Is the keto diet safe for a woman with fatigue and cramps?

Question

Hello doctor,

I am a 70-year-old female in good health with no underlying issues. I have been on a strict keto diet for the past two months to lose 20 pounds. So far, I have lost 11 pounds, but I have started experiencing fatigue, brain fog, calf cramps, a few achy joints, and poor-quality sleep. None of these symptoms is normal for me.

After researching keto for my age group, I found that most articles suggest it may not be the best choice for older adults. I was consuming fewer than 20 grams of carbohydrates daily and keeping my calories under 1,000.

Recently, I increased my calorie intake to 1,250, and my carbohydrate intake is 35 to 50 grams per day. I am also drinking more water and using two no-sugar electrolyte packets daily. My current medications are Synthroid 100 (Levothyroxine), Prozac (Fluoxetine) 20 mg, Crestor (Rosuvastatin) 5 mg, and Mirtazapine (Remeron) 7.5

I am slowly beginning to feel better. I am 5 feet 5 inches tall and currently weigh 148 pounds. My ideal weight is between 135 and 138 pounds.

Am I taking the right approach, and how long might it take for these symptoms to resolve fully?

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I have gone through your query and understand your concern.

It sounds like you have been following your ketogenic diet quite strictly. Still, the symptoms you are experiencing, such as fatigue, brain fog, muscle cramps, and sleep issues, are common signs that your body is under stress from both calorie restriction and carbohydrate deprivation.

At your age, a very low carbohydrate intake combined with a calorie level under 1,000 per day can slow metabolism, reduce energy availability for the brain and muscles, and alter electrolyte and hormone balance. Since you are already taking medications such as Synthroid (Levothyroxine) for thyroid function, Prozac (Fluoxetine), Crestor (Rosuvastatin), and Mirtazapine (Remeron), your body may also be more sensitive to nutritional changes.

Increasing your calories to around 1,250 and your carbohydrate intake to 35 to 50 grams is a smart adjustment, as it helps restore glycogen stores, improves hydration, and reduces muscle cramps. The fact that you are already noticing gradual improvement is a good sign.

You can expect most of your symptoms to resolve gradually over the next one to two weeks as your body adapts to the higher calorie and carbohydrate intake.

Continue taking your electrolytes, stay well-hydrated, and ensure you are getting enough magnesium, potassium, and sodium in your diet, as these nutrients are often depleted on the keto diet.
Aim for balanced meals with healthy fats, moderate protein, and complex carbohydrates such as vegetables, berries, and small portions of whole grains if tolerated.
Consider a more moderate low-carbohydrate plan rather than a strict ketogenic diet, as this can be safer and more sustainable at your age.
If your fatigue, cramps, or mental fog persist beyond two weeks, consult your doctor to review your thyroid levels, electrolytes, and kidney function to ensure everything is in balance.

I hope I have answered your question.

Let me know if I can assist you further.

Thank you.