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Swollen Hands And Feet On Keto? Here’s Why.

Transitioning to a ketogenic diet can be quite stressful on the body for some individuals. Often, it's this increased stress along with other changes that may be causing your hands and feet to become swollen. 

In fact, during extreme dieting situations, as with my last bodybuilding prep, I was putting my body through long periods of dieting combined with high amounts of physical exertion. This stressful situation led to a period of VERY swollen ankles and feet.

Why your hands and feet are swollen on keto. Swollen hands and feet on keto are usually due one or even a few of the following causes: electrolyte imbalance, too much physical stress (diet and exercise), an injury, or increased temperatures. 

Keep reading along, I'll explain the major causes behind swollen hands and feet, how keto may play a role, and a few dietary and physical solutions to fix the swelling.

Swollen hands and feet on keto

What Causes Swollen Legs, Ankles, and Fingers? 

Electrolyte imbalance

There are two probable causes when it comes to electrolytes, though both are related. One, you're consuming too much salt, the other, you're consuming too much salt, but in proportion to potassium. Meaning, you're not consuming enough potassium.

Sodium and potassium are electrolytes that your body needs to function normally and help maintain fluid balance. When these minerals are out of balance, edema, or fluid retention, may occur in your ankles, fingers, legs, and even around your eyes. 

On average, Americans consume too much sodium in relation to potassium.1 According to the World Health Organization, the general guideline for sodium to potassium should be close to 1:1. 2 

Physical stress

For a variety of reasons, too much physical stress may lead to swollen hands and feet. 3

When we exercise, blood flow is diverted not only to the working muscles but also to your heart and lungs. Exercise can reduce blood flow to your extremities like your hands and feet, making them cooler. As a result, the blood vessels in your hands or feet may react by opening wider, which is the swelling you're experiencing.

It's not uncommon for runners to experience swollen hands and feet. The constant movement of your arms swinging and feet hitting the ground may contribute to fluid retention. Constant movement increases air across the skin to improve heat exchange with the air to stay cool.

An injury

Swollen ankles on keto

A common source of swelling in the legs, feet, and hands are from injuries. Injuries include strains, sprains, and even broken bones. While a broken bone may be more visible, sometimes we experience slight injuries or traumas without necessarily experiencing any feedback (i.e., pain). In the case of an injury, blood rushes to the affected areas.

 If there is a chance you may have suffered an injury, please seek medical attention.  

Increased temperatures

It's quite common for hands to swell in hot weather, referred to as heat edema. Heat causes the blood vessels to expand, sending more blood to the skin in an attempt to help cool you down. 

As blood vessels expand, fluids leak into surrounding tissues. With a little help from our friend gravity, fluids can also move and collect in the hands and feet. 

If you're going to be in hot temperatures, try to wear breathable clothing and shoes in addition to staying well hydrated. 

If exercising outdoors during hot temperatures, try to work out during the colder period of the day if and when possible. Also, tight-fitting jewelry, especially something like a ring, may lead to swelling of the hands and fingers while exercising. 

Low protein intake

In rare cases, a deficiency in protein may lead to increased water retention while on a ketogenic diet. Often, people either restrict protein to maintain specific percentages or have heard about protein converting into sugar. 

While a deficiency in protein is less common in developed countries, if you're going out of your way to consume LESS protein, you may be doing your body a disservice. Protein attracts water and plays an essential role in helping to maintain water balance.

To figure out your protein intake and other macros, try our keto macro calculator, which will guide you through our recommendations.

How To Fix Water Retention On Keto

Resolving swollen hands and feet on keto will depend on the root cause of water retention. 

Stay hydrated and maintain electrolyte balance

Contrary to popular belief, drinking too little water may cause your body to hold onto more water in an attempt to prevent dehydration. Make sure you are drinking plenty of water, preferably to thirst, to stay well hydrated.

Additionally, you must be getting a sufficient amount of electrolytes, especially sodium and potassium. Many people who start a ketogenic diet suffer from the keto flu, which is usually a result of a massive shift in water and electrolytes. 

Make sure you're salting your foods liberally and to taste, but also making sure you're getting in enough potassium. Keto-friendly foods rich in potassium include avocados, mushrooms, leafy greens, and even BACON! If you haven't tried Pederson farms bacon, I'd highly recommend it. 

Potassium for swollen hands on keto

Additionally, you can also supplement with an electrolyte drink or supplement, which were specially formulated with the keto and low-carb dieter in mind.

Supplement vitamin B1

Surprisingly, vitamin B1 deficiency is one of the most common deficiencies. A deficiency in vitamin B1 can lead to fluid retention in your ankles, also known as edema.

Nutritional yeast is a keto-friendly source rich in B1. You may have seen nutritional yeast at your local store like Trader Joes, but it typically comes in the form of little flakes. It's the perfect way to season vegetables or anything of your choosing as it has an almost cheese-like nutty flavor to it, similar to parmesan cheese. 

Lower intake of FODMAPs

Sometimes water retention can be a result of inflammation due to food sensitivities. FODMAPs stands for Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols'. 

Mainly, certain types of carbohydrates and sugar alcohols may cause digestive stress to specific individuals, especially those who suffer from Irritable Bowel Syndrome (IBS). 

Some common keto-friendly foods that are high in FODMAPs include:

  • Cauliflower
  • Garlic
  • Onions
  • Asparagus
  • Avocado *gasp*

It may be worth experimenting with the elimination of certain foods from your diet for some time and seeing if the swelling in your hands and feet subside. For a complete list of foods high in FODMAPs, click here

Compression socks

Compression socks are popular among travelers to help provide pain relief and prevent fluid from collecting in their legs, ankles, and feet. These socks can be a great tool to help alleviate the symptoms if you suffer from swollen ankles and other lower body extremities. 

You can find a pair of compression socks at your local drug store, shoe store, or even online on Amazon. 

Check prices for compression socks here.


Swollen legs on keto

In some cases, exercise may be the cause of swollen hands and feet. However, if you're NOT exercising, then doing so may help with swollen hands and feet. 

Exercise can help with blood flow in addition to losing weight, which may reduce swelling and will improve your health overall. Sometimes it's sitting down, standing in one place, or being sedentary that can cause your body to retain water and cause swelling.

Additionally, here are seven exercises for leg edema or swelling that you can use.

Increase fiber and probiotic-rich food intake

Many people starting keto try to limit ALL of their carb intake, even fiber. Increasing fiber intake is useful in helping your body digest and balance fluids properly. 

Can A Keto Diet Cause Swelling?

There's nothing specific about a ketogenic diet that gives reason to believe that it would cause swollen hands or feet. Chances are you're making changes to your diet and lifestyle, which can be stressful on your body.

Additionally, these changes can affect not only your fluid balance but your electrolyte balance. These changes may have you feeling other side effects such as nausea, increased sweating, and maybe even experiencing a higher heart rate than average. 

Once you're able to get a hold of making sure you're well-hydrated, balancing your electrolytes, and getting proper nutrition, you'll be coasting along towards your goals. 

Final Thoughts

Swollen hands and feet on keto may be more common than you think. A ketogenic diet is usually a drastic shift from what most people used to eat, which is a stress on your body.

 If you find that the pain or swelling in your hands and feet aren't subsiding, you should consult with a doctor as there may be something more serious going on. 

Frequently Asked Questions

Does keto cause water retention?

Yes, when you enter into ketosis, the body starts to use up ketones and as a result it starts to hold more water as well!

Why am I swelling on keto?

One of the main reasons why you experience swelling on keto is because it stops the circulation of insulin in the body. As a result, the human tissues starts to hold more water.

Why am I gaining weight while on keto?

Water retention might be one of the main reasons why you're gaining weight during the keto diet. However, if you consume too many fats, that's why you might be gaining weight on keto.


Founder of The Art Of Keto.

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