It's Electric! The Importance of Electrolytes.

I know that I briefly mentioned the importance of electrolytes in a previous post about hydration, but this is an important topic that is worth looking at more in depth.  Plus, my POTS journey has been evolving and my relationship with electrolytes has changed.  While my personal approach has changed, I don't feel this discounts any previous tips I have provided on food or drinks that provide you with your high sodium needs.  I do believe there are times or stages of dysautonomia (especially in the beginning) where you simply can't function and need quick fixes.  If these traditional methods of salt intake and downing Gatorade are working for you, then please keep doing it.  If it isn't working for you, then you may want to consider trying a different route.

Comic from NatalieDee.com

Why are electrolytes so important?

Electrolytes are key components in hydration and cell function within our bodies.  An article by Dr. Lynne August explains that our cells act as batteries within our body and electrolytes are what recharge these batteries. (1)  When these batteries aren't able to work at their full capacity, it can cause or exacerbate issues with irregular heart rate, dizziness, muscle contractions and fatigue, just to name a few.

POTS patients tend to be more prone to electrolyte imbalances and depletion.  For one, many of us suffer from low blood volume (hypovalemia) and/or blood pooling, which is a contributing factor in low blood pressure and tachycardia.  The true marker of a POTSie diet -- increased salt intake -- is meant to help increase our blood volume and blood pressure.  In addition, the salt helps us hydrate as too much water, without taking in salt and other electrolytes, will flush the body of its electrolytes and cause further dehydration.

This is where the Gatorade, Pedialyte and Nuun recommendations come in.  I used to drink 32 ounces of Gatorade a day, but the amount of sugar I was consuming just through sports drinks always made me uncomfortable.  I kept reading that refined sugar was bad for your nervous system, which made me fear I was taking one step forward and two steps back.  When I shared these concerns with my PCP, she agreed, but didn't know what alternatives to offer since I didn't feel I could survive the day without Gatorade.  This is where my ND stepped in to help me find those solutions.


What are the primary electrolytes?

When we think of electrolytes sodium and potassium usually come to mind since they are prominent in sports drinks.  In addition to sodium and potassium, the other four primary electrolytes in the body are magnesium, chloride, phosphate and sulfate.


Sea Salt

Instead of table salt, I am now using sea salt exclusively.  Sea salt not only provides you with your sodium needs, but it is less processed or unprocessed (depending on the source) and doesn't include the additives of table salt.  As a result, sea salt contains trace minerals -- including traces of the primary electrolytes.  Even though the type of salt I am using has changed, my use of it has not.  I still generously salt everything I eat.

Personally, I have been using Celtic Sea Salt at my doctor's recommendation.*  This brand has no additives and is unrefined and unprocessed.  I really like the flavor it provides.  While it is pricier than standard-issue table salt, a one-pound bag will last me at least four months.


Electrolyte Drinks

Obviously, even if you choose to forgo sports drinks, you will want to make sure you drink more than just plain water to help maintain and replenish your electrolyte balance.  Sometimes I simply add a pinch of salt to my water bottle.  In addition, Emergen-C is a good way to add electrolytes to your water.  My doctor has me using Emergen-C MSM Lite* to keep the sugar intake low.  Aside from providing three of the six primary electrolytes, it also gives me my daily vitamin C for immune support and B vitamins for proper metabolism and energy.

 While I haven't used it, so I can't speak to its palatability or effectiveness, I did notice in researching for this post that Selina Naturally (the brand that produces Celtic Sea Salt) has an electrolyte powder.  This powder is sugar-free, gluten-free, non-GMO, vegan and contains all six primary electrolytes.  The nutritional facts and ingredients look good, so I plan on asking my ND about it during my next appointment.  When I am having a "POTS attack" or an especially weak day, I sometimes feel like the jolt from Gatorade is the only way out, so I would love to have a more potent, natural electrolyte mix for times when I am really struggling.


Magnesium

As POTSies, we talk a lot of about sodium, but I have found magnesium to be a very important electrolyte for me.  When I first got sick, I went to my PCP, and she ran a full workup to see what she could find before deciding which type of specialist I should try to see.  Based on my bloodwork, she suggested I take vitamin D and magnesium supplements.  In the beginning my muscle twitches, tremors and tachycardia were constant.  I was not diagnosed or on prescription medications, but I would notice if I was extra shaky or my tachycardia was out of control, my system would calm down to more bearable levels shortly after taking 250 mg of magnesium.

According to an article by Dr. Christiane Northrup, magnesium is essential for over 300 enzymes in the body which work to "produce, transport, store, and utilize energy".  Some of these functions include protein synthesis and vascular, nerve and muscle health. (2)

Supplementing by taking magnesium orally is one option, and something I still do from time to time when I am extra "shaky".  If, with your doctor's support, you are supplementing with magnesium, it is best to take smaller doses at different times of day as magnesium can have a laxative effect in large doses.  For daily therapeutic effect, I soak my feet in an epsom salt bath. (I will do a separate post all about epsom salt later this week.)


Making a point to support your body's electrolyte balance may not be a cure for POTS or other chronic conditions, but an imbalance can certainly contribute to your symptoms and feeling unwell.  As Dr. Lynne August said, "Use a chronic condition as an indicator light on your dash -- it's time to cultivate health, starting with charging your cell batteries." (1)

And since the "Electric Slide" has been running through my head the entire time I was writing this...

Footnotes

(1) HYDRATE..., by Dr. Lynne August

(2) The Magic of Magnesium: A Might Mineral Essential to Health, By: Christiane Northrup, MD

* These products are mentioned based on personal experience.  I have not received compensation to include these brands in my post.

A Spoonful of Cacao Helps the Medicine Go Down

Diet and nutrition are the building blocks of healing.  Yes, I am taking a lot of supplements for my symptoms and issues, but creating an environment within your body that supports and encourages wellness is really important.

During my first visit with my ND, she asked, "How do you feel about smoothies?"

"I am pro-smoothie," I replied.

Enter my new daily breakfast.  There are many, good-for-you smoothie recipes out there, but my daily smoothie is a concoction of a few health products by my doctor's recommendation.  The main idea is that the smoothie is an optimal combination of protein, carbs, vitamins and minerals.  It is basically like drinking my multi-vitamin.

The best part about starting my day with a smoothie is it helps me enjoy breakfast without having to force-feed myself.  Thanks to POTS I always find it hard to eat in the morning due to nausea, but I know not eating just perpetuates the problem.  Drinking my morning meal is much easier on my stomach and digestive system.  It helps to prime the well for the rest of day.

The basis of my smoothie is a product called PaleoMeal.  It is available in various flavors and also available in a dairy-free variety.  My body hates dairy, so I use the dairy-free version.  Personally, I like the berry flavor over the vanilla flavor.  The vanilla has too much stevia in it for my taste; I am not a stevia fan.  I will admit, just mixing the powder directly into water or milk isn't all that tasty.  When I mix mine, I blend it with a banana, unsweetened almond milk and water.  One other POTSie bonus about the PaleoMeal... 400 mg of sodium!

In addition to the PaleoMeal, I mix in SpectraGreens and Natural Health Fruit Anthocyanins.  (I believe these two products are only available through licensed health professionals.)  I forget the exact ratios of how many cups of vegetables and fruits these add to my smoothie, but basically it ensures I get my daily needs in this area. That does not mean I am done eating fruits and veggies for the day.  Remember, I think of this as my multi-vitamin, not a pass to eat whatever I want for the rest of the day.

The great thing about smoothies is you can get creative with them.  I could add more fruits and green veggies, sometimes I add ground flaxseed, or I could even add some almond butter.  This morning I added raw cacao powder, and it was such a great treat!  I am not sure how I lived this long without it.

I had been reading a lot about the health benefits of raw cacao lately, so when I saw some at my local health food market I grabbed a bag of it.  This stuff really packs a lot of nutrition: magnesium, iron, potassium, antioxidants and fiber.

Obviously, if you don't have access to the products I use for my smoothies or want to take a more basic approach, that's not a problem.  You still might find that whipping up a healthy smoothie in the morning is a helpful start to your day.

If you are looking for some healthy and creative smoothie recipes, check out deliciouslyella.com!  Ella has wonderful recipes and great photos.  (You should also follow her on Instagram and Twitter.)  She is a fellow POTSie in London who has been helping her body heal through nutrition and natural means.  Ella is such an inspiration, and I hope I can find as much success as she has on my own natural journey to wellness!

Be Kind to One Another

Illness is hard. I mean, really hard.  It assaults every fiber of your being... physically, emotionally and mentally.  Invisible or visible, it doesn't matter.  Suffering is suffering.  Ideally, no one would have to struggle with and feel the pains of illness, but unfortunately that is not the reality of our world.

On the plus side, however, illness gives everyone involved -- the afflicted and their friends and family -- a chance to put love, mercy, faith and compassion into practice.  Really when it comes down to it, those four things are the essence of life.  We should embrace the chance to allow them to flow out abundantly from ourselves unto others.

Personally, being ill has honed my recognition of love, goodness and beauty in the world and the people I encounter.  I'm more reflective.  I see people and situations differently.  Even people I know well, I feel myself caring for them more deeply and seeing their true beauty shine through.

It is very true that illness will show you who your true friends are, and not everyone will make the cut, but those who do stand by you will become all that more dear to you.  While I have certainly felt the hurt of being sick in a healthy person's world, and I can tell some people don't "believe in" my symptoms, ultimately I have had a group of friends really stick by me and try to understand.  They will never know how much that has meant to me and how much I love them for it.  Additionally, my family, especially my mom, has been so amazing and loving.  I know that they have my back and will stand by me, even when it is hard on them too.  Yes, I am so very blessed.

What really breaks my heart are all the stories I hear from fellow POTSies whose family is annoyed with them or don't believe in their illness or friends who disappear because "they aren't fun anymore".  There are numerous stories of eye rolling, passive aggressive comments, or physical and emotional abandonment. This really and truly saddens me that anyone would be treated this way.

So for any doubters out there, let's set the record straight...

POTS is real. It is not anxiety.  It is not hypochondria.  It is a true syndrome with an unpredictable onset of symptoms, pain, exaggerated physiological functions and daily inconsistencies.  Many of the symptoms, while not life threatening, are very scary and often mimic life-threatening events.  Please believe your loved ones and trust that they understand their own body.  Even if you can't truly understand what someone is going through, offer them compassion and don't try to invalidate their illness or their limitations.  We are entrusted with people in our lives to take care of each other, so please accept that responsibility for those around you and be kind to one another.

Let us all try to make a concerted effort to keep those who are ill or struggling in our thoughts and prayers and reach out to them.  I can tell you from my experience that there is no greater renewal of hope than a card, visit, text, email or phone call from a friend.  It keeps me going and gives me a reason to laugh, smile and know that I am still a part of the world around me.


See the resources below if you know someone with Dysautonomia/POTS and want to learn more:

DINET: Dysautonomia Information Network

Dysautonomia International: For Family and Friends

POTS - Together We Stand: Riding the Waves of Dysautonomia [Book]

CHANGES: Living with Postural Orthostatic Tachycardia Syndrome [Video]

Medical Journal Article by Dr. Blair Grubb

Giving the Natural Route a Go

I guess I took another blogging sabbatical.  As usual, it was POTS' idea, not mine.  Oh well, let's dust ourselves off and get back to it.

Integrative medicine.  Holistic medicine.  Naturopathic doctors.  I know these phrases may make some skeptical or uncomfortable, but I have to say, I am becoming a believer in these alternative options.  Of course, as with anything, there are probably some quacks out there; but let's be honest, I have felt that way about some of my Western medicine doctors as well.

I began going to an ND in May of this year.  I was originally referred to her by my PCP, who dabbles in holistic medicine.  My PCP wanted me to go for a nutrition consult, since my vitamin deficiencies were a wreck, and my symptoms were all over the map.

Since I was a new patient, I had to fill out the health history forms, mark down my symptoms, diagnoses, etc.  I walked into her office, and she hit the ground running.  This was no longer just about nutrition.  She said it seemed pretty clear that I was suffering from adrenal fatigue.  Since that first visit, we have also began treating intestinal issues (which started up about 3 years prior to POTS), yeast overgrowth, chronic sinusitis and, most recently, gall bladder issues.  So she and I have a lot of balls in the air and of a lot of rebalancing to do in my body.  For anyone considering the holistic route, here are some things you will want to consider up front:

1. Find a doctor you can trust.  This is super important.  Do your research and trust your gut.  If you during your first visit with your ND, you don't feel comfortable and trusting, then find another doctor.  In my case, I like the ND I was referred to.  She immediately started putting a treatment plan together, AND she knew what POTS was.  My ND had been an MD previously, but then went back to school to become an ND.  For some reason, this makes me more comfortable with her since she has experience on both sides of medicine.  Also, she is so accessible and responsive.  I can email or call with any question or issue and have a reply within a few hours.  It is just a much more personal experience.

2. Be ready to put in the time.  Even with natural medicine, there is not a magic bullet.  Healing takes time, so you will have to be patient.  After 3 months with my ND, am I all better?  Nope.  Is my life still really limited?  Yep.  Have I turned some corners and made slow improvements?  DEFINITELY.  A few examples, I am off my side-effect-ridden beta blocker now... for real, and my BP and HR are stable more often than not.  I can spend most days sitting on the couch instead of laying on it.  My blood doesn't pool as severely or as quickly in my feet.  I can shower more than once or twice a week.  I can prepare my own meals.  Sure, these are simple things, but they are wonderful.

Aside from giving yourself time to heal and being patient with slow progress, the process itself is very time consuming.  My diet is pretty strict, which takes time and preparation.  I can't just go grab the first salty, processed thing I see in the kitchen.  In addition, I am on a lot of supplements right now.  I take about 48 capsules a day, plus medicinal teas.  This, along with eating on schedule, quite literally takes a lot of time.  Taking this approach to healing is a big commitment.

3. It is not cheap.  Nothing about this is cheap.  Between the doctor's appointments, supplements and "health food", there are a lot of out-of-pocket costs, which are not covered by insurance at all.  This is definitely a financial strain when there is no income.  But, honestly, none of my doctors who are covered by insurance have been trying anything at all to help me, so I feel it is worth the money if I am able to heal my body in the long run.  I mean, I spent thousands at Cleveland Clinic last year and that really only got me a diagnosis.

4. Be open.  You will need to open yourself up to a different perspective and to the idea that natural products and diet can be used as medicine.  The famous quote by Hippocrates, "let food by thy medicine and medicine be thy food" is really what this is all about.  But if it isn't something you truly believe in, it will be a waste of your time.  Also, be open to learning new things about your body and how it works.  My doctor is very good at explaining the process at work in my body with charts and diagrams.  I actually really enjoy learning in such a practical way... plus I am much better at answering biology and anatomy questions on Jeopardy now.


Have you considered taking the natural route or had any successful experiences with holistic medicine?