Potassium vs Sodium

I have had an experience a few times of a high potassium reading after a day of higher than normal exertion and wonder if it is a result of sodium loss through sweating that my potassium was high.

Yesterday I was in some adverse conditions skiing and exerted myself to a much higher level than I was comfortable with. This morning I awoke at 3am with a hard heart beat and immediately felt a run of ectopic beats. Very scary as it is exactly the feeling leading up to an afib event prior to my ablations. On my Cardy meter it showed up as being 1500, whereas 950 converts to the ideal reading of 4.5. (I don't have the conversion chart with me at the moment).

I took the same amount of magnesium as usual yesterday, along with my other supplements and potassium rich foods and should have been in the typical safe range for potassium. However, my diet does not include very much sodium, and there would have been virtually none in my food intake yesterday.

When I awoke in the night I deduced this and drank several pinches of salt mixed in water and started to feel better.

I'm curious if there is an inverse relationship between sodium and potassium? If sodium is depleted does this result in a high potassium reading? Or am I now experiencing something else that causes high potassium.

Ron

Are you taking any diuretics? Also, what kinds of food did you have? There's lots of sodium in processed foods, but you say virtually none in the foods you ate yesterday.

Hi Ron - spend some time reading at least the introduction to CR 72...



SUBJECT: Potassium/Sodium Ratio in Atrial Fibrillation Sodium and potassium!

Biophysicist Richard D. Moore explains:

"For purely physical reasons (connected with the law of osmotic equilibrium), inside the cell the sum of sodium and potassium must be constant. This means that... sodium and potassium are unalterably linked together like two children on a teeter totter. You can’t change one without changing the other.

"Thus, in the perspective of biophysics, it makes no sense to talk about either sodium or potassium alone - these two substances always affect each other in a reciprocal relation. Hence their ratio ... reflects the state of the living cell more completely than either sodium or potassium alone... It is not only a simplifying concept, but a much more scientifically valid measure of the state of health of the living cell.

"Reflecting the action in the cell, potassium and sodium always work in a reciprocal manner in the whole body... This means that increased consumption of potassium will drive sodium out of the body through the kidneys. Thus, potassium has been called "nature’s diuretic"... This is an example of the fact that elevation of sodium inside our body cells must always be accompanied by a decrease in the potassium level." [1, 11]

Continue: [www.afibbers.org]


Jackie

Ron, a high Potassium level has put me into afib in the past, the only good thing about this cause for afib is that you can swiftly and easily correct it, especially if you have a cardymeter, low Magnesium is much more difficult to correct, I think that taking Magnesium (you have to take if you want to stay in NSR) has something to do with absorbing the Potassium more efficiently through routine diet. I rarely have to supplemrnt with Potassium anymore now that I have stayed away from Potassium -robbing wheat products. I think it is a mistake for a lot of peple dealing with afib to supplement with Potassium, I would never use it without having a cardymetere handy.

Ron,

According to Dr. Moore in his High Blood Pressure Solution book <[www.amazon.com] , a potassium/sodium ratio of 4:1 or greater on intake will signal the kidney to excrete sodium. Moore also notes that increased levels of insulin (usually from a high carb diet) will signal the kidney to conserve sodium. Conversely a very low carb (VLC) diet will create low insulin levels that signal the kidney to excrete sodium.

There is advice for those on a VLC to supplement with sodium (<[www.amazon.com] <[www.amazon.com] ). I have friends (ski patrollers) eating a VLC who supplement with sodium, and notice a difference in their performance when they don't.

I seem to be relatively insensitive to either sodium or potassium intake. I did have one experience where I was really lethargic skiing. In the middle of the day, my friend took me into the patrol room and gave me a cup of bullion - basically a bunch of sodium. In the afternoon, my energy returned dramatically.

That being said, I usually fix all my food from scratch and it is naturally low sodium and usually VLC. Last week, I got a wild hair and skied 53 laps, about 52,400' vertical, all without stopping & no sodium or water. I can eat a lot of sodium salt or go without. Likewise I've supplemented with up to 10 g/day of potassium and now typically supplement with 1 g/day K+. All without any noticeable effect on my heart or how I feel. In my case my self-regulation seems pretty good.

I do need lots of mag - in the 2-4 g/day range. As long as I get the mag, the K seems to take care of itself.

In your case, I'm guessing your sodium was too low due to your normal low sodium diet, coupled with some hard exercise. Sodium is commonly made out to be the villain. This is really because most in our society eat a high carb (i.e. high levels of insulin all the time) diet coupled with a high sodium diet. Hence the body's self-regulating mechanisms (to excrete sodium) are overwhelmed. If you are NOT living the "standard," then it is possible to get into a situation where there is too little sodium. Overdrinking water is another way to do this. "Exercise-associated hyponatremia (EAH), however, is common at marathons and other endurance events.[5] 13% of the athletes who finished the 2002 Boston Marathon were in a hyponatremic state, i.e. their salt levels in their blood had fallen below an acceptable level." <[en.wikipedia.org]

George

I'm about 2 months into my realization of how important potassium-sodium balance is for me. My pvc's have basically disappeared during this time that I have focused on it, and my afib has reduced by more than half. Knowing this could be transitory, I'll cautiously offer my thoughts. My main potassium supplement is a banana, and occasionally (once every couple of days or so) a teaspoon of Potassium Gluconate. Each have around 500mg of Potassium. I've been eating a banana every morning, and will either eat another or have a teaspoon of PG when I've had a meal which doesn't clearly have more potassium than sodium. Examples are most sandwiches (bread, cheese and cured meats are all out of whack), and many or most restaurant meals. I eat mostly fresh food. And, although it is indulgent and probably isn't that healthy, my main exceptions to that are Potato Chips (3.7 - 1 Potassium - Sodium in Kettle Chips) and dark 85% chocolate (Magnesium rich).
A rough guess for me is that my overall Potassium -Sodium ration is about 3-1. There you have it.

Thanks for the comments everyone.

Tom I am interested in your comment that high potassium can be corrected. How do you correct it? I can understand fixing low potassium by supplementing.

Jackie I have once again spent several hours reading CR72 and following the various threads. When I previously read it I think my brain was in quite a fog; possibly from gluten, exhaustion and the stress of constant afib. It was more helpful this time, although technical beyond my capacity. Most of it dealt with low potassium and high sodium, which has been my typical issue. There were also a few references to high potassium and low sodium. I understand the tetter totter can tip both ways, although it is not typical to have low sodium.

One thread was interesting in regards to low blood volume levels. I have the symptoms of cold extremities and a hard heart beat and have commented about these often. I always attributed my hard heart beat to low, or high, potassium. Perhaps the blood volume is another angle I need to explore. I am awaiting results for a comprehensive thyroid test and an iodine test, so maybe these will shed some light.

For sure the hard heart beat is an uncomfortable state, and I am experiencing it right now despite my potassium levels being optimal.

George, your take on the situation supports my thesis that I may have been low on sodium. I have a very low carb VLC diet most of the time. My ski jacket is loaded up with veggies, fruit, nuts, small gluten free sandwich with protein and fresh water. None of this food is salted. My breakfast on a ski day starts with some fermented vegetables, eggs, avacado etc. We ski hard and perspire, and typically don't replace any sodium. I do take most of my supplements in the morning to avoid and stomach problems with them later, but also take some magnesium at lunch and dinner. (Ps, what area are you at? We are usually at Lake Louise).

Ralph, my understanding is that bananas, although high in potassium, may not be your best source to rely on. I have a Cardy meter and will only supplement with potassium glyconate after confirming that I am low, as low and high feel similar, and you definitely do not want to be adding extra potassium supplements if you are high. Also my potassium levels peak during the night and to avoid hypo I never supplement after about mid afternoon. I've tested my potassium hundreds of times and so have a pretty good handle on my trend most of the time.
Ron

Ron, is there something you've heard about bananas specifically, or are you talking about supplementing potassium without a cardy meter?

Ralph,

I think the issue is the high glycemic nature of bananas is somewhat counter productive. That is the the sugar in the bananas stimulates an insulin response which signals excretion of potassium.

Ron,

I live in the Denver area of Colorado. I ski often with friends who are volunteer ski patrollers. One husband/wife couple lived in Calgary 20 years ago for her job. They volunteered at Lake Louise during that time. They've told me stories about their time there. I ski a number of the resorts. My friends ski at Loveland, which closed yesterday for the season. They had 474" of snow for the season. A good year. There is still one resort open - Arapahoe Basin, which is scheduled to close 1 June, though sometimes they stay open longer, depending on the snow. 3 years ago, they stayed open till 4 July. I'll be skiing the rest of the month.

George

It seems circuitous at best to suggest that the a high potassium food like a banana would result in net potassium loss because it has sugar (if that is what you are suggesting George). Bananas appear to be working for me in any event

Here is an article for consideration:

[www.ncbi.nlm.nih.gov]

Ralph,

Yes, I am suggesting that. I'll let Jackie weigh in on this as she most often makes this argument. If it works for you, then obviously, do it!

At this point, I eat VLC most of the time, and potassium isn't an issue for me. My first afib episode 10 years ago, my serum K+ level was low (3.2 mmol/l, from memory). At that point, I thought potassium might be key. Years of experience have suggested that as long as I keep my mag intake high, potassium doesn't really matter. I take 0.5g 2x/day now. Compared to some of my past intake, it is modest. The form I use is K citrate. 12-15 years ago pre-afib, I had two kidney stones a year or two apart, while eating a vegetarian diet. Subsequently, I learned that citrate can reduce stone formation dramatically (80+% over 5 years). There is a prescription form of K citrate, just for this purpose. So I take it for that reason, more than the afib.

George

Morpheus,

So the key points from your link:

Eating up to 2 servings of bananas caused marginal increases in plasma potassium concentration.

The small increases in plasma potassium concentration occurred 30 to 60 minutes postingestion of bananas.

Eating bananas is unlikely to be an effective treatment for exercise-associated muscle cramping.

Actually, I've found magnesium to be a very effective treatment for exercise-associated muscle cramping, with my friends. Both oral and transdermal work.

George

It makes no sense to me George. I am big on things making sense- at least to me. And, the article Morpheus posted, as I skimmed it, was more about bananas not having a significant immediate effect than it was about them not having a significant effect (90 minutes later for example). I chalk up the theory that eating bananas reduces potassium levels alongside the theory that eating a lemon is alkalizing in your system.

George - Thanks for mentioning the problem with relying on potassium from bananas... It is known that high glycemic foods such as bananas, while they do have a high potassium count they are also high in sugar and are not as beneficial overall because of the higher requirements to handle or metabolize the high glycemic content which requires both magnesium and potassium in the process along with other complications such as glucose handling challenges... compared to, for instance, an avocado which is low glycemic.

Also - when Dr. Moore talks about a 4:1 ratio, he is targeting a bare minimum mainly directed at managing hypertension. In reality, research shows that cultures today who are not influenced by the Standard American Diet which is weighted heavily toward high sodium and low potassium, disease conditions related to insufficient potassium and/or high sodium are not found in past or present health histories....and their intake ratio is more likely to be 11:1 from totally natural foods. The Paleolithic era shows the ratio to be 16:1.

Ralph... the lemon as alkalizing is not a theory but fact. It does metabolize to alkaline ash even though a dipping a pH strip will show as an acidic pH. This has nothing to do with blood pH which is held at a close tolerance automatically.
Rather, it is the result of metabolizing foods that produce alkaline or acidic ash which affects tissue conditions in the body... health is supported by alkaline tissue; disease, such as cancer thrives in an acidic tissue environment.

Ron B... Keep in mind that the body does require some sodium... as in adrenal function. You could be too low.

Also, if you persist with elevated readings of high potassium, why not consider having tests to make sure your kidney function is normal since "people with decreased kidney function may have difficulty getting rid of excess potassium. (Moore)

You may want to request an initial screening or urinalysis of serum creatinine and verify the serum potassium formally. If that indicates a kidney problem, then follow with a more comprehensive evaluation for kidney function including the filtration rate, clearance, etc. As we age, sometimes kidney function impairment lurks behind the scenes.

Jackie

Hi Ralph,

I don't have time to dig out the detailed research, however, I can say it is known that insulin has an effect on the cellular sodium/potassium pumps as well as kidney excretion and retention of sodium. You can dig out more of the science in Moore's book referenced above.

From an emergency medicine post: <[crashingpatient.com] "When treating significant hypokalemia with IV potassium replacement, initial therapy should consist of potassium administered in glucose-free solutions. Glucose may cause a further decrease in the serum potassium concentration, presumably caused by the enhanced insulin secretion stimulated by glucose, which results in the movement of potassium into cells. This has been documented to precipitate arrhythmias and neuromuscular paralysis (1,2)."

Regards,

George

Hi Ron,

I have cold extremities and some times hard heart beat. I cure it by taking ginger.
I know you have tried ginger before without any benefit, but have you tried taking a larger amount, like 1 gram twice a day. I would suggest New Chapter Ginger Force, you can get from the vitamin shop.
Cardio & Digestive Support - Ginger Force supports blood platelet health and cardiovascular function, in vitro. Active ingredients support the growth of beneficial intestinal microorganisms, which are vital for intestinal health.

It works for me I have been taking ginger for almost 18 months. during which time I have had 6 afib events, down from 3 a month. My last afib event was Dec 13 last year, from which time I now include curcumin which is a great anti-inflammatory.
There is a lot of stuff on the net about ginger, check out this article [www.quantumbalancing.com]
I hope this helps.

Colin

Hi Colin - it took time and some serious prodding by my wife, but I have embraced ginger, mostly as tea. In fact it is my "go to" drink now. We slice thin fresh ginger root and freeze it. I drink it after dinner, in the morning, and if I cannot sleep in the night I keep all the lights out, and have a cup up ginger tea and invariably go back to sleep. My gut issues have vastly improved. Of course I have done any and all other heroics possible, so it is not possible to say what impact ginger has had. What I can say is that I am enjoying the taste and find it soothing.

I have not tried the higher dose yet, but will do so. Recently instead of simply steeping the tea, Linda has been simmering it to make a stronger brew.

I will take your suggestion to heart and ramp up the dose.

Many thanks, Ron

Ron, eating acidic foods will bring down your Potasium level very quickly, meats, breads, beans just to name a few.

"Very scary as it is exactly the feeling leading up to an afib event prior to my ablations."

How's this scenario sound?:

25 years of fairly intense training and competition--->develop a-fib--->get an ablation or 2--->nice new heart, all the bad actors in the atria from the historic exertion taken care of--->start up again with the high intensity exertion--->currently experience some precursor warning signs that new bad actors are forming--->perhaps gives cardiac over-exertion a lower priority in terms of explanation for the latest scary events and focuses on electrolyte and mineral causes (which clearly *can* be contributors)

Low heart rate may be due to the training and competition (among other things). Cold hands and feet as well as low heart rate may be hypothyroidism (among other conditions). Constipation (sees ears perk up) can be associated with low thyroid functioning.


1500 converts to?



Edited 5 time(s). Last edit at 05/08/2014 11:51AM by morpheus.

Tom, what are you referring to? Do you have any data behind that statement, and by acidic foods do you mean Jackie's acidic or PH acidic?

Morpheus,

1500 converts to ~ 5.4. 1500 x 0.026 = 39 & 39 ~5.42 serum. See: <[docs.google.com]
<[hkpp.org]
<[hkpp.org]

George



Edited 2 time(s). Last edit at 05/08/2014 05:28PM by GeorgeN.

Thanks, George (any worries about nigari from Japan, the country of the recent sort-of “China syndrome”? [en.wikipedia.org] I'm thinking what are the air and water circulation patterns, as well as ship bilge water from vessels that sail both the Sea of Japan and the Pacific, and other potential vectors of contamination such as ship holds, etc. Another thread might be informative, so that this thread isn't hijacked.)

“The normal range for serum potassium is narrow (3.5 to 5.5 mEq/L), and minor departure from this range (by less than 1.0 mEq/L) is associated with significant morbidity and mortality. Although a 1.0 mEq change in concentration is small in absolute terms, it changes the KI:Ke ratio by 25%. Therefore rapid evaluation and, when indicated, treatment of hypo- and hyperkalemia are critical.” [www.ncbi.nlm.nih.gov]


Normal ranges will vary depending upon the sources of the information.

A 5.42 (high end of scale) doesn't seem all that bad, if the 3.5-5.5 range given above is accurate, but people differ. In addition, the state of calibration of Ron's meter at the time of the measurement is unknown as is the existence of any possible errors introduced while performing the measurement procedure.

In a different thread Jackie noted, by way of citation:

"Estimated daily paleolithic intake of selected nutrients
Sodium 768
Potassium 10,500"

High potassium in comparison with today's "standards". Seems reasonable, though.



Edited 7 time(s). Last edit at 05/08/2014 07:12PM by morpheus.

Morpheus,

There seems to be a lot of individuality in how people react to serum potassium levels. For example, while 3.5 is the low end of "normal," many afibbers know they're in trouble with numbers less than 4 or even 4.5 for some. Conversely some have issues as they approach 5 or greater. A serum sample taken in the ER during my first afib episode was 3.2. Five days later at my primary doc's office, it was in the low 4's (from memory). They'd given me 720 mg potassium in the ER, but nothing else. So the driver, at least in my case, appears to be something other than intake. Though I take 1 g/day now, serum K+ is not something I worry about. As long as my mag intake is sufficient, the K takes care of itself, at least for me.

An interesting part is why people get high readings. In theory, the kidney should excrete any excess. In my case, I've taken 10 g/day for significant periods of time without issue, so my control mechanisms appear to work well. This may not be the case for everybody.

As to Nigari, when the quake happened, I contacted the US distributor. They still had pre-quake inventory, so I ordered 40 kilos. It will take me a while to go through this... I have a radiation meter and have thought of ordering a small sample to see how it tests by comparison. I'd previously run the pre-quake stuff through a lab for heavy metals & it was clean.

George

cryptic self promotion is the work of the devil's advocate. I think maybe anyway

Morpheus,

Of the nigari, I generally consume 0.2 liters/day of a solution I make up. I put 1/2 cup nigari in 2 liters water. 1/2 cup is about 61.7 g of MgCl2. The molar mass of MgCl2 is 95.2 and of Mg++ is 25.5. So Mg represents 26.8% of the compound. 0.2 liters x 61.7/2 x 0.268 = 1.65 grams Mg/day and 6.2 grams of the nigari. This is about a 17.7 year supply. I probably have 15+ years left. It is kind of funny how fast I go through it though.

I also consume 2 g/day of Mg in the form of dimagnesium malate and 0.3 grams/day in the form of magnesium bicarbonate. About 4 g/day total.

20 kg (44 pounds) of nigari can be had from the supplier for $76 US, plus shipping. That represents 5,360 g Mg++, at a cost of $0.014/gram. If one is concerned about cost, this is the cheapest mag around. I'd probably test to see if it glows before I got more in the post earthquake world.

George

" I'd probably test to see if it glows before I got more in the post earthquake world. " LOL

And thanks for the other info, George.

All this sounds like a lot of work. Not sure if I should take the Blue pill or not. I rarely sense heart things 18 mths post (not Natale) ablation but if I do then I gulp down a good few tablespoons of KCl mixed with Orange flavored water, sometimes an antacid with it, and it goes away

Ralph, in the book Wheat Belly by Cardiologist Dr. William Davis, Chapter 8 discusses in detail the effects of acidic foods on pH. This is a good book with a wealth of info on how what we eat effects our health.....namely the "new" strains of wheat.

Morpheus - I'm getting back to you on your first post. I did consume some diuretics - ie two drinks after skiing, and a coffee earlier. Both of these are a simmering issue for me. I eliminate them from my life when not feeling well, and as the sun starts to shine again they creep back into my life. I wonder if they are cause and effect. I don't take any other meds, although I do take a handful of supplements in the morning.

Thanks for the threads you have provided. Very informative.

Ron

Ron - You probably have read the numerous comments about alcohol being a poison for heart cells.

Dr. Natale cautions ablatees not to consume alcohol. Alcohol depletes magnesium and acts, as you say, as a diuretic, so if you were marginal or already low in the critical electrolytes, the result is predictable. And, of course you know that some people are bothered by either the caffeine in coffee or are reactive to the abundance of pesticide residues in coffee that is not organic. Reports here from several coffee drinkers say they are reactive to non-organic coffee.

Another factor for you may be consuming either on an empty stomach.....which is often the case for either beverage.

Jackie

Morpheus:

I wouldn't play with Tiger, he is having some physical problems and isn't playing too good right now.

L



Edited 1 time(s). Last edit at 05/12/2014 04:34PM by Elizabeth.

Ron B - Also another consideration is that previously you've mentioned gut disturbances. Sorry but I don't recall if you were found to have intestinal permeability or leaky gut syndrome (LGS) - but if so, then you are vulnerable to 'mainlining' via that gut permeability toxic substances directly into the system and they also contribute to the inflammatory process. Whereas in normally, healthy, undamaged intestinal linings, those toxins are managed and eliminated.

Jackie

Morpheus,

My partner is having issues after foot surgery 9 moths ago. My hand surgeon friend referred her to the same doc he is sending his wife to. That is a pretty good recommendation.

George

Wellllll, perhaps its a good recommendation, but perhaps not! (the docs may be "buddies" in a less-than-conventional way, if you get my drift, and "co-conspirators" if not ) [abcnews.go.com]

Morpheus,

I don't think so. The doc he recommended is top notch in all respects, as was the alternate. I've been close friends with the hand surgeon and his wife for many years. I've vacationed at the beach, skied and backpacked with them. My friend is considered tops in his field and is nothing but professional when anything medical comes up.

George

Morpheus - for my ablation(s) I used the guy who teaches many of the EP's - Pr Jais in Bordeaux. I made a good choice, now the rest is up to me not to screw it up!
Ron