Need advice on monitoring the fluctuation of IC Na/K levels

What is the best way to monitor IC levels "on the fly"?

I have read about this Horiba Na+ and K+ meters on this site, and am trying to clarify some things before I buy one.

If I'm worried about the IC Na/K ratio fluctuating and impacting my AFIB status, then should I get both the Na+, and the K+ meters?

What is the consensus here as to whether or not the Horiba meters reflect the closlely with the Blood values, or the IC values as measured on an Exatest?

My blood draws seem to be fairly normal, regardless, of whether I do the testing right after onset of AFIB, during an episode, or in NSR. What seems to be happening, is that the IC ratio is fluctuating more so than the blood ratio. At the onset of my last episode, I immediately did an Exatest, that showed to much K+ over Na+. My blood draws several days later were normal. Do the kidneys normally maintain homeostatis better in the blood better than on an IC level? It appears to me that IC electrolyte shifting (could be caused by various reasons) is a main factor in predisposing me to the AFIB hyper-vulnerability state (AFHVS).

My last Exatest at AFIB onset showed the following:

Mg 30.4 (low)
K+ 336 (high)
Na 5.7

The ratio of K+ to Mg was high at 9.4 as was the ratio of K+ to Na+ high at 46.1.

2 days later, my blood was drawn and showed Na at 138, K at 3.9, which I did not interpret as a high K to Na ratio,
although I am thinking that the AFIB process may have caused an this shift.

Also how does drinking to much fluid effect all this? I consume around 10L of fluid (mainly water) a day (I live in desert).



Edited 4 time(s). Last edit at 09/27/2014 10:32AM by The Anti-Fib.

Any serum potassium below 4 for me is low and is a risk zone with afib.

Its been 10 years since I looked at an Exatest result, but from memory, your Mg looks very low. As I recall, the bottom of normal is 33.9 (I looked it up) <[www.exatest.com] I recall I was around the bottom of normal or just below. Magnesium has been my issue ... and my salvation.

Though I was the one that initially posted about the Cardymeter, I've never gotten one. "Horiba meters reflect the closlely with the Blood values, or the IC values as measured on an Exatest" I would say serum values. The periodic paralysis people that came up with the idea correlate cardymeter saliva readings with serum. [hkpp.org] I have read of people using the Cardymeter for direct serum testing also.

Having read our group's experiences with the Cardymeter, I don't know of anybody with an Na probe. However those that have the potassium probe have noticed correlations such as increased sodium intake will decrease saliva potassium levels.

In your shoes, I would probably get a potassium meter at a minimum and start testing. Then see what correlations you come up with. Sodium might be interesting, too.

George

10 liters seems like a lot of water and could subject you to hyponatremia. I generally eat a very low carb diet. This can also cause electrolyte fluctuations. Low insulin levels signal the kidney to dump sodium, hence I supplement with sodium. I've had several instances over the years that low (serum) sodium levels were afib triggers. Once I dramatically reduced my carb consumption, my fluid requirement decreased a lot. For example, I could ski hard all day at 12,000' and not consume any water unless the temperature is above 45 deg. F (altitude also being dehydrating). I grew up in the desert, so I know about them. My own gage on hydration is urine color. I my "Goldilocks" point is just a bit of color in the urine. Not clear, not dark at all.

Ha, Ha that's right the urine color is the "gold standard" for determining hydration status. I used to marvel at how clear and clean my urine did seem, looking just as good as the tap water.

Actually, I did have hyponuetremia requireing hospitalization with a blood level of 120, (135-145 normal) in the past, but it was was when I was consuming closer to 15-20L of fluid, and also on a low salt diet that was supposed to be so great for you about 25 years ago. All that ____ about only needing 2000mg a day, and don't add no salt to your food. Hogwash if your active in the hot desert.

I don't shy away from salt, but I don't supplement it either. I do love saltly foods, especially with sea salt in it.

The minimun value for Mg according to the Exatest is 34.0. Mg does also seem to be the key supplement for me.
I have noticed a benefit, even better than compared to the 2 Anti-arrythmics that I have tried. I thought that after taking 600 mg for several years, that my values would be corrected, so I dropped down to only 300mg, and alas then onset of AFIB episodes, and my Exatest Mg level is low.



Edited 1 time(s). Last edit at 09/27/2014 11:53AM by The Anti-Fib.

Its very common for afibbers to test low even after what should be sufficient oral doses of magnesium for a good long while. Mag repletion can take a full 6 months to a year for some people with good absorption and assimilation of the mineral ( which is hard to absorb in the best scenario in any event, but many afibbers ... like myself ... also happen to be magnesium wasters, and also often potassium and sodium wasters as well, and tend to run though these critical electrolytes as fast as we can dump them down our throats, up to a point.

Often when you are still getting low to borderline low IC Mag on Exatest, even after robust oral mag dosing for a long while, you must go for a full blown IV magnesium infusion program using Myers Cocktail formula as the base which you can often find with an integrative or functional medicine MD or naturopath in your area who offers an IV nutrient service in their practice.

Then go for a solid Myers cocktail that includes healthy doses of all the B vitamins, large 10gram to 30gram IV doses of Vitamin C, a number of other nutrients like Biotin etc ( ask them to nix or go light on the IV calcium) and often with IV glutathione added and injected in at the very end of the IV fluid bag just as it is empty and they then inject 500mg to 1 gram of IV glutathione ( make sure they keep the large syringe used to inject the Glutathione into the IV port of the IV tube covered with an opaque cloth or towel the entire time from the moment they fill the syringe with glutathione until it is fully injected into your IV bag port and thus into your body as Glutathione degrades very quickly in light exposure .. also make sure they wait to the very end of the Myers cocktail infusion before injecting the Glutathione into the IV bag part as well as it will degrade and dilute it almost completely when mixed with all the other nutrients) for an instant boost of this critical detoxifying master anti-oxidant in the body that also is typically deficient after age 50. But also have them add in from a minimum of 2 grams to a max of 4 grams of IV magnesium sulfate to the Myers cocktail and drip the whole thing in over 30 to 45 minutes while you sit back in a lazy boy lounger and read or listen to your music.

Highly relaxing and doing this once a week for the first month then twice a month for the second and third month and often them you can get by with once a month going foward for the first year, will really restore you IC magnesium the fastest way.

You also wnat to keep up with your oral Mag protocol as well while you are building up your IC levels with the IV Mag so if you start to get any bowel intolerance just back off some on the oral mag until you have tapered down on your IV protocol and got a repeat EXATEST showing a much better IC Mag level.

Doing this exercise will forever change a persons mind, and I wish every cardio and EP on earth had to experience this themselves or see it in a host of patients, and see how much better the heart stability gets with the IC Mag levels approach an ideal level of 40 for an afibber, or as close to that as you can get.

Also, be sure to add in the potassium as spelled out in The Strategy in detail along with getting sufficient mag on board and that might help buy you even more time managing the beast conservatively and will surely help other aspects of your cardiovascular and overall health as well.

It is a real shame with otherwise smart people give up on magnesium or other nutrient repletion that has a good biochemical basis of action for hte issue at hand simply becuase after a few months or longer of taking 600 to 800 mg a day of oral pills its still a very mixed to poor results bag in spite of all teh effort.

The have to realize that there is some genetic or acquired biochemical/hormonal dysfunction that make us just run through these critical heart stabilizing ions and it takes a truly heroic effort in many cases just to get the IC levels up a little bit into the more optimal range which is from 36 to 40. An IC level of 34 on Exatest is definitely too low for Afibbers and the closer one can get to being able to maintain more or less 40 the better.

Then with a healthy dose of potassium being confirmed with a Cardymeter testing whenever you wish at home ( the way Horita who makes the Cardymeter also makes a sodium bio-sensor for their Sodium Cardymeter as well, but alas no Magnesium sensor as yet as they is not need so often in the horticultural field this device is mainly and initially intended for.

Also learn to stock up and apply effective topical magnesium 'oil' and then in the last months of the 4 to 6 months of gradually tapering IV magnesium replacement therapy, start to apply liberal doses of topical magnesium sprayed on and rubbed in vigorously on both sides of your torso, inner arms and inner legs and back of knees etc and also chest and stomach too, assuming you are not hairy like a wholly mammoth, and you will definitely be able to get your IC mag levels at least to a moderately decent range from 36 to 37 is about the best I get even with heroic efforts but without it Im down to 30 to 31 even with a gram of oral chelated glycinate a day ... which is no mans land.

The other problem with regular docs recognizing magnesiums impact, even though they fully under stand the theoretical role of Mag in the cardiac cellular cycle, is because they see so many people with AFIB with what they feel have perfectly normal serum Mag readings from 2.0 to 2.5. This can be very misleading, particularly in many Afibbers as there can be a many years, or even a decade, lag between a real functional IC magnesium deficiency and it showing up that way in serum Mag levels, as the body is very adept at scavenging large amounts of magnesium from the cells of muscles, skin, organs etc and redirecting it to the blood to sustain the all important and very narrow range of blood hemostasis of these vital life giving minerals.

By the time a person is testing frankly low on serum Mag in the <1.7 range then there is real trouble in the heart muscle cells and elsewhere in the body with extreme deficits in IC magnesium. Its a real shame no one yet seems to teach this fundamental biochemical and physiological process fact to doctors in med school. It seems that most of the teaching docs in med schools mainly focus on passing along the "normal' ranges in serum magnesium test and never really look at the issue any further going into this IC level issue discussion. That is a real shame.

Shannon



Edited 1 time(s). Last edit at 09/27/2014 06:46PM by Shannon.

I'm clearly a mag waster. I consume 3-5g oral mag/day. Right now near the high end of that range. I've never done the IV mag, though I'm sure would be a benefit. I've also not retested IC mag as what would I do differently? I already know I need to slam as much mag in the system as possible.

It might be an academic curiosity George to do one more Exatest at a point when you feel fully replete and are at near max intake level for some time to see who that reads on IC levels. No doubt it would be significantly better than on a typical lower oral only dose, but it would be interesting to see how far you have been able to push it and perhaps you might be plenty high and could lower the dose a bit as well? Anyway, thats and expensive lab experiment when you already know pretty much the functional outcome anyway .... the idea is more a curiosity for us.

Shannon

Thanks for all the good info.

Shannon, George, or anyone else:

I'm taking 600 mg of Dr's Best Chelated Mg.
It says on the back "Magnesium (elemental) 200mg (from 2,000mg magnesium glycinate/lysinate chelate)

I have thought about switching to Bulk Supplements Mg Glycinate powder, to save money.
Is the conversion the same? I mean, do I need to take more mg of the Bulk Supplements powder to equal the same strength of the Doctor's Best?



Edited 1 time(s). Last edit at 09/28/2014 06:00AM by The Anti-Fib.

I agree with George that 10 L of water sounds like a little much , even for the desert. I've read that you're urine should not be constantly clear, more like a mellow yellow! Maybe you're flushing some nutrients. They were talking about that recently on a podcast Called Bulletproof radio with Dave Asprey and a Physiotherapist named Kelly Starrett. They were recommending putting a pinch of sea salt in your water to help absorption. I was a little worried about that because of the Na/k ratio balance with afib, but I tried it with a little added potassium also and it seemed to decrease my PVCs for longer than just adding the potassium would.
I'm in NSR after an ablation 7 weeks ago, but still working to eliminate the PVCs.

John

Shannon,

I may consider doing that at some point. I have to say it isn't a high priority. Right now I'm spending a lot and pulling a lot of tests trying to figure out my odd lipid metabolism. I have a very unusual situation in that an intentional "carb nite" carb spike (or slam) equates to low (<50 mg/dL) triglycerides while every other eating situation, including multi-day fasts equates to TG's at least double this.

Anti-Fib,

As long as you keep the elemental mag the same, it should not make any difference. Every day I take a combination of mag chloride, bicarbonate, malate and glycinate totaling (today) 3.9 gr of mag. When I travel, I simplify and switch to one form and it all works the same for me.

George