Wednesday, June 23, 2021

Guest Post: Electrolytes Revisited

by George Groot

George is a member of our Facebook Group and has written for us before.

With summer coming up, I wanted to write about the importance of electrolyte drinks and oral rehydration salts. 

For me, the first sign that I don’t have enough salt in my bloodstream is a horrible headache (sometimes in the form of an ocular migraine) and a general lack of energy.  In this case, a bit of salty water (home mixed or commercial product) peps me up very quickly. This is because the cells of the human body can’t pump water, but they can pump ions, and due to osmotic pressure the water will follow. Your cells cannot take in water without salt, which is why sports drinks have salt: to speed up the intake of water.

Hyponatremia is the condition of very low blood sodium. If you drink a lot of water and sweat it out, you aren’t replacing the necessary salt. The signs for hyponatremia are the same for low salt: headache, fatigue, muscle cramps, nausea and/or vomiting. In addition to sodium, our body also needs potassium, calcium, and magnesium. These are easily absorbed by your body as salts such as sodium chloride, potassium chloride, calcium citrate, or magnesium citrate. The two most easily lost through sweat and urine are sodium and potassium. 

Make Your Own Drink
Generally, you'll get all the electrolytes you need from food. But strenuous activities, or even simply being in a really hot environment (such as Georgia or Florida with no air conditioning) where you sweat profusely, can cause your normal diet to be insufficient at providing the salts you need to stay healthy.

To make a simple sodium/potassium drink, get some pure table salt and Morton’s Lite Salt and mix 1:1 to make a salt mix that is 75% Sodium Chloride and 25% potassium chloride. 

There are about 5.7 grams of salt in a teaspoon, so to make a sports drink mix you’ll want about 1/8th of a teaspoon per 16 oz of water depending on your taste buds. One teaspoon per gallon is a good starting point for a hydration drink that replaces sweat. If you find that you can’t taste the salt at that level, odds are you can add a little more and be fine.

For an oral rehydration mix, you'll want greater concentrations of salt; mix about 1/2 of a teaspoon into a 16 ounce water bottle and sip as needed. 

Oral Rehydration Salts (sometimes you’ll hear a veteran or medic talk about ORS packets) add calcium and magnesium to the mix. This is because after your body starts running low on sodium and potassium, it starts giving up calcium and magnesium to keep you alive, so if you are severely dehydrated you’ll need to replenish those ions as well. I generally don’t recommend people mix their own ORS salts because food grade calcium and magnesium citrate aren't things that you normally find at a grocery store, but you can find it on Amazon and a tub or sack will last you a very long time. 

There are also commercial Oral Rehydration Salt packets available. I don’t recommend people consume them on a regular basis, but they are excellent for having on hand to treat a heat casualty, and I recommend people carry a few in their bug out bag.

I recommend the Ultima brand, and in a recent trip to Kuwait I used some DripDrop after a 10 mile run in the heat, but I honestly don’t have any brand preference here as they all work. Unfortunately they are all a bit more expensive than blending some table salts together from the grocery store. The good news, however, is that shelf life is essentially indefinite, so having a few on hand is really cheap insurance.

Rectal Rehydration
In an emergency where your buddy passes out, stops sweating, and you need to save his life right now, you might consider rectal rehydration, or what veterans refer to as an “Israeli IV.” The steps to turn a Camelbak or other hydration bladder, into a rectal rehydration setup can be found here, but by adding a cheap enema kit to your preps you can apply an ORS solution that way instead of ruining a Camelbak as the technique is the same. 

I prefer the rectal rehydration method for most cases, as severe dehydration can make starting an IV line difficult even for experienced medics, and the risk of infection is massively decreased.

Have a happy, healthy, and safe summer.

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