I can do it with food instead, do take magnesium already though.  Does it sound like I'm still not getting enough potassium??

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Thank you Coralie! I think you should get enough potassium if you eat avocado and nuts every day... Yes, it's great that you're taking magnesium, that's always hard to get on a very low-carb diet.  What you can do if you have low potassium is to try "lite salt" or combine it with regular sea salt. Just 1/4-1/2 teaspoon will make a difference. I only had this issue when I started following a low-carb diet and ver since then. Good luck Coralie and have a look at this resource - it's full of useful information on keto & cancer: http://greymadder.net

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I don't understand the need for "lite" salt, or the "NO-salt".  If you need salt, why not the regular kind?

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It's used to boost potassium. "Regular" salt doesn't contain potassium like the other salt substitutes.

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i searched comments but was wondering witch magnesium supplement should be taken, is it called Magnesium Taurate?

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Hi Tim, I take magnesium citrate but magnesium threonate is a great option too. Studies show that it's great for the brain and increases cognitive function. Other good forms of magnesium are these: magnesium malate, magnesium glycinate, magnesium chloride, magnesium taurate, magnesium lysinate, magnesium ascorbate, magnesium sulfate, magnesium aragonite and magnesium ZMK.

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wonderful- I am eating like 1400-1600 now, feel like I'm solidly in ketosis, not really hungry that much- kind of have to get myself to eat these days...
but also not really doing LCHF to lose weight but to make my IBS gut happy, its solved a lot of problems, Yes I take the Calmag citrate too, but probably should've taken more when I dropped even lower on carbs recently, didn't have heart palpitations until I dropped to almost 0 carbs. I probably was getting some good mag from the nuts and chocolate I was eating before...thanks for being so responsive and helpful- I appreciate it! I do wish there were more doctors versed in this!

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Thank you for your kind words Elle! I think you can keep your gut happy even at 20-30 g net carbs which will also help you get your magnesium Smile

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Got the App! Its great and I am Rec'ing this to my other LCHF friends! started eating more avo's... Are there any high magnesium foods you like? I'm taking slo mag now but I am wondering if you have any more thoughts on LCHF foods for magnesium?

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Thank Elle! Glad you like it! Smile Yes, foods like nuts and unsweetened cocoa powder are high in magnesium but I'd still recommend taking magnesium supplements (that's what I do).

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are there any mag supplements that you like? If you don't want to reveal in public forum I understand too... I am trying a few different options with the mag- some of them seem like sledgehammers and I end up with intestinal distress and seriously woozy feeling, others I am not sure if they are releasing slowly in my body... so trying out different ones- but any rec's I'd appreciate it...
on another note- I am trying to get my protein up- last few days I have been running 80% F, 13% P, 7% C... I usually get more protein but my appetite has just plummeted...not sure why...

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In general, I like Solgar or Now Foods supplements: astore.amazon.com/ketblo-20?node=37&page=1
I take magnesium citrate but that may actually cause digestive issues in some people so you may want to avoid it. I've hard that magnesium chloride is very well absorbed, better than other types. Another option (from many) is magnesium threonate which is a new type and it's supposed to be one of the best.
Based on your macros, you may not be eating enough protein but it is relative - it depends on your overall food intake (calories and grams of protein). If your protein intake is low (you can check that here: http://ketodietapp.com/Blog/page/KetoDiet-Buddy), try to add more foods rich in protein and less fat. You should not eat more than you can - always follow your appetite. Hope this helps!

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I've noticed no on has mentioned that one truly enjoyable way of increasing magnesium is by taking epsom salt baths.  It is my understanding (from reading about it) and my experience that magnesium is absorbed by our skin quickly and efficiently.  
I also take Dr.'s Best Best Brain Magnesium Supplement.  I started taking 2/day after noticing "brain fog," and it helps tremendously.  I didn't know about the benefits of taking it before bed and I will tonight.
Thanks Martina for all the information about the Keto diet and to all the helpful commenters.  I learned about the diet from a friend last December and stumbled upon your site today.  As soon as I can stock up on the right groceries this week, I'm starting it.  LC diets are the only ones that have ever helped me lose weight in the past and I'm looking forward to following this new way of life and health.
Best, Pamela  

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That's true Pamela, thanks for your insights and your kind words! Yes, it's magnesium sulfate that is absorbed through the skin. I guess that supplement may be based on magnesium threonate which is known to be good for the brain.

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What a relief to find your site- I am going to get your app asap. I have been LCHF for almost a year now. I only recently significantly cut down my already low carbs 25-30 to almost 0 because of an IBS issue. I am starting to eat a small amount of cooked veg but not much.  I also happened to have stopped the 91% chocolate, nuts and most whole fat dairy to decrease load on gut- I woke up with my heart pounding, racing and my anxiety increasing and my breath short. I went to the ER and my heart was fine according to the doc. All my labs were completely normal, my sodium on the low end of normal. Doc recommended electrolytes. I realize I have been eating almost no potassium. It is a relief to find out other people experience the same thing and how to remedy it.

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Thank you for your kind words Elle! An avocado a day sprinkled with salt is a great way to prevent this Smile

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I've been on a very low carb (under 10/day) for over a week.  I've been in ketosis for about 5 days, and now I'm @ "large" according to the ketone test strips.  I've lost only 1 pound.  I lived on a low carb diet for a number of years, but now it doesn't seem to work as well.  Any suggestions as to what I should do?

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Genia, have you tried to calculate your macros? You may not be eating enough / or you may be eating too much protein or fat: http://ketodietapp.com/Blog/page/KetoDiet-Buddy (usually I'd go or the "slow" fat loss option)

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Stephen, I have insomnia even without being keto. I've noticed it getting bad again when im keto. This more likely due to adrenal issues than keto tho. I have adrenal issues myself. And my insomnia fluctuates even when Im not keto.
Have you checked into ur adrenals? With poorly controlled diabetes for so long you've probably severely stressed ur adrenals.
I do take a supplement with Mg, rhodiola, l-theanine and some other things. It seems to help. Theanine Serene with Relora. After a few wks I noticed it keeps me calmer throut the day also, even if it's not too effective that nite for sleep.
I feel ur pain, Stephen. Insomnia is a private hell.

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If you eat alot of veggies, you will get ur potassium. I can imagine eating lite salt is like eating morton's other salt. I wudnt eat it at all. I use real salt, not even "sea salt". If there is a version of real potassium, I'd be happy to know. But if ur eating sufficient low carb veggies, u'll get potassium. It's in meat too, like salmon. Lowcarb does not mean no veggies. We NEED the micronutrients in veggies! Pills will not give u all u get from eating the whole plant. Pls see Dr Wahl's bk The Wahl's Protocol or listen to Dr. Eric Berg's videos on utube. He has some bks also.

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Yes, it's easier to get enough potassium for me - after years of eating this way. However, it's fairly difficult to get enough magnesium, sometimes even on a 30 g net carb diet which is not that low. I agree, low-carb is not about avoiding veggies - no need to count "total" carbs and avoiding fibre Smile

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Okay, question about Potassium: exactly how much should I take per day? The article states Adequate Intake is 4,700 mg. So is that what I should be shooting for? Other sources say 3,500 mg is the highest safe limit. I'm confused.
Anyway, thanks for the article! Already lost 20 lbs on keto but I realized I was forgetting about the electrolytes!

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Hi Leon, the minimum is 2000 mg per day, ideally more, especially during the first 4 weeks of the ketogenic diet (thus AI is 4700 - yes, it is safe to eat 4700 mg). The toxic level is a lot higher than that. Thanks for your kind words and congrats on your weigh loss! Smile

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Hi. I've been a (poorly controlled) diabetic for 20 years. Got peripheral neuropathy and retinopathy (which is being treated). Started a strict LCHF ketogenic diet over three weeks ago and got into (moderated) ketosis by the end of day 2 - and maintained that for 3 weeks. Was enjoying the diet but the problem is that severe  insomnia set in at some point in the 3rd week and I can't shake that  - hours getting to sleep (4 or more) and broken sleep after that. Only way I can sleep is by taking warm milk and honey (together with natural sleeping powder from the health shop) but that, of course, knocks me out of ketosis. Also fasting BG levels still way too high. Any suggestions? I'd be really grateful for any tips or comments.

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Hi Stephen, have you tried taking magnesium? Sufficient magnesium will improve your sleep. Have you been taking any other supplements? I wouldn't advise taking cod liver oil (vitamin D) in the evening. Have you tried herbal tea like chamomile, lavender, peppermint, etc. (not black or green) instead of milk with honey? Higher blood glucose levels may be caused by the milk with honey - do you have this problem even when you skip it? Here is an interesting article about higher BG on a ketogenic diet - you may want to check it out: ketopia.com/.../

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The only thing that works for me is a 2:1 ratio of Calcium citrate : magnesium citrate.  Either alone doesn't work as well.  It's worth a try.  Good luck.

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Hi,
Great post!  I began experiencing some palpitations since getting deeper into nutritional ketosis.  I added homemade bone broth and increased my intake of Himalayan pink sea salt.  Neither stopped the flutter.  Two days ago, I began upping my potassium from 100 mg/day to 300mg/day.  The palpitations were quieted almost immediately.  
Keep up the good work!

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Thank you Dave!! An avocado a day will help you get your daily potassium Smile

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I am so glad i found your post. Ive been on a keto diet for two weeks and have felt terrible. Headaches, dizziness, and heart palpatations since a couple days into it. I had no idea about this potassium issue. I take a calcium/magnesium supplement but really dont eat any of the potassium foods you mentioned. I doubt im even getting 1/4 of my needed requirement. Last night, the palpatations were so bad that i almost felt i was having a heart attack! I went to the kitchen and ate a banana, piece of chocolate, and a handful of dried apricots. I felt fine about an hour later but no doubt ketosis is out the window! They were the only noticeable potassium/magnesium rich foods in my house. Im hoping to still do a keto diet since my body looks great but i hate these dangerous side effects. I plan on getting a bag of avocados, a box of spinach and bag of mushrooms at the store today.

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Yes, definitely get some avocados! Or you can try a potassium supplement or use lite salt. I think some of the foods are an acquired taste - I never used to eat avocados before keto and now I love them Smile Hope you feel better soon!

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I am glad that I found this. I will go get some avocados very soon. As I find that no-salt stuff absolutely atrocious and my potassium supplement makes me feel really sick for at least 2 hours after taking it sometimes. But without it, on a low-carb diet, I just can't sleep. It's like I always have what I refer to as "premature" waking. I sleep for about 4-6 hours and then wake up and can't get back to sleep. I really hate this, especially since I also suffer from Chronic Fatigue, but only have a little ways to go until I can go back to eating low-fat (normal).

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Thank you! I personally don't take potassium supplements, just magnesium. I eat avocados almost every day so I know I'm always fine. Are you saying you want to go back to low-fat eating? I'm not sure why you'd want to do that, most people just stay low-carb or paleo. Going back to low-fat may just ruin all your efforts, low-carb diet shouldn't be perceived as a "quick fix" but rather as a lifestyle change.

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I read everywhere that broth is good for this. However, I don't like to use the bouillon cubes because they have soy and corn. We make our own broth because we also raise our own cattle. I salt the broth some when I drink it, but does broth naturally have sodium? Or when you say it provides sodium, is it because people are adding salt? I have terrible headaches and they've turned into daily headaches since I started keto. I'm hoping this is it. Thanks!

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Hi Kelly, yes, it's better to make your own. I actually never buy the ready-made product. I store bones in the freezer and once I have enough, I just throw them into my crockpot (with some oxtails, salt, spices, lemon juice and vegetables to boost the flavour. Broth naturally has some sodium but you'll have to use salt - I add about 1 tablespoon of salt into my broth (8-10 cups).

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Potassium deficiency is called hypokalemia not hyperkalemia.

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It was actually just a typo. I had "hypekalemia" which looked like a hybrid of those two words - corrected Smile

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I'm allergic to eggs, coconut, and walnuts. Are there any super quick meals you can recommend that are VLC and high fat? I really wish I wasn't allergic to eggs because they'd be perfect when strapped for time but I get sooooo sick when I eat them.

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Hi Amanda, yes, you can have a look at my recipes here (all are egg-free): ketodietapp.com/.../catEggfree&title=Egg%20free If you go through them, you'll find savoury recipes with no coconut & walnuts. I'm planning to add multiple filtering on my blog but that's what I have now Smile If there was one food everyone should have on a LCHF, it's avocados!

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Just the info I was looking for Martina, Thank you.  My body water percentages have been slowly dropping as well as the increase of side effects, especially at the gym and in recovery.    (One month in to Keto) No doubt keto is the way to go for me for so many reasons beyond weight loss.  Half an avocado and magnesium citrate seems like a good place to start.  Thanks again!

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Hi Scott, thank you! Yes, if you are physically active, make sure you pay extra attention to electrolytes.

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Hi,  I've been trying to get into ketosis for about a fortnight now. My readings are, best ever 0.7. Everything in in my diet seems ok but it's taking a while!
My problem is I feel terrible. I'm a keen cyclists but I can't train at the moment I just feel too weak and I'm tired all the time. I'm already taking extra salt and magnesium but not potassium yet. Starting that tomorrow. Any other ideas please, I really don't want to give up now.
Also my blood glucose seems really high in the morning 6.7ish or slightly less most mornings any advice about that would also been welcome.
Thanks

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Hi Tim, it takes about 3-4 weeks before your body starts using ketones effectively and you become keto-adapted. If this doesn't improve even after 3-4 weeks, 100% keto may not be the best approach for you. If you do a lot of high intensity exercise, you may benefit from carb backloading after your workouts. People involved in loads of HIIT don't generally do well on keto. On the other hand, strength training can be done without carbs - it really depends on the type and intensity of exercise. When it comes to high levels of glucose on a LCHF diet, this is a common issue and should only be short-term. Your ketone levels don't necessarily have to be high (as I explained in my post about ketosis) but it may be an indication that your macros are not quite right: http://ketodietapp.com/Blog/page/KetoDiet-Buddy Hope this helps!

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Correction, it is a teaspoon of magnesium citrate not a tablespoon.

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Any opinions - I have been making my own electrolyte drink.  A tablespoon of magnesium citrate (Calm), a teaspoon of potassium bicarbonate, half a teaspoon of sodium bicarbonate.  I also add a tablespoon of apple cider vinegar, a tablespoon of lime juice, and a tablespoon of lemon juice.  The ACV, lime and lemon juice are supposed to be good alkalizes (even though they are acetic) bring the pH closer to 7.0, and improves the taste.  I think that comes out to about 162 mg Mg, 2 grams K, and 600 mg Na.  Taking 2 X day.  

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Yes, this sounds great - from 2 drinks a day, you get 70% RDA magnesium, 200% EMR potassium and some sodium. However, you also get more electrolytes from food so it should be enough if you have just one drink a day instead of two.

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I have a further query about potassium - my reading indicates that potassium can be absorbed by the body from most 'potassium salts' so I have been testing "Cream of Tartar" - I add a 5 gram sachet to a large glass of cold water - which gives it a very slight sour taste (not unpleasant at all) - you need to stir it, as the 'salt' does not really dissolve. This Cream of Tartar is mainly Potassium tartrates (about 4500 mg) so I am assuming that the body will adsorb this????
If this works, it is slightly cheaper than those 200 mg tablets (5 gram sachet costs about 16p).
Is anybody able to comment on this?

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Yes, cream of tartar contains potassium. There is about 500 mg (25% EMR) in a teaspoon (~ 3 grams per tsp) of cream of tartar but also 1.8 g net carbs. If you're ok with that, you can boost you potassium intake with this ingredient too.
A bit unrelated but worth mentioning that I use cream of tartar in baked goods (1/4 tsp of baking soda + 1/2 tsp cream of tartar) - the combination of these two act as raising agent. You can use baking soda + apple cider vinegar to get the same effect but I personally prefer using cream of tartar.

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I'm currently battling back and forth with this potassium thing. I've been keto for 4 weeks and it just seems to come and go as it pleases. I get through it and am okay for about 3 days and then it slams me again. Right now I'm down to drinking 1/4 tsp of Lite Salt in bottled water (I"m allergic to stevia and splenda, so no water flavors for me, booooo). I felt pretty rotten a little bit ago. We'll see if I can kick this in the bud for good. I upped my carbs to 40 for today, I'll probably be nearly kicked out of keto.
Thanks for the information!

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You're welcome Renee! Do you like avocados? If you have 1/2 - 1 a day, it will help a lot. An average avocado has ~ 50% EMR of potassium and is low in net carbs.

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Thanks for the great article Martina! I've been taking one particular brand of electrolyte replacements and now I know how woefully inadequate they are. I have one question on the magnesium because there are so many different forms available. Do you know which one is the proper form of magnesium for electrolyte replacement or does it matter? I've searched but it's hard to find a specific answer. It seems like Magnesium Chloride is best but it's confusing.

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Hi Daniel, thank you! I take magnesium citrate but I've hard that magnesium chloride is very well absorbed, better than other types. Another option (from many) is magnesium threonate which is a new type and it's supposed to be one of the best. Hope this helps Smile

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I am a medical doctor, and I found your blog because I recently started a low-carb diet. While I understand you are trying to "educate" yourself and others, there are some serious misconceptions in what you have posted, and I am concerned that your advice could actually cause harm to some people with underlying health problems.
First of all, while I have never had what you call the "keto flu," I seriously doubt that it is caused by potassium deficiency. It's correct that most Americans don't get enough potassium in their diet every day, but that would not be enough to cause a severe deficiency by itself (unless someone is literally eating a starvation diet). To get a serious deficiency, you need to be excreting too much potassium, a condition which is usually caused by diuretics such as Lasix (which is why doctors often prescribe potassium supplements along with it). I am on Lasix myself, and I have experienced the symptoms of real potassium depletion: severe muscle cramps. But you really can't cramps like that from garden-variety potassium deficiency.
Second, even if we assume that the symptoms you describe are really potassium deficiency, I don't know why a keto diet would cause such a deficiency. Again, while it is certainly true that the richest sources of potassium are non-keto foods like peas and beans, there is plenty of potassium in keto-friendly foods like nuts and even fresh meats (a 4 oz serving of cooked meat contains over 400 mg of potassium). And concentrated forms of meat protein like beef jerky would give you even more. If you choose your diet intelligently, you can get plenty of potassium on a low-carb regimen (although it certainly takes some effort).
I have an even bigger problem with your assertion that the low-insulin state induced by the keto diet would increase K and Na requirements. While you are correct that insulin reduces excretion of both K and Na, it does not follow that you need more of these minerals if there is less insulin around. K is needed for insulin to be released from beta cells, so if insulin is on board more K is needed by the body-->less is excreted. Therefore, if you have less circulating insulin, you don't need as much potassium and you can safely excrete more. As for Na, while it is not completely clear why insulin causes the kidneys to retain more sodium, this is not actually a good thing. But regardless, your blood sodium level is very closely regulated by your kidneys, and as long as they are healthy, it will stay at the same level all the time regardless of how much you eat. As long as you don't have another disease that affects this process, the amount of sodium you excrete in your urine each day should equal the amount you ate. Period. There is no reason to eat more sodium because you think you have a "deficiency"--in fact, it can be bad for certain people by raising their blood pressure. Since many people going on low-carb diets are probably diabetics who have to be very careful about their blood pressure (because it can cause permanent kidney damage), this is a very important issue.
The same goes for potassium intake. While, as I mentioned, very low potassium can cause muscle cramps, other than that it's really not dangerous at all. But the opposite problem, excess potassium, is EXTREMELY dangerous and can easily kill you by disrupting your heart's normal rhythm. That's why high-dose potassium supplements are only available by prescription, so that doctors can monitor the patient's potassium levels and make sure they're not getting too high. People with kidney failure--again, a group including a lot of diabetics, who could be on diets like this--have problems excreting potassium, so they have to be especially careful about eating potassium-rich foods. People without kidney disease can eat all the high-potassium foods they like--the kidney will just get rid of any excess--but I would really not advise dosing yourself with extra Lite Salt or similar products to get extra potassium. That's definitely pushing it a bit.

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Hello Harriet, thank you for your insight. I can assure you that misleading anyone or giving the wrong advice is not my intention. That's why I base my views on valid research rather than my own opinion. Firstly, "keto-flu" is necessarily not something people always experience - my partner didn't have any issues either. However, the vast majority of people following the ketogenic diet does. These recommendations for increased electrolyte intake (all electrolytes: sodium, magnesium and potassium) are not my own assertion but are based on advice from Dr Volek, Phinney, Lyle McDonald and many more. The need for additional electrolytes is perfectly explained in The Art and Science of Low Carbohydrate Living (Dr Phinney and Dr Volek).
I did emphasise that the requirements for healthy individuals are different to those suffering from health issues (diabetes, kidney failure, heart failure) - medical advice is always needed in such cases. Although I mentioned this a few times in my post, I also have a warning related to it (above the image with nuts). I changed the formatting in my post and made this warning more obvious.
When it comes to potassium, it depends on what you see as deficiency. When referring to deficiency, I used the EMR (2,000 mg), not even the AI (4,700 mg). If you track your diet, you will actually discover that unless you eat avocados, mushrooms, nuts and fish, it's not easy to get even to your daily EMR. Some people are allergic to nuts, some don't like avocado and some don't eat meat (not common but it happens). For example: 4 oz of cooked beef has 300 mg potassium (15% EMR) compared to 1 large avocado (50% EMR). The problem with meat is that you can't eat too much of it on the ketogenic diet (too much will put you out of ketosis).
On the other hand, it is VERY difficult to get an overdose of potassium. Potassium chloride is toxic in excess which is at about 2.5 g/kg of body weight (again, for healthy individuals). Even if you use 1/2 tsp of lite salt, you only get 750 mg potassium. It's still a long way to get to AI (4,700 mg) which is the "adequate intake". I understand this may all be different for those who have health issues, but that's why they should consult this with their doctor first - that applies to any diet.
When it comes to sodium, the trend has been to avoid it at any cost - even for those who are healthy. As a result, many people don't use salt at all (I didn't use any 2 years ago) and when they start following the ketogenic diet, they may not be getting enough and experience headaches, etc. It doesn't mean we should have a mountain of salt in every food we eat, it simply means we may need to use some. Again, the recommendation for additional sodium intake is not my own, but based on available literature mentioned in the first paragraph.

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How interesting that you mention that about the sodium. I gave up Atkins last time because of edema and having to use my as needed doses of torsemide entirely too frequently. My doctor suggested it might be due to eating too much processed food. I am giving it another shot minus the hot dogs and cold cuts since I have lost sixty pounds on this diet without this issue previously and kept most of it off.

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Hi Ashley, it may have been other ingredients often found in processed foods. Bacon, salami and other processed meats should be eaten in moderation. The keto diet should be based on fresh meat, eggs, full-fat dairy, avocados, non-starchy vegetables and some nuts. Hope this helps!

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Hey - Trying a Ketogenic for the first time, more for improved health than weight loss. Real important question for you. I've been researching the fatigue that comes with Keto Flu and after looking over the food I typically eat in a day I see I'm low on Potassium intake. I got some of the Lite Salt (because of your suggestion - thanks). My concern...Is there the same danger with taking Lite Salt as there is from the capsule supplements? I'm going to be hard pressed to get my Potassium intake up from food alone. Thanks!

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I'm not sure whether you are referring to potentially toxic overdose? For the tablets, it's very unlikely because regular potassium tablets contain ~ 5% EMR of potassium which is extremely low and that's why it's also not worth getting them. If you use 1/2 - 1 tsp of pure potassium chloride a day, you won't get anywhere near to potentially toxic levels. You would literally have to eat almost a cup of it. Hope this helps!

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I have been low carb for about 5 weeks and have yet to have a blood ketone reading above 0.4. I have been eating about 20 carbs a day but may have a beer a couple nights a week. Even with the beer, I should be under 50 carbs. I have lost about 9 pounds but am wondering if I can truly be in ketosis with those numbers. Also, I exercise daily and drink a gallon or more of water per day. Recently I have added about a tablespoon of coconut oil per day.

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Hi Sue, I'm afraid beer is a no-no on low carb, it's quite high in carbs. If you want to have a drink, opt for a glass of wine or wine with sparkling water. If you stop losing weight, it's likely the beer.

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Do you have any plans for an android app??

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Yes, we will make KetoDiet for additional platforms but this will take some time - we are now working on a universal app. We will eventually make it available for everyone (not just Apple users).

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Is Lo Salt the same as Lite Salt in the UK?

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Yes, it should be the same. It's a mixture of regular salt (sodium) and potassium.

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I'm just loving your app! All the low-carb experts should be recommending it. I'm a personal trainer and my clients love it Smile Thanks for all the hard work and updates!

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Thank you Gabrielle, that's great! We are will add some features for this purpose (e.g. data export) soon! Smile

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Thank you for helping out and I like it. ..so nice explaining everything

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You're welcome Elisabeth! Smile

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Thank you this was very helpful I had all the same symptoms. I find eating pickled vegetables and drinking pickle juice with it's high sodium has made all the difference. I have been eating a lot of salmon and taking a magnesium supplement. I am feeling much better! Do take your magnesium sup at night, for it aids sleep!

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Hi Kristina - pickles are great, especially if you make your own. I do take magnesium supplement before bed and you are right, it improves sleep. One mistake I used to make was taking vitamin D (cod liver oil) before bed - that has ruined my sleep and I couldn't figure out what was wrong until I stopped taking it at night. Now I only have it with my breakfast or lunch and everything is back to normal Smile

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I just got you app and love it!! However, am finding it difficult to add in a potassium supplement, as the recommended lite salt alternatives as a source of potassium are not listed in your Quick section, and in order to create a custom ingredient, it must be per 100 grams, apparently. The trouble I am having is that my supplement, No Salt, has 650 mg per 1/4 tsp, 1.3 grams. Which makes it somewhere around 49,000 mg per 100g, and your form does not allow input of such high numbers. Is there a way you could add potassium in, and magnesium as well, to the Quick section so those of us needing to supplement might add it in easily to our daily consumption?
Am new to the app, please let me know if I have missed something or am mistaken.
Thanks so much!

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Thank you for your kind words and your feedback Jen!
We are now about to submit a new quick update which will include lite salt in the quick  meal section. We will also expand the range, so you can put milligrams in tens of thousands to cover supplements. Other improvements will be added in our frequent updates Smile
Martina

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After several months of low carb lifestyle with intermittent periods of nutritional ketosis, I started feeling wicked awful!  It increased along side my workouts which had been going up in intensity. I started to think.... Maybe my body does need carbs now. At least from natural sources like fruit and starches.  Anyhow, I was constipated, lethargic, constant head aches and just generally sluggish during workouts that I could usually perform on an empty stomach. All I had to do was increase the sodium and the response was practically instant!  I have underestimated the importance of electrolytes and will now be paying attention to all of them. Thanks for this article.

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Thank you Alexandra! I had the same issue with electrolytes... I was worried that low-carb eating was bad for me but it ended up being potassium deficiency. We always have avocados and nuts at home (best for magnesium and potassium) and I often make beef bone broth (oxtail is my favourite) with a tablespoon of pink Himalayan salt. I keep the meet in the fridge and use it on top of omelettes or lettuce. The broth wouldn't last, so I store it in small containers in the freezer - we usually use it within a week or two.

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Oh my gosh! Reading these are incredible. Yesterday all of my muscles cramped up, I got super sick and started seeing dots. I've been hospitalized for potassium deficiency before and I cant believe I overlooked this on my daily nutritional values. I quickly ate about 10 ounces of salmon and 3 1/2 tsp of Mortons light salt. The cramping stopped. I now add 1/4 tsp of Mortons lite salt to every bottle of water I drink. roughly nine bottles a day. I do this on days I dont eat potassium rich foods. So much to learn!
This salt isnt dangerous is it?

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Hi Henry, this sounds quite scary, I'm glad you're ok now! I use pink Himalayan salt and lite salt together to boost my potassium intake. I also eat avocados or mushrooms, almost daily. The cramping could even be magnesium deficiency and I sometimes take magnesium supplement for this (1 tablet has 400 mg = 100% RDA). You would have to eat more than 1/2 cup of lite salt to get to a toxic level, so I wouldn't worry Smile You can read more about it here: http://en.wikipedia.org/wiki/Potassium_chloride

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*sigh* I give up! "Answer" dang it! :s

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I have been researching this a lot lately, so I was glad to read this today. So what would you recommend on the potassium? Supplement? Don't supplement? If so, how much? I have used cronometer for 2 yrs and I know I am not getting enough and I do eat LC friendly NK foods like avocados, but it's just not enough. Thoughts???

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The problem with supplements is that they are usually very low in potassium. The one I got has only 5% RDA which is a bit pointless in my opinion.
Almost every day I have an avocado (50% RDA) or a handful of nuts (15% RDA). I also eat vegetables such as eggplants (1 medium eggplant has 30% RDA) and leafy greens (1 cup of cooked spinach has 45% RDA). If it's still not enough, I add lite salt. I've made a mixture of lite salt and pink Himalayan salt that I use anytime I feel deficient or anytime I know I don't eat enough potassium (1/2 tsp lite salt has 40% RDA of potassium).
Also, do you feel deficient or is it just the numbers you see on your tracker?

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Thank you for the response! I guess the to your question is both, actually. I had a few days last week where I was severely fatigued, light headed and at times even slightly disoriented. I did drink some broth that night before bed and awoke feeling SO much better. So it couldn't have been sodium imbalance. I do eat avocado, but not daily. I do have to stay at a VLC count right now, so the starchy veggies are not on my plate often, though I do use Morton Lite Salt now to at least help me reach the RDA. I use Cronometer to track everything and I rarely reach even 50% RDA. Short of eating potatoes, I wasn't sure how even SAD eaters get enough potassium! I read somewhere recently that our ancestors had upwards of 7x our daily intake of potassium!

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My apologies, typos... that should say the ANSWET to your quesiton... and COULD'VE been sodium imbalance.

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That's ok, I find my own typos of all kinds in my posts all the time! Smile
I just checked my own progress (using our KetoDiet iPad app) and my potassium intake is always 100-150% RDA (without using lite salt). On the other hand, I noticed my magnesium level is sometimes lower than the RDA (80-90% RDA on days I don't eat any nuts).
On the other hand, I don't do VLC - my current level is round 50 and maintaining my weight. If you try to eat as little carbs as possible, lite salt is the best option you have. Here is another tip you can try: mix 1/2 tsp of lite salt in a 2 litres of water and drink throughout the day. If you can taste the salt and it's unpleasant, use more water. I guess our ancestors had access to more nutritious food - everything these days has just a fraction of vitamins and minerals - even compared to 50 years ago :-(

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Hey, thank you so much for all your feedback! I realized today that many of the foods in cronometer don't even register potassium!!!!! So that could be one reason why I'm reading "low", but I am going to do your water trick. I actually often put salt under my tongue before bed to help calm the sympathetic nervous system, so I doubt I'll mind the taste! ;) Thank you again! Your site is an amazing resource and I have recommended it to many of my fellow Keto friends!! <3 Much love!

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Thank you Klynn!
I thought that could be the issue (not registering potassium). We use USDA data (most complete when it comes to details about nutrients) plus our own database (foods common in LC diets).
Lite salt has a slightly different flavour than "normal" salt and you may not like it - in case it's too much, just mix it with water.
Glad I could help! Smile

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Thank you so much for all the info! I'm using your iPad app (btw it's amazing!) and realized I must have potassium deficiency (hardly get over 70% RDA). I don't like avocados but will try lite salt!

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Thank you! I knew this was a key feature to have in the app - the right intake of electrolytes is VERY important on a low-carb diet Smile

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Really good site thank you so much for your time in writing the posts for all of us to learn about.

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Thank you! Smile

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Thanks for great article! I hope I can find lite salt, I guess that's the best for potassium...

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I'm sure you can, I found it online and there are some products you can use: LoSalt, Lite Salt, AlsoSalt, etc.

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I use Morton salt substitute which gives 610 mg potassium per 1/4 tsp serving and can be found very easily.

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