When we talk about “getting enough electrolytes,” we usually mean the big three: sodium, potassium, and magnesium. There are many others, including calcium, chloride, and bicarbonate, but the big three are the ones targeted by supplement and sports nutrition companies.
In part, that’s because sodium especially, but also potassium and magnesium, are lost through sweat. Athletes need to replenish these electrolytes during and after hard workouts or endurance outings in order to maintain optimal hydration and performance. Sodium and potassium work together to manage fluid balance throughout the body and facilitate muscle contractions and nerve firing. Magnesium is critical for cellular energy production and the transport of sodium and potassium across cell membranes.
I’m not going to go into a lot of detail about the other functions of electrolytes in the body since Mark recently covered the topic in his Electrolytes 101 post. Suffice it to say that if you don’t maintain the proper levels of electrolytes, you’re in a world of hurt.
Should I Be Taking Electrolyte Supplements?
Not everyone needs to supplement with electrolytes, but everyone needs to get the right amount. Your kidneys do a good job keeping electrolytes in balance by retaining or excreting specific electrolytes as needed. However, the kidneys can only do their job if you provide enough electrolytes to begin with, and there’s the rub. Even Primal folks who consume abundant produce and animal products may struggle to get enough electrolytes from their food due to mineral-depleted soil. Paleo godfather Loren Cordain speculates that potassium intake in particular lags behind our biological needs.
Furthermore, if you’ve jumped on the ketogenic train, you need more electrolytes than the average person. When you drop your carb intake, insulin secretion decreases accordingly. This triggers ketone production as well as a rapid flush of electrolytes. Failure to replenish lost electrolytes, particularly sodium, is probably the number one culprit in the dreaded keto flu.
Sports drinks are not the best way to up your electrolyte intake, though. Most of them are designed to provide energy (read: sugar) and hydration first and foremost. They probably won’t offer the amount of electrolytes you want, plus they usually contain other undesirable ingredients you don’t need. Luckily, it’s easy to up your electrolytes intake with better, more Primal-friendly sources.
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How Much Sodium, Potassium, and Magnesium Do You Need?
Sodium: The current recommended daily intake for adults is 1,500 mg per day, but that’s probably not enough for most people. The sweet spot seems to be between 4 and 6 grams per day for adults who do not have salt-sensitive hypertension or kidney disease.
Potassium: The FDA’s recommended daily intake (RDI) is 4,700 mg per day.
Magnesium: For adult females, 310 mg per day up to age 30, 320 mg per day thereafter. For adult males, 400 mg per day up to age 30, 420 mg per day after that.
Keto Dieters’ Electrolyte Requirements
Keto dieters should aim for:
- 3 to 5 grams (3,000 to 5,000 mg) of sodium
- 1 to 3.5 grams (1,000 to 3,500 mg) of potassium
- 300 to 500 mg of magnesium
These are in addition to what you get from food. If you are already getting at least the RDI of potassium from your diet, you might choose not to add more. However, as I said, it’s unlikely that you consistently get enough.
How to Get Electrolytes without Sports Drinks
Start with Food
Getting electrolytes from your diet is preferable to supplementing. Start by estimating your typical daily electrolyte intake, ideally by tracking your food for a few days using an app. I prefer Cronometer, but any app that provides detailed nutritional information will do. Don’t forget to track beverages, too.
If you find that you’re not hitting your targets, try adding more electrolyte-rich foods first, then supplement as needed.
How to Get Sodium in Your Diet
(Note: All the nutrition information below comes from Cronometer.)
Bacon and other cured meats, canned fish, or salted nuts can contribute up to a few hundred mg of sodium per serving. Smaller amounts naturally occur in some produce like beets and carrots, and in seaweed and fresh seafood. Dairy products also contain sodium, and even your drinking water contributes a little.
By and large, though, most of the sodium you consume in a day comes from the salt you add to your food. Different types of salt contain different amounts of sodium. A teaspoon of sea salt has about 2,100 to 2,300 mg of sodium, whereas a teaspoon of kosher salt only has between 1,100 and 1,900 mg.
Primal eaters should feel free to salt their food liberally. Your food will taste better if you do! Also, adding a generous pinch of salt to your drinking water enhances the body’s ability to absorb the water so you stay hydrated. (Add a squeeze of lemon to mask the taste.)
Foods Rich in Potassium
Primal eaters usually don’t include many of the highest-potassium foods in their diets: legumes, dried fruits, bananas. No worries! A medium-sized banana contains 422 grams in a medium-sized fruit. There are plenty of Primal-friendly options that beat it. Here’s just a sampling:
- Avocado (1 whole, 136 g): 690 mg
- Clams, cooked (10 small, 100 g): 628 mg
- Butternut squash (1 cup cubed, 205 g): 582 mg
- Spinach, raw (3 cups, 90 g): 502 mg
- Beets, cooked (1 cup diced, 157 g): 479 mg
These don’t beat bananas, but they still get honorable mentions:
- Coconut water (8 ounces, 240 ml): 410 mg
- Ground beef, 85% lean, raw (4 ounces, 113 g): 333 mg
- Sockeye salmon, raw (3 ounces, 85 g): 306 mg
- Canned anchovies (Wild Planet brand, one can, 85 g): 235 mg
- Broccoli, raw (1 cup chopped, 91 g): 288 mg
Potatoes are still controversial in the ancestral health space, but they contain more potassium than any of the foods listed above. A medium-sized baked potato (131 g) clocks in at 512 mg of potassium. Eating the skin nets you an additional 400 mg! If you don’t want to eat white potatoes, and you’re not aiming for very low carb intake, a medium-sized sweet potato (150 g) delivers 713 mg of potassium.
As you can see, though, it takes quite a lot to hit the RDI of 4,700 mg per day, even if you eat plenty of these relatively high-potassium foods.
Best Foods for Magnesium
With both magnesium and potassium, you’ll get some from most Primal foods. Some of the higher-magnesium foods are:
- Almonds, dry roasted (¼ cup, 35 g): 96 mg
- Spinach, raw (3 cups, 90 g): 71 mg
- Pumpkin seeds, roasted (¼ cup, 16 g): 42 mg
- Chia seeds (1 Tbsp, 10g): 39 mg
- Avocado (1 whole, 136 g): 39 mg
- Sockeye salmon, raw (3 ounces, 85 g): 23 mg
Remember, you don’t need nearly as much magnesium as you do potassium or sodium.
Supplement Electrolytes as Needed
You can purchase magnesium and potassium as individual supplements. Check your daily multivitamin/multimineral formula, too, to see how much you’re getting there.
The easiest way to add sodium is from good ol’ salt. Losalt is a lower-sodium salt that contains 1800 mg of potassium and 688 mg of sodium per teaspoon.
You can also buy electrolyte powders that you add to water. Read the labels to see how much sodium, potassium, and magnesium you are getting with each product and to make sure they don’t have added sugar. Some products don’t contain all three electrolytes, which might be desirable or not depending on what you need. Others contain all three but in paltry amounts. My personal favorite is LMNT, which contains good amounts of the big three in the correct proportions.
What about Baking Soda?
Some evidence suggests that baking soda is anti-inflammatory and can buffer acidosis, which is why it’s becoming increasingly popular among athletes and folks with autoimmune issues. It also seems to boost ketone production.
The chemical formula for baking is sodium bicarbonate (NaHCO3). One-quarter teaspoon contains 315 mg of sodium, plus bicarbonate, another electrolyte. The downside to using baking soda as a supplement is that it can cause significant GI distress if you overdo it. Start small!
A Note on Safe Supplementing
It’s almost impossible to overdo electrolyte intake when you’re talking about the minerals that naturally occur in real food. However, supplementing is a different story. With any electrolyte, you can run into problems by taking too much. That’s why I suggest tracking your food intake first—so you know how much more of each you actually need.
In particular, excessive potassium can lead to heart arrhythmias. When taken correctly, potassium supplements are generally considered to be safe for adults whose kidneys are healthy. As always, ask your doctor if you’re not sure if they’re right for you.
Moderna booster increases antibodies against Covid-19 variants, early data shows – ET HealthWorld
The early data comes from a 40-person trial testing of both Moderna’s existing shot and a version developed to protect against the South African variant of Covid-19 called mRNA-1273.351.
Moderna is also studying a shot that combines both the new and existing vaccine.
Natco files for patent waiver for arthritis drug to fight Covid-19 in Hyderabad – ET HealthWorld
In its application, Natco has cited the unmet medical needs due to the lack of supply and affordability in light of the grave and life-threatening national public health emergency, due to the Covid-19 second wave, as the main grounds for seeking the CL.
“The CL, if granted, will help in improving the accessibility and affordability of the drug, bringing its price down substantially”.
Under the World Trade Organisation TRIPS Agreement, compulsory licences are legally-recognised means to overcome barriers in accessing affordable medicines. Under the rules, governments allow a company to manufacture a patented drug without the consent of the innovator firm.
Analysts said Natco’s move puts pressure on the US drug maker. It has only two choices – either give a voluntary licence or sue Natco for the patent, which could result in a public backlash given the soaring Covid-19 case load and death toll in India.
Natco has applied for a CL at a time when India and South Africa have approached the WTO for a temporary suspension of intellectual property rights of pharma companies so that Covid-19 vaccines and other medicines can be accessible to poor countries.
Natco has urged the controller of patents to grant it a CL to manufacture and market Baricitinib, both as bulk API (active pharmaceutical ingredient) and finished dosage only for Covid-19 treatment in India till the pandemic prevails. It is also willing to pay a 7% royalty on net profits from Baricitinib sales to the patent-holder.
Making its case, Natco’s application said not only is Olumiant not manufactured in India, less than 9,000 tablets were imported in 2019 and 2020, at an average cost of Rs 3,230 per tablet.
Citing the pricing as a significant barrier, it said a 14-day regimen (one tablet a day) works out to approximately Rs 45,220 per patient, which most Indians can ill-afford.
Natco said it would structure its pricing at Rs 30 each for a 4mg tablet, which translates to Rs 420 for a 14-day course, Rs 20 for a 2mg tablet (Rs 280 for the regimen) and Rs 15 for each 1mg tablet, costing only Rs 210 for the entire 14-day therapy.
It also pointed out that the drug’s limited imports, which dropped from 8,870 tablets in 2019 to 8,385 tablets in 2020, would not be enough to cater the nearly 34 lakh Covid-19 patients in India. “The tablets of Olumiant imported through 2020 by Lilly would serve at best to meet the needs of only approximately 600 patients,” Natco said in its application, a copy of which was reviewed by TOI.
“It’s time India set up an independent committee of experts to consider and advice on compulsory licensing and use of other safeguards for Covid-19 medical products including medicines and vaccines’’, lawyer and IP expert, Leena Menghaney told TOI.
This is not Natco’s first battle for CL with a global pharma biggie. In 2012-13 it took on Bayer for cancer drug Nexavar and won India’s first ever successful compulsory license.
Roche receives emergency use approval in India for its investigational Antibody Cocktail used in the treatment of Covid-19 – ET HealthWorld
The antibody cocktail (Casirivimab and Imdevimab) is to be administered for the treatment of mild to moderate coronavirus disease 2019 (Covid-19) in adults and pediatric patients (12 years of age or older, weighing at least 40 kg) who are confirmed to be infected with SARS-COV2 and who are at high risk* of developing severe Covid-19 disease. It could significantly help these high-risk patients before their condition worsens. On March 23 2021, Roche announced that a large phase III global trial (n=4,567) in high-risk non-hospitalised COVID-19 patients (“outpatients”) met its primary endpoint, showing that Casirivimab and imdevimab significantly reduced the risk of hospitalisation or death by 70% compared to placebo. Casirivimab and imdevimab also significantly shortened the duration of symptoms by four days.
‘With the increasing number of Covid-19 infections in India, Roche is committed to doing everything we can to minimise hospitalisations and ease pressure on healthcare systems. This is where neutralising antibody cocktails like casirivimab and imdevimab can play a role in the fight against COVID-19 and in treatment of high risk patients before their condition worsens. We are thankful to the CDSCO for granting an EUA for casirivimab and imdevimab. This outpatient treatment for Covid-19 will be complementary to the ongoing vaccination drive and support our fight against the pandemic in India’, said V. Simpson Emmanuel, Managing Director, Roche Pharma India.
Commenting on the partnership, Umang Vohra, MD & Global CEO Cipla said, “We are deeply committed to exploring all possible treatment options and being at the forefront in our fight against COVID-19. This partnership with Roche is a significant step in enabling access to promising treatments in furtherance to our purpose of ‘Caring for Life’.
Cipla will market and distribute the product in India by leveraging its solid distribution strengths across the country. The drug will be available through leading hospitals and Covid treatment centers.
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