Lick the Salt to Kick the Competition

Come every racing season there is a good amount of news about decreased sodium concentration in the body, also known as hyponatremia, and most all talk about how to eat and drink before, during, and after training (exercise). As simple as it sometimes sounds, most people get confused by the contradicting information. Eat more salt? — Use a higher/lower carbohydrate solution? — Drink more water? — Use salt tablets? The questions remain and the confusion continues.But there are other questions that you may ask yourself, and the answers will help your training and racing significantly. And, your health will also improve as an added bonus. Why do some people sweat out so much salt that their shorts or their bike helmet chin strap turns from black to white? Why do some people crave salt, and others don’t? Why do some people always feel thirsty even though they are constantly drinking water and constantly going to the bathroom? Why do some people get dizzy or lightheaded when they stand up or get out of bed too quickly? Why does that person I sleep next to twitch or jump as they’re falling asleep? The answers to all these questions are probably not what you’ve been told by a friend or unenlightened physician. “That is normal. It happens to everybody.” Well, you don’t want to be like everybody else, and in this case, you certainly do not want to be “normal”.

Your body normally excretes sodium and chloride in urine and sweat. When it loses too much, or retains too much, problems arise. The levels of sodium and chloride, (which I will now just refer to as sodium for simplicity), are regulated by aldosterone levels. Aldosterone is secreted by the adrenal glands, which are the small endocrine organs sitting just on top of each kidney. They cause the kidneys to resorb sodium and maintain electrolyte balance in the body. Maintaining electrolyte balance also means maintaining water balance. When aldosterone levels are low, excessive sodium is lost in the urine and sweat. So aldosterone is a major player in how well you will keep sodium and water in your body during a race, or all day long for that matter.

How do aldosterone levels become diminished? The answer to that is excessive stress. Under stress, especially chronic stress, the adrenal hormones become depleted and no longer function as optimally as they should. Although this is not a pathological response, and therefore not medically recognized, excessive and high stress levels directly fatigue the endocrine glands where our stress hormones, such as cortisol and epinephrine, are produced – the adrenal glands. Hypoadrenia, or a lowered production of adrenal hormones, is a functional problem found in the vast majority of athletes and persons with high stress levels. Yeah, that’s most people living on this planet.

When the adrenal glands are no longer functioning optimally, a person loses excessive amounts of sodium in their sweat and urine. But along with the decreased aldosterone levels, the adrenal glands also cut down their production of cortisol, the body’s natural anti-inflammatory hormone and the same one used to help balance blood sugar. Many athletes end up needing a shot of cortisone for symptomatic relief of joint or muscle pain. Yet we naturally make this compound in our body, in the necessary amounts, when the adrenals are working well. Decreasing the nutritional, emotional, and physical stresses will take the burden off the adrenal glands allowing them to produce normal amounts of cortisol so inflammation can be dealt with as needed. Decreased cortisol levels are seen in persons with chronic joint and muscle aches, as well as chronic fatigue syndromes, and even in a burnt-out athlete.

So onto the “But why?” questions. The hypoadrenic person/athlete has low aldosterone levels and loses too much sodium. Therefore, they crave sodium (salt), especially after prolonged exercise. Their clothes look white, their skin is salty, and the family dog thinks their leg is a giant salt lick. When sodium levels are low, hydration status is low because the cells cannot absorb water. Drinking plain water at this time just ends up sitting in the stomach, sloshing around during a run, unable to be absorbed. This is also the person who may be constantly drinking water and their urine is always clear – yet they are actually dehydrated. They are not absorbing all of the fluid into their tissues; it is just passing right on through. So taking in some sort of electrolyte drink or salt tablets most often is good idea at this time, even better is fixing the problem at the source, the adrenal glands. That means dealing with the stress in life.

The stress could be from too much racing, too much anaerobic activity, lack of rest or lack of sleep. Many times these problems go hand-in-hand. If you train too hard, you aren’t resting well, and you’re not sleeping well. Cutting down the racing and resting more often with aerobic (not anaerobic) exercise is the plan to follow if this is the case.Excessive stress could be emotional due to work, family, or personal stress. Meditation, deep breathing exercises, and listening to relaxing music will help generate alpha waves in the brain and decrease cortisol and stress levels. Many people have chronic nutritional and dietary stress from eating too many refined carbohydrates, partially hydrogenated fats, vegetable oils, MSG and other artificial flavors and sweeteners, and from caffeine. Take a hard look at your diet and clean it up if you’re eating those processed and refined foods.

The kidneys and adrenal glands play a major role in the regulation of blood pressure. Normally, when a person goes from a lying to sitting position, the blood pressure should slightly rise. From a sitting to standing position, it should rise some more. But with the hypoadrenic individual, the blood pressure actually stays the same or drops during these postural changes, instead of rising like it should. This drop in blood pressure causes dizziness and sometimes a darkened view. When the problem gets worse, and the blood pressure drops too much, a person can black out. That is why you may feel dizzy or lightheaded upon rising. It is not normal, and it is not healthy. It is due to adrenal insufficiency. Next time you have your blood pressure taken, do so in the different positions, there is no rule saying that it has to be done in a sitting position only.

The last point to be made about the adrenal glands involves the electrolyte potassium. The balance between potassium and sodium is extremely important. Sodium mostly lies outside the cell, potassium inside. When excessive sodium levels are lost, potassium levels are at a higher perceived level in the body, due to the imbalance. This imbalance confuses the nervous system and does not allow for proper firing of certain neurons, hence the “jump” or twitch in muscles, usually at night. Heart palpitations, or a “racing heart” that some athletes feel can also be a result of this phenomena. Of course, you should have this checked by a qualified physician if it persists, unhealthy athletes die from heart problems too.

The previous symptoms are considered normal because they are exhibited in the majority of people, especially athletes. Correcting the problem – the adrenal gland problem – will not only save you the hassle of trying to figure out the exact fluid ratios, but it will perhaps resolve many nagging health problems too. The time it takes to correct the adrenals depends on stress levels, and how long that stress has been present. Reduce your nutritional/chemical stress, which means eliminating caffeine, hydrogenated fats, and refined sugars. Physical stress is lowered by training aerobic more often and using proper technique and posture (such as bike fit and proper footwear), when training and at work (sitting at a computer). Emotional stress is the stress that I just put into your mind because you read this too quickly and are overwhelmed by the information. Seriously though, a lot of people deal with chronic emotional stress due to jobs they hate, working with people they don’t like, and family members they no longer have good relationships with. Understanding this will lead to better health, less injuries and illnesses, faster recoveries, and a faster you.

Dr. Stephen Gangemi "Sock Doc"

I'm a board-certified chiropractic physician and clinical nutritionist with a passion for true natural health care. I implement dietary & nutritional therapies, exercise & movement practices, and lifestyle changes along with manual therapy techniques to help the body heal and prevent illness and injuries.