Prediabetes Levels of sodium, potassium, magnesium with LCHF

[lindisfel]

A quick scan of many keto diet sites such as Atkins, Paleo, Phinney& Voleck et al all say salt needs to be increased for a keto diet by about 2g above RDA. The only sites I found who advocate lowering salt with keto diet are the Bodybuilding and extreme fitness blogs, and many of them say to cut salt intake to zero, which sounds dangerous to me. I have searched PubMed and found nothing that relates to this discussion,

I did find this outside PubMed: for this one study into epilepsy in children using keto.
http://www.pediatricneurologybriefs.com/articles/10.15844/pedneurbriefs-14-2-4/

It relates to increased excretion of sodium when in keto, leading to electrolyte inbalance,

If the adrenals fail to work via the aldosterone/angiotensin/renin system would be a serious criticism of keto diets. In other words I don't believe it! If your adrenals are working properly and one is fit, one will just pee it out again because it will be surplus to requirements. The sick will take on water and put up their bp and water weight!

 

[Oldvatr]

If the adrenals fail to work via the aldosterone/angotensin/renin system would be a serious criticism of keto diets. In other words I don't believe it!

In laymens terms, the andenelin/insulin systems work fine, its just that the diuretic nature of the keto diet, especially while reducing weight in the early days, will flush out useful nutrients such as sodium. My furusomide med also does this. It is a well documented characteristic of the keto diet during induction phase. Once fully fat adapted and no longer liver dumping, then salt can be reduced, so I believe.

The following is a blog from a site I do not normally use, but it is quite explanatory and believable.
http://www.livestrong.com/article/554837-sodium-potassium-and-the-ketogenic-diet/

 

[lindisfel]

Tim Noakes has a podcast that deals with athletes loss of electrolytes. In extremis endurance athletes can override the body feedback system but I very much doubt our diet will do it long term, perhaps briefly during the shock of adaption to keto. If we continue to have more than the normal amount of salt in our diet our bodies take on water and we have to pee it out, often having to get up in the night. You have to take furosemide. It gets rid of water and sodium that retains water, unfortunately that drug also robs your body of potassium as well. Counter intuitively Tim Noakes points out taking more sodium in vigorous exercise actually depletes sodium in the body rather than enhancing it. We apparently do not need to keep replacing sodium and water it leads to low sodium in the blood!

BTW I take a potassium sparing diuretic.regards D.

 

[Oldvatr]

Tim Noakes has a podcast that deals with athletes loss of electrolytes. In extremis endurance athletes can override the body feedback system but I very much doubt our diet will do it long term, perhaps briefly during the shock of adaption to keto. If we continue to have more than the normal amount of salt in our diet our bodies take on water and we have to pee it out, often having to get up in the night. You have to take furosemide. It gets rid of water and sodium that retains water, unfortunately that drug also robs your body of potassium as well. I take a potassium sparing diuretic. regards D.

I get the impression you did not read the blog, which explains how insulin triggers the kidneys to release sodium and water, thus overriding the body's natural mechanism involving the adreneline hormone. So as IR reduces due to keto actions , so the need for added salt should reduce too.

 

[Oldvatr]

Tim Noakes has a podcast that deals with athletes loss of electrolytes. In extremis endurance athletes can override the body feedback system but I very much doubt our diet will do it long term, perhaps briefly during the shock of adaption to keto. If we continue to have more than the normal amount of salt in our diet our bodies take on water and we have to pee it out, often having to get up in the night. You have to take furosemide. It gets rid of water and sodium that retains water, unfortunately that drug also robs your body of potassium as well. Counter intuitively Tim Noakes points out taking more sodium in vigorous exercise actually depletes sodium in the body rather than enhancing it. We apparently do not need to keep replacing sodium and water it leads to low sodium in the blood!

BTW I take a potassium sparing .diuretic.regards D.

I believe that I already wrote that Bodybuilders and in extremis athletes have different dietary requirements. I was covering a large number of people who visit this site because they are enquiting into diabetes conditions. This group would generally not fall into the class you propose, amd many will exercise at a more relaxed rate. It is to these that I address my commentary to.

I also have some issues with the science you are referencing. Adding salt does indeed increase water retention, but does not in itself lead to increased nocturnal micturation, So we put on water related weight.

Where you say <<<Counter intuitively Tim Noakes points out taking more sodium in vigorous exercise actually depletes sodium in the body rather than enhancing it. We apparently do not need to keep replacing sodium and water it leads to low sodium in the blood!>>> then increased exercise itself leads to increased urine production, and also perspiration, which will deplete sodium and potassium, and this is why athletes have energy drinks that contain glucose AND electroltye supplements so as to replace lost electrolyte, which is the converse of what you imply Tim Noakes says. I have not read this particular Guru, but I am surprised if he actually says this. In fact the following shows he does not, but does say to reduce processed foods as a source of excess salt during his 5 day LCHF crash diet. I am on this LCHF path for life and living.

http://www.timeslive.co.za/thetimes/2015/08/20/Noakes-rubs-in-the-salt

Looking at the prime energy drink Gatorade for athletes, has the following
Gatorade Thirst Quencher contains water, sucrose (table sugar), dextrose, citric acid, natural flavor, sodium chloride (table salt), sodium citrate, monopotassium phosphate, and flavoring/coloring ingredients; some Gatorade flavor variations use brominated vegetable oil as a stabilizer.

Edited to add a warning: I note that the ingredients refer to BVO being present in some drinks. This is banned in Europe and restricted by the FDA.
http://www.mayoclinic.org/healthy-l...ealthy-eating/expert-answers/bvo/faq-20058236

 

[lindisfel]

I believe that I already wrote that Bodybuilders and in extremis athletes have different dietary requirements. I was covering a large number of people who visit this site because they are enquiting into diabetes conditions. This group would generally not fall into the class you propose, amd many will exercise at a more relaxed rate. It is to these that I address my commentary to.

I also have some issues with the science you are referencing. Adding salt does indeed increase water retention, but does not in itself lead to increased nocturnal micturation, So we put on water related weight.

Where you say <<<Counter intuitively Tim Noakes points out taking more sodium in vigorous exercise actually depletes sodium in the body rather than enhancing it. We apparently do not need to keep replacing sodium and water it leads to low sodium in the blood!>>> then increased exercise itself leads to increased urine production, and also perspiration, which will deplete sodium and potassium, and this is why athletes have energy drinks that contain glucose AND electroltye supplements so as to replace lost electrolyte, which is the converse of what you imply Tim Noakes says. I have not read this particular Guru, but I am surprised if he actually says this. In fact the following shows he does not, but does say to reduce processed foods as a source of excess salt during his 5 day LCHF crash diet. I am on this LCHF path for life and living.

http://www.timeslive.co.za/thetimes/2015/08/20/Noakes-rubs-in-the-salt

Looking at the prime energy drink Gatorade for athletes, has the following
Gatorade Thirst Quencher contains water, sucrose (table sugar), dextrose, citric acid, natural flavor, sodium chloride (table salt), sodium citrate, monopotassium phosphate, and flavoring/coloring ingredients; some Gatorade flavor variations use brominated vegetable oil as a stabilizer.

TimNoakes has taken on Gatorade and shown their science is not correct. See net entries for Gatorade and Tim Noakes.

 

[Oldvatr]

TimNoakes has taken on Gatorade and shown their science is not correct. See net entries for Gatorade and Tim Noakes.

I assume you are talking about his treatises on hypo / hyper natria. Again I point out that the seminars I have seen are aimed at endurance athletes, and in extremis athletes, and are not really applicable to most visitors to this Forum. Also he is talking about training needs, not a keto diet per se when he is giving these lectures. He does not appear to address the induction phase of the LCHF diet, and offers a 5 day crash course in LCHF which is actually IMHO quite irresponsible,

I do not use Gatorade or Lucozade myself, as it would be a major bad decision for my condition except posibly as an emergency hypo recovery tool. I believe myself in having moderate salt intake, but did increase it while starting LCHF as advised. I did not suffer cramps at all. Personally I found that using Splenda dropped my sodium levels dramatically.

I add a link to a paper that discusses electolyte imbalance, and in conjunction with Diabetes, and with reference to the effect of insulin medication which may be appropriate to this discussion.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4198400/

 

[Resurgam]

If I get cramps, I drink water.
I tried all different supplements and additives, none helped, but a drink of water fixed it every time

 

[lindisfel]

If I get cramps, I drink water.
I tried all different supplements and additives, none helped, but a drink of water fixed it every time

You are right Resurgam, the overall point I am making you make succinctly, there is no one size fits all. We all have different bodies and some of us take different meds. Not everybody is on insulin. Some have my condition others have Cushing's and yet others have Addison's. regards D.

 

[lindisfel]

Hi oldvatar, Since you were excluding special cases I didn't see the relevance of you including a reference to extreme low carb for epileptic children since their systems are not fully developed and I think the work was done in rodent models. One can take or leave the live strong quote which is qualified as I said at the outset, get tested by u&es at the surgery! What concerns me is the one size fits all approach and this need to have a fix for a poor diet on lchf. If the adrenals are bypassed on lchf then the diet would have a considerable negative mark against it. Actually increased insulin inflames arteries and puts up bp, according to Dr. Kraft, the father of theinsulin assay! I doubt very much that medical opinion will state that adding more sodium to our diet will mitigate high bp due insulin! But then again I believe the low carb good fats diet does not long term override normally functioning adrenal glands. Your last quote applies to serious illness and complex drug therapies. Because I have Conn's and take a Potassium sparing diurectic for bp control I have to have my potassium monitored on a two week basis by blood testing. D.

 

[Oldvatr]

Hi oldvatar, Since you were excluding special cases I didn't see the relevance of you including a reference to extreme low carb for epileptic children since their systems are not fully developed and I think the work was done in rodent models. One can take or leave the live strong quote which is qualified as I said at the outset, get tested by u&es at the surgery! What concerns me is the one size fits all approach and this need to have a fix for a poor diet on lchf. If the adrenals are bypassed on lchf then the diet would have a considerable negative mark against it. Actually increased insulin inflames arteries and puts up bp, according to Dr. Kraft, the father of theinsulin assay! I doubt very much that medical opinion will state that adding more sodium to our diet will mitigate high bp due insulin! But then again I believe the low carb good fats diet does not long term override normally functioning adrenal glands. Your last quote applies to serious illness and complex drug therapies. Because I have Conn's and take a Potassium sparing diurectic for bp control I have to have my potassium monitored on a two week basis by blood testing. D.

I have been replying to the OP posting, OP is recently started LCHF VLC phase, so is still in the induction stages of
ketosis, This is something that many go through when doing an LC keto diet, and so is not a 'special case [as you like to make out].
The response I gave to the OP was for a temporary increase in salt intake (assuming table salt I admit, so covering both sodium and potassium) in the early stages as advised by many adherents to LC diets (Atkins, Paleo et al). I agree with your sentance above in that long term use of a keto diet does not need extra salt, but the OP second question is specific to what they could do now to relieve the cramps. I was told in Junior school that the cure for leg cramps was salt, and that was way before LCHF - but not Banting - I am not THAT old) so is not new medicine, You are also correct in saying that insulin and increased salt leads to increased BP due to sodium retention. Where the new science relating to keto diets is showing is that fatty liver leads to increase in Insulin Resistance, and this has the opposite effect. So by using keto as a means to reduce IR then there is a window where sodium is more readily excreted rather than retained. This effect will reduce as the fatty liver issue becomes resolved, so is not a long term condition.

 

[Oldvatr]

Since you were excluding special cases I didn't see the relevance of you including a reference to extreme low carb for epileptic children since their systems are not fully developed and I think the work was done in rodent models. .

I am sorry, but where do you think LCHF comes from? It is the modern re-branding of the Banting Diet that was used originally for controlling epilepsy, and then successfully used to treat diabetes in the days before the discovery of insulin. It is very relevant to the discussion, which concerns a keto diet, and is effectively what the OP is using at the moment. There is now a great deal of in vivo evidence to support it.

Edit to add: and where did the idea of a 'poor diet on lchf ' come from? Not from the OP and not from me.

 

[AloeSvea]

I don't know if I am helping or hindering by contributing to this discussion, but I will give my two cents worth and see how it goes... I have never been able to get my head around the science of electrolyte balance - even after I closely read the above well-researched posters, and reading it in nearly everything good and well researched on healthy low carb and keto diets.

But, being a simple person (really!), I use the standard lipid blood test as the basis of my concern ie if my doctor isn't concerned than I don't need to be? Re electrolytes. (Due to the fact I don't understand them.) And all that liver and kidney health stuff. Those strange acronyms and so on.

But I absolutely DO use how I feel and my general health and if I am cramping to increase sprinkling salt on my raw nuts, and taking a magnesium supplement. I take on board the constant reports that most of us are magnesium deficient. (If it's supplementation companies' propaganda it sure is good propaganda!) And there is 'stuff' on what kind of salt is best, and yeah that hurts my head thinking about that too. . So I use sea salt, from here in the Pacific where I live, and hope for the best. When I lived in Europe I used Himalayan pink salt and hoped for the best. (See - not very scientific at all!)

On a good LCHF diet I am hoping, assuming, I get enough potassium, and assume my general health and wellbeing would suffer if I were not. Perhaps this assumption is wrong? But it works for me, in terms of being able to be physically active and with muscles and so on, and not getting infections very much at all. (Way way way less than days of old pre LCHF and pre diagnosis. Yes, a bit like what Prof Noakes says that one of the best things you can do for your overall health is get a chronic disease! so you start really looking after yourself diet and exercise wise.) (But no, I still don't wish a chronic disease on anyone! Even for better health otherwise.)