The ketogenic diet, which requires a severe restriction of carbohydrates, fundamentally changes how the body manages energy and fluid balance. As the body shifts from burning glucose to burning fat for fuel, it enters a metabolic state called ketosis. This shift is often accompanied by a rapid loss of water weight, which flushes out significant amounts of electrolytes. This depletion of minerals like sodium is a primary cause of the temporary side effects known collectively as the “keto flu.” Headaches, fatigue, dizziness, and muscle cramps are common symptoms that can be largely mitigated by intentionally increasing sodium intake.
Why Sodium Requirements Increase on Keto
When carbohydrate intake is drastically reduced, the body produces significantly less of the hormone insulin, which plays a direct role in signaling the kidneys to retain sodium and water. With lower insulin levels, the kidneys begin to excrete sodium at a much higher rate through urine, leading to a rapid and considerable loss of this mineral.
The body’s stored carbohydrates, known as glycogen, are also a major factor in fluid retention. As the body depletes its glycogen reserves when starting a ketogenic diet, the associated water is released, taking essential electrolytes like sodium with it. This dual mechanism—lowered insulin and depleted glycogen—creates a physiological demand for sodium that is far greater than the requirements for a person on a standard diet.
This increased rate of sodium excretion is a predictable consequence of metabolic change, not a sign of poor health. If this loss is not quickly offset by increased dietary intake, the resulting drop in blood sodium can cause symptoms of dehydration and low blood pressure. The goal is to prevent the electrolyte imbalance that causes most of the initial discomfort associated with the diet transition.
Recommended Daily Salt Intake
The amount of sodium required on a ketogenic diet is substantially higher than the typical recommendation for the general population. Most experts suggest that individuals following a ketogenic plan should aim to consume between 4,000 milligrams (mg) and 7,000 mg of sodium each day. This broad range accounts for individual differences such as body size, activity level, and climate, particularly the amount of sodium lost through sweat.
Translating this recommendation into teaspoons of salt provides a clearer picture for daily consumption. One level teaspoon of common table salt contains approximately 2,300 mg of sodium. This means that to meet the lower end of the recommended daily intake of 4,000 mg, a person would need to consume roughly 1.7 to 2.2 teaspoons of salt over the course of the day.
For highly active individuals or those experiencing noticeable symptoms of electrolyte depletion, the intake may need to approach the higher end of the range. Consuming 7,000 mg of sodium, for example, translates to just over 3 teaspoons of salt per day. It is important to remember that this total includes all sodium from food, not just the salt added manually.
Strategies for Consuming Enough Salt
Meeting a daily sodium target that can exceed two teaspoons requires effort beyond simply seasoning meals to taste. A simple and effective strategy is to create a homemade electrolyte drink, often referred to as “ketoade.” This involves mixing a small amount of salt, sometimes along with other electrolytes like potassium and magnesium, directly into a glass of water or a sugar-free beverage.
Another excellent method for increasing sodium intake is by regularly consuming bone broth, especially homemade versions where you can control the salt content. Bone broth is naturally rich in minerals and can be seasoned liberally with salt to provide a significant sodium boost in a warm, palatable format. Drinking one to two cups of salted broth daily can easily account for a large portion of the daily requirement.
Liberally salting whole, unprocessed foods throughout the day is also a straightforward strategy. Since the ketogenic diet eliminates many processed, high-sodium foods, one must proactively add salt to meats, eggs, and non-starchy vegetables. Spreading the salt consumption throughout the day, rather than taking it all at once, helps the body maintain a more stable electrolyte balance.
Medical Considerations for High Salt Intake
While increasing sodium intake is generally beneficial and often necessary for managing a ketogenic diet, it is not without important medical caveats. Individuals with pre-existing health conditions need to exercise caution before drastically increasing their salt consumption.
Specifically, those who have hypertension or a history of kidney disease should consult with their healthcare provider before changing their sodium habits. The kidneys are responsible for regulating sodium and fluid balance, and impaired function can make it difficult to handle a high salt load. Moreover, individuals taking medications for blood pressure or fluid retention, such as diuretics, must seek professional medical advice.
In these specific populations, the risks associated with excessive sodium intake, such as fluid retention and increased blood pressure, can outweigh the benefits of preventing keto flu symptoms. A medical professional can assess individual risk factors and help determine a safe and appropriate sodium target. For most healthy people, the increased sodium on keto is well-tolerated, but medical guidance is important for anyone with a chronic health concern.