Monday, April 12, 2010

Sodium and Potassium: Deficiency and Excess

Your body works really hard to keep the amount of sodium and potassium in your blood normal, as that is essential for fluid management. However, deficiencies and excesses are possible. Some individuals have great sodium loses through their skin. Endurance athletes are an example (marathoners, triathlon runners, etc.). If you are exercising for more than two hours you’re going to have a significant amount of sodium lose due to excess sweat. The amount of sodium lost through sweat varies significantly among individuals, and depends on whether or not you’re a salty sweater. How do you know that? Well, if when running you can feel the grains of salt on your face, you are a salty sweater. If you’re a salty sweater you lose more sodium in your sweat than normal.

Sodium loses in athletes can be up to 2500 milligrams of sodium per liter of sweat. Sweat tends to be saltier in the early stages of training. When you train longer, your body actually reduces the amount of sodium loss. If you are working out for more than an hour, I encourage you to drink a sports drink with enough sodium, at least 100 milligrams per 8 ounces. Although fluid consumption is important for the prevention of cramping during exercise, it is almost always the excessive loss of sodium that causes it.

Sodium deficiency, called hyponatremia, is most often seen in endurance athletes who eat a large amount of fresh food (with very low sodium content) and drink water excessively during exercise. Hyponatremia can cause the brain to swell, lack of energy and confusion. I’ve heard of college fraternities hazing with water. You almost get the same kind of look to the person as when they had too much alcohol.

There are no upper safety limits that have been established for sodium because excess amounts are generally filtered and excreted by the kidneys. Excess consumption of this mineral is associated, however, with higher blood pressure, edema and fluid retention. High blood pressure, as a disease, is associated with increased risk of heart attack, heart failure and stroke. Additionally, high blood pressure is the leading cause of chronic kidney failure. Keep in mind that even a moderate elevation of arterial blood pressure can cause a shortened life expectancy. This is why controlling and limiting your sodium intake is so vital. A great gift you can give your children is to not salt your food. The more you introduce it in young children, the more likely they are to depend on it the older they get.

Potassium deficiencies are rarely due to dietary causes alone. It can develop due to the over-excretion of potassium, which is medication-induced. Another underappreciated cause of low potassium is a low-carbohydrate diet. Low carbohydrate diets contain very little potassium, because they eliminate most fruits and vegetables.

What are the general symptoms of potassium deficiencies? Fatigue, muscular weakness, confusion, anxiety, temporary memory loss, diarrhea or constipation, sleep disruption and noise in your ear. These symptoms are vague, non-specific and often described as “don’t feel well”.

What about too much potassium, or hyperkalemia? It is most often caused by abnormal kidney or renal functioning, resulting in ineffective elimination. For example, if you have kidney disease and end up with dialysis, you lose the body’s ability to get rid of the potassium excess. Excessive intake of potassium causing hyperkalemia is rare. Excessive intake of salt substitutes, however, may cause it. If I use a salt substitute I’m getting rid of the sodium, but I have to put some other mineral for my food to have a taste. Often these salt substitutes have potassium chloride. Dietary supplements also can be a source of excess potassium. The general symptoms are heart palpitations, muscular weakness and sometimes sudden death in extreme cases.

These are the results of too much or too little sodium or potassium in your body. Excessive sodium intake is common among Americans. This, as I mentioned, causes a higher risk of heart disease because of higher blood pressure. This is why keeping your sodium relatively low and your potassium high is so vital. In a future article I’ll give you practical tips to do just that, stay tuned.

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