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Nutrition & Training · Hydration & electrolytes

Second pass at: Sodium, potassium and magnesium when intake drops

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LeitermanTL3Regular13 Jul 2024#1

Second pass at: Sodium, potassium and magnesium when intake drops Writing it up because I had to work it out twice and would rather nobody else did.

A hydration and intake question, with the figures, since this one is unanswerable without them.

Fluid intake over a day, roughly, plus what I take with it and when. Intake is down substantially on where it was, which I gather is the ordinary consequence of eating much less rather than anything else.

What I would like to understand is which of the symptoms attributed to this are plausibly about fluid and salt, and which are being attributed there because it is the easy explanation.

42 likes 2y
NS
n.szaboTL215 Jul 2024#2

The opening post is right about the mechanism and I think understates the practical bit.

Where there is a genuine question, a measurement answers it and a supplement does not. Blood tests for the common electrolytes are routine and cheap.

The mechanism is plausible, which is not the same as established.

10 likes 2y
VK
v.klausenTL3Regular16 Jul 2024#3
n.szabo, post #2: The opening post is right about the mechanism and I think understates the practical bit. Where there is a genuine question, a measurement answers it and a supplement does not. Blood tests for the common electrolytes are routine and cheap. The mechanism is plausible, which is not the same as established. Go to post

I would be cautious about generalising from the Sodium example above. It is a good example. It is one example.

1 like in reply to #2 2y
EC
e.coelhoTL217 Jul 2024#4
n.szabo, post #2: The opening post is right about the mechanism and I think understates the practical bit. Where there is a genuine question, a measurement answers it and a supplement does not. Blood tests for the common electrolytes are routine and cheap. The mechanism is plausible, which is not the same as established. Go to post

Very low total intake produces multiple simultaneous deficiencies rather than one, which is why single-nutrient reasoning goes wrong here.

0 likes in reply to #2 2y
SC
septum_checkTL1Member18 Jul 2024 · edited#5

I read the opening post twice before replying, because I had assumed the opposite.

Where a laboratory result exists, quoting it with the reference interval makes the discussion tractable. Without it the thread is guesswork.

I would be glad to be shown a cleaner way of putting this.

30 likes 2y
DN
d.nilsenTL219 Jul 2024#6

Post #5 answers the question as asked. The question underneath it is different.

The claim about Sodium upthread is stronger than its source supports. I have read the source. The source says "associated with" and the post says "causes".

15 likes 2y
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OkaforTL3Regular20 Jul 2024#7

Supplementing without measuring is the default approach described here and it carries its own risks, particularly for potassium.

3 likes 2y
FI
f.ibarraTL221 Jul 2024#8
v.klausen, post #3: I would be cautious about generalising from the Sodium example above. It is a good example. It is one example. Go to post

Appreciated. The plain phrasing does more work here than a longer post would.

0 likes in reply to #3 2y
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DOdendaalTL3Regular22 Jul 2024#9

Everything in post #5 holds. The case it does not cover is the one I have.

Reading this Sodium thread as someone who came in with a fixed view: the third and seventh replies moved me and the confident ones did not.

0 likes 2y
MB
ma.balogunTL223 Jul 2024#10

Exercise and electrolyte losses: sweating during exercise increases sodium and potassium losses. Electrolyte replacement during or after intense exercise helps maintain balance.

21 likes 2y
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TL4_HalvorsenTL4Leader · Journal club24 Jul 2024#11
Leiterman, post #1: Second pass at: Sodium, potassium and magnesium when intake drops Writing it up because I had to work it out twice and would rather nobody else did. A hydration and intake question, with the figures, since this one is unanswerable without them. Fluid intake over a day, roughly, plus what I take with it and when. Intake is down… Go to post

Potassium: similar to sodium; losing weight involves some potassium loss. Bananas, sweet potatoes, and other potassium-rich foods help. Severe depletion is rare but symptomatic (weakness, palpitations).

25 likes in reply to #1 2y
HL
h.lindqvistTL225 Jul 2024#12
e.coelho, post #4: Very low total intake produces multiple simultaneous deficiencies rather than one, which is why single-nutrient reasoning goes wrong here. Go to post

Baseline measurements before a substantial change in intake give you something to compare against, and almost nobody has them.

Correct me on the arithmetic if it is wrong; I would rather know.

0 likes in reply to #4 2y
AD
appeals_deskTL3Regular26 Jul 2024#13

Picking up post #10: that is the part I would want checked first.

The thing about Sodium that took me longest to accept is that a plausible mechanism is not evidence of an effect. It is a reason to look, not a result.

4 likes 2y
AK
a.kirchnerTL227 Jul 2024#14

On post #12 — agreed on the reasoning, with one qualification.

Posting my Sodium numbers with the method attached so they can be discounted properly. Uncontrolled, unblinded, and collected by someone who wanted a particular answer.

12 likes 2y
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chromatogramTL4Analytical chemist27 Jul 2024#15
a.kirchner, post #14: On post #12 — agreed on the reasoning, with one qualification. Posting my Sodium numbers with the method attached so they can be discounted properly. Uncontrolled, unblinded, and collected by someone who wanted a particular answer. Go to post

Confirming post #14 from a second method, which matters more than confirming it from a second person.

Magnesium: deficiency during weight loss is common and symptoms (fatigue, muscle cramps) are nonspecific. Supplementation is inexpensive and low-risk if needed.

0 likes in reply to #14 2y
MA
m.adeyemiTL228 Jul 2024#16

Noted, and thank you for writing it out rather than summarising it.

0 likes 2y
RI
retention_indexTL2Analytical chemist29 Jul 2024 · edited#17

Sodium intake often falls sharply when processed food intake falls, and that transition is abrupt rather than gradual for many people.

If the premise is wrong, everything after it is decoration.

7 likes 2y
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j.vogelTL230 Jul 2024#18
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fr.translation_moTL2Translator · FR31 Jul 2024#19
m.adeyemi, post #16: Noted, and thank you for writing it out rather than summarising it. Go to post

Narrowing post #17, because the general version has more than one answer.

The number people quote for Sodium is a central estimate presented without its interval, and the interval is wide enough that the estimate is nearly uninformative on its own.

12 likes in reply to #16 2y
EN
e.nilsenTL231 Jul 2024#20

Everything in post #17 holds. The case it does not cover is the one I have.

Fluid intake and electrolyte intake are separate questions and drinking more water alone can make a dilutional problem worse.

26 likes 2y
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microgramsTL2Regular1 Aug 2024#21

Fluid intake: baseline needs increase with gastrointestinal effects and exercise. Thirst is not a reliable guide during appetite suppression. Drinking regularly (not just when thirsty) is prudent.

The strength of my opinion here exceeds the strength of my evidence.

21 likes 2y
MR
m.radichTL22 Aug 2024#22

Lab testing: if symptoms are severe or persistent, checking electrolytes and minerals (sodium, potassium, magnesium, calcium) and interpreting them in context of losses during weight loss is reasonable.

If that is already documented somewhere, ignore me and link it.

9 likes 2y
RH
revision_historyTL3Wiki editor2 Aug 2024#23
j.vogel, post #18: Post #17 describes the usual case. This is about the unusual one. Sodium is a good example of a question where the honest answer is boring and the interesting answers are unsupported. I would go with boring. Go to post

Post #21 put the caveat in the right place and I want to underline it.

Cramping is the symptom most confidently attributed to electrolytes and has the weakest evidence linking it to them.

I am confident about the direction and much less about the magnitude.

2 likes in reply to #18 2y
AA
a.adeyemiTL23 Aug 2024#24
a.kirchner, post #14: On post #12 — agreed on the reasoning, with one qualification. Posting my Sodium numbers with the method attached so they can be discounted properly. Uncontrolled, unblinded, and collected by someone who wanted a particular answer. Go to post

Building on post #21 rather than restating it.

Symptoms attributed to electrolytes here are non-specific and overlap with dehydration, low intake and poor sleep. Attribution from symptoms alone is unreliable.

0 likes in reply to #14 2y
SC
sourced_claimsTL3Regular4 Aug 2024 · edited#25

Magnesium supplementation is widely recommended in this space with very little supporting evidence for the indications it is recommended for.

The part I am sure of is shorter than the part I have written.

28 likes 2y
SG
s.grimaldiTL25 Aug 2024#26

Adding the measurement that post #25 says would settle it.

Sodium: losing weight involves losing some sodium. Electrolyte drinks or salty foods help maintain sodium balance. Very low sodium intake on these compounds raises orthostatic symptoms risk.

Genuinely open to being wrong about this one.

14 likes 2y
HO
h.oyelowoTL2Regular5 Aug 2024#27

Where I part company with post #25, and it is a narrow parting.

What I would check first on Sodium is whether the thing being measured moved or whether the way of measuring it moved. Those look identical in a graph.

5 likes 2y
RZ
ro.zielinskiTL26 Aug 2024#28
fr.translation_mo, post #19: Narrowing post #17, because the general version has more than one answer. The number people quote for Sodium is a central estimate presented without its interval, and the interval is wide enough that the estimate is nearly uninformative on its own. Go to post

Right, and stated more narrowly than I would have dared to state it.

0 likes in reply to #19 2y
MH
ms_hollowayTL4Mass spectrometrist7 Aug 2024#29

On post #25 — agreed on the reasoning, with one qualification.

Adding a small correction to the Sodium summary above rather than a disagreement with it. The substance holds; one of the figures is out by a factor that matters.

0 likes 2y
RS
r.serranoTL27 Aug 2024#30

The most useful posts here describe what was measured, what was changed, and what happened, in that order.

20 likes 2y