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The role of sugar in electrolyte solutions?

Discussion in 'Problems Standing: Orthostatic Intolerance; POTS' started by ahimsa, Mar 12, 2013.

  1. ahimsa

    ahimsa Senior Member

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    [Edit - When I say "sugar" I mean either glucose, fructose or sucrose (table sugar) ]

    I found a web page that talks about oral rehydration therapy -- http://rehydrate.org/ors/ort-how-it-works.htm

    I realize that this web page is describing therapy for people (mostly infants and children) who have dehydration due to diarrhea and vomiting (e.g., cholera). But I wonder if any part of the scientific discussion of rehydration therapy also applies to folks who have either dehydration or low blood volume and have some kind of Orthostatic Intolerance? (POTS, NMH/NCS)

    Here's the part where it talks about the difference between plain saline vs. when glucose is added:
    So, is there anyone out there who understands this science and can tell whether this applies to our patient population? I'd love to know if this is why sometimes (not always!) solutions like pedialyte (or generic versions) seem to help me so much more than just water/salt/potassium, without any sugar.

    My other thought is maybe sometimes I just need more potassium. One liter of pedialyte has 20 Meq potassium. My daily prescription of Klor-Con has half of that, 10 Meq.

    Here's a much longer extract from the web page for those who want to read more:
    Thanks in advance to any scientist(s) out there who can understand this and can shed some light!
     
  2. ahimsa

    ahimsa Senior Member

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  3. Sea

    Sea Senior Member

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    Thanks for those links Ahimsa, good information there. I've heard several times that the glucose is a necessary component for the electrolyte mix to be absorbed effectively but I haven't before heard a clear explanation of the process.

    I'd say the warning in the second link against giving the home mix to children is either because they need a slightly different ratio or because they'd rather not have you take matters into your own hands with children. Dehydration in children can escalate rapidly into a critical life threatening state.
     
  4. adreno

    adreno 3% neanderthal

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    I don't see why this principle wouldn't apply to us? 2 tablespoons of sugar per liter is an awful lot of sugar though...

    I have used 1/2 teaspoon sea salt, 1/4 teaspoon sugar, 1/4 teaspoon potassium, but this seems to be too little sugar. On the other hand, if we don't have diarrhea, I believe there must be some glucose present in the GI tract from the foods we eat, so the question is if it really necessary to provide so much in the drinks? Not sure about this.
     
  5. xchocoholic

    xchocoholic Senior Member

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  6. ahimsa

    ahimsa Senior Member

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    Thanks for the link! I tried to read that article but I kind of got lost trying to figure out how it applied to this situation of people with OI (POTS, NMH) who are trying to retain more fluid and which electrolyte drinks are the best choice in this situation.

    For example, here's the study conclusion:
    I think I get the main point here. People with celiac disease have serious problems with absorbing things in their intestines. I'm assuming that this includes sodium?

    But what does this mean when it comes to folks with OI choosing electrolyte drinks either with sugar (either glucose, sucrose, or something else) or without sugar? Yes to sugar, in limited amounts, in electrolyte drinks? (e.g., the levels that the WHO uses -- or maybe even less -- NOT Gatorade levels) Or no to sugar? (meaning sugar is not relevant or helpful for us when it comes to absorbability of sodium and potassium )

    Maybe the point of the link is that many (most?) folks here have undiagnosed celiac disease? (even those without any diarrhea or other intestinal symptoms?) So, no matter what type of food/drink we take we are not going to absorb sodium (and many other things) properly in the intestines? Or was there some other point being made that I missed?

    :confused: I'm sorry if these are dumb questions but I don't understand. :confused: Thanks!!
     
  7. LaurelW

    LaurelW Senior Member

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    What about people like me who don't tolerate table sugar at all? I've made a home-grown sports drink with sodium chloride, potassium chloride, lime juice and stevia. Seems to help with the OI.
     
  8. ahimsa

    ahimsa Senior Member

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    That makes sense...but I also have no idea whether it's true.
     
  9. ahimsa

    ahimsa Senior Member

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    I used the word "sugar" in the title as a catchall category to include options like glucose, fructose or sucrose (table sugar). I didn't mean to use sugar to mean only sucrose.

    For example, that first link I included talks about glucose, not sucrose. I know that a lot of the pre-mixed versions (e.g., Pedialyte) use glucose (often labelled as dextrose - it's just a different word for the same chemical formula, C6H12O6).

    Most of the homemade recipes that I've seen use fruit juice of some kind. Your recipe has lime juice (I've also seen lemon and orange juice) and any of those options would provide some fructose. I just happened to post a second recipe that uses table sugar. I can't see why one could not substitute glucose or fructose.

    Of course, the only reason to add sugar of any kind is if it would actually help with absorption of sodium. And that's what I'm trying to figure out. I'm just too dense to understand the science behind this.

    I do think it's true that table sugar is harder to digest for most people than either glucose or fructose. Although one person posted that he/she could not digest glucose (dextrose). Although I wonder if maybe they were thinking of maltodextrin since the word sounds somewhat similar?
     
  10. xchocoholic

    xchocoholic Senior Member

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    http://www.ncbi.nlm.nih.gov/pubmed/20415666
    I'm not sure if people actually have to have celiac disease to have this problem. This study is just specific for celiacs.

    Later in that same PR thread I gave a link for there is another link about how the FDA is defining celiac disease now. Check out the first 8 pages of the FDAs info tho. A dx of celiac disease isn't as cut and dried now as it used to be. At least according to the FDA. There's been a lot of interest in this in the last few years so there's new info that many doctors won't know but our govt does.

    I'm not sure if being dehydrated is just an OI thing. Maybe it's just common in chronic illness. For sure it's common for celiacs. There are many different auto immune illnesses associated with celiac disease. Maybe OI is auto immune for some of us.

    It's late so I can't read anymore tonight. tc ... x

    ps .. great info btw ...
     
  11. adreno

    adreno 3% neanderthal

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    Science to the rescue:

     
  12. adreno

    adreno 3% neanderthal

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  13. Dreambirdie

    Dreambirdie work in progress

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    Hi LaurelW--This is what I've been looking for. How do you make this drink, and what amounts of each ingredient do you use, and how do you store it?

    Like you, I do not tolerate sugar. And I don't think it's necessary.

    Thanks in advance for your info.
     
  14. LaurelW

    LaurelW Senior Member

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    Somebody here on PR posted the link, I don't remember where now. The recipe is: 1 cup water, 1/8 tsp. sodium chloride, 1/8 tsp. potassium chloride, lime juice to taste, stevia to taste. I make a quart at a time, which is 1 qt. water, 1/2 tsp. of each of the salts. etc.
    It was difficult to find plain old potassium chloride. Most of the "Lite" salts these days have a bunch of other crap in them. I ended up buying a pack of six on Amazon. It's called Morton Salt Substitute.
     
  15. adreno

    adreno 3% neanderthal

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  16. Sparrow

    Sparrow Senior Member

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    I believe that if your intestines are working well, you should absorb some salt without the glucose/dextrose (or table sugar, which has glucose in it). But with it, you will absorb more. So if you can tolerate some sugar, your drink should be more effective that way.
     
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  17. Dreambirdie

    Dreambirdie work in progress

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    Thanks LaurelW and adreno Much appreciated.
     
  18. ahimsa

    ahimsa Senior Member

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    Thanks, that makes sense.

    Do you happen to know whether adding some lime juice (e.g., the recipe posted by LaurelW) would help the sodium absorption in the same way as glucose?
     
  19. Dreambirdie

    Dreambirdie work in progress

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    That's actually a good idea. Maybe a squirt from an orange or a Meyer lemon would be a good option?
     
  20. SOC

    SOC Senior Member

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    All carbohydrates (fruits, vegetables, grains, sugars) are broken down to glucose, a simple sugar, in the digestive tract. That occurs mostly through the action of enzymes in the mouth and small intestines. Glucose is the small energy storage unit that can move through the intestinal walls and into the bloodstream where it is moved to where it is needed, The majority of our food is converted to glucose. If it wasn't, our bodies wouldn't be able to use it. (We also eat foods that contain fats and proteins which break down into fatty acids, glycerol, and amino acids, but that's not relevent to this discussion.)

    If you are digesting any food that is not exclusively fat or protein, you have glucose in your intestines. Infants with diarrhea often are not digesting much of anything -- they are either vomiting it up or passing it through so fast nothing is getting absorbed.

    An adult ME/CFS patient without absorption issues is almost certain to have glucose in his/her intestines from the digestion of fruits, vegetables, grains, etc. I don't see that it would be necessary to add the glucose to electrolyte mix for the purpose of improving OI/low blood volume. Dehydration due to vomiting and diarrhea is a different matter.
     

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