Maintaining a healthy balance of electrolytes is foundational for all health and a critical imbalance can be fatal, at worst. Electrolytes (sodium, potassium, magnesium, chloride, calcium, and, to a lesser degree, phosphorus) balance fluids within body tissues, maintain the body’s pH, move nutrients and wastes in and out of cells, and support the function of the cardiovascular and neurological systems. The kidney and lungs are the most crucial organs in maintaining a healthy electrolyte balance, making those with kidney disease or failure more likely to experience dangerous electrolyte imbalances.
Perhaps one of the more common effects of a mild electrolyte imbalance in patients is the presence of acid-base disorders. The acid-base balance is important for metabolic health since intracellular pH governs protein synthesis, cell growth, and reproduction. Extracellular pH is important in managing the activation of the immune system, angiogenesis, and formation of the extracellular matrix. Thus, the effects of an electrolyte imbalance can be seen in numerous organ systems.
Potassium is the chief cation of intracellular fluid. It is primarily obtained through the food we eat (especially fresh fruits and vegetables), but also easily excreted through the kidneys by the influence of aldosterone. Aldosterone is secreted from the adrenal glands and states of acute or chronic stress can lead to a deficiency in electrolytes such as potassium. Additionally, normal dietary intakes of potassium fall below the daily requirement. In 2016, the journal Nutrients reported that “only 3% of adults and 10% of children under the age of five in the United States meet the adequate intake (AI) level for potassium.” Perhaps it is our shift away from fresh, whole foods and toward processed foods, but regardless, supplementation is often required to reestablish healthy levels of this important electrolyte. Hypertension, mild acidosis, poor regulation of blood sugar, and increased insulin resistance are all documented outcomes of a chronic deficiency in dietary potassium. Catecholamines (epinephrine and norepinephrine) and insulin are capable of stimulating the Na+-K+ ATPase pumps which manage the balance of this crucial electrolyte.
Magnesium is another cation that ranks second to potassium as an intracellular electrolyte. Large portions of magnesium also reside in bone and teeth. Like potassium, magnesium intake is often low, but remains largely unrecognized due to “normal” serum levels which do not adequately reflect tissue stores. A chronic magnesium deficiency has been linked to numerous health conditions given the fact that magnesium participates as a cofactor for hundreds of biochemical reactions and is utilized in vital processes such as RNA and DNA syntheses, antioxidant level maintenance in the cell, and energy metabolism. Skeletomuscular, cardiovascular, and metabolic conditions are commonly associated with magnesium imbalances. Similar to potassium, poor glucose control and insulin sensitivity are linked to low magnesium stores. Consumption of magnesium-rich foods has decreased, and processing often removes this key electrolyte, making it difficult to consume adequate amounts. It is also interesting to note that caffeine consumption increases renal excretion of electrolytes such as magnesium. Coffee is a commonly consumed beverage among adults. When 37 adult women drank a beverage with 6mg of caffeine or no caffeine in the morning, it was found that “total urine output of water, calcium, magnesium, sodium, chloride, potassium and creatinine increased in the two hours following caffeine ingestion when compared to the control beverage.”
Of all the electrolytes, potassium and magnesium seem to be in the limelight because of the relatively widespread deficiency of each. Further, both electrolytes are related to some of our most common health conditions seen in an aging population. Hypertension, diabetes, congestive heart failure, osteoporosis, and oxidative stress are all linked to an imbalance of electrolytes, with the focus on potassium and magnesium. Given the fact that diuretics, which speed along the excretion of both potassium and magnesium, are commonly used in these conditions, it is even more critical that we focus our attention on preserving a healthy balance through a diet concentrated on whole foods and proper supplementation.