Leg Cramps On Keto – How To Prevent It?

leg cramps on keto

There are many advantages and benefits to follow a keto diet; however, some people experience severe leg cramps as a result of eliminating carbohydrates from their diet. Read about why these conditions occur and how to prevent leg cramps on a keto diet.

What Causes Leg Cramps on Keto

Leg cramps associated with keto are usually due to essential mineral imbalances (usually magnesium deficiency, but also sodium and potassium) as well as dehydration. This imbalance tends to occur as you transition into ketosis, before your body begins to regularly utilize ketone bodies instead of glucose for energy. If you experience muscle contractions, you can experience them at any time of the day or night, whether you are on a ketogenic diet with the goal of losing weight or not.

Electrolyte (Mineral) Imbalance

When you eliminate carbohydrates from your diet, your body produces less insulin (insulin’s job is to process carbohydrates). With far fewer carbohydrates to process, your body produces (and uses) significantly less insulin. The reduction in insulin in your system triggers your kidneys to absorb less sodium, so more sodium is released in your urine. This can trigger a sodium deficiency and the ensuing electrolyte imbalance.

What exactly are electrolytes? Electrolytes are positively charged minerals that help hundreds of processes in your body, mainly in your muscles and nerves. They are present in almost all of your body fluids (sweat, urine and blood). Their main functions are to move fluid in and out of cells (aka stay hydrated), contract and relax muscles, and nerve conduction. The main electrolytes involved in leg cramps associated with ketosis are potassium, magnesium and sodium.


The transition to a keto diet often leads to increased urination due to certain factors, such as increased sodium excretion and decreased insulin levels. This increased urination can lead to dehydration – another possible cause of muscle cramps. Dehydration is a common side effect of ketosis and may increase your risk of leg cramps, so make sure you drink plenty of water and stay hydrated.


When you start a keto diet, drinking too much coffee can increase your chances of leg cramps because the caffeine stimulates your muscles to contract rather than encouraging muscle tissue to relax. It’s also a diuretic, so it takes water out of your body, which can lead to dehydration and muscle cramps.

Exercising Without Hydrating

If you are exercising, you will lose water and electrolytes in your sweat. Make sure you have enough water and electrolytes!

Sitting for too long

Many people with electrolyte imbalances experience more severe leg cramps at night (nocturnal leg cramps) due to lack of exercise during the day. When you don’t exercise, your muscles become tighter and can “jam” you up. This is why getting up and walking around sometimes helps stop the “charley horse” (leg cramps).

Other Possible Causes

Other possible causes of leg cramps not necessarily related to the ketogenic diet include certain medications such as diuretics, statins, and asthma medications, sedentary habits, strenuous physical activity, and medical conditions such as kidney and liver failure.

Top Tips for Preventing Leg Cramps on Keto

The best way to prevent and treat keto leg cramps is to make sure you eat nutritious foods, take supplements when necessary, and stay properly hydrated. Here are a few tips:

  • Eat potassium-rich foods. Avocados, Swiss chard, spinach, onions, tomatoes, beets and mushrooms are all potassium-rich foods that are keto-friendly and can help rebalance your electrolyte levels.
  • Choose magnesium-rich foods. Pumpkin seeds, Brazil nuts, cashews, kale, arugula, broccoli and oysters are low in carbohydrates and high in magnesium, which can help your electrolytes.
  • Consider taking an electrolyte supplement. For people transitioning to a keto diet, taking magnesium, potassium or a multi-mineral supplement may be a good idea.
  • Consume enough salt. Add salt to your food and consider sipping salted bone broth to reduce the chance of electrolyte imbalance.
  • Drink plenty of water. Staying properly hydrated can reduce your risk of leg cramps and other keto side effects, such as headaches and constipation. Pale yellow urine is a sign that you are properly hydrated.
  • Cut back on or avoid alcohol. Alcohol is a diuretic and may exacerbate dehydration. Some studies suggest that alcohol consumption may be associated with leg cramps.
  • Engage in gentle exercise. Try walking, stretching and yoga when you are first adjusting to ketosis. Avoid vigorous exercise for the first few days to reduce the chance of leg cramps. 

When to Talk to a Doctor About Your Leg Cramps

While it is often safe and effective to address leg cramps by changing your diet, in some cases, you should seek medical advice as soon as possible.

Leg cramps are your body’s way of telling you that something isn’t quite right. To be on the safe side, here are the times you should see your doctor:

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

In addition, your doctor can perform a physical exam and provide services such as lab tests to detect electrolyte imbalances, dehydration or other problems that cause leg cramps.

The Bottom Line

While many people are convinced by the keto diet, the transition to a very low-carb, high-fat diet can lead to uncomfortable symptoms, including leg cramps.

That said, making some simple changes to your diet and lifestyle, such as staying hydrated, eating plenty of electrolyte-rich foods, and engaging in gentle activity, may help treat and prevent keto-related leg cramps.

If you experience leg cramps, try some of the tips listed above – but if your cramps are persistent or extreme, remember to see your healthcare provider.

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