I am currently on a physician monitored low carb diet.  In the past, I
have experienced extreme fatigue from low carbing, but docs are now
giving me medicine to prevent hunger and fatigue.  Now, when I am in
ketosis, I am experiencing extreme joint and muscle pain--especially
in my trapezius area.  When I carb load, the pain subsides
significantly.  I'm drinking lots of water and am wondering if I could
be low on electrolytes or other nutrients?  I am staying focused on
not dehydrating, so I don't think that's the problem.  Any thoughts? 
My doctors and I are stumped.

Between March 2005 and March 2006, I was on the Atkins Diet.  Well,
technically, one stays on it forever, just at different phases. 
Having what he called high metabolic resistance, and which I call
hypoglycemia, virtually that entire year was at zero carbs, NOT low
carbs.

His latest book, 2002, really fell apart on supplements. Fortunately,
I had the older 1992 printing.

Here are the supplements I had to take for that entire year, and
essentially still do.

1. Four multivitamins a day, I use Wal-mart Equate for Centrum
w/Lycopene.  When I first started, I missed the word "four" and was
only taking one a day. I experienced extreme fatigue, (sound
familiar?) and when I finally discovered the missing word, I felt
great on 4 a day. Half morning; half evening.  Many who have gone to
low carbs with inadequate supplements have experienced the same
extreme fatigue.

2. Four Vitamin C (not chewable) 500 mg each, again Wal-mart cheapies,
half am, half pm.

3. Four Calcium 600D, Wal-mart Equate w/125 units of Vitamin D, since
I get a lot in the multivitamins, half am, half pm.

4.  Sixteen Wal-mart Fiber Therapy  capsules, the Equate for
Metamucil, do not take the sweetend since they are loaded with carbs.
At zero carbs, if you do not get enough fiber, you can get hemorrhoids
or far worse, impacted. I did once, and as gross as this sounds, I had
to dig myself out with my finger, one of the grossest things I have
ever experienced.  I can see why Elvis died of this, I really thought
I was going to die myself.

5. I also take a Wal-mart Equate, two a day, Stool Softener Docuasate
sodium 100 mg, for the same reason.

And, for many years, I have been taking a Saw Palmetto because I had a
urinary blockage. Recent research suggests Saw Palmetto has a placebo
effect, but as long as it works as well for myself and an uncle in
Mexico, and until they get a better placebo, I am continuing to use
it. Saw Palmetto has nothing to do with this diet.

At one time, before I got up to 4 calcium a day, I was having leg
cramps.  since going to this level of supplements, I have had no leg
cramps at all.

Before starting the diet, I was drinking so much milk that I
calculated I was taking in near 2500 mg of calcium a day, which would
also explain my excess weight in part, since milk has a large amount
of carbs.

My blood pressure was originally 130/72. Recently, it bounces around
106/69 to 114/72.

When I started, at our house in rural Mexico, I could only swing a
pick ax around 20 minutes, than had to lay down for a long siesta.
now, I can easily work over three hours. I am 63. I look  really good,
not handsome, but healthy, and feel just as good.

The diet also served as an aphrodisiac -- for my wife!   :)  I should
not need to explain that.

I forgot to mention I only lost around a pound a week, due to
hypoglycemia, thus zero carbs for such a long period.

Not everyone can stay on such a diet for that long a time, nor swallow
that many pills a day. I joke my name is William Power, but I prefer
to go by my nickname (Will).  I know this is not usual, so I do not
ever really recommend the Atkins Diet for others, though I made the
decision for myself.

There is no requirement nor minimum daily requirement at all for
carbs. The Eskimo have traditionally lived half the year on zero
carbs, and there are no veggies on the ice floes.  They got their
minerals and vitamins from special organs in the animals  they killed.
 I do not know where they got fiber.

I was surprised at your hunger.  As Atkins said, when I was burning
fat I had little hunger, since my body was getting plenty of calories
from my own fat.

I was around 215 when I started and am just above 180, which varies
depending upon water and time since bathroom.

I did use Ketone test strips, the best price is Wal-mart, and I almost
never exceeded 40, which is a result of my hypoglycemia.

After considerable thought, Questioner, I am convinced your question
is hopelessly inadequate.  You have not stated your age nor said if
you are in generally good health. You have not said your beginning
weight and desired weight.  You have not said if your doctor is a
specialist in low-carb diets or if you just asked your regular doctor
for help, thinking that will automatically give you a safe diet. 
These things are important in any discussion. I am confident your
doctor knows all these things about you as a routine matter, or he/she
would not be working with you. Note I did not really give you advice,
but to tell you of my own experience, and in my posting I included all
that information if you read for it.

I kept thinking about this, and am extremely curious why on earth you
would be hungry.  Atkins, with around 60,000 patients of whom 95%
successfully lost weight, said most people should eat whenever they
are hungry. He also commented that one should lose weight at 2,000
calories a day, and some did so even at 2,800 calories a day.

Even as a hypoglycemic, losing only 1 pound a week, I was never hungry.

Since you seem to prefer not to supply more information, I am going to
guess here as to the unsupplied information.

I can think of 2 reasons you might be hungry on a low-carb diet.

1.  For the extremely resistant person, as rare as they are, Atkins
said to go on a 1,000 calorie a day diet, consisting of only Macadamia
nuts, and, and, and, rats, I can't remember the other food, but it
wasn't much, maybe cream cheese, restricted to a total of 1,000
calories a day.  If you are resistant, perhaps your doctor has you on
low-carb plus low-calorie. The problem with hunger is that it is a
great predictor of diet failure.  Few people will continue a diet
which causes them to suffer hunger pangs all the time.

2.  Ahem, maybe your doctor simply doesn't have a background in
low-carb diets, and is guessing her/his way through this.  If so,
he/she may be assuming it is necessary to restrict calories.  Not
every doctor understands low-carb; see the book LOW FAT LIES for an
example of a doctor who has no clues at all, when he trashed the
Atkins Diet while making it clear he did not follow Atkins at all. (He
said the Atkins Diet made him feel bad.  That is a sure sign he did
not read Atkins, since the recommended supplements prevent feeling
bad.)

Since you are brave enough to ask total strangers on google-answers
for advice, perhaps you should perhaps do some other stuff if you have
not already done so.

That is, get some ketone test strips, walgreen or Wal-mart, with the
latter being best due to low costs.  Do in any case get the 15 second
type, not the two minute type.

hold them in your urine stream or catch urine in a small cup and dip
the reagent area in it.  Do you show considerable ketone, such as 80;
or 160?  If so,  then either ask your doctor why he/she put you on
low-cal, for a valid reason  or from lack of knowledge. If you are
just into the pink, even when going hungry then one must assume you
are very resistant and low-cal is indeed necessary to lose any weight.

If he/she thinks low-cal is part of low-carb, which is not so, and if
you have no strange illnesses or problems, and if you are capable of
trying something on your own, try increasing your calories by eating
more no-carb meats or fish or poultry or cheese, until the hunger goes
away, monitoring your urine ketone to see if you keep burning fat. Of
course, you may well know the answers to these questions and simply
not realize that information might be important to someone talking
about it.

I really do not see why you should be hungry on low-carb.  But, as I
have said, you are not giving enough information for anyone to discuss
your question with any utility.

Some years ago, I supplied no-fee counseling for divorced fathers.
From time to time, some guy would call me and ask for help on some
problem. After spending large amounts of time answering the question
he gave me, he would say, "Well, no, that is not right." Then, tell me
something really important that he failed to disclose in his original
question which changed the entire situation, and his tone would be
such that he felt I was somehow wrong when the probem was his failure
to tell me the whole truth about his circumstances. it was a great
waste of my time. Once in a while, we would go through that loop more
than once, before he finally told me what was really happening.

I do hope you understand what i am telling you here.