Ketogenic thirst

So this is kind of out of the blue, and I have no idea if anyone among the small number of people who read my blog knows anything about a ketogenic diet, but I have been in ketosis for about a month.

The reason I opted to do this is because a while ago I tore the meniscus in my knee and a piece of it is folded over and stuck in my knee joint. I have to have surgery on it next month, and it has been very painful. My orthopedic surgeon has had me taking prescription anti-inflammatories twice a day, but I really hate popping pills and wanted to stop taking them, and I remembered that Sarah’s Daughter, who doesn’t seem to blog anymore, talked about following a ketogenic diet for pain relief.

So I thought, what the heck, I will try it.   Women love a new diet, as Cane Caldo once quipped. But do you know what? To my surprise, it actually worked! After about two weeks in ketosis, I was able to stop taking the anti-inflammatories.  Of course, my meniscus is still torn and therefore if I overdo it, the pain is there again. But it’s not nearly as bad.

Oh, and did I mention that I lost 10 pounds in the past month? Without ever feeling hungry? Yeah, so what’s not to love?

The problem is that I feel like I am dying of thirst all the time. So I drink and I drink and I drink, and then my electrolytes get all out of whack and I get terrible muscle cramps. I have  mostly gotten the electrolyte thing under control by using pink Himalayan salt on everything I eat and supplementing with magnesium, potassium, and vitamin D.

But the thirstiness is not getting any better. I wake up at night and I can’t sleep because no matter how much I drink, my mouth feels like the Sahara desert. I have tried researching this, but no one ever seems to answer the simple question of, “Does the thirstiness ever go away?”

So on the outside chance that anybody reading this knows anything about it, can you tell me if thirstiness ever goes away, or am I stuck with it for so long as I keep my carbohydrate intake under 20 g per day?  I love the pain relief but I just can’t stand my mouth being parched all the time. It’s kind of a work issue too because I am a speech pathologist.

Any advice would be appreciated.


43 thoughts on “Ketogenic thirst

  1. I wish that I could help, but the only diet that bears are familiar with is hibernation. We bulk up before winter, sleep without eating for a long time, and come out in the spring skinny and very grumpy. I don’t recommend it for humans. There is one thing that I have noticed, in winter, when you don’t perspire, a lot of your water intake goes to digestion. Perhaps that may help lead you to an answer.


  2. Google trim healthy mama good girl moonshine. The key ingredient is apple cider vinegar. This has a ton of what you need and it is easily absorbed. Also, it slows down after awhile. You are eliminating toxins and need tons of water.

    Liked by 2 people

    • OK, so it sounds like you’re saying it gets somewhat better eventually but not completely better?

      I’ll read up on the Apple cider vinegar piece. I do have some that has the “mother”. I usually use it as a tonic for my chickens.


      • Yes, at least for me, the first two months I felt the same. Remember, fat holds toxins and when you lose it the toxins have to clear out. Also you are processing less carbs and more protein. You need way more water. Eating fats like coconut oil or really good butter in a bullet proof coffee or a bullet proof chai tea latte help. Coconut water works great. ACV is a miracle. I add a bit to every drink I can. Makes excellent cold teas. You will feel a difference in the intensity of your thirst within 3 days. Start with a tiny bit and work up. My moonshine tastes like soda because of the stevia. Quick tip….add stevia to ACV and mix then add other ingredients.

        As for pain, adding tumeric, ginger and
        cinnamon (make sure it is the correct cinnamon..there are 2 types…google it) to anything you can really eliminates pain and inflamation as well. Tumeric is a miracle. I just add a bit to coffee, smoothies or marinades. 2 weeks and you wont believe it if you just add a bit to your daily coffee.
        Braggs is a great brand with the mother. Land o lakes has amazing kosher beef collagen you can add to anything and it is amazing for joints too.Nails and hair become amazingly strong as a bonus.

        Heres to your health.

        Liked by 1 person

      • Sorry, last thing. Make fresh lemonade or limeade using stevia to sweeten (disolve in juice first) . I think I drank a gallon a day but you actually feel like you drank something. Took it to bed with me.
        You will pee a ton…no getting around it lol.


      • Got turmeric on my shopping list – thanks so much for all this info! I’m just a couple weeks from my surgery and hoping for an easy recovery.


      • Yes! If you have access to fresh coconuts, absolutely…but probably not feasible where you’re at….fresh coconuts are expensive in Hawaii…and they grow here abundantly! But maybe you can find it at Costco or Sam’s Club or any Asian/Chinatown stores. I believe most Costco’s carry Zico brand coconut water from Brazil. My personal fav is young coconut water from Thailand. Thai coco juice is just naturally sweeter (no added sugar!) – although some Filipino brands are also pretty comparable.

        Thai coconut farms sell their coconuts to a co-op so there are many different brands of Thai coconut water (TAS, Jus’ Cool, C2o), but they are all basically the same quality juice. Don’t know if you can find it in upper Midwest USA. Here in Hawaii, we get ’em in 16 oz. cans. I buy it by the case. i’ve seen many of the same brands in California (from SF to SD) and Las Vegas as well. Maybe you can find it at your local grocery stores. Just be careful when you find it and make sure it’s unsweetened. Some brands are half coconut water and half sugar water. While that would probably be better then nothing…if you have a choice, get natural/organic/unsweetened if you can.

        But anyhow, tastes by region may vary, but the nutritional and physiological benefits of coconut water are all good, regardless of region. They are rich in many trace minerals like magnesium, potassium, manganese…as well as far superior to man-made concoctions like gatorade. With naturally grown electrolytes (not synthesized and/or concentrated in a laboratory) natural nutrients and minerals in coco water are much more easily absorbed (“bio-available”) by drinking coconut water then in vitamin pill form. Also, coconut water (yes, you may also find it sold as “coconut juice”) is so good for the human body, you can actually use it intravenously. In WW2, injured soldiers in emergency situations in the Phillipines where given coconut water IV’s straight from the coconuts.

        Ever since I began drinking coconut water and working extended hard days of manual labor for the past 5 years or so, I rarely experience muscle cramps or extreme fatigue. I also have no problems doing things like working a 10 hour day (then going to a 2 hour martial arts class afterwards) with no food at all since the previous day’s dinner….but 2 X 16 oz. cans of coconut water and 2 cups of black coffee in the morn are all I need to get it going all day until dinner time. Granted I don’t do this all the time ( I don’t work a steady 9-5/40 hr week of manual labor), but in terms of physical endurance and basic well being, I think it’s coconut water bar none. I could drink coconut water every day…but it’s just too precious as a fuel and/or medicinal. If I don’t have hard work or hard play scheduled and I’m not sick, I don’t drink my stash. I save it for when I need it. It’s become that vital to me.

        Finally, while there is no such thing as a surefire hangover “cure,” coconut water is about as close to it as you’re gonna get. There is no better option for re-hydration, heat exhaustion, low-blood sugar/hypoglycemia, fevers or even dehydration from illness (vomiting/diarrhea). Know how Docs recommend pedialyte for kids with fever/dehydration? Pedialyte is just a pale imitation of the real thing.

        When you are tired, hungry, hot, sweaty, fatigued, queasy, or feeling run down or hung over, coconut water will literally make you feel better in seconds. NECTAR OF THE GODS

        BTW, can you tell…I LOVE coconut water? This is probably the longest comment I’ve dropped anywhere on teh Interwebz in a year or so….but that’s because this is actually a blog post I never got around to completing. I think I still have a draft sitting in my blog folder with pub med reference links and quotes from 2012 0r 2013 that I never got around to finishing.

        Hope you can find some in your area.

        You’ll see!

        Liked by 1 person

    • Coconut water is awesome. The stuff they sell in stores is not even close but it is all I can get by men. You get the thick coconut milk from small brown coconuts. Green ones you literally give a chop and stick a straw in and drink. You feel 20 years younger in 30 min. Only Spirulina comes close. Sigh, miss real coconuts.


      • I am going to check at Costco this weekend and see what I can find. I live in a small town called Chelsea, but Ann Arbor isn’t far from here and there are a lot of ethnic food stores where I may be able to find coconut water as well.


  3. Here’s the Mayo Clinic on this one:

    ….and a source on nutrition I trust (my late mother was a member) is, which is the site for the Academy of Nutrition and Dietetics–which certifies dieticians (like my mom) and such.

    My quick search didn’t find any ways to get around the thirst–when you have a lot of ketones in your blood, your kidneys will work hard to eliminate them, hence you pee a lot and get thirsty. Ketosis appears to be mainly a problem if you’re diabetic, as it can mask the signs of a much more serious ketoacidosis.

    Good luck!

    Liked by 1 person

    • Yea Sunshine… I don’t think it’s good to **stay** in ketosis… from just what I learned about biochemistry and biology in the body, longterm I don’t think it’s good. Better to eat in moderation but focus on eating healthier foods which are more alkaline anyway, and the alkaline will cause a smaller effect of ketosis that won’t be problematic longterm.

      Look into alkaline foods, a lot of it is the same 🙂


  4. Oh yeah, and one more thing, based on everything I’ve read up on and experienced for myself and other people I know in real life who have tried it…ketogenic aka zero carb diets or simple “low-carb” diets are what I consider temporary therapeutic interventions.

    Remember, it goes back to basic human biology. We have omnivorous dentition and omnivorous digestive systems. We were designed to eat carbs (just not the highly refined, processed and prepped with crap like hydrogenated oils and refined sugars that are so common in our modern world).

    But if you’re sick/overweight/obese or got other issues, these diets can help recovery and weight loss in the short term. But you will hit a plateau point. A lot of folks experience the positive initial results from these sorts of diets and think they found the holy grail of human nutrition. Only problem is 1-3 years later they find they’ve stalled, and no longer feel so good as they once did. Then they double down on the extreme diet protocol thinking that will fix the problem and they just make it worse. It works the same whether you do a paleo-eskimo-inuit all ketogenic whale blubber diet or a pure vegan one. As your body begins to burn off it’s stored fat for energy and chronic inflammation subsides, you’ll feel dramatic improvements. But once that initial surplus of nutrients are burned off, continuing to eat at one dietary extreme or the other will eventually result in other problems related to a new set of nutritional deficiencies you experience if you stick to a rigid and dogmatic approach to diet like “all carbs are bad” or “all animal products are bad” etc.

    It’s not that ALL carbs are the problem. Just the refined wheat flours, or deep fried in vegetable oils, or made with hydrogenated GMO soybean or canola oil based carbs with additives like high fructose corn syrup or even plain sugar, that are so detrimental to health….aka cookies, crackers, cakes, pastries, most breads, chips, tortillas, hamburger and hot dog buns etc.

    But to swear off carbs for good and never eat broccoli, green beans, brussel sprouts, cauliflower, peppers, yukon gold potatoes, jasmine rice, thai sticky rice, apples, oranges, squash, pears, grapes, dates, nectarines, mangoes, bananas, plums, peaches, asparagus, kale, beets, carrots, sweet potatoes, peas, parsnips, sweet & bell peppers, or even organic pasta or corn on the cob or the occasional loaf of organic sour dough or rye bread ever again?

    Not all carbs are equal…it’s just that some are more equal than others.

    Liked by 2 people

    • +1 on Keoni’s comments here. A lot of diets work for a very simple reason; the dieter leaves the “Standard American Diet”, where most calories come from refined carbohydrates, sugars, and added fats. It often doesn’t matter how you cut off white flour and added sugars; as long as you do, you will tend to lose weight.

      Liked by 1 person

    • Great comment and in line with my own thinking. I am new to ketogenic dieting, but I really am using it mostly to deal with both chronic inflammation and pain issues. I think that I will eventually transition to a more moderately low carb diet, something more in line with the 50 to 100 g of carbs from fruit and vegetable sources. I grow a wide variety of organic fruit but won’t be able to eat any of it until I transition off keto at some point. But for now it’s keto or pain pills – so pass the bacon and avocados! 😊


      • MORE POWER TO YA. I decided to go Keto like a week ago and I’m already getting so much pessimism about how I can’t do it forever and how it’s so hard and blah blah blah. Who cares if it’s not a 100% permanent change? You do you and if it makes you feel better, awesome. If you at some point in your life decide that a grape is your craving, do it. It’s ok to have phases in life (: I totally support you! I’m doing it for similar reasons (pain)


    • Right! Try the amazingly good carbs like sweet potatoes, etc. as a replacement. Even just giving a cursory glance at fit bikini body competition ladies’ diets, you’ll see what they eat as carbs are very different from the normal population. And their bodies look AMAZING – perfectly trim with just the right amount of fat % and not overly muscular.

      But carbs are great – but it does matter which ones (Keoni mentions some great ones!).

      Liked by 1 person

      • I love pretty much all fruit and vegetables. What is odd, though, is that when I eat them, I begin craving grain and sugar… like really craving it in this almost irresistible way. But when I am eating more fat plus fewer than 20 carbs per day (which means no fruit and restricted vegetables), all of my food cravings stop. No idea why, but what I read from other people who find keto helpful is that they experience the same kinds of cravings when they eat fruit or starchy vegetables. All I can suss from this is that not everyone responds the same way to the same diet.

        But I did find unsweetened coconut water at the grocery store. I have it chilling in the refrigerator right now! Unfortunately, it’s my entire allotment of carbohydrates for the day.

        Liked by 1 person

      • You’re right that not everyone responds the same to different diets – I forget about that at times! It’s our genetic makeup I believe. I know I heard when I was studying this stuff in college that they may eventually be able to develop genetically specific diet plans for people – but I’m not sure where they are on that right now or if they’ve scrapped the whole idea.

        I just thought being in ketosis longterm was unhealthy, but maybe it is for different people and isn’t for others? I have pregnancy brain so I feel nutty! 🙂

        Liked by 1 person

      • Late June 🙂 and we’re having our first girl!!!! I’m excited but scared about how different it will be. All I’ve known our boys for the past 7 years… and the pink adorable clothing looks so WEIRD in the laundry LOL!

        Liked by 2 people

      • And it looks like I was thinking of ketoacidosis… not just ketosis. I searched around online after talking with you about it and found so many people who have been on it for years and lost weight and done well health-wise.

        Liked by 2 people

  5. Glad to help and Keoni knows his stuff. Can’t recommend Trim Healthy Mama way of eating enough for not only weight, pain and inflamation control but long term maintenence. Lots of good carbs, sweets and breads. Pinterest has tons of recipes. Feel better soon.


  6. Just dropped by to see what was new. 🙂 So good to hear the ketogenic diet is helping you with that inflammation pain. I have now been eating this way for two years. I am just shy of having lost 50 pounds and have not missed inflammation pain at all! I’ve become a student of this way of eating and have more info than I know what to do with so feel free to email me if you have any questions I can help you out with. I’ve shared this WOE with many people and run an info group and a weight loss group (for the VP Dread Ilk) on FB. Last tally I’ve been honored to help people shed over 500 pounds in addition to being a pain to big pharma by enabling people to come off their pain meds, fibro meds, diabetes meds, asthma medications, the list goes on!

    Liked by 3 people

  7. As for your thirst question. A couple things. First off, could you be diabetic? Excessive thirst is common with diabetes. You probably aren’t but should check that off first.
    Second is electrolytes. You can read more about the carb/insulin/kidney/water retention concept. What is happening to you now is your kidneys are doing what they’re designed to do – flushing toxins and waste out of your system. Insulin is no longer signalling them to retain water and as a result you lose electrolytes that you need to replace. Also, you have substantially reduced your sodium intake just by cutting processed food. The recommended amount of sodium per day on keto is 5000-7000mg. Magnesium is 500mg, and Potassium is 1000-3500mg. Measure out the amount of salt you need to get to 5000mg of sodium and be sure to consume it. I put 1/4 tsp in 4oz of warm water, dissolve and drink several times throughout the day. Do that for 5000mg, the rest you’ll get salting your food. Then, drink to thirst. There’s no magic in “x” number of ounces of water per day. If you’re thirsty, drink. If not, don’t worry about it. For some added potassium, get some “No Salt” and dissolve 1/4 tsp in your water (you’ll get most of your potassium in food so this may not be necessary). Keep up on your magnesium supplements to avoid leg cramps (most of us are magnesium deficient to begin with). I personally take Magnesium Malate and I use Ease brand spray everyday after a shower.


    • I think I am not getting enough salt maybe. Is “no salt” the same as “lite salt”? Because I have some of the lite salt. I definitely think I’m not getting enough potassium.

      Today I ate more vegetables and a little bit of strawberries. I was just feeling like crap, with digestion off and muscle cramps, and I thought some extra fiber and minerals would help. Total carbs was 43 g, with 25 g of fiber, so net carbs are still under 20 g. It is OK to count net rather than total carbs, correct? I am less thirsty at this evening, which makes me wonder if I kicked myself out of ketosis with those strawberries. For the most part I have not been eating any fruit.


      • I take magnesium citrate. I have been doing it for several years, since I started reading Mangan’s website.

        Also, I have started a big pot of bone broth and will add salt to that. I think getting the salt and electrolytes straightened out is really going to help.

        I had begun to wonder, too, if there’s something going on with my insulin levels. My mother had diabetes; I’ve had my fasting blood sugar checked and never had a problem before. But my insulin levels don’t seem to be evening out even though I’ve been eating LCHF for about six weeks.


      • Yes, lite salt is also potassium. And yes, you count “net” carbs. It shouldn’t be enough to kick you out of ketosis but everyone is different. If you do have some insulin resistance, this might be enough to trigger sodium retention . The good news is, if you are at all insulin resistant you are on the right diet for that!

        Also, observe how your pain responds to the strawberries. RLB was so sad when he ate just two of our garden strawberries (when he first started keto), the pain shot right down his sciatic. He’s very sensitive to fructose.


  8. This might be even more disappointing to hear…bone broth contains a high content of glutamine. While glutamine is an excellent short term solution to repair gut issues, it is also known to cause insulin spikes, hinder ketosis, and happens to be cancer’s second favorite food (sugar is number one).
    Broth itself (whether homemade or from bouillon) is a great way to replenish electrolytes, though.


  9. Sarah’s Daughter makes an excellent point about checking one’s blood sugars–and remembering my gracious hostess was born the same year I was, I hate to say it, but gracious hostess, you might ask your doctor if a lipids profile (which will include blood glucose) is a good idea. It’s a good time to start if you haven’t already. A cardiac nurse (if I remember correctly) in your acquaintance might endorse that idea as well. :^)

    (having a grandfather who died at age 59 of a massive heart attack, I’ve been tracking my cholesterol and such since my twenties….seemed like a cheap way of tracking my most likely problems)

    Liked by 2 people

  10. I am glad you didn’t take my advice. Bear diets are pretty extreme. I saw a National Geographic documentary once about bears in Kamchatka, where bears outnumber humans. During the salmon run, they were only taking the fat from the salmon and throwing away the meat. I”ll bet a lot of fish eaters cried over that. There is one commonality, bears love human food. It is nutritionally dense.

    Liked by 1 person

  11. Well, knee surgery was done yesterday. The surgeon found damaged cartilage inside my patella that he had to remove in addition to taking care of the torn meniscus.

    Pain level is not bad. I took one of the Vicodin when I got home and one in the night. None today.

    Husband made an omlette for me so I can stay in ketosis. ☺️


  12. I noticed when I increase the allowed sweetners, I notice I have a dry mouth. So I really am trying to get my carbs all natural. Not that the sweetners are not allowed, but I am noticing the dry mouth.


  13. I forgot to mention!! If you’re just starting a ketogenic diet you should be drinking salt and potassium regularly throughout the day. Some people use LiteSalt to cover their potassium (available in most Target stores).

    Another option for electrolyte intake is to buy/drink chicken broth (I know it sounds a little weird), or put Mio in your water.

    Some people make/use bone broth, too! 🙂


  14. I too noticed the pains I suffered from have subsided! I am thirsty all the time, even when I “take breaks” every other weekend while doing Keto. I lost around 8 lb. I manage so is not completely out f control thirst. I do Tumeric, and bought the supplements to balance but I am so forgetful about taking pills on a daily. Will stop in to get this Apple Cider and try to do it regularly. Look up Dry Mouth Lozenges but they may have sugar! ACT has Xylitol so it should be ok.SalivaMax by Forward Science …


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