Electrolytes and Blood Pressure

[ALR]

Wow, thanks so much for posting this question…I had to read it twice to make sure it wasn’t me writing.

Last year I started focusing on pre-, during, and post-workout nutrition more, and started making my own mix: fructose, malto, and sodium citrate. I also eat a lot of salt (love me some anchovies, fish sauce, miso, capers, olives, marmite, a giant salt lick in the woods, whatever).

Then, a couple of months ago I got a recent high blood pressure at doctor office—surprisingly high, and surprising given my history. They rechecked (and cleverly, in retrospect: they got me relaxed and did a second BP check after I’d been sitting awhile without ever indicating anything concerning).

I’ve cut sodium waaay back (I stopped salting my pasta water ), and eliminated the sodium citrate from my mix for indoor workouts (still cold here in the North, so I won’t be on any long, hot rides for at least a month… probably more). My BP seems to be trending down.

I have two questions: (1) Dr_Alex_Harrison above mentions sodium with respect to sugar absorption and gut training… do I need at least some sodium in my mix to make carbs available during the ride? Or is it that sodium is important for gut training? Both? I’m blessed with a capable gut, and not at the far edge of performance needs, so don’t need to train the gut. I really just want carbs to sustain rides / make them more fun.

(2) Does anyone here have a explanation of the relation between chronic sodium consumption and high BP (and kidney / blood vessel function, maybe?) over the long term and acute sodium consumption and high BP (due to blood volume)?

In any case, thank you to the folks on this thread for chiming in.

[alexfthenakis]

My understanding is that just a very tiny pinch of salt is required for absorbtion:

@Dr_Alex_Harrison

Cut sodium citrate out of the post-workout shake. Maybe shake in 1/16th tsp (just a short shake) of table salt. That’ll be all you need for sugar absorption purposes, unless you’re super dehydrated, in which case you only need more sodium because you need to be consuming copious water to fix the dehydration.

As for the mechanism that connects sodium to high BP, I imagine it takes us back to high school chemistry lessons on osmosis. Salty blood draws in and holds more water? Maybe one of the doctors on this thread (either kind) can confirm/elaborate?

EDIT: I see your second question is actually a lot more complex than what I tried to answer and actually begins from a place of already understanding osmosis perfectly well. I’ll step back into the corner and wait for the experts!

[Patt_Movlich]

As it was mentioned in another reply sodium tends to hold on to water. That leads to more pressure.

(1) Someone else already answered the question in your replies and it seemed reasonable.

(2) Does anyone here have a explanation of the relation between chronic sodium consumption and high BP (and kidney / blood vessel function, maybe?) over the long term and acute sodium consumption and high BP (due to blood volume)?

Sodium intake is associated with elevated BP in migrant, cross-sectional, and prospective cohort studies. Keep in mind we need sodium to survive without sodium a person will die, we just need it in moderation. I am not sure regarding “acute sodium consumption” which, I would think is a sodium tablet during or before an event.

High blood pressure will negatively impact our kidneys. We have filters called glomeruli in our kidneys and elevated blood pressure can put too much pressure on those filters/glomeruli that results in damage.

It also exerts excess pressure on your vessels that causes damage to the vessel lining that can obstruct blood flow. It also aides in depositing plaques. If plaque forms in a blood vessel it can eventually obstruct the flow of blood in that vessel.

High blood pressure can be caused by ONE or MULTIPLE different things. That is why it is best to work with a medical professional such as an MD to help manage it, so another cause may not be missed.

[Dr_Alex_Harrison]

@ALR

(1) Dr_Alex_Harrison above mentions sodium with respect to sugar absorption and gut training… do I need at least some sodium in my mix to make carbs available during the ride? Or is it that sodium is important for gut training? Both? I

Yes. But not nearly as much as is recommended for optimal hydration. Example: on a hot day with very high sweat rates it might be perfectly optimal and healthy, and not risk increased blood pressure, if someone were to consume 1500mg sodium per hour. Some folks can lose well in excess of 3000mg sodium per hour. (rare) But to optimize carb absorption you probably only need 10% of that. This is a ballpark estimate. There is not strong research studying the effects of sodium content of beverages on facilitating the absorption of carbs, OR on the facilitation of hydration status and thereby the latent effect on carb absorption due to a well-hydrated gut & whole-body system.

@ALR

(2) Does anyone here have a explanation of the relation between chronic sodium consumption and high BP (and kidney / blood vessel function, maybe?) over the long term and acute sodium consumption and high BP (due to blood volume)?

First, I think @Patt_Movlich made great points. Especially, this:

@Patt_Movlich

High blood pressure can be caused by ONE or MULTIPLE different things. That is why it is best to work with a medical professional such as an MD to help manage it, so another cause may not be missed.

Second, a quick clarifying question.

Are you asking about

(A) the relationship between acute higher sodium consumption periodically, and the development of long-term blood pressure increases?

Or

(B) were you asking two separate questions, each about the relationship between sodium consumption and blood pressure increases? First question chronic. Second question acute. Just checking!

@Patt_Movlich’s answer does well for (B).

Regarding (A), Pinging any nephrologists well-versed or even slightly versed in exercise physiology! I’d love to chat with you! I can chat at length about what I think is happening, but if such a person exists (a nephrologist or maybe hematologist well versed in exercise science) they could probably do better. And I want to be careful here because the big take-home message is that blood pressure should be monitored regularly and managed by a physician. And I am not one!

[JoeX]

@alexfthenakis

Is the first step just to slash the salt component

Not really.

First of all, if you are low on electrolytes then they aren’t affecting your blood pressure negatively.

Secondly, there’s an implicit assumption you’re making that you cramp not for the reason the vast majority of people do (over exhertion) but due to chronically low electrolytes.

Lastly, it’s also implied that this is a cause of your high blood pressure readings when there is no reason to assume so.

Basically, I don’t see any reason to look at electrolytes at all in response to your hypertension without more information.

[ALR]

That’s enormously helpful, thanks!

Are you asking about

(A) the relationship between acute higher sodium consumption periodically, and the development of long-term blood pressure increases?

Or

(B) were you asking two separate questions, each about the relationship between sodium consumption and blood pressure increases? First question chronic. Second question acute. Just checking!

Good question. I was asking (A), though I didn’t really understand the first part of (B) (chronic) so Patt_Movlich’s answer was very helpful there. My concern is that I know chronic consumption can be the basis of hypertension (I’m working on that). And I know that acute consumption can increase BP in the short term. But I’d like to be able to ingest sodium in increased amounts on long, hot days without counteracting my efforts on the chronic side.

I know that’s complicated and really the domain of specialists. I’m not in a bad place at the moment and am monitoring BP. Just trying to get my mind around it. Thanks for the insights!

[Patt_Movlich]

Good for you for being proactive and smart about your overall health.