Muscle issues-dehydration/electrolytes

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I don't know exactly how much I should drink so am sticking with 12 cups of water a day (very thirsty and peeing a lot) from hyper POTS/mild hyperaldosteronism. But I have been getting muscle aches/cramps (more like muscle pulling sensation) behind my knees lately. I had my sodium and potassium tested three days ago but they were normal. I have been eating more potassium-rich foods and a tiny bit of extra salt. Or could it be dehydration?

I'm still confused about how to maintain balance and why this got worse only when I found out about the hyperaldosteronism. It seems like the nocebo effect because I asked for the test trying to prove I had diabetes insipidus, I didn't know what hyperaldosteronism was. Now I do, worse symptoms! :( If I hadn't asked for the test I feel like it wouldn't be so bad.
 

Mary

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@Saraswati - hyperaldosteronism is new to me so I just looked it up and found that many people with hyperaldosteronism have low potassium. And low potassium can cause many of your symptoms - excess thirst, muscle cramps, fatigue, increased urination. See this: https://columbiasurgery.org/conditions-and-treatments/primary-hyperaldosteronism-conns-syndrome
While patients with hyperaldosteronism may have normal potassium levels, many patients may have low potassium levels. The hypokalemia (low potassium level) can cause symptoms like fatigue, numbness, increased urination, increased thirst, muscle cramps, and muscle weakness.
I know you're eating potassium-rich foods but it may not be enough. I also know you said that you had your potassium checked 3 days ago and it was normal. However, people with ME/CFS can have normal blood levels of potassium while their intracellular levels of potassium are low. This post explains how this can happen: https://forums.phoenixrising.me/thr...ded-in-methylation-treatmt.18670/#post-283712

I've experienced low potassium many times and for me it causes weakness and muscle cramps, which go away quickly when I get enough potassium.

Your symptoms sound so much like low potassium, I would suggest getting something like low-sodium V8, which is high in potassium (about 900 mg per 8 ounce glass) and drinking a couple of glasses and see if it helps you at all. Many people here on the board have experienced low potassium when they've started taking B12 and methylfolate - it happened to me. And the low-sodium V8 has helped many with their symptoms. I ended up having to take a potassium supplement, which I've been taking every day now for 9 years I think - can't believe it's been that long! But I do well with it. And I don't get the awful symptoms of low potassium any more. I have to take 1000 - 1200 mg. a day in divided doses. The daily RDA is 4700 mg.

Also, my potassium levels were always normal on blood work. But my symptoms told a different story.
 
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Thank you @Mary . I think this might be a big part of my problem. I talked to a dietician and she suggested I write down my potassium intake and it's kind of low even though I eat fruit and vegetables. I sometimes take Ener-C which has 200 mg of potassium in it and it seems to help, sodium helps too.

Thank you for the link, it's very interesting but complicated! I was taking 1,000 iu of vitamin B12 a day but my blood levels were high and I was told to stop taking it. But I don't eat much meat so it's weird that it was high. V8 is a good idea, it probably has a lot of other nutrients too.
 

Mary

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I was taking 1,000 iu of vitamin B12 a day but my blood levels were high and I was told to stop taking it. But I don't eat much meat so it's weird that it was high. V8 is a good idea, it probably has a lot of other nutrients too.
Actually your high B12 blood level is not weird. It can (and often does) mean that one's intracellular levels of B12 are low, it's all circulating in the blood but not being utilized properly. My B12 levels were always quite high but on hair analysis my levels were almost undetectable. It wasn't until I started taking two 5000 mcg. doses of liquid methylcobalamin a day that I started to notice a modest increase in energy.

So I'm not telling you that need more B12, but you very well might. The standard B12 blood test is not good for diagnostic purposes This post talks about a methylmalonic acid test for B12, which is supposed to be more accurate than standard blood tests:
A methylmalonic acid test either in serum or urine is more sensitive and could give a more accurate picture if your body is able to metabolize the B12 (otherwise without metabolizing, as high it may go in serum, you're still actually short of it). A simpler homocysteine test could indicate there is shortage of B12, B9, B6, B2 or choline too.
This post also talks about the methylmalonic acid test for B12 and why it's better than serum B12 testing:
Serum B12 will be high of you gave been supplementing. The test is useless. You need to have a methylmalonic acid test to assess Your true B vitamin status.
V8 is a good idea, it probably has a lot of other nutrients too.
I would definitely give this a try. It's safe and if you have low potassium, it can help you feel better rather quickly - often within several hours, if you drink enough. Sort of like with B12 - our potassium blood work does not tell us what our intracellular levels are, and as the link above explained, we can have low potassium in our cells, even though it appears normal in our blood. Enough of it may not be getting into the cells, because of ME/.CFS. And almost no doctor will know anything about this.
 
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Thank you @Mary. Sorry for the late reply. That is a good idea about hair analysis. I had one years ago that was interesting. I guess the methylmalonic test might be something to get from a naturopath. Thanks again!
 

Mary

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Thank you @Mary. Sorry for the late reply. That is a good idea about hair analysis. I had one years ago that was interesting. I guess the methylmalonic test might be something to get from a naturopath. Thanks again!
Hi @Saraswati - I've never had it done (though I should!) but I think a regular MD should be able to order it, if he or she is willing to do so . . . you'd probably have to bring something to your doctor to show why you wanted the test - it all depends on your doctor whether they will do it or not!