My post “Arrhythmia, heart palpitations, ketosis, and low-carb diet” has been consistently popular since I published it back in April. It of course helps that it is generally around the top of my top posts, and people who explore the blog tend to go there first. More interestingly however I get a steady traffic from Google to this page, with keywords such as “low-carb+palpitations” or “ketosis+arrhytmia” so clearly this is an issue for a number of people.
First the good news: I am mainly fine now, and clearly (as you can see from my WOD’s) palpitations are no longer an impediment for me to exercise. I did however never get back to Roman’s hormone-focussed training that had been interrupted by those palpitations – maybe at a later stage…
I have seen a cardiologist at one point and I was wearing one of those long-term ECG boxes for a day. Funny story first: when I saw the cardiologist to discuss results she seemed very worried, as she had identified two episodes of tachycardia (around 180bpm) and she asked me whether I was alright. She was relieved when I told her that this was me doing some metcon stuff – I wanted to see whether during the de-loading phase there was a higher occurence of palpitations than usual – there wasnt.
In any case she could identify what exactly were those palpitations that I’d feel every couple of minutes: those were extra systoles coming from the atrium. She then explained me that those are actually rather normal and nothing to worry about, and that in particular they are often a reaction to stress. Now I was reasonably stress free in my personal life at this point in time, there were nevertheless a couple of stressors
- I had increased my squat from 0 to 125kg; in this process however I had developed some permanent pain in the hip flexors, probably because of overuse / inflexibility after more than a decade of desk-bound work
- I was going to the gym pretty much every day, alternating heavy lifts (well, sort of heavy; they were heavy for me anyway) and metcons
- I had tendonitis in my right elbow that I could shake for a couple of months
- I had started eating paleo, and slowly but surely drifted into the 50g of carbs per day territory
- I had got myself a cold
So I decided at this point that I’d lay a bit low. Also, luckily enough Paleo 2.0 had just “come out”, and my take-away was that some starchy food (potatoes, rice) is actually OK if one does not go overboard on it, so this is what I did. The impact was actually quite impressive: whilst not going entirely away, adding starches made a big difference how I felt (the fact that my cold went away might have also contributed though….)
So my final take-away: eating low-carb is a stressor for the body (I have read this somewhere by the way – something about
adrenalin cortisol being released so that protein can be converted into glucose that is needed for the brain, even in ketosis). Some people deal better with it, some worse. Probably this can either because of different stress levels induced, or a different stress-tolerance level, which is an important distinction, as the latter sounds to be a recipe for long-term disaster: even if LC eating seems to be fine for a couple of months or even years it might catch up eventually. For me in any case the stress induced by LC eating leads to palpitations, so I am not trying to make sure that I have enough carbs. I am no longer counting, but I estimate that my daily carb intake is between 100-200g, a lot of it from fruit an vegetables, the preferable from rice or potatoes, and I have to admit unfortunately also a fair amount of from baguette with or without cheese (when in Athens….).