About 2 years ago, I was on a family vacation in Florida and started having extreme kidney pain out of nowhere. I was about one year into the keto diet at the time. I would describe the pain as dull. It radiated out from the middle of the back (near kidneys). 30–45 minutes after this all started, I HAD to lay down… 2 hours later, after drinking plenty of water, the pain calmed down… The experience wasn’t fun, to say the least.
That next week, I experienced the same dull pain in the kidney area while at home. I again had to lay down and wait for the pain to subside. After that, there were a handful of other occurrences. At the time I was COMPLETELY confused as to what was happening.
Was there a problem with my kidneys? Maybe my gallbladder? What about my pancreas? After bouncing around between my doctor and the ultrasound lab for Allegheny General in Pittsburgh, I resolved the problem on my own. The ultrasound didn’t detect any stones in my gallbladder and my doctor had just ordered a HIDA scan. I never needed to have that test done.
So, How Did I Fix the Issue?
Well, it was more or less by accident. Back then, I was still fairly new to the ketogenic diet. I was also doing intermittent fasting for long periods of time. These were 18 hours or more several days a week. On days where the issue was happening, I realized that I was doing a long fast.
I also noticed that the problem was always happening right after I broke the fast. Almost every time, I was eating a high-fat protein source. This would be something like salmon or grass-fed beef. AND, I was eating the protein BY ITSELF.
Ultimately, I ended up resolving the problem by increasing my vegetable intake. I also started consuming green leafy vegetables WITH high-fat meats. It has been 2 years now and I have not had another episode of kidney pain on the keto diet.
I haven’t needed to adjust my fasting window either. But, I generally don’t do 18 to 24 hour fasts like I used to.
What is the Relationship with Protein and Kidney Pain?
There are a few possible culprits for radiating pain in the mid back. While it may seem like kidney pain, it could also be caused by the gallbladder. Interestingly, both the gallbladder and the kidneys can be affected by protein intake.
Excessive protein intake is one of the most common causes of gallstones in the gallbladder. The first thing that happens is that the proteins will cause congestion in the liver. This may result in a fatty liver developing which then results in stones forming. [*] Gallstone pain may radiate into surrounding areas. [*] The symptoms I described to my doctor made him believe that gallstones were present.
Protein is used to create sugar in the body when we need it. This process is called gluconeogenesis. When you are in ketosis, the body will use gluconeogenesis to feed the organs that require sugar (I.e. the brain). During this process, nitrogen levels in the blood rise and a compound called urea is used to remove the nitrogen via the urine. The measurement for this is Blood Urea Nitrogen (BUN). Higher levels of urea, mean MORE ACIDIC urine which then may cause pain in the kidneys. [*] Its possible that eating high amounts of protein may exacerbate this issue and cause kidney pain on the keto diet.
One study recorded that 8 weeks into a ketogenic diet that urea levels had increased by 20% before dropping back down to normal. So, this might suggest that adaptation helps reduce urea levels. [*]
Why Do Vegetables Help With Fixing Kidney Pain?
Regardless of whether the issue is coming from the kidneys OR the gallbladder, green leafy vegetables are going to help. This was the main adjustment I made to get rid of kidney pain on the keto diet.
The magnesium found in green veggies has been shown to be protective against gallbladder stones in men. [*] Magnesium has also been shown to speed the transit of pancreatic enzymes through the body. [*]
Several people have recently reported that drinking epsom salts dissolved in water have alleviated their symptoms. Epsom salt contains magnesium sulfate. [*]
Vegetables are an alkalizing food, meaning they lower acidity levels in the blood and urine (by increasing pH). Meat, on the other hand, INCREASES acidity (by decreasing pH). [*] While we DO need the acid to digest food, in this case, the body may be TOO acidic with the rise in BUN.
What Else Can be Done to Relieve Kidney Pain?
The following solutions may also help to ease pain in either the gallbladder or kidneys.
- Baking Soda Drink – Reduces acidity in the blood (also increases alkalinity in the stomach) [*]
- Lemon Juice – Although lemon juice is more acidic by pH, it produces alkaline byproducts which reduce the acidity of urine. [*]
- Bile Salts (Ox Bile) – help to dissolve any gallstones that may be present. Also prevents them from forming. [*]
- Epsom Salt Drink – Contains a high amount of magnesium sulfate that has been shown to be beneficial to the gallbladder. [*]
Seek Professional Medical Advice
As always, this blog is not intended to treat or diagnose any medical condition. I’ve simply outlined my experience with kidney pain on the keto diet to help educate others. If you have kidney pain on the keto diet and it is lingering around, seek professional medical advice immediately. This could be a sign of a more serious condition like pancreatitis.