Keto Leg Cramps: Causes, Treatment, and More
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Keto Leg Cramps: Causes, Treatment, and More

Leg cramps are sudden involuntary contractions in your leg muscles. They can be painful, alarming, severe, and even debilitating. 

But can going keto cause leg cramps?

The answer is yes…sometimes. But there are some simple ways to avoid leg cramps, whether it’s because of your keto diet or other nutrition-related reasons. If you follow the ketogenic diet and you’re currently dealing with leg cramps, you’ve come to the right place!

Keep reading to learn the most common keto-related cramping culprits, plus safe and easy at-home solutions, as well as signs that could indicate your cramping is more serious (and when to seek a professional medical opinion).

Common Causes of Leg Cramps on Keto

#1: Dehydration

If you’re new to ketosis, there’s a chance you may experience leg cramps due to dehydration.

Although the keto diet isn’t inherently dehydrating, some people experience a phenomenon called keto flu at the beginning of their keto journey.

In a nutshell, keto flu occurs when your body flushes out glycogen (sugar stored in your muscles), which also reduces the overall water content in your body. 

And until your metabolism catches up and you become fully fat-adapted, the flushing and rebalancing can lead to other symptoms including brain fog, irritability, headaches, and excessive hunger.

Although it’s exciting to drop a few pounds of water weight quickly, your best bet to avoid cramping is to drink some extra water each day while your body adjusts to keto. The added water will not only work to hydrate your body, but can also help curb your hunger until fat-adaptation occurs.

Also, if you’re exercising vigorously or live in a hot climate, pay extra attention to your water intake–regardless of how long you’ve been on the keto diet 

Want to learn more about the causes of keto flu, plus how to recognize and deal with it? Read Keto Flu: What It Is and How to Get Rid of It.

#2: Overhydration

Dehydration is no good, but drinking too much water can also lead to serious health issues.

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Staying hydrated is one thing, but be careful not to chug too much water (or other liquids) throughout the day. 

Doing so can flush electrolytes from your cells through osmosis and, in extreme cases, can also cause severe symptoms like brain swelling. Sadly, people have even died of “water poisoning”[*].

Basically, if you’ve been chugging water nonstop, you may be able to reduce or eliminate your leg cramps by drinking less.

Instead, ensure you only drink enough water so that you aren’t thirsty. And consume some extra fluids whenever you exercise or sweat. 

But as long as your urine is clear or light yellow (instead of medium- or dark-colored), you’re probably sufficiently hydrated[*].

#3: Not Getting Enough Salt

Electrolytes are an important, but often neglected, aspect of your dietary intake and overall health.

Sodium or salt is the most prevalent electrolyte in your body, and your cells, muscles, and organs require it for proper functioning[*].

But when you first begin keto, or if you sweat or exercise a lot, your body may flush out sodium, which can result in cramping.

The solution is pretty simple, but it may surprise you: try eating more salt.

Is adding extra salt to your diet safe? Generally speaking, yes–especially if you’re deficient. 

Unless you have sodium-sensitive hypertension, which affects about 12% of the population, upping your salt consumption is unlikely to be dangerous[*]. (If you aren’t sure, ask your doctor before changing your diet.)

Any type of salt can work, but natural and unrefined forms of salt–such as natural sea salt–are tastier and also contain other beneficial minerals.

#4: Magnesium Deficiency

Magnesium is another vital electrolyte that your body requires for proper muscle and nerve function.

And a deficiency in magnesium can result in leg cramps as well as other serious symptoms, including insomnia, high blood pressure, and cardiac arrhythmias[*][*].

Excessive water intake or sweating can contribute to magnesium deficiency, but so can stress[*].

Therefore, even if you already consume plenty of magnesium, you might still have a deficiency. Some researchers estimate that up to 30% of the population is at least slightly deficient in this essential mineral[*].

The natural way to boost your magnesium intake is by eating keto-friendly foods that are rich in magnesium:

  • Pure cacao contains up to 140 milligrams of magnesium in a 1 oz serving (about 45% of your recommended daily allowance)
  • An ounce of almonds has about 75 milligrams of magnesium, or nearly a quarter of your RDA[*]
  • A pitted, 200-gram avocado contains about 60 milligrams of magnesium (about 20% of your RDA)[*]

Or natural mineral water like San Pellegrino is another convenient way to get extra magnesium.

Alternatively, some people opt for daily magnesium supplements as a way to elevate their magnesium levels. 

Magnesium citrate is the most common supplement form, but sometimes causes loose stools. If it doesn’t agree with your body, you may have better results with magnesium glycinate, magnesium threonate, magnesium acetyl-taurate, or a “slow-release” form of magnesium.

#5: Potassium Shortage

Similar to sodium and magnesium, potassium is another electrolyte involved in the function of your nervous system and musculature.

And studies show that insufficient potassium commonly leads to leg cramps and other typess of cramping[*].

Potassium deficiency, also called hypokalemia, may occur due to excessive alcohol intake, sweating, vomiting, or diarrhea.

Also, some people don’t eat enough potassium on keto because many potassium-rich foods are also high in carbohydrates. 

However, you can easily get more potassium without going bananas:

  • Avocados are the reigning champion, with over 950 milligrams of potassium per 200-gram pitted avocado (representing as much as 27% of your RDA)[*]
  • Gram-for-gram, leafy greens like Swiss chard or spinach contain nearly as much potassium as avocadoes[*][*]
  • With around 350 mg potassium per 100 grams, mushrooms are also an excellent way to increase your potassium intake[*]

Conversely, there’s not much point in taking potassium supplements. The FDA limits potassium chloride content of supplements to 99 milligrams per serving (about 3% of your recommended daily allowance) for safety reasons–too much potassium in isolation can cause stomach problems as well as serious cardiac issues[*].

Therefore, if you’re mildly deficient in potassium, you may be able to remedy it with a dietary tune-up. 

But if you suspect you have a moderate or severe case of hypokalemia, you should talk to your doctor.

#6: Consuming Too Much Caffeine 

Coffee or other caffeinated beverages can lead to leg cramps in several different ways.

First of all, overconsumption of caffeine may increase the sensitivity of your muscles and lead to excessive muscle contractions[*]. 

And second, when you consume a lot of caffeine, especially if it’s not part of your regular routine, it flushes water out of your body–potentially leading to dehydration and electrolyte imbalances[*].

Finally, caffeine is physically addictive, and caffeine withdrawal is often associated with muscle cramps, pain, and stiffness[*]. 

Fortunately, the solutions to caffeine-related leg cramps are pretty simple: if you’re overdoing your caffeine intake, cut back. 

Or, if you’re already quitting or cutting back caffeine and you suspect it’s causing leg cramps, try tapering instead of going cold turkey.

#7: Non-Dietary Triggers

Keep in mind that while the keto diet may temporarily cause leg cramps in some people, there are a variety of other causes, too.

If nothing we’ve discussed so far resonates, consider these non-dietary triggers that can also lead to leg cramps:

  • Tight muscles, which you may be able to solve through stretching and mobility work
  • Physical overexertion, such as overtraining or participating in a sports competition
  • Too much sitting (for example, at a desk or in an airplane)–try to get up and walk around a few times each hour, or if you can’t, flex and relax your calf and thigh muscles periodically
  • Heightened stress levels
  • Anti-hypertensive medications for high blood pressure
  • Other diuretic medications

Overall, dietary causes of leg cramps are common, but they’re far from the only reason you might experience leg cramping.

When to Talk to a Doctor About Your Leg Cramps

While solving your leg cramps with dietary changes is typically safe and effective, there are some instances where you should seek a medical opinion as soon as possible. 

Leg cramps are your body’s way of telling you that something isn’t quite right. Here’s when you should visit the doctor to be on the safe side:

  • If your leg cramps are severe, constant, or excessively painful
  • If your leg cramps last longer than two weeks, or you can’t solve them through basic dietary changes or other lifestyle adjustments
  • If other physical symptoms accompany your leg cramps
  • If you’re having trouble sleeping due to cramping
  • If you also experience “restless legs,” especially at night
  • If you have a known medical condition
  • If you currently take prescription medication
  • If you are pregnant
  • If you’re a senior citizen

Additionally, your doctor can perform a physical and provide services like lab tests that can detect electrolyte imbalances, dehydration, or other issues that cause leg cramping.

The Takeaway

Leg cramps are unpleasant, but most of the time, they’re nothing to worry about.

If you’re experiencing leg cramps, they could be related to the keto diet. Luckily, you don’t have to switch diets–there are plenty of keto-friendly foods rich in electrolytes, plus other at-home measures you can take to address cramping.

Keto electrolyte supplements are another convenient, easy way to address leg cramps and other hydration- or dehydration-related issues on the keto diet.

On the other hand, severe or lasting leg cramps, or leg cramps in conjunction with other symptoms, are cause for concern.

If you can’t solve your leg cramps through basic dietary changes, or if they’ve lasted longer than two weeks, go ahead and schedule an appointment with a physician.

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