LIGHT ON THE SALT, HEAVY ON THE PERFORMANCE

Stephen C. Gangemi, D.C.

Every Spring, there is a good amount of news about hyponatremia, or decreased sodium concentration in the body, and most all talk about how to eat and drink before, during, and after training (exercise). As simple as it sometimes sounds, most people get confused by the contradicting information -- Eat more salt. Use a higher/lower carbohydrate solution. Drink more water. Use salt tablets. The list goes on and on. So enough of that. I'm going to tell you all you need to know to keep your electrolyte balance stable. You're also going to learn the answers to those questions you may have thought of here and there, but didn't get a straight answer to such as - why do some people sweat out so much salt that their shorts or their bike helmet chin straps turn from black to white? Why do some people crave salt, and others don't? Why do some people always feel thirsty even though they are constantly drinking water and constantly going to the bathroom? Why do some people get dizzy or lightheaded when they stand up or get out of bed too quickly? Why does my significant other involuntarily twitch or jump as they're falling asleep? The answers to all these questions are probably not what you've been told by a friend or unenlightened doctor. "That is normal. It happens to everybody." Well, you don't want to be like everybody, and in this case, you certainly do not want to be normal.

Your body normally excretes sodium and chloride in urine and sweat. When it loses too much, or retains too much, problems arise. The levels of sodium and chloride, (which I will now just refer to as sodium for simplicity), are regulated by aldosterone levels. Aldosterone is secreted by the adrenal glands, the small endocrine organs sitting just on top of each kidney. They cause the kidneys to resorb sodium and maintain electrolyte balance in the body. Maintaining electrolyte balance also means maintaining water balance. When aldosterone levels are low, excessive sodium is lost in the urine and sweat. So aldosterone is a major player in how well you will keep sodium and water in your body during a race, or all day long for that matter.

So how do aldosterone levels become diminished? The answer to that is stress. Under stress, especially chronic stress, the adrenal hormones become depleted and no longer function as optimally as they should. Although this is not a pathological response, and therefore not medically recognized, excessive and high stress levels directly fatigue the endocrine glands where our stress hormones, such as cortisol and epinephrine, are produced…the adrenal glands. Hypoadrenia, or a lowered production of adrenal hormones, is a functional problem found in the vast majority of athletes and persons with high stress levels.

When the adrenal glands are no longer functioning optimally, a person loses excessive amounts of sodium in their sweat and urine. But along with the decreased aldosterone levels, the adrenal glands also slow down on their production of cortisol, the body's natural anti-inflammatory hormone and the same one used to help balance blood sugar. Many athletes end up needing a shot of cortisone for symptomatic relief of joint or muscle pain. Yet we naturally make this compound in our body, in the necessary amounts, when the adrenals are working well. Decreasing the chemical, emotional, and physical stresses takes the burden off the adrenal glands allowing them to produce normal amounts of cortisol so inflammation can be dealt with as needed. Decreased cortisol levels are seen in persons with chronic joint and muscle aches, as well as chronic fatigue syndromes.

So onto the "but why?" questions. The hypoadrenic person/athlete has low aldosterone levels and loses too much sodium. Therefore, they crave sodium, especially after prolonged exercise. Their clothes look white, their skin is salty, and the family dog thinks their leg is a giant salt lick. When sodium levels are low, hydration status is low because the cells cannot absorb water. Drinking plain water at this time just ends up sitting in the stomach, sloshing around during a run, unable to be absorbed. This is also the person who may be constantly drinking water and their urine is always clear. Yet they are actually dehydrated. They are not absorbing any of the water; it is just passing right on through. So taking in some sort of electrolyte drink or salt tablets is a good idea at this time, but even better is fixing the problem at the source, the adrenal glands.

The kidneys and adrenal glands play a major role in the regulation of blood pressure. Normally, when a person goes from a lying to sitting position, the blood pressure should slightly rise. From a sitting to standing position, it should rise some more. But with the hypoadrenic individual, the blood pressure actually stays the same or drops during these postural changes, instead of rising like it should. This drop in blood pressure causes dizziness and sometimes a darkened view. When the problem gets worse, and the blood pressure drops too much, a person can black out. That is why you may feel dizzy or lightheaded upon rising. It is not normal, and it is not healthy. It is due to adrenal insufficiency. Next time you have your blood pressure taken, do so in the different positions, there is no rule saying that it has to be done in a sitting position only.

The last point to be made about the adrenal glands involves the electrolyte potassium. The balance between potassium and sodium is extremely important. Sodium mostly lies outside the cell, potassium inside. When excessive sodium levels are lost, potassium levels are at a higher perceived level in the body, due to the imbalance. This imbalance confuses the nervous system and does not allow for proper firing of certain neurons, hence the "jump" or twitch in muscles, usually at night. Heart palpitations, or a "racing heart" that some athletes feel can also be a result of this phenomena. Of course, you should have this checked by a qualified physician.

Everything just covered is considered normal because it is exhibited in the majority of people, especially athletes. Correcting the problem, the adrenal problem, will not only save you the hassle of trying to figure out the exact fluid ratios, but it will perhaps resolve many nagging health problems. The time it takes to correct the adrenals depends on the stress levels, and how long that stress has been present. It may not be something you can do yourself. But you can start by lowering nutritional/chemical stress, which means eliminating caffeine, hydrogenated fats, and refined sugars. Physical stress is lowered by training aerobic more often and using proper technique and posture, when training and at work. Emotional stress is the stress that I just put into your mind because you read this too quickly and are overwhelmed by the information. So to decrease that stress, start back at the top. Understanding this will lead to better health, decreased injuries and illnesses, faster recoveries and a faster you.