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Keto Diarrhea & Keto Constipation — Side Effects of Low-Carb Diets

By: Alison Moodie
May 25, 2018

Keto Diarrhea & Keto Constipation — Side Effects of Low-Carb Diets

You’ve just started the high-fat, low-carb keto diet and you’re no doubt excited about all the promised benefits. Weight loss! Increased energy! More brain power! But what you might not be prepared for are some of the less-than-fun side effects as your body learns to convert fat into fuel. Some fall under the category of, ahem, potty talk. Diarrhea and constipation, anyone? Find out why your digestion gets funky when starting keto, and how to tackle it.

What is the keto diet?

9 Fat-Healthy, Superfood Avocado Recipes_Smoked Salmon Egg Stuffed Avocados

The diet is made up of mostly fats (75 percent of your daily calories), some protein (20 percent) and a small amount of carbs (5 percent). Eating lots of fat and few carbs puts you in ketosis, a metabolic state where your body burns fat instead of carbs for energy. When your body can’t get glucose from carbs, your liver converts fatty acids from your diet into ketones, an alternative energy source. Burning ketones instead of glucose helps you drop weight fast and reduces inflammation in the body.[1] 

Related: Ketosis and the Ketogenic Diet Explained – A Complete Beginners Guide

The keto diet and digestion

You’re eating mostly meat, fish, eggs, vegetables, and smart fats on the keto diet. It doesn’t allow for many fruits and starchy vegetables like carrots and sweet potato (whole grains, beans, and legumes are off the menu). If you’re new to keto, there’s a good chance you’re adding in foods that you didn’t eat much of before you started the diet, says Stephanie Pedersen, holistic nutritionist and author of “Keto Lunches: Grab-and-Go, Make-Ahead Recipes for High-Power, Low-Carb Midday Meals.”

“For many people, suddenly giving these fiber-filled foods up means giving up the sources of dietary fiber their bodies used to help stay regular,” she says, adding that eating more meat and fats can slow digestion even more.

Although it can be uncomfortable and worrisome (not to mention inconvenient) when your bowels aren’t working like clockwork, rest assured that keto constipation and diarrhea is only temporary.

“If you’re someone who is experiencing this, there is nothing wrong with you or your body, you’re just getting used to eating in a new way,” says Pedersen. “Once these foods become a regular part of your diet, you will find that they are digested more easily and efficiently.”

Related: High-Fat, Low-Carb Keto Diet Melts Fat. Here’s How to Do It Correctly

Keto constipation: what to do

Constipation is one of the most common complaints from people who have started the keto diet. Here’s how to get things moving again: 

Up your salt intake

Keto Diarrhea & Keto Constipation - Side Effects of Low-Carb Diets_p your salt intake

Make sure you get 2 to 2 ½ teaspoons of salt a day. Keep it Bulletproof with pink Himalayan salt or a high-quality sea salt — they contain dozens of trace minerals and are generally free of heavy metals and pollutants.

“Constipation when going keto or low carb, especially in the early stages, can commonly be attributed to not getting enough salt,” says Maria Emmerich, nutritionist and author of “Quick & Easy Ketogenic Cooking.” “The colon is a master extractor of moisture and if you are getting enough sodium to retain enough water, the colon will remove it from the stool to retain it.”

Keep a food diary

Keto Diarrhea & Keto Constipation - Side Effects of Low-Carb Diets_Keep a food diary

Track what you eat and make a note of what you do and don’t digest well. Each body is unique and metabolizes food differently, says Pedersen. “Some people digest lamb beautifully, but struggle with beef,” she says. “For some other people, avocado is not a problem, but coconut oil causes constipation. If you notice you’re particularly constipated, do a mental rundown on what you’ve eaten that day and try to identify the culprit.”

Don’t skimp on water

Keto Diarrhea & Keto Constipation - Side Effects of Low-Carb Diets_Don’t skimp on water

If you were drinking a half-liter of water a day before you went keto, doubling it to a liter (or more) will help, says Pedersen. “Hot water with lemon and a pinch of sea salt can help encourage a bowel movement if you need assistance,” she adds.

Supplement with magnesium and potassium

Keto Diarrhea & Keto Constipation - Side Effects of Low-Carb Diets_Supplement with magnesium and potassium

Your kidneys start to excrete more water as your body switches from burning glucose to fat for fuel. This flushing of water accounts for the dramatic weight loss people often experience when they first start the keto diet. But in the process, your body loses valuable minerals called electrolytes (salt is one too). Supplement with 150 to 600 mg of magnesium citrate, and 200 to 800 mg potassium citrate a day, says Carole Freeman, a certified nutritionist and ketogenic diet expert. Also load up on lightly-cooked spinach and add an extra avocado to get a boost of these minerals.

Keep moving

Keto Diarrhea & Keto Constipation - Side Effects of Low-Carb Diets_Keep moving

Exercise is one of the best ways to keep you regular, says Pedersen. “Do not rely only on the keto diet to lose weight or heal a health condition — use movement, too,” she says. “Any kind of movement works, from a lunchtime stroll to a quick yoga video before bed.”

Fill up on high-fiber, low-carb vegetables and healthy fats

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Think greens like lightly cooked kale that cover your plate, with high-fat foods like egg, avocado, and wild salmon to top it off. If you cover your plate in salad greens at every meal, you’ll get a great boost of fiber, which makes stools softer and larger.  

And if all else fails

Keto Diarrhea & Keto Constipation - Side Effects of Low-Carb Diets_Start slowly with MCT oils

Up your intake of MCT (medium-chain triglycerides) oil, since it helps loosen your bowels and gets things moving. Or you can take 1 tbsp of raw potato starch at night — though bear in mind it’s high in carbs, so not ideal for daily use.

Keto diarrhea: what to do

Take activated charcoal

Keto Diarrhea & Keto Constipation - Side Effects of Low-Carb Diets_Take activated charcoal

Activated charcoal — a byproduct of burning a carbon source like wood or coconut shells that is then activated at a high temperature — has been used for thousands of years to detoxify the body, boost digestive health, and slow down aging. Activated charcoal binds to toxins and chemicals in the gut, stopping your body from absorbing them. But take it slow. Too much activated charcoal can cause the opposite of diarrhea — constipation. Start with 1 or 2 capsules and cut down if you start to feel stopped-up.[2] 

Start slowly with MCT oils

MCT oil is a saturated fatty acid that gives your body instant energy in the form of ketones. It helps fuel your body, especially as it adapts to keto. It can take a little bit of time for your digestive system to get used to MCT oils.

“If you recently introduced MCT oils into your diet, try reducing them,” says Emmerich. Even though Brain Octane Oil, a form of MCT oil, undergoes triple steam distillation in a non-oxygen atmosphere, you can still get “disaster pants” from taking too much, too soon. Start with 1 tsp at a time and work your way up from there.

Add a digestive enzyme

Keto Diarrhea & Keto Constipation - Side Effects of Low-Carb Diets_Add a digestive enzyme

You may not be properly digesting fats. “If you used to eat lower fat, your gallbladder may take a little time to get working at peak performance again,” says Emmerich. Supplements to try:

  • Lipase: This enzyme digests fat in the body. Take it on an empty stomach at night to help your body break down long-chain and branched-chain fats. You can also take one capsule with your Bulletproof Coffee in the morning. Combine lipase with ox bile, which further helps break down fats and promotes fat-soluble vitamin absorption.
  • Hydrochloric acid (HCL): HCL is the same acid you produce in your stomach. Taking an HCL supplement helps increase stomach acid, which aids digestion. Start with one 650mg capsule of HCL with pepsin (another digestive enzyme) at the beginning of each meal. If you don’t feel any discomfort after a couple of days, you can up the dose to two capsules at the start of a meal.