Leg Cramps and Low Carb Diet: Causes and Treatments

Low-Carb Diets and Muscle Aches in the Legs

Low-Carb Diets and Muscle Aches in the Legs
Iulia Cozlenco/iStock; Everyday Health

There are several potential benefits to reducing your carb intake, including weight loss and improved heart health, according to The Nutrition Source. But the shift to a low-carb diet can cause some potential side effects.

Muscle cramps are just one of the many possible side effects you may experience when starting out on a low-carb diet, though they're probably not as common as some of the others.

Types of Low-Carb Diets

Reducing your carbs below 130 grams (g) is considered a “low-carb diet,” according to StatPearls. But some people reduce their carb intake by much more than that. For example, the Atkins 20 diet limits carb intake to about 20 g a day, according to the Atkins website.

A ketogenic diet limits carbs to less than 50 g per day and involves getting most of your daily calories from fats and some protein. But you may also be following a low-carb, high-protein diet that increases your protein intake instead of your fat intake.

Some people may just want to cut out the unhealthy carbs from sugar and refined grains. Giving up soda, cakes, cookies, candy, chips, white bread, and similar foods can lower the number of carbs you eat and have dramatic benefits for your health.

Low-Carb Diet Side Effects

The side effects you may experience when starting a low-carb diet depend on the extent to which you cut carbs. They also depend on your own sensitivity to a lack of carbs.

If you previously ate a high-carbohydrate diet, and you switch to a ketogenic diet, you are likely to feel more marked side effects than someone who makes a more moderate change.

According to Cleveland Clinic, side effects of a very low-carb diet like the keto diet may include:

  • Fatigue
  • Headache
  • Nausea
  • Vomiting
  • Dizziness
  • Insomnia
  • Reduced exercise intolerance
  • Constipation or diarrhea
  • Skin rash
  • Bad breath
  • Weakness
  • Muscle cramps and soreness (which can occur in the legs)

These symptoms are often referred to as the “keto flu.” They aren't a virus like the flu, but they can cause you to feel tired and achy as if you have the dreaded bug. Much like the flu, these symptoms are at their worst in the first few days, then gradually begin to improve.

Sore Muscles on Keto

No one is quite sure of the causes of keto leg pain. In general, most people feel run down during the first few days of the keto diet because their bodies are trying to adapt to the huge dietary change.

Your body likes to maintain homeostasis, or a state of balance. Suddenly taking away carbs, its preferred source of energy, can throw your body into a tailspin. Now the body has to search for another means of providing energy, burning fat, and creating ketones, in a metabolic process known as ketosis.

The effects of ketones on the body aren't well understood. In people with diabetes, a buildup of ketones in the blood causes a dangerous condition called ketoacidosis, which can have side effects including fatigue, nausea, weakness, shortness of breath, and a fruity odor to the breath, according to Mayo Clinic.

This is not the same as ketosis, which is a natural process that raises ketone levels but not nearly as high as in ketoacidosis; however, ketones may be responsible for some of the uncomfortable side effects you experience.

In addition, when you drastically reduce your carbs, you lose a lot of water weight in the first few days. In fact, most of the weight loss you'll see at the beginning of a diet is water loss. If you're not adequately replacing these fluids, you risk dehydration, primary symptoms of which include muscle cramps, according to MedlinePlus.

If you're also exercising during this time, you risk even more fluid loss through sweat. Doing vigorous activities such as running or interval training while dehydrated can make matters worse. Putting stress on muscles that are already fatigued from lack of carbs and fluids will likely result in greater muscle damage and soreness after your workout.

Lastly, losing fluids and cutting carbs can lead to losses of important electrolyte minerals, including magnesium, potassium, calcium, and sodium. Collectively, these minerals play a major role in muscle function, and being deficient in one or more of them can cause discomfort, numbness, or tingling in the legs, according to Cleveland Clinic.

Help for Keto Leg Pain

Like many of the symptoms of ketosis, leg cramps are typically short-lived. As your body adapts to the change, your legs should start to feel better. In the meantime, here are a few tips to minimize your discomfort.

Take it easy: Don't put any more stress on your legs than you need to. There's no need to stop exercising — in fact, light exercise may even help — but this is probably not a good week to increase your marathon training mileage. Instead, opt for short sessions of low- to moderate-intensity activities like brisk walking.

Drink up: It's crucial to focus on proper hydration during this time. According to Mayo Clinic, men need 15.5 cups of fluids per day and women need about 11.5 cups daily. While about 20 percent of this comes from the foods you eat, most comes from drinking water and other unsweetened beverages.

Keep track of your fluid intake to make sure you're reaching your goal. You should also weigh yourself, according to UPMC Sports Medicine, especially before and after exercise, and try to replace the weight you have lost with extra fluids. As mentioned earlier, this is not fat loss — it's water loss. If your weight is dropping, you're probably becoming dehydrated.

Replace electrolyte minerals: Most people can get all the electrolyte minerals they need through their diet. Eat plenty of leafy greens, snack on some keto-friendly nuts like pecans, and add a little extra salt to your meals.

If your keto leg cramps don't subside after a week, you should check in with your doctor. Leg pain and leg cramps have myriad causes that may not be due to your diet change. Tell your doctor about any other changes you've made recently or any other changes in your health that you've noticed so you can get an accurate diagnosis.

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Reyna-Franco-bio

Reyna Franco, RDN

Medical Reviewer

Reyna Franco, RDN, is a New York City–based dietitian-nutritionist, certified specialist in sports dietetics, and certified personal trainer. She is a diplomate of the American College of Lifestyle Medicine and has a master's degree in nutrition and exercise physiology from Columbia University.

In her private practice, she provides medical nutrition therapy for weight management, sports nutrition, diabetes, cardiac disease, renal disease, gastrointestinal disorders, cancer, food allergies, eating disorders, and childhood nutrition. To serve her diverse patients, she demonstrates cultural sensitivity and knowledge of customary food practices. She applies the tenets of lifestyle medicine to reduce the risk of chronic disease and improve health outcomes for her patients.

Franco is also a corporate wellness consultant who conducts wellness counseling and seminars for organizations of every size. She taught sports nutrition to medical students at the Albert Einstein College of Medicine, taught life cycle nutrition and nutrition counseling to undergraduate students at LaGuardia Community College, and precepts nutrition students and interns. She created the sports nutrition rotation for the New York Distance Dietetic Internship program.

She is the chair of the American College of Lifestyle Medicine's Registered Dietitian-Nutritionist Member Interest Group. She is also the treasurer and secretary of the New York State Academy of Nutrition and Dietetics, having previously served in many other leadership roles for the organization, including as past president, awards committee chair, and grant committee chair, among others. She is active in the local Greater New York Dietetic Association and Long Island Academy of Nutrition and Dietetics, too.

Jody Braverman, CPT, FNS, RYT

Author