I drink about 110 ounces of fluids daily including coffee, water, and electrolytes (propel) .
I don’t like salty food so I have always limited my sodium intake. I never add salt to anything and buy low sodium foods.
I’m always tired and I’d have to say dizziness, muscle cramps, and brain fog bother me the most. I don’t sleep well and this started with SSRIs for anxiety 30 years ago.
I take duloxetine and Paxil for anxiety and depression. I stopped taking losartan after losing 50 pounds and stopped trazodone for sleep when my sodium levels dropped to 131. My physician followed my sodium for months and it increased to 136 after 6 months. So my sodium has been stable since last August.
You’re actually helping me refine my intake questions for others in the future who may benefit from my perspective on health, so it’s a win-win.
I’m not attached to whether you choose to use any of my suggestions, but if something I share resonates with you, I’ll do my best to offer thoughtful, practical guidance.
I can also help with the psychology of change, because we humans are creatures of habit after all 😄.
I’m optimistic that after these next few questions I’ll have a much clearer picture of what’s going on and be able to offer some genuinely hopeful ideas for you to consider, if you’re willing.
If you’re short on time or don’t have a blood pressure monitor, Questions 1, 3, and 4 will still give me plenty to work with for now. 🙂
The blood pressure measurements would simply help me understand how your body responds to the challenge of standing, but they’re not essential for us to continue.
1. What is your sitting resting heart rate first thing in the morning before you get out of bed?
2. If you have a blood pressure monitor, would you be willing to measure:
• Blood pressure and heart rate while lying down after resting quietly on your back for 5 minutes
• Then stand up and measure them again after standing quietly for 3 minutes
3. What are the two most common things you typically have for:
* Breakfast
* Lunch
* Dinner
* Snacks
* Drinks
(If you drink coffee, approximately how many cups per day?)
4. Do you intentionally avoid or limit any of the following?
* Salt
* Fat
* Red meat
* Eggs
* Dairy
* Fruit
* Carbohydrates
And if so, what are your reasons for avoiding them?
I am feeling lightheaded and have ringing ears; feel like I’m going to pass out 2 hours after lunch today.
HR in am: 81
After lying at rest for 5 minutes:
HR 88
BP 112/70
after standing:
HR 132
BP 86/54
Breakfast I usually have egg bites or oatmeal
Lunch—Greek yogurt with granola or 1TBSP peanut butter and 5 low salt crackers
Dinner—healthy choice simply steamers with chicken or beef, healthy choice protein bowls.
Snacks—hummus and pretzel chips, or cheddar cheese, turkey, and almonds prepared as a snack
I don’t avoid salt, however I don’t like a lot of it. I never salt anything I cook. I like potato chips and crackers, but I am avoiding them because I’m trying to lose all the weight I gained after taking Abilify. I also gained weight after ovaries were removed 18 years ago.
Fat— I limit fat for weight loss. Sometimes I don’t eat enough of it. I know I need fat along with every other nutrient.
Red meat— I don’t avoid salt, but can’t afford it due to recent retirement.
Eggs— I love eggs, so I don’t limit them if I can afford them.
Dairy— I have to avoid dairy products due to lactose intolerance. It is so bad that taking OTC lactase doesn’t help. I still get severe diarrhea with water for stools. I try to eat Greek yogurt and oat milk, also I’ve been reading that hard cheeses don’t cause as many digestive problems. Sometimes true sometimes not.
Fruit— I avoid for several reasons. I live alone and they rot before I eat them. I get migraines and citrus fruits are a big trigger and they also cause digestive problems.
Carbs— I tend to limit because of my weight. I do eat peanut butter with thin sliced “Dave’s Killer Bread—usually sprouted grains “. However, bread also spoils quickly, so I don’t buy it often.
As I read my responses, I can see that I need some expert nutritional advice. I’m on semaglutide and have lost 60 pounds slowly over a year. I have had diarrhea and digestive problems with it, but it finally stopped causing diarrhea after about 8 months.
I have reduced my HgA1C from 6.7 to 5.4. I have reduced my cholesterol and was able to stop ezetimibe and avoid a statin that I was being threatened with. I have been able to stop my BP medication also.
My husband died 13 years ago and he did the majority of the cooking. I have also gained weight due to fast food because I was avoiding cooking for just me.
Thank you for sharing all of that Sam. I’m busy with a cousin’s wedding this weekend, so this will be short and sweet to get you on some solid healing ground, moving forward.
First, I want to acknowledge how much progress you’ve already made. Losing 60 pounds, improving your A1C, lowering your cholesterol, and getting off a blood pressure medication are significant accomplishments.
A few things stand out to me. You’ve dealt with chronic digestive issues, you’ve intentionally limited fat for years, you rarely add salt to food, and you’ve gradually eliminated many foods while trying to improve your health.
Rather than making a lot of changes at once, I’d start with three simple experiments:
• Begin salting your meals to taste and pay attention to whether your energy, dizziness, muscle cramps, or brain fog improve.
• Include a nourishing source of fat at least twice per day (eggs, peanut butter, olive oil, avocado, nuts, salted butter, etc.).
• Consider keeping an easy fruit option on hand that won’t spoil quickly, such as frozen fruit or dried fruit (like dried apricot, dried apple, banana chips, etc.) that agrees with you. Or just put the fruit in the fridge on a plate or something so it keeps long enough to eat it 🙂🍑🍊.
I’m not asking you to do anything extreme. I’m simply looking for opportunities to help your body feel more supported and less restricted.
You’ve already shown that you’re capable of making meaningful changes. My goal now is to help you feel better while continuing that progress.
What stands out to me most is that you listened to that little voice that said, “Maybe there’s something here worth paying attention to.”
A lot of people ignore those nudges. You followed your curiosity, asked questions, and then took an honest look at your habits. That’s often where meaningful change begins.
As for your original question, my concern wouldn’t be that you’re drinking too little electrolyte solution. It’s that one electrolyte drink per day is probably not doing much to balance 110 oz of mostly low-sodium fluids, especially when you rarely add salt to food.
Rather than trying to hit a specific ounce target, I’d be more inclined to let your thirst gradually guide you as you begin nourishing yourself more fully and salting food to taste.
Try not to get too caught up in what’s ‘better or worse’ with fats, fruits, or salt. For now, just choose foods you enjoy and can comfortably stick with.
As you start to feel better, variety often expands naturally as you learn more and continue listening to your body.
Keep paying attention to your energy, dizziness, muscle cramps, brain fog, and sleep. Your body will give you feedback along the way.
Of course, free to reach out anytime if questions come up. 🙂
First Of like to say thanks for the Sub 🙌! It means a lot, especially in these early days for me here on Substack. Really sorry to hear that happened to your Mom. I would bet anything she’s not alone. In regards to your question, I gave it a good amount of thought and I realize that I couldn’t give you an honest answer without asking you some questions first, so if you could direct message me the answers to these questions (or leave them here if you’d like others to learn from this), I’d be happy to give you a clearer, more grounded answer, either way, because honestly, even something like Gatorade can be dilutional if you drink too much of it due to its generally low concentration of sodium relative to fluid ounces.
Here are the key questions:
1. How much fluid do you drink, on average, in a typical day?
My mom became severely hyponatremic when she was drinking extra fluids in preparation for a colonoscopy. She became so confused that she had to be hospitalized and treated with sodium over a week.
How does salt restriction lead to heart dis-ease and fear based reactionary thinking? Is the article where I explain why salt restriction impacts the kidneys and adrenals.
The kidneys love removing salt - designed for this - it is their drive mode.
The adrenals switch on with low salt status because hyponatremia is an emergency.
The adrenals cause the kidneys to work counter to their primary design and scavenge for salt to maintain blood salinity - in reverse mode.
This is fine in short bursts but it causes kidney dis-ease if salt restriction causes a chronic deficiency.
Drinking water all day + salt restriction causes kidney dis-ease and adrenal exhaustion/enlargement over time.
Hydration = SALT + water
Water follows salt into & out of the body. Salt is the cup water must fill.
Add salt to your water bottle, you’ll notice the difference.
So age (lowered kidney filtration efficiency) and chronically pushing our kidneys to work in “reverse mode” by chronically restricting salt is likely deteriorating our kidneys even faster (speeding up age related drop in efficiency). This is the sad paradox. When we pair potassium rich whole food intake with salt consumption, we’re able to consume the amount of salt our body craves/needs with less of the adverse side effects typically associated with salt intake (bloating, higher blood pressure, etc.).
Bloating is a signal of fermentation instead of digestion, salt provides Cl to make sufficient stomach acid, HCl. Low salt / salt restriction leads to low stomach acid, heartburn, bloating etc.
Salt might rise bp 4-5pts in most people whereas salt sensitives rise 15-20pts.
Salt is not a factor in rising bp for the majority.
Salt restriction + adrenals that have adapted/enlarged to a low sodium dietary are very efficient when salt is added to diet, hence the over reaction.
Add salt gradually, gain confidence as the benefits become very apparent.
I drink about 110 ounces of fluids daily including coffee, water, and electrolytes (propel) .
I don’t like salty food so I have always limited my sodium intake. I never add salt to anything and buy low sodium foods.
I’m always tired and I’d have to say dizziness, muscle cramps, and brain fog bother me the most. I don’t sleep well and this started with SSRIs for anxiety 30 years ago.
I take duloxetine and Paxil for anxiety and depression. I stopped taking losartan after losing 50 pounds and stopped trazodone for sleep when my sodium levels dropped to 131. My physician followed my sodium for months and it increased to 136 after 6 months. So my sodium has been stable since last August.
Hi Sam 👋! Thank you for helping me help you 🙂.
You’re actually helping me refine my intake questions for others in the future who may benefit from my perspective on health, so it’s a win-win.
I’m not attached to whether you choose to use any of my suggestions, but if something I share resonates with you, I’ll do my best to offer thoughtful, practical guidance.
I can also help with the psychology of change, because we humans are creatures of habit after all 😄.
I’m optimistic that after these next few questions I’ll have a much clearer picture of what’s going on and be able to offer some genuinely hopeful ideas for you to consider, if you’re willing.
If you’re short on time or don’t have a blood pressure monitor, Questions 1, 3, and 4 will still give me plenty to work with for now. 🙂
The blood pressure measurements would simply help me understand how your body responds to the challenge of standing, but they’re not essential for us to continue.
1. What is your sitting resting heart rate first thing in the morning before you get out of bed?
2. If you have a blood pressure monitor, would you be willing to measure:
• Blood pressure and heart rate while lying down after resting quietly on your back for 5 minutes
• Then stand up and measure them again after standing quietly for 3 minutes
3. What are the two most common things you typically have for:
* Breakfast
* Lunch
* Dinner
* Snacks
* Drinks
(If you drink coffee, approximately how many cups per day?)
4. Do you intentionally avoid or limit any of the following?
* Salt
* Fat
* Red meat
* Eggs
* Dairy
* Fruit
* Carbohydrates
And if so, what are your reasons for avoiding them?
Sorry it’s taken me so long to respond.
I am feeling lightheaded and have ringing ears; feel like I’m going to pass out 2 hours after lunch today.
HR in am: 81
After lying at rest for 5 minutes:
HR 88
BP 112/70
after standing:
HR 132
BP 86/54
Breakfast I usually have egg bites or oatmeal
Lunch—Greek yogurt with granola or 1TBSP peanut butter and 5 low salt crackers
Dinner—healthy choice simply steamers with chicken or beef, healthy choice protein bowls.
Snacks—hummus and pretzel chips, or cheddar cheese, turkey, and almonds prepared as a snack
I don’t avoid salt, however I don’t like a lot of it. I never salt anything I cook. I like potato chips and crackers, but I am avoiding them because I’m trying to lose all the weight I gained after taking Abilify. I also gained weight after ovaries were removed 18 years ago.
Fat— I limit fat for weight loss. Sometimes I don’t eat enough of it. I know I need fat along with every other nutrient.
Red meat— I don’t avoid salt, but can’t afford it due to recent retirement.
Eggs— I love eggs, so I don’t limit them if I can afford them.
Dairy— I have to avoid dairy products due to lactose intolerance. It is so bad that taking OTC lactase doesn’t help. I still get severe diarrhea with water for stools. I try to eat Greek yogurt and oat milk, also I’ve been reading that hard cheeses don’t cause as many digestive problems. Sometimes true sometimes not.
Fruit— I avoid for several reasons. I live alone and they rot before I eat them. I get migraines and citrus fruits are a big trigger and they also cause digestive problems.
Carbs— I tend to limit because of my weight. I do eat peanut butter with thin sliced “Dave’s Killer Bread—usually sprouted grains “. However, bread also spoils quickly, so I don’t buy it often.
As I read my responses, I can see that I need some expert nutritional advice. I’m on semaglutide and have lost 60 pounds slowly over a year. I have had diarrhea and digestive problems with it, but it finally stopped causing diarrhea after about 8 months.
I have reduced my HgA1C from 6.7 to 5.4. I have reduced my cholesterol and was able to stop ezetimibe and avoid a statin that I was being threatened with. I have been able to stop my BP medication also.
My husband died 13 years ago and he did the majority of the cooking. I have also gained weight due to fast food because I was avoiding cooking for just me.
Thank you for sharing all of that Sam. I’m busy with a cousin’s wedding this weekend, so this will be short and sweet to get you on some solid healing ground, moving forward.
First, I want to acknowledge how much progress you’ve already made. Losing 60 pounds, improving your A1C, lowering your cholesterol, and getting off a blood pressure medication are significant accomplishments.
A few things stand out to me. You’ve dealt with chronic digestive issues, you’ve intentionally limited fat for years, you rarely add salt to food, and you’ve gradually eliminated many foods while trying to improve your health.
Rather than making a lot of changes at once, I’d start with three simple experiments:
• Begin salting your meals to taste and pay attention to whether your energy, dizziness, muscle cramps, or brain fog improve.
• Include a nourishing source of fat at least twice per day (eggs, peanut butter, olive oil, avocado, nuts, salted butter, etc.).
• Consider keeping an easy fruit option on hand that won’t spoil quickly, such as frozen fruit or dried fruit (like dried apricot, dried apple, banana chips, etc.) that agrees with you. Or just put the fruit in the fridge on a plate or something so it keeps long enough to eat it 🙂🍑🍊.
I’m not asking you to do anything extreme. I’m simply looking for opportunities to help your body feel more supported and less restricted.
You’ve already shown that you’re capable of making meaningful changes. My goal now is to help you feel better while continuing that progress.
Thank you so much for all your feedback. It was eye opening to write it down and realize how much I’ve restricted myself.
You’re very welcome, Sam. 🙂
What stands out to me most is that you listened to that little voice that said, “Maybe there’s something here worth paying attention to.”
A lot of people ignore those nudges. You followed your curiosity, asked questions, and then took an honest look at your habits. That’s often where meaningful change begins.
As for your original question, my concern wouldn’t be that you’re drinking too little electrolyte solution. It’s that one electrolyte drink per day is probably not doing much to balance 110 oz of mostly low-sodium fluids, especially when you rarely add salt to food.
Rather than trying to hit a specific ounce target, I’d be more inclined to let your thirst gradually guide you as you begin nourishing yourself more fully and salting food to taste.
Try not to get too caught up in what’s ‘better or worse’ with fats, fruits, or salt. For now, just choose foods you enjoy and can comfortably stick with.
As you start to feel better, variety often expands naturally as you learn more and continue listening to your body.
Keep paying attention to your energy, dizziness, muscle cramps, brain fog, and sleep. Your body will give you feedback along the way.
Of course, free to reach out anytime if questions come up. 🙂
Have a wonder full week!
So it’s been recommended for me to drink 100 ounces. My sodium tends to run on the lower side of normal. 130-132.
If I drink an electrolyte solution once daily will that help with dilution or should I drink less water?
First Of like to say thanks for the Sub 🙌! It means a lot, especially in these early days for me here on Substack. Really sorry to hear that happened to your Mom. I would bet anything she’s not alone. In regards to your question, I gave it a good amount of thought and I realize that I couldn’t give you an honest answer without asking you some questions first, so if you could direct message me the answers to these questions (or leave them here if you’d like others to learn from this), I’d be happy to give you a clearer, more grounded answer, either way, because honestly, even something like Gatorade can be dilutional if you drink too much of it due to its generally low concentration of sodium relative to fluid ounces.
Here are the key questions:
1. How much fluid do you drink, on average, in a typical day?
(Including water, tea, coffee, electrolyte drinks, etc.)
Why:
Excess fluid intake is one of the fastest ways to worsen low sodium.
It immediately tells you whether dilution might be part of the picture.
2. Do you deliberately limit salt, or do you salt your food to taste?
Why:
This quickly identifies whether there’s a meaningful sodium intake restriction.
Many people with low sodium values have been told for years to avoid salt.
3. What symptoms bother you most?
Examples:
Fatigue
Dizziness when standing
Brain fog
Anxiety
Poor sleep
Heart palpitations
Muscle cramps
Why:
Symptoms often reveal more than the sodium number itself.
They also give clues about autonomic nervous system activation.
4. Are you taking any medications regularly?
Especially:
Diuretics
Antidepressants
Blood pressure medications
Why:
These are among the most common causes of chronic hyponatremia.
5. Have your sodium levels been around 130–132 for years, or is this something new?
Why:
Chronic stable hyponatremia and newly developed hyponatremia are very different situations.
A recent change deserves more urgency and investigation.
My mom became severely hyponatremic when she was drinking extra fluids in preparation for a colonoscopy. She became so confused that she had to be hospitalized and treated with sodium over a week.
How does salt restriction lead to heart dis-ease and fear based reactionary thinking? Is the article where I explain why salt restriction impacts the kidneys and adrenals.
The kidneys love removing salt - designed for this - it is their drive mode.
The adrenals switch on with low salt status because hyponatremia is an emergency.
The adrenals cause the kidneys to work counter to their primary design and scavenge for salt to maintain blood salinity - in reverse mode.
This is fine in short bursts but it causes kidney dis-ease if salt restriction causes a chronic deficiency.
Drinking water all day + salt restriction causes kidney dis-ease and adrenal exhaustion/enlargement over time.
Hydration = SALT + water
Water follows salt into & out of the body. Salt is the cup water must fill.
Add salt to your water bottle, you’ll notice the difference.
So age (lowered kidney filtration efficiency) and chronically pushing our kidneys to work in “reverse mode” by chronically restricting salt is likely deteriorating our kidneys even faster (speeding up age related drop in efficiency). This is the sad paradox. When we pair potassium rich whole food intake with salt consumption, we’re able to consume the amount of salt our body craves/needs with less of the adverse side effects typically associated with salt intake (bloating, higher blood pressure, etc.).
Bloating is a signal of fermentation instead of digestion, salt provides Cl to make sufficient stomach acid, HCl. Low salt / salt restriction leads to low stomach acid, heartburn, bloating etc.
Salt might rise bp 4-5pts in most people whereas salt sensitives rise 15-20pts.
Salt is not a factor in rising bp for the majority.
Salt restriction + adrenals that have adapted/enlarged to a low sodium dietary are very efficient when salt is added to diet, hence the over reaction.
Add salt gradually, gain confidence as the benefits become very apparent.