electrolytes diet

Electrolyte Balance With Different Low Carb Diets

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Over recent years, a number of new diets have become popular among health conscious individuals. The most popular include: the low carb high fat (LCHF) diet, as well as the ketogenic and carnivore diets. In this video-interview I discuss how diet affects electrolyte balance. Electrolytes, minerals like salt and potassium are essential “cofactors” for enzymes involved in metabolism. They are essential, meaning we cannot make them on our own. We have to ingest them through diet. Each of these new diets differs in available electrolyte cofactors. In addition, each of these new ways of eating modifies how much insulin we use. Insulin holds onto sodium and so as we reduce our insulin need, we also reduce sodium. Since electrolytes affect everything from cell firing to heart rhythm, it is important to consider whether one’s chosen diet provides sufficient quantities of these critical elements.

I have written about the electrolytes salt and potassium on several occasions, see here and here and here. I have also written about how thirst is an indicator of electrolyte balance or imbalance, see here. In the video, we discuss salt thirst from a different perspective, and sodium requirements with different diets. US Dietary Guideline recommends 2300 mg sodium (sodium is 40% of salt) for the general population and 1500 mg sodium for the elderly and those with heart disease. This is in contrast to research showing that such low sodium actually increases mortality. Accordingly, the ideal amount is around 3500-4500 mg sodium a day for all populations. Another study found that 4000 – 6000 mg sodium was ideal for non-hypertensive individuals.

Salt, Edema, Thirst, Insulin, and Hydration

In diets more heavily focused on animal proteins, managing hydration can become difficult without proper electrolyte support. Edema, or swelling, is a common symptom of improper electrolyte balance and dehydration. Because these diets reduce circulating insulin, and as a result also sodium and water levels,  the body becomes dehydrated. To conserve water and salt, the body stores it in the tissues, leading to edema. Rather than reducing water and salt, an increase in both is required to prevent edema. Thirst may also follow, but drinking water is often an inappropriate response.

I also cover protein to some extent in this interview. Much is yet to be clarified about the amount of protein that is ideal. I have written about protein before, you will find it here.

I hope you enjoy this video discussion.

Keto & Carnivore: Electrolytes, Water Retention & More

 

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This article was first published in April 2020.

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Angela A Stanton, PhD, is a Neuroeconomist who evaluates changes in behavior, chronic pain, decision-making, as a result of hormonal variations in the brain. She lives in Southern California. Her current research is focused on migraine cause, prevention and treatment without the use of medicines.

As a migraineur, her discovery was helped by experimenting on herself.

She found the cause of migraine to be at the ionic level, associated with disruption of the electrolyte homeostasis, resulting from genetic mutations of insulin and glucose transporters, and voltage gated sodium and calcium channel mutations. Such mutations cause major shifts in a migraine brain, unlike that of a non-migraine brain. A non-migraineur can handle electrolyte changes on autopilot. A migraineur must always be on manual guard for such changes to maintain electrolyte homeostasis.

The book Fighting The Migraine Epidemic: How To Treat and Prevent Migraines Without Medicines - An Insider's View explains why we have migraines, how to prevent them and how to stay migraine (and medicine) free for life.

Because of the success of the first edition and new research and findings, she is now finishing the 2nd edition. The 2nd edition is the “holy grail” of migraines, incorporating all there is to know at the moment and also some hypotheses. It includes an academic research section with suggestions for further research. The book is full of citations to authenticate the statements she makes to be followed up by those interested and to spark further research interest.

While working on the 2nd edition of the book she also published academic articles:

"Migraine Cause and Treatment" Mental Health in family Medicine, November 23, 2015, open access
"Functional Prodrome in Migraines" Journal of Neurological Disorders, January 22, 2016, open access
"Are Statistics Misleading Sodium Reduction Benefits?", Journal of Medical Diagnostic Method, February 3, 2016, open access
“A Comment on Severe Headache or Migraine History Is Inversely Correlated With Dietary Sodium Intake: NHANES 1999-2004” Angela A Stanton PhD, 19 July 2016 DOI: 10.1111/head.12861 not open access, membership required to read it.

Dr. Stanton received her BSc at UCLA in Mathematics, MBA at UCR, MS in Management Science and Engineering at Stanford University, PhD in NeuroEconomics at Claremont Graduate University, and fMRI certification at Harvard University Medical School at the Martinos Center for Neuroimaging for experimenting with neurotransmitters on human volunteers.

For relaxation Dr. Stanton paints and photographs. Follow her on Twitter at: @MigraineBook

10 Comments

  1. Dear Angela,
    I wrote above about my daughter. She stopped the drug 8 months ago and the edema is still here. She stopped as soon as it appeared. Did the drug damage her is some way? Can her sodium/ potassium channels be damaged? We have seen so many doctors and no one can help her. No one seems to understand how this drug works. She took it for pelvic pain.

    • Dear Anne,

      I have seen 5 comments from you and all refer to the same case, so I just respond to one to simplify things. In one of your posts you also added that she was taking Gabapentin but stopped, and is now supplementing potassium, magnesium, calcium and sodium. So let me help you take this whole thing apart.

      Gabapentin:

      From Wikipedia: “Gabapentin is a ligand [ligand = connects to] of the α2δ calcium channel subunit.[69][70] α2δ is an auxiliary protein connected to the main α1 subunit (the channel-forming protein) of high voltage activated voltage-dependent calcium channels (L-type, N-type, P/Q type, and R-type).[9] Gabapentin is not a direct channel blocker: it exerts its actions by disrupting the regulatory function of α2δ and its interactions with other proteins. Gabapentin prevents delivery of the calcium channels to the cell membrane, reduces the activation of the channels by the α2δ subunit, decreases signaling leading to neurotransmitters release, and disrupts interactions of α2δ with NMDA receptors, neurexins, and thrombospondins.[9][10][11] Out of the four known isoforms of α2δ protein, gabapentin binds with similar high affinity to two: α2δ-1 and α2δ-2.[70]… Gabapentin is a potent activator of voltage-gated potassium channels KCNQ3 and KCNQ5″

      I highlighted some of the sentence parts with bold because those are the problem areas for your daughter both for the edema and also for what she is supplementing, and why there may be some permanent damage.

      Basically the bolded sentences mean the following:

      1) Gabapentin blocks both L and R type calcium channels. L is associated with the heart and R with the brain in the cortex, hippocampus, striatum, amygdala and interpeduncular nucleus. (here). These calcium channels are responsible for the function of the heart for its beat (L type) and the neurotransmitter release in the brain (R type). As a result, her brain and cardiovascular systems are significantly affected in how they can function.

      2) Calcium must enter the neurons to have the neuron release it’s neurotransmitters. Neurons that cannot communicate, degenerate. So this drug degenerated her brain–this doesn’t mean the brain remains degenerated. It may recover over time.

      3) Gabapentin activates voltage-gated potassium channels. This is also a problem because of how the brain must have sodium and potassium in a particular ratio (3:2 sodium:potassium) in order to properly function and be able to start action and resting potentials. Neuronal communication starts with sodium rushing into the cells and this initiates action potential–the start of voltage–and once the voltage started, in those areas where the voltage started it is an action potential. When that is started, immediately sodium must leave the cell and potassium must rush into the cell, and this creates the resting potential, which stops the voltage at that particular point in the neuron.

      The voltage is going from sodium channel to sodium channel of the neuron (Nodes of Ranvier) as the action potential goes all the way to the end of the neuron. The resting potential follows all the way, in step, with a tiny delay, putting the voltage out. When the voltage reaches the foot of the neuron, that is where the voltage-gated calcium channels come into action, where calcium rushes into the neuron and literally kicks the neurotransmitters into the synaptic cleft, which is the area between neurons. From here the connected neuron can pick the neurotransmitter up and start its own action and resting potential and send the neurotransmitter to the next neuron it is connected to.

      So all of these activities are blocked in the brain except for the potassium channels, which are actually enhanced and activated. And this blocks all chance for an action potential. So her brain basically came to a standstill while on Gabapentin.

      Now, she stopped Gabapentin 8 months ago, but while she was taking it, neither her heart nor her brain was able to work properly and drugs that inhibit, do so by connecting (ligand as I noted above) to proteins. And that’s very dangerous, because the connection may damage the folding of the particular protein and it may render it damaged for life. We don’t know if any of this happened but can be. In addition, since her heart was also controlled by this drug, and the heart cannot heal very well because it cannot stop or slow down, it changed her vascular behavior.

      The edema is associated with her vascular system not functioning the way that it should. Add to this that she is supplementing electrolyte minerals that she shouldn’t. Please read my article on why supplementing with potassium is a very bad idea. Also, supplementing with calcium may be a bad idea, particularly if she isn’t also supplementing with D3, K2, magnesium, and vitamin C, and assuming that she even needs to supplement with calcium. Supplementing with calcium should only be done in small amounts at the time since the body can only absorb 400 mg at once and while calcium is water soluble, in the body it is fat-soluble.

      Calcium supplementing also requires a high-protein diet because over 40% of the bones is protein, which creates a scaffolding onto which calcium can adhere to form bone. So if she is not eating a lot of animal products high in protein, protein synthesis is not going to happen very easily and so her ability to place that calcium anywhere useful is questionable.

      And finally: being able to take salt as part of her electrolytes requires that she drink enough water for her weight. For females the minimum water a day is 55% of her weight in pounds. So a female weighing 100 lbs would need 55 ounces (7 cups of 8 oz water each) minimum a day. If she drinks less water than this and if she eats a lot of carbohydrates, her body will hold onto water and also salt, hence the edema. It also matters how much sodium she is taking at once.

      I would recommend that she join my Facebook migraine group where she can learn how to eat and what to help recover and stop the edema.

      I hope this message is helpful for you.

      Best wishes,
      Angela

  2. My daughter took a drug called gabapentin and has been struggling with Edema in her hands and feet ever since, painful Edema. She has also recently tried to cut her carbs out and add in a lot more healthy things like eggs meat liver fish etc. Is there anything else she can do to stop the edema.

    • Dear Anne,

      I am very sorry that your daughter is taking Gabapentin. This drugs is a voltage gated calcium channel blocker, which disrupts neuronal communication. In addition, it is a strong activator of voltage-gated potassium channels, meaning it increases fluids leaving cells. So this explains the edema of your daughter. The low carbohydrate diets will not help with edema caused by a drug. To stop the drug-caused edema, she needs to discuss discontinuation of the drug with her doctor.

      Since Gabapentin is prescribed for many conditions, including migraines, if migraines are the reason for the medication, there are way better alternatives out there. If she was prescribed this for seizures, she should contact the Charlie Foundation for help. If for migraine or nerve pain, she should join my Facebook group and we can help her learn to prevent migraine and reduce/prevent nerve pain, depending of the cause.

      Best wishes,
      Angela

  3. These articles are helping me understand so much more. But I still have problems I cannot fix. I am on a carnivore diet and I have tried increasing my salt intake and drinking small amounts of milk. It has helped a little, but I still have problems with minor muscle cramps but mainly lack of power when exercising.
    It would be great to hear your thoughts, thank you.

    • Dear Sammy,

      The problems can have a lot to do with you body’s struggle with insulin resistance. Many people have a hard time because additional steps are often necessary and the switch to a new diet is not enough. Please join us in my Facebook migraine group where you will learn how to apply the carnivore diet right.

      Best,
      Angela

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