Is LC Healthy? Part I: What's with the Cramps?

At the risk of needing a hankie for my moist and dreamy eyes, I can't help but notice that so many seem so almost brainwashed to equate VLC with healthy, they don't listen to their bodies.  The two most recent blog posts by Dr. Eades, here and here, are illustrative for examining the validity of the "healthy low carb lifestyle" mantra.  

Let me say off the bat here that I do not consider the "induction flu" or a couple of days of feeling like crap whilst getting keto-adapted to be dangerous or unhealthy.  I've never experienced this myself.  But I have experienced one of the other side effects of low carbing -- that being severe cramps, usually in the middle of the night -- and I must say they were excruciating and worse by a mile than my worst menstrual cramps.  In his second post, Eades relates what I would consider rather scary episodes of cramping:

... When MD and I were driving over to Napa one day, the cramps were so severe I could hardly drive. I had to keep the seat back as far as I could get it so I could straighten my leg when one hit me. Then my hands started cramping just holding them on the steering wheel. I pulled off the freeway and made a beeline for a convenience store and grabbed a one liter bottle of diet tonic water and proceeded to chug the entire thing as I drove down the road. Miraculously, my cramps subsided. So, I figured tonic water (quinine) was the solution.

One night – after being out of tonic water for a few days and being failed by my bride in resupplying – I had another brutal night of cramps. The next day I was scheduled for blood donation. After going through the long list of questions that must be answered verbally (and fighting down the impulse to tell my interrogator that I had recently paid for sex while imprisoned in Africa – those who have given blood lately will know what I mean), I was sent to actually have the blood taken. The phlebotomist couldn’t find my vein, which had never happened before because I usually have rope-like veins in my forearms. She asked if I was dehydrated. I told her I didn’t think so since I had had my normal four of five cups of coffee that morning along with my gulp of water. She brought me a couple of 16 ounce bottles of water that I drank, and, bingo, there were my veins. Big and robust as usual.

It finally occurred to me that my cramping problem might be due to dehydration ...

Now, near as I can tell from his various postings, Mike Eades used to be overweight decades ago, and lost weight doing a low carb diet.  Although we're not offered up "before" pictures, apparently the weight loss was considerable enough for some of his patients to notice and ask about.  So eventually this morphed into his practice becoming one centered on weight loss.  He and his wife wrote some books, developed middle aged bellies (I think we have a clue to the origin of at least Mike's now) and remained staunch advocates of low carb dieting.  At some point Eades became obsessed with the notion that LC worked by some magical metabolic advantage and ran with that to sell people on his diet and books.  

Now, although the Eades have admitted to not being LC 24/7/365 -- for example when they tried IF they didn't follow LC during it -- I think it is safe to say they are dedicated practitioners of the lifestyle.  This being the case, when Eades speaks of these cramping episodes, this is his "daily life", not merely a couple of days of his body getting used to eating low carb.  

For all those Grokkies out there, it seems common sense to me that such a persistent condition would not have been evolutionarily advantageous to Grok and Grokette.  When I've had them, the effect is nothing short of paralysis!  Now whether it's sodium depletion or dehydration -- and Eades seems to conclude that dehydration is the main issue -- we'd have to ask ourselves whether a diet that induces a dehydrated state is, ultimately, healthy.  I contend it is not.  

The fact of the matter is that we get plenty of fluid from our foods on essentially a meat and veggie diet.  I don't drink a lot of plain water most times.  Some use this as an appetite controlling tool or whatever, and I've done that many-a-time here and there.  But I've noticed my own cat's water consumption is way down since we switched his diet from dry to wet food.  If anything then, when switching from a carb-based lower water content foods diet to a higher water content foods diet should not lead to dehydration per se.  If it does, and that state leads to this severe cramping, we have to question how humans survived the condition.  If someone can get so dehydrated that a phlebotomist can't find their veins and they pop right back up after consuming a quart of water, that doesn't sound like a healthy diet to me.

I imagine clean drinking water was not always easy to come by for paleolithic humans, and certainly the whole  hydration-mania is a rather recent phenomenon.  Gatorade is only around as old as I am -- and I'd note it contains carbs to improve hydration.   The bottled water craze is even newer still.  If one thing is pretty universally agreed upon in paleo circles it is that our ancestors took in much less sodium than we modern humans do.

Now I'm in the camp that doesn't believe old NaCl (table salt) is an evil compound or plays anything more than a minor role in hypertension, etc.  But any diet that requires someone to add more salt to foods over the long haul seems a bit counterintuitive to me.

I'm going to suggest another cause for Eades' problem with cramps.  That being the "upping of alcohol consumption".  The alcohol is not dehydrating him, it's taxing his liver.  Our livers are multi-tasking organs, but apparently they're not all that good at the multi-tasking.  Pre-occupy your liver with metabolizing ethanol and it tends to be less able to perform it's other functions such as metabolizing fructose and, especially in the low carber, gluconeogenesis.  One diabetic on Jimmy's forum shared once that to pass his military (I think) physical he would limit carbs the day before and have several shots of booze the night before.  This way, apparently, his FBG would be low enough.  Muscle cramps are yet another symptom of hypoglycemia.

As fashionable as it is for even non-diabetics to monitor BG levels, there are legions out there who have no clue what their blood sugar levels are fasting or otherwise, or the effects of low carbing long term on them.  If you're cramping all the time or even periodically, it may behoove you to figure this out.

In any case, whether it's dehydration or hypoglycemia, or perhaps some mix of the two, if the "adapted" body has this reaction to sugar and starch deprivation, it doesn't seem to be a healthy diet.  I'd also suggest that if you are inclined to consume alcohol on a low carb diet, you at least give your liver a break and eat around 100g starch carbs to give it a rest on it's other functions rather than putting extra stress on it.