Hand Tremors And Keto: What You Need To Know

Several diet and lifestyle trends have emerged over the past few years focused on safely and effectively preventing or reversing unhealthy weight gain. One popular trend is the ketogenic diet. Despite the remarkable health benefits of keto, there are potential side effects of the diet. 

Can keto cause my hands to shake?

Keto can cause your hands to shake due to electrolyte imbalance. Since keto emphasizes healthy fats in place of carbs, the body’s supply of glucose is reduced and forces us to make adjustments to cope. These changes disrupt several systems resulting in side effects, but they fade in time. 

Electrolyte imbalance is quite common while on keto, so it’s essential to understand it. This article explains the electrolyte imbalance resulting from a keto diet, why it occurs, its symptoms, and how to replenish electrolyte levels with food and supplements. 

Side Effects of Ketogenic Diet 

Keto is a low-carb, high-fat diet. This diet shifts your body’s primary fuel source from blood glucose to fat. Ketones converted from fat by the liver are used by the cells instead of glucose. This state is referred to as ketosis. An increased rate of fat breakdown causes rapid weight loss. 

Before fat loss and other keto benefits are realized, the body organs take some time to adapt to using ketones instead of glucose. During this period of biological adaptations, you can experience several undesirable effects. 

A few days into the keto diet, you may start experiencing fatigue, shaking, heart palpitations, constipation, and dizziness. This may be due to electrolyte imbalance. 

How a Keto Diet Causes Electrolyte Imbalance

The body needs a balanced blend of electrolytes to function correctly. These electrolytes are minerals that allow your body to perform essential functions like heartbeat regulation, muscle action, bladder control, temperature regulation, and neurological functions. Essential electrolytes include calcium, sodium, potassium, magnesium, chloride, and phosphorus. 

Electrolytes are obtained from food and drink. A diet that is deficient in carbohydrates contains low levels of these minerals. When you switch to a keto diet, you drastically reduce your electrolyte intake. The kidneys also excrete more sodium when insulin levels are low, disrupting the balance of electrolytes in the body. 

As you lower your intake of carbohydrates, your body rapidly burns through its stored glucose. Glucose is stored in the muscles in the form of glycogen. Each gram of glycogen holds up to three grams of water, so a loss of water weight accompanies glycogen stores’ reduction. Loss of water also causes an electrolyte imbalance. 

The body reduces its blood volume as it tries to maintain a normal electrolyte concentration. The reduction in blood volume is what causes the symptoms described as keto flu. These symptoms include:  

  • Heart palpitations
  • Headaches, migraines, or brain fog
  • Constipation and water retention
  • Fatigue, dizziness, and feeling shaky
  • Weight loss
  • Cramping

How to Replenish Electrolytes 

You can fix the electrolyte imbalance caused by a keto diet by replenishing the electrolytes in your body. The two main options are consuming keto-friendly whole foods and taking electrolyte supplements. Increasing water intake is also imperative in restoring electrolyte levels. 


When the blood’s carbohydrate levels reduce significantly, so does the amount of insulin released into the blood. Low insulin increases urinary sodium excretion. Sodium is excreted in urine at a faster rate. The symptoms of low sodium levels include fatigue, headaches, weakness, and difficulty concentrating. 

Although many health organizations like the American Heart Association recommend a daily sodium intake of 1.5 to 2.3 grams, most people consume between 3 to 6 grams. Due to increased excretion of sodium when you are on a keto diet, your sodium intake should increase. 

To replenish sodium levels in your body, you should eat dill pickle, bouillon, and tomatoes. You can also sprinkle salt on meals, raw vegetables, or dissolve it in drinking water. If you have a severe condition like kidney disease, hypertension, or congestive heart failure, you should be cautious about the levels of sodium you consume.


In response to lower sodium levels during ketosis, the kidneys start dumping potassium into the urine to maintain sodium-potassium equilibrium. This leads to a further loss of electrolytes. Symptoms of potassium deficiency include muscle twitching, muscle cramps, and heart palpitations.

The daily need for potassium is 3 to 4.7 grams. Most foods contain moderate amounts of the mineral, including several low-carb sources. Keto-friendly potassium sources include avocado, almonds, hemp seeds, artichoke, salmon fish, mushrooms, and spinach.   

Potassium supplements are available, but you run the risk of raising your blood potassium levels to dangerous heights by taking them. Food intake is the best way to replenish potassium levels, especially if you have kidney disease or are taking certain medications. 


A drop in sodium and potassium levels leads to declines in other essential electrolytes, including magnesium. Magnesium deficiency can cause muscle cramping and twitching. 

Magnesium is available in a wide variety of foods. However, it is estimated that a significant portion of the US population fails to meet the daily dietary requirement for minerals. Several high-magnesium foods can be included in a keto diet.

Most of them are also sources of potassium. Snacking on pumpkin seeds, eating salmon, halibut, spinach, and other green vegetables, or including dark chocolate and cocoa powder in your dessert is a great way to replenish your magnesium levels during ketosis.   

Other Negative Impacts of Keto

Other side effects of a keto diet include hypoglycemia, bad breath, insomnia, irregular menstrual cycles, and decreased bone density. Hypoglycemia, also known as low blood sugar, results from carb withdrawal. It occurs during the first few days before the body has adapted to running on ketones from fat. Hypoglycemia subsides when the body is effectively keto-adapted. 

Hypoglycemia resulting from a keto diet can also cause your hand to shake. Other common symptoms of hypoglycemia include: 

  • Frequent urination
  • Excessive thirst
  • Hunger 
  • Fatigue
  • Lightheadedness and shakiness
  • Tachycardia
  • Confusion, anxiety, and irritability
  • Sweating and chills  

Is Keto for Everyone?

Despite having the benefits of improving people’s health and well-being, the keto diet is not suitable for everyone. Since the diet can cause significant changes in a person’s body systems, including metabolism and response to certain medications, it should be done cautiously. People with chronic conditions such as diabetes and high blood pressure are not ideal candidates for the diet. 

A keto diet can be done in short-term fat loss or management of other diseases like epilepsy only under strict medical supervision for patients with underlying conditions. This is because the level of dietary restriction in a keto diet may require electrolyte supplementation and change in medication dosages.


When done safely, the keto diet is beneficial for rapid weight loss. It also reduces the risk of heart disease and diabetes, alleviates neurological disorders symptoms, and improves cognitive function. Getting the first few days on a keto diet is the hardest part. 

You are likely to experience several adverse side effects, including shaky hands. If you don’t understand keto’s side effects and alleviate them, you might conclude that the diet is not right for you. You should address the electrolyte imbalances caused by the keto diet and give your body enough time to get used to the changes.

Here’s a quick recap of the post:

  • Always consult a medical professional before committing to a drastic diet change.
  • Failure to adhere to the Keto diet’s specific guidelines can cause shaky hands and other unwanted issues.
  • Always replenish your electrolytes to prevent trembling hands and malnourishment.
  • If you’re urinating too often or you feel sick all of the time, talk to a medical expert immediately.

Related Questions

Can your pancreatitis become worse from keto? Keto can make pancreatitis worse due to the diet’s high-fat content. Even healthy fats can cause a person to develop hypertriglyceridemia, which can trigger or worsen pancreatitis. Patients who have or have had pancreatitis should consult a doctor before going on the keto diet.

Does keto cause body odor? The keto diet can cause body odor to become stronger and more intense. This condition mostly affects the smell of sweat, armpits, breath, urine, and genitals. It is caused by acetone and sulfur, two chemicals produced by the body when it enters ketosis, and usually fades away once your body adapts.

Does keto cause your feet to swell? Keto makes your feet swell due to the electrolyte imbalance and dehydration, which may cause your body to begin retaining water. This is especially likely to happen if your ketogenic diet involves low potassium intake. However, it does not occur in every case.



Derek Masters

Derek Masters is an Amazon best-selling author. After much research, he began keto at 381 pounds in the middle of 2019. Losing 60 pounds and counting, he wants to share what he's learned with others who wish to learn about the ketogenic lifestyle

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