Low Blood Pressure

If cold feet onset coincides with starting keto, low blood pressure from fluid loss is almost certainly the cause. Low blood pressure reduces oxygen and nutrient delivery to the extremities, causing cold feet. Starting a ketogenic diet commonly causes low blood pressure because dropping carbohydrate intake triggers significant fluid loss, which reduces blood volume. Adding salt and increasing fluid intake restores blood volume and circulation, resolving keto-related cold feet from low blood pressure.