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What causes dehydration/electrolyte imbalance

Aerose91

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This is such a huge issue for me and has been for 8 years. Even my SPECT scan shows scalloping due to dehydration.
I have constant, absurd 24/7 carb and sugar cravings but i know they are electrolyte issues because on the rare occasion that i get my electrolyte levels correct they completely subside. However, it's incredibly rare that i get it right. I take electrolytes all day, every day. I use copious amounts of salt but I rarely feel much better. There's no way to know what balance my body needs at any given time so often times taking electrolytes alters the balance and makes me feel worse.

Do we know what the underlying cause of this is? Id love to be able to address that vs spending all my days messing with my mineral levels and coping with insatiable cravings
 
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@Aerose91
Do we know what the underlying cause of this is? Id love to be able to address that vs spending all my days messing with my mineral levels and coping with insatiable cravings
The obvious causes that come immediately to mind are diarrhea, excessive heat/sweating, and nausea/ vomiting. Bad stress can also contribute.
 

BeADocToGoTo1

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The first thing that comes to my mind is blood sugar/glucose control. Do you have a glucose and ketone meter with which you can check your levels with a small drop of blood from a finger? It is great for knowing how meals affect you personally. When you have sugar cravings that is often a sign that you are a 'sugar burner' as opposed to a 'fat burner'. This can mean you have chronically been eating too many carbs/sugar for your body to handle, and no longer efficiently are using adipose fat for fuel.

Have you had the following things checked recently?

Important Blood Sugar and Insulin Resistance Measurements (all before breaking fast)

1. A1c. "Low" carb means something slightly different for everyone, but if your A1c is too high (5.3% or higher) you should try to lower carb intake as it can indicate excess sugar or carb intake.

2. Triglycerides. If your triglycerides are high (<100 mg/dL is optimal) you should try to lower your carb intake as your liver is transforming excess into energy storage.

3. Ketones. I also try to keep my ketone level around 0.5 or higher, but I never go to extremes and never add exogenous ketone salts either. Great indication of diet quality.

4. Insulin. Higher than 5 uIU/mL is an indicator of too high carb/sugar intake and/or start of insulin resistance

5. Blood glucose. <100 mg/dL is the expected norm, but <85 is better for longevity and health.

6. C-peptide. Indication of insulin production

Please look into nutritional ketosis. Please check your blood glucose before and after meals. Please count your carbs (grams per meal and per day) for a week to get an idea of your current intake from food and drinks....be very honest.

Please take a close, hard and honest look at everything you eat and drink. Perhaps keep a food diary for a while and note how you feel as well.
 

Aerose91

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I have eaten ketosis for several years now. Like 10 probably. I may come out of it slightly in the summer by adding a little fruit but the core of my diet has always been good proteins, seafood, copious vegetables and high animal fat. I never had the electrolyte issue until the M.E. hit.

I have had a few of those tests done over the years but don't have much bloodwork done these days because I've had so damn much. I'm usually hypoglycemic because my adrenal function is low and my triglycerides are high which I know is inflammation. The others I have not. I often times have low ADH and I've always wondered if that plays a role.

I have constant sugar cravings, another thing that started with the M.E. but I think that is a hidden dehydration/electrolyte issue because often times something like red meat will vanquish it. I guess I always wondered what the underlying cause of the dehydration is so I don't have to try and keep competing with it.
 

pamojja

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I take electrolytes all day, every day. I use copious amounts of salt but I rarely feel much better.
I have had a few of those tests done over the years but don't have much bloodwork done these days because I've had so damn much.
Personally I wouldn't have known how much potassium, sodium, calcium, magnesium.. etc. I would need, without starting low and increasing gradually over the years, while regularly monitoring serum levels (rbc for magnesium).

With a limit of 99mg by the FDA on potassium, 'copious' could mean anything. I need at least 2 g of elemental potassium each day (additional to 4.2 g from diet). Sodium at 3 g/d (without the chloride caption) still didn't bring serum levels to optimal, have to increase further. And for magnesium not even 2.4 g/d of elemental oral magnesium corrected my deficiency, finally only monthly Mg-sulfate IVs did. While a calcium deficiency corrected with vitamin D alone.

How much sodium and potassium you supplement each day? To you have any recent electrolye lab tests at all?
 
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Aerose91

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Personally I wouldn't have known how much potassium, sodium, calcium, magnesium.. etc. I would need, without starting low and increasing gradually over the years, while regularly monitoring serum levels (rbc for magnesium).

With a limit of 99mg by the FDA on potassium, 'copious' could mean anything. I need at least 2 g of elemental potassium each day (additional to 4.2 g from diet). Sodium at 3 g/d (without the chloride caption) still didn't bring serum levels to optimal, have to increase further. And for magnesium not even 2.4 g/d of elemental oral magnesium corrected my deficiency, finally only monthly Mg-sulfate IVs did. While a calcium deficiency corrected with vitamin D alone.

How much sodium and potassium you supplement each day? To you have any recent electrolye lab tests at all?
My electrolytes come back normal on all my labs. Potassium over 4, sodium and magnesium in normal ranges. I need to tank down the salt all day, though. I think that's my adrenal fatigue
 

sb4

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@Aerose91 Might be worth while trialing adding carbs back in and monitoring symptoms, I personally do worse with carbs however I have been able to side step this somewhat with MCT oil.

If you have been ketosis for a long time there is a chance your body is rebelling against it somewhat. I know some people struggle to hold on to electrolytes in keto.
 

Aerose91

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I tend to think it's not the ketosis because I wasn't in keto when the illness first hit and the electrolyte issues started. Previously I could do things like a sauna and feel better afterward. Since the M.E. if I sweat it was like getting hit by a truck.
 
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You sound a *lot* like me! I eat insane amounts of salt. I drink maybe 10L of water a day and pee about the same!If I don't drink I feel terrible. I assume blood volume gets too low.

One thing I've done recently that seemed effective was to shift brand of magnesium. I've taken magneiusm for ages, but when I shifted to the Blackmores MagMin brand I noticed somthing quite immediate. Less thirsty, less PEM.

Other things that are more like maintenance: I eat lots of bananas and I think the potassium helps. I put salt in my drinking water. I wear compression garments. I lie down as needed. I avoid the heat.

I personally find, and this would be a big change for you - that stuffing my body with carbs, fats and protein around any exertion also helps. If I eat lots of things I avoid weird low blood sugar feelings that sometimes come on after exercise and generally avoid pem.
 

pamojja

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How much sodium and potassium you supplement each day? To you have any recent electrolye lab tests at all?
My electrolytes come back normal on all my labs. Potassium over 4, sodium and magnesium in normal ranges. I need to tank down the salt all day, though. I think that's my adrenal fatigue
Optimal for potassium would be between 4-5. Sodium between 142 -145. Calcium close to 2,4. Magnesium in Serum > 0,86, though in my case even with 0,89 (all in mmol/l) I had sever deficiency with very pain-ful muscle cramps, and in whole-blood already showing severe deficiency below even normal, finally only overcome with Mg-sulfate IVs.

I asked how much of the elemental minerals you're using. From your answer I take it, you're not really aware?
 
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JES

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Ketosis is associated with both water and electrolyte loss, so I would look at that first as the most likely explanation. I have been on and off keto several times over the past year and while it gives me certain benefits, it seems when I go under a certain amount of carbs per day my body starts to struggle, not in the typical ME/CFS way, but with a different set of symptoms. I think for people with ME/CFS ketosis can be a lot harder on the body than for the average population, so you should for sure weigh the pros and cons.
 
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I have eaten ketosis for several years now. Like 10 probably. I may come out of it slightly in the summer by adding a little fruit but the core of my diet has always been good proteins, seafood, copious vegetables and high animal fat. I never had the electrolyte issue until the M.E. hit.

I have had a few of those tests done over the years but don't have much bloodwork done these days because I've had so damn much. I'm usually hypoglycemic because my adrenal function is low and my triglycerides are high which I know is inflammation. The others I have not. I often times have low ADH and I've always wondered if that plays a role.

I have constant sugar cravings, another thing that started with the M.E. but I think that is a hidden dehydration/electrolyte issue because often times something like red meat will vanquish it. I guess I always wondered what the underlying cause of the dehydration is so I don't have to try and keep competing with it.
It seems many posts are missing the point that you were using ketosis prior to your illness without problems. Your experiences are roughly in line with mine.
I'm sure the issues arise from a hormone imbalance which is central to many of our issues, keto or otherwise.
I think the hypothalamic dysfunction is the prime candidate as it could be for many other of our uncomfortable persistent symptoms.
On a side note, I know it's very much individual, but when I ate most fruit and veg my metabolism was uncontrollable. I would have to eat constantly throughout the day to ward off hypoglycemia, electrolyte issues etc. Since keto/carnivore I can eat 2-3 times a day and am MUCH more stable metabolically. If I could get to the root of this "hormone" issue, life would be much more comfortable and simpler! (And no, I can they a doctor to test for any imbalance. Doctors are zero help).
I really do think this is a much overlooked and wider reaching issue that is not given the attention it deserves. Just my thoughts.
Best wishes.
 
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I don’t know the cause of it, but pedialyte has helped me a lot. The biggest help though has been SCIG. I used to be incredibly thirsty all the time, and nothing could quench my thirst in the slightest. SCIG improved my ability to finally hold onto liquids. I don’t know why but definitely grateful it’s helped so much with this