Topping up fluids and electrolytes

[FeralCatman]

I have issues with hyponatremia due to the 2 meds I am still on so have to consume extra salt to balance things out. I made a chart to use every day to make sure I get the right amount of sodium and potassium every day without overdoing it and this is based on my own blood work. I thought this might be a good example of something others could do for themselves if they develop similar issues since many of the meds can cause hyponatremia (Low Sodium) and issues with fluid balance.

 

I am currently testing 3000mg daily sodium intake (7.65g or 1-1/2 tsp Salt Equivalent) to see where that puts me on my next blood test.

 

I drink 1500ml of water plus what is in my food every day which is based on my body weight of 165lbs.

 

My doctor cleared me for up to 10 g total daily salt intake or 3,923 mg sodium daily (Including what is in my food)

 

US RDA was not enough. The US RDA is 2300 mg of sodium every day which is the equivalent of 1 1\8 teaspoons (5.86 g) of salt every day. This number includes what is already in the food I eat.

 

My current diet gives me 975mg of sodium daily so I am short 2,025 mg sodium every day and need to add that much including what is in my snacks if I eat them. Sometimes I do and sometimes I don't so my added salt varies day to day. This gets very hard to keep track of so I made a chart.

 

I also take 700mg of potassium chloride salt substitute which is 365 mg potassium

 

I got the food sodium data from my nutritionist and my diet app based on the diet I eat every day plus the labels on my snacks so if you need to do this you will have to do the same thing. I use the 'MyNetDiary' diet app.

 

My vegetable snacks have on average 180mg sodium per serving except the crunchy carrot sticks which have 410mg sodium.

 

Here is the chart. Each scoop is 1/4 teaspoon or 510mg sodium (1.3 g salt). I hang this on my cabinet so I can measure it out every day in the morning and lay out snacks for the day so I know how much to add. I keep my diet very consistent to make things easy on myself with tracking things. It's not as complicated as it looks. Once you know the numbers it is pretty easy. If it turns out I need a little more to keep things in the normal band I can adjust the chart as needed until I get it right. It takes a little finagling and time but once you have it down right this makes things very easy day to day. This was all done with input from my PCP and nutritionist.

 

Salt Dosing Chart with 1500 mL water daily plus water in food
Daily Sodium Goal – 3000 mg – 7.65 g Salt equivalent
# of Scoops	Mg Na	Food Only	Food + 1 Snack	Food + 2 Snacks	Food +3 Snacks	Food + Carrot Snack (CS)	Food + CS + 1	Food + CS + 2	Food + CS + 3
2 Scoops	1020 mg								X
2.5 Scoops	1275 mg						X H	X
3 Scoops	1530 mg				X H	X H
3.5 Scoops	1785 mg		X H	X L
4 Scoops	2040 mg	X
4.5 Scoops	2295 mg
5 Scoops	2550 mg

Added Potassium – 1 Heavy Scoop (Scoop came with the package)

 

Added Fiber – 2 scoops a.m   1 scoop p.m. (Scoop is 1/2 teaspoon psyillium fiber husk) I add this to homemade apple sauce.

 

[FeralCatman]

Aside from my hyponatremia one of the reasons getting your fluid electrolyte balance is so important is that your nervous system depends on it and if you have too much of one or the other your nervous system will start to complain and let you know in all kinds of strange ways. What happens to me is if I don't get enough fluids or if I get too much salt then there's not enough fluid in my digestive tract to run things through and I get constipated. Once that happens my nervous system lets me know by releasing adrenaline to start pushing things through my guts and of course adrenaline is non-selective and affects your entire body and creates issues with anxiety and mood which really sucks.  I just went through a week of this where I had gotten stressed on Sunday and Monday and then on Monday I stress ate a bunch of snacks that were very salty and overdid it on the salt. As a result my body started stripping fluid out of my guts to get my sodium levels correct which made me constipated and my body panics which then started kicking in Adrenaline surges at night before I had to pee which of course then leaves you sleep deprived and depressed and anxious and miserable. All due to a little stress coupled with a fluid electrolyte imbalance and it snowballs fairly quickly and this is something that has only been happening since I got off the Seroquel. In recovery your nervous system seems to want to overreact to even the slightest imbalance and make a mess out of you which is why getting a good simple diet and plenty of fluids and electrolytes and a good balance of all of it is so important when you are recovering.

[FeralCatman]

I should add that crazy things happen if I get too much fluids and not enough salt as well such as the leg pain and cramping. Too much either way is a bad thing especially in withdrawal. I want off this ride 🤒

[FeralCatman]

I figured out my electrolyte imbalance problem and posted the answer as verified by my PCP (MD) on my thread.

 

 

[FeralCatman]

On 6/22/2023 at 1:38 PM, FeralCatman said:

I figured out my electrolyte imbalance problem and posted the answer as verified by my PCP (MD) on my thread.

 

 

Turns out the problem is not dietary as we had thought and hoped. It is actually due to one of the medications I am currently taking. Here is a link to the updated I posted with the details of what is going on.

 

 

[FeralCatman]

I heard back from my primary care doctor about the plan I cooked up with my nutritionist to deal with the hyponatremia and posted it on my thread.

 

 

[poohstix]

I was hoping this could help someone. As part of withdrawal, I sometimes get mild nausea that radiates into a headache (it's a very bizarre feeling), with or without dizziness. I found what helps is to ingest something with electrolytes, or just salt, and some simple carbs.

 

Some of the things I eat and drink are:

--gatorade, though I think it's too sweet, so I have a less sweet Japanese electrolyte drink called Pocari sweat that I get in powder form online

--broth. Ramen is actually excellent for this, though not the healthiest

--chips. Again, not the healthiest but very helpful.

 

The reason the electrolytes work is probably because they have magnesium, and a body might go more into sympathetic dominance when it's hungry, so that's probably why a quick shot of calories helps. However, straight magnesium is not something I can tolerate unless it's topical.

 

Please exercise caution with any new food or drinks, since people with sensitized nervous systems can be sensitive to food too. 

[Altostrata]

Thanks, @poohstix, good advice!

[FeralCatman]

17 hours ago, poohstix said:

I was hoping this could help someone. As part of withdrawal, I sometimes get mild nausea that radiates into a headache (it's a very bizarre feeling), with or without dizziness. I found what helps is to ingest something with electrolytes, or just salt, and some simple carbs.

 

Some of the things I eat and drink are:

--gatorade, though I think it's too sweet, so I have a less sweet Japanese electrolyte drink called Pocari sweat that I get in powder form online

--broth. Ramen is actually excellent for this, though not the healthiest

--chips. Again, not the healthiest but very helpful.

 

The reason the electrolytes work is probably because they have magnesium, and a body might go more into sympathetic dominance when it's hungry, so that's probably why a quick shot of calories helps. However, straight magnesium is not something I can tolerate unless it's topical.

 

Please exercise caution with any new food or drinks, since people with sensitized nervous systems can be sensitive to food too. 

@poohstix It might be a good idea for you to go to your doctor and get a comprehensive metabolic panel and a magnesium level done and get your electrolytes checked, especially the sodium, if you are finding that extra salt works. Also in the United States you can order the test online from a private lab and just go get it done yourself which I sometimes do when I need to. I have been going through this myself and was diagnosed with hyponatremia which I have been through in the past.  All of my other electrolyte levels were fine.  I ended up in the ER a few days ago due to this problem and it had to be corrected with IV fluids. This problem can be caused by many things including medications such as antidepressants, antipsychotics, and mood stabilizers, infections, surgery, and traumatic brain injury such as a hard hit to the head. I can't say this for sure in your case obviously but there's no way to know without getting the blood test done and as I have found out the hard way just taking a guess doesn't always work and can sometimes be dangerous which is why I spend the time and effort to get tested. If you are having symptoms of headache and nausea it's best to get tested before assuming it is just a withdrawal issue.

[poohstix]

1 hour ago, FeralCatman said:

@poohstix It might be a good idea for you to go to your doctor and get a comprehensive metabolic panel and a magnesium level done and get your electrolytes checked, especially the sodium, if you are finding that extra salt works. Also in the United States you can order the test online from a private lab and just go get it done yourself which I sometimes do when I need to. I have been going through this myself and was diagnosed with hyponatremia which I have been through in the past.  All of my other electrolyte levels were fine.  I ended up in the ER a few days ago due to this problem and it had to be corrected with IV fluids. This problem can be caused by many things including medications such as antidepressants, antipsychotics, and mood stabilizers, infections, surgery, and traumatic brain injury such as a hard hit to the head. I can't say this for sure in your case obviously but there's no way to know without getting the blood test done and as I have found out the hard way just taking a guess doesn't always work and can sometimes be dangerous which is why I spend the time and effort to get tested. If you are having symptoms of headache and nausea it's best to get tested before assuming it is just a withdrawal issue.

I’ll ask my doctor for that, thank you. I had labs when all of this started, before we figured out I had med side effects and withdrawal (I had both early on and it was not pleasant). The sodium and magnesium were normal, but you never know if it might change.  The symptoms I have do go in the classic windows and waves pattern which makes me think it’s withdrawal, hopefully.

[FeralCatman]

33 minutes ago, poohstix said:

I’ll ask my doctor for that, thank you. I had labs when all of this started, before we figured out I had med side effects and withdrawal (I had both early on and it was not pleasant). The sodium and magnesium were normal, but you never know if it might change.  The symptoms I have do go in the classic windows and waves pattern which makes me think it’s withdrawal, hopefully.

As I have learned the hard way when you have symptoms that could be related to an electrolyte imbalance there is no way to know without getting tested and best to be tested when you are symptomatic if possible. There may very well be no problem in which case it's just a withdrawal thing but electrolyte imbalances are nothing to fool around with. Also as I am finding out if it turns out you do have hyponatremia you can manage it while you finish coming off the meds. As I have experimented it turns out that with a whole crap load of salt I can keep my numbers in the normal range while I'm tapering the suspected offender. It is certainly not ideal but it does get you by and of course I'm doing this under the guidance of my primary care doctor and my nutritionist.

[poohstix]

Just now, FeralCatman said:

As I have learned the hard way when you have symptoms that could be related to an electrolyte imbalance there is no way to know without getting tested and best to be tested when you are symptomatic if possible. There may very well be no problem in which case it's just a withdrawal thing but electrolyte imbalances are nothing to fool around with. Also as I am finding out if it turns out you do have hyponatremia you can manage it while you finish coming off the meds. As I have experimented it turns out that with a whole crap load of salt I can keep my numbers in the normal range while I'm tapering the suspected offender. It is certainly not ideal but it does get you by and of course I'm doing this under the guidance of my primary care doctor and my nutritionist.

Totally agree. Silver lining? The solution to hyponatremia seems to be to add more salt to your diet and that means I get to eat a lot if my favorite foods.

[FeralCatman]

22 hours ago, poohstix said:

Totally agree. Silver lining? The solution to hyponatremia seems to be to add more salt to your diet and that means I get to eat a lot if my favorite foods.

The solution in my case is to restrict fluid intake to 1500 ml a day plus whatever is in my food and eat a ton of salt which I don't mind. I am mostly Scandinavian and my grandparents were Swedish and always had a lot of salty snacks in the house that I grew up with and love to eat so as you said perhaps this is a silver lining.😁

[FeralCatman]

Here is a study done in 2017  as part of the Russian space flight program regarding how the body regulates salt and fluids and how these two go on to regulate other hormones. Though it seems like this process is well established fact it actually is not and they are still learning how this process works at a basic level but this is definitely an interesting study that sheds a bit more light on the topic.

 

https://www.nih.gov/news-events/nih-research-matters/how-body-regulates-salt-levels

[FeralCatman]

On 7/3/2023 at 11:48 AM, FeralCatman said:

The solution in my case is to restrict fluid intake to 1500 ml a day plus whatever is in my food and eat a ton of salt which I don't mind. I am mostly Scandinavian and my grandparents were Swedish and always had a lot of salty snacks in the house that I grew up with and love to eat so as you said perhaps this is a silver lining.😁

There is more to this story than this. Here is the complete story I posted on my thread regarding a procedure I am using to deal with hyponatremia. When you read it please note the warning about not doing this on your own. Hyponatremia needs to be managed by working with your doctor.

 

 

[poohstix]

Update: It seems like I do not have hyponatremia or any other electrolyte abnormality based on labs even while symptomatic. 
 

But I suspect that even minor variations in sodium might change how I feel with a more sensitized nervous system.

[FeralCatman]

1 hour ago, poohstix said:

Update: It seems like I do not have hyponatremia or any other electrolyte abnormality based on labs even while symptomatic. 
 

But I suspect that even minor variations in sodium might change how I feel with a more sensitized nervous system.

That is definitely a good thing that your blood work is normal. That said it is entirely possible that variations in fluids and or electrolytes that are normally tolerable may not be as tolerable during withdrawal and so if you're not getting enough of one or more of them it may be enough to make you feel crappy when normally it would not. Sodium does an awful lot in the body so a sensitive nervous system could possibly react too smaller changes. The good thing is that if your labs are normal it's most likely not dangerous just uncomfortable.

[FeralCatman]

I finally found a reference that discusses electrolyte imbalances and dysautonomia. If you ask a doctor about it they will probably tell you that dysautonomia does not cause this problem however it is widely known amongst patients who suffer from dysautonomia that electrolyte imbalances are actually pretty common in this population. Therefore since protracted withdrawal syndrome is autonomic dysfunction and therefore falls under the category of dysautonomia you can fairly easily make the jump from dysautonomia to protracted withdrawal and electrolyte imbalances. It is therefore possible that the issues I'm having now with low sodium may in fact be part of the recovery process. Here is a link where dysautonomia patients are discussing this issue.

 

https://www.dinet.org/forums/topic/1191-electrolytes/