4.1 Electrolytes
Maintaining electrolytes can be challenging, due to expected renal dysfunction in this disease model. If you are suffering from any pre-existing kidney disease consult your doctor prior to supplementing any of these elements.
Maintaining your electrolytes is arguably one of the most critical goals for your daily micronutrient intake, relative to your quality of life. According to the intracellular data collected and disease modelling, these are highly problematic in many chronic diseases, yet poorly captured by standard serum testing.
Electrolytes include potassium, sodium, calcium, magnesium, phosphate, chloride and bicarbonate. Electrolytes are required for ion channels / transporters, signalling pathways, blood pressure regulation any many important metabolic pathways.
When electrolytes are deficient, neurological symptoms, fatigue, muscle spasms and pain/inflammation may occur (skeletal, smooth and cardiac tissues). Digestion and nutrient absorption may be impaired. Serum levels of electrolytes are tightly regulated and often fail to help indicate intracellular or systemic levels until an emergency hospital visit is required.
Electrolytes can “exchange” at the cellular membrane as pairs by pumps called "ATPases", which consume approximately 2/3 of ATP produced inside the cell, to maintain functional levels of each electrolyte inside and outside the cells.
For example:
The Na+K+-ATPase exchanges sodium : potassium.
The Ca2+-Mg2+-ATPase exchanges calcium : magnesium.
Under extreme metabolic conditions, alternate exchangers, such as the Na+/Ca2+ exchanger (NCX) can exchange sodium : calcium, too.
This is not an exhaustive list.
For this reason, a deficiency of one electrolyte in the pair can create
issues absorbing and retaining the other, creating a secondary
deficiency. Ideally, deficiencies for electrolytes should be addressed as pairs, or all at once, to prevent exacerbating an existing imbalance.
Intracellular deficiencies for each electrolyte can come from various influences other than simple dietary deficiency of it and / or its "exchanging partner", eg.
Calcium deficiency can also be created by parathyroid hormone (PTH) issues downstream of eg. low iron and phosphate. Other influences include elevated oxalate synthesis, low Vitamin D, low Vitamin K2 mk7 and excessive NCX activity.
Common symptoms include low energy, low neurotransmitter synthesis, sleep disturbances, muscle tremors and osteopenia.
Magnesium deficiency can also be created by silicon deficiency and chronic diarrhoea.
Common symptoms include low energy, low neurotransmitter synthesis, sleep disturbances, muscle tremors and constipation.
Sodium deficiency can also be created by chronically elevated IFN-gamma and CYP2D6 enzyme activity in the kidneys, which produces renal dopamine and promotes renal sodium excretion. Other influences include frequent diarrhoea, vomiting or sweating. Above daily values of sodium intake are required during periods of immune activity.
Common symptoms include low energy, dizziness, nausea, muscle tremors and low blood pressure.
Potassium deficiency can be created by chronic alcohol / acetaldehyde, chronic kidney disease / infection, diabetic ketoacidosis, frequent diarrhoea, vomiting or sweating, folate deficiency, chronic elevation of aldosterone.
Common symptoms include low energy, low neurotransmitter synthesis, muscle tremors and high blood pressure.
Phosphate deficiency can also be created by chronic alcohol / acetaldehyde elevation and also acidemia, triggering renal excretion of phosphorus. This can come from metabolic or respiratory acidemia. Elevated lactic acid + low intracellular zinc is one mechanism which can allow elevated lactic acid from an energy crisis, mineral deficiencies or hypoxia to progress to acidemia.
Common symptoms include low energy, muscle tremors / poor strength, seizures, rhabdomyolysis, respiratory suppression, softening of bones and teeth.
Bicarbonate deficiency can also be created by metabolic acidosis, chronic diarrhoea, elevated oxalate levels and chronic kidney disease / infection.
Common symptoms can include tachycardia, confusion and fatigue.
Chloride deficiency has not been commonly observed.
Most electrolytes should be consumed slowly over the day. They may cause diarrhoea and other symptoms in large doses.
Transdermal administration has been demonstrated as a superior route for magnesium absorption due to the "slow-release" aspect. Rapid absorption and downstream elevation of serum electrolytes triggers rapid excretion to restore homeostasis, resulting in poor electrolyte retention and wasted effort. This can be exacerbated by low activity levels and intracellular deficiency of the corresponding partner in the electrolyte pair.
Electrolytes are commonly available as salts, and the second table below outlines the relative amounts of each electrolyte in these salts.
The weekly DIY "sipper" recipe contains suggested amounts based on poor dietary intakes from food sources and can be adjusted where necessary.
TOTAL daily elemental targets from all food / supplement sources
Element | Target Daily Amount | Notes and Sources |
Sodium Na | >4g | (Daily value is 2300mg. More is required than normal, due to elevated excretion rate.) 5g (1 teaspoon) of table salt contains 2.5g Na |
Potassium K | >5g | (Daily value is 4700mg.) 10g of Nu-Salt (potassium chloride) contains 5g of K. 3 large potatoes (900g) contains roughly 5g of K. |
Magnesium Mg | >500mg | Supplemental regimen should include transdermal route, where deficient. |
Calcium Ca | >750mg | Increase supplementation to 1.5–2g if deficient. Cronometer can help visualise your calcium intake. CMA results show intracellular deficiencies. Low phosphorus and also low strontium in hair testing may also infer calcium status. Oxalate dumping can be expected initially. |
Phosphate Pi | 1g | Meat, dairy, pumpkin seeds / pumpkin seed oil, red lentils, sunflower seeds, potatoes. Supplement if deficient. Supplements which combine phosphorus with various electrolytes, e.g. calcium phosphate, may be available in some regions. |
Bicarbonate HCO3 | As needed | Commonly found in sodium bicarbonate / baking soda (NOT baking powder) and/or potassium bicarbonate. Typical dose is 1/4 teaspoon AWAY FROM MEALS, multiple times per day, if lactic acid is elevated and/or phosphorus is either high OR low in OAT results, or phosphorus is low in Oligoscan. |
Reference material: Elemental weights, by compound, for calculating servings of various electrolytes
Electrolyte Compound | % Proportions | Weight Proportions |
Sodium Chloride NaCl | Na 39%, Cl 61% | 6.4g contains 2.5g sodium & 3.9g chloride |
Sodium Bicarbonate NaHCO3 | Na 27% | 5g contains 1.4g sodium & 3.6g bicarbonate |
Potassium Chloride KCl | K 52%, Cl 48% | 9.6g contains 5g potassium & 4.6g chloride |
Potassium Citrate C6H5K3O7 | K 38% | 13g contains 4.9g potassium & 8.1g citrate |
Dicalcium Phosphate CaHPO4 | Ca 29%, P 23% | 3.8g contains 1.1g calcium & 870mg phosphorus |
Disodium Phosphate Na2HPO4 | Na 32%, P 22% | 7.73g contains 2.5g sodium & 1.7g phosphorus |
Monosodium Phosphate NaH2PO4 | Na 19%, P 26% | 6.6g contains 1.25g sodium & 1.7g phosphorus |
Dipotassium Phosphate K2HPO4 | K 45%, P 18% | 10g contains 4.5g potassium & 1.8g phosphorus |
Magnesium Aspartate C8H12MgN2O8 | Mg 8% | 6g contains 500mg magnesium 5.5g aspartate |