Vagal afib or electrolyte related? Low carb/keto

Known paroxysmal afib for 3.5 years now. Probably a few episodes before that. Originally afib would hit most when traveling (altitude, dryness, dehydration or other) but lately it only happens during periods of low carb dieting. When not doing keto my diet is heavy with potatoes (love those hash browns) and salty snacks (Doritos). When on keto, I have to consciously add salt. Which so times feels like it helps with afib and sometimes has no effect.

Regular blood tests always show sodium, calcium, magnesium and potassium in range. Sometimes sodium comes in a bit low but still in range.

My problems are nearly always at night. Occasional pvc in late evening. Afib when in bed; sometimes when awake. Lately I’ve been able to clear it by just going about my morning routine or even going for a walk to force my HR even higher and somehow it shocks me back into NSR. Pickles seemed to help my PVCs for the past few days of coming back n keto (was off for a few weeks with thanksgiving). And like clockwork, afib has returned.

For the 3.5 weeks not on keto - no afib. But I also added back 20 pounds. I blame the potatoes and apple pie.

Cpap, left side sleeper, low does lisinopril…. What I don’t know is is this vagal or electrolyte related? My keto is cardiologist supervised and he’s not concerned bout the afib. Says losing weight is better for me. Intuitively it seems electrolyte. But the issues only happening at night… and this will sound strange but often I now afib is coming on because of how my stomach feels prior, I’ve had a mag RBc test and it was fine. I do take one slowMag at night.

What could this be? How can I isolate triggers? Potassium RBC next? Exatest? I have another 70 pounds I need to lose so will be on keto a while longer. Thanks all.

I was getting more frequent afib during low carb keto dieting. The er doctor said it was because of that.

I saw a nutritionist who said to always combine a protein with a carb during a meal, eat less big meals and instead 4-6 smaller meals and try to avoid eating after 6-7 pm. I don’t eat potatoes, pasta or rice. Instead I’ll eat smaller portions of low glycemic carbs. I’m gluten free so instead of the one cup cereal serving size, I half it and eat the other half as a daytime snack.

The apple pie is the sugar content you should consider reducing.

Good luck!

Have you considered that keto diets cause significant water loss? Dehydration is an afib trigger for almost everyone, so try substantially increasing your water intake while on a keto diet.

Good to know Carey! Thanks

I dropped 45#'s starting in 2009 with keto. My first afib was in 2004, including a 2 /12 month episode. When keto adapting, the way I knew back then was Dr. Atkins 20g/day carbs. I did have one 3 am episode that I attribute to the keto adaptation. I've maintained adaptation since, though eat quite a bit of carbs for being keto, up to 200 g/day. On a morning finger stick, I usually test 0.4-0.7 mmol/L BHB. When I studied the afib issue with keto, it appears that the low insulin causes the kidneys to excrete sodium (high insulin will cause the kidney to conserve sodium). This excretion can be so dramatic that potassium will also be excreted also. So increasing sodium intake may beneficial. Sodium can be a trigger for some afibbers, but it is a common suggestion to minimize "keto flu." [www.dietdoctor.com] In may case, I also upped my magnesium to bowel tolerance. I also added potassium. As potassium will get excreted immediately, if taken in large quantities, I put 2 tsp potassium citrate powder in liter of water and drink over the day. These suggestions assumes you have good kidney function.

The water loss that Carey talks about is from the water that is stored in the muscles & liver. Each gram of glycogen stored in your body is bound to 3 or 4 grams of water. When you deplete the glycogen, the water gets excreted. In my experience this does not lead to dehydration. It is the cause of body weight shifts that can occur when you restrict or add carbs.

As to vagal, yes does sound vagal. In my case, when I have electrolytes optimized, most triggers go away. When I don't have them optimized, there are episodes with no triggers, just because.

Lastly I'm in a group that has a twist on straight keto. Here is an "elevator speech" for their approach. I can elaborate on any of this, if there is interest.

Australian engineer, Marty Kendall, has developed systems to help people lose weight (fat) and optimize their metabolism. Helping his type 1 diabetic wife optimize her insulin use and control her glucose sent him down this path. Analyzing data from her closed loop continuous glucose monitor/insulin pump system led him to understand one flaw in common approaches to weight loss. It is assumed that carbs have the greatest insulin response, protein has about half of that of carbs and fat has virtually none. What Marty observed is that fat has a longer impact on basal insulin and a large intake of fat will raise insulin levels over the course of the day. Everyone knows that insulin needs to be low during a period of time of the day for the body to access stored body fat.

Marty knew that the order of fuel use in the body is alcohol, ketones, blood glucose, liver and muscle glycogen (glucose), fatty acids in the blood, then body fat. When the non-body fat fuels are elevated, insulin and glucose are too. So Marty developed a system using a glucometer (blood glucose meter) as a fuel gauge. This system could also be used for individualized hunger training. Hunger training allows a person to get feedback as to whether their hunger feeling is due to low fuel on board, or something else. Marty calls this system, Data Driven Fasting.

Marty also observed that when people optimized their nutrition with nutrient dense foods, to optimize the intake of the important amino acids, vitamins and minerals, they consumed less total calories. This is because the body has nutrient sensing pathways that signal a person to eat till these nutritional requirements have been met. So Marty also developed a course to teach people how to optimize their nutrition, no matter their way of eating (from carnivore to vegan and everything in between).

Here are a number of links were you can explore this in more detail:

Data Driven Fasting: [optimisingnutrition.com]

Hunger Training, using a glucometer as a fuel gauge: [optimisingnutrition.com]

Oxidative Priority: The SECRET to optimising WHEN and WHAT you eat (or the order in which fuels – foods – are used); [optimisingnutrition.com]

Want to lose fat? DON’T aim for stable blood sugars! (Why your CGM could be making you fat): h[optimisingnutrition.com]

What is nutrient density?: [optimisingnutrition.com]



Edited 1 time(s). Last edit at 11/07/2022 12:11PM by GeorgeN.

Boy oh boy. I will read this twice tomorrow. TFS.