Search Articles
clear search termsSkewed Electrolyte Balance: A Purposeful Stress Response
Stress doesn’t just affect hormones and metabolism; sustained stress also effects electrolyte balance. And it happens on purpose! As I often say during SAFM courses, the body is not a “dumb bucket”. The human body is constantly and intelligently orchestrating a systemic response to help us to thrive in the environment in which we are asking it to live. This includes helping us to fare well during times of perceived threat to our survival.
Hormones are messengers. The HPATG axis coordinates the body’s response to our environment across many steroid hormones, tissues, and organ systems. Cortisol and aldosterone are both triggered releases from the adrenals (in response to the brain’s ACTH), so their sustained dynamics go hand-in-hand. The kidney-adrenal partnership finely controls our electrolyte balance and downstream dynamics such as blood pressure, interstitial pH, stomach acid production, and much more. A great example that downstream symptoms are not “random” anomalies but rather logical, expected downstream reactions to our upstream environment/lifestyle/genetics/beliefs that you can learn to interpret with confidence and keen wisdom. At SAFM, we call this “puzzle piecing”. Check out today’s clinical tip, a great one to teach your patients to increase their inspiration and empowerment in response to common symptoms. You (and they!) can come to an aha moment when you realize the root cause behind a common craving during times of sustained stress.
We think about blood pressure increasing during times of stress (hence the “whitecoat” hypertension dynamic). But it can be hard to discern whether this labile marker is a reflection of higher aggregate life stress or just a singular stressful morning on the way to the lab. There are many often-overlooked pearls to be gleaned from an everyday Comprehensive Metabolic Profile (CMP). Persistent high stress can manifest as skewed electrolyte balance between potassium and sodium, as the increased aldosterone output of a hyperadrenal state drives sodium higher and potassium lower. It may also show up as a notably high first-morning, fasting glucose that is out of synch with a HbA1c level due to an exaggeratedly high cortisol awakening response. Blood urea nitrogen (BUN) may be elevated as a reflection of an increased catabolic state which mobilizes more amino acids in times of high, persistent stress. Triglycerides may be elevated as well, reflecting increased fatty acids from catabolism. Now we want to hear from You! What other “everyday annual physical” markers do you use to help put together the puzzle pieces of an increased stress state featuring high cortisol?
Myth-busting and Truth-simplifying are things we do every day here are SAFM. Want to learn what savvy practitioners know and use with confidence? Join us for the next enrollment into the SAFM Transformational Training.
Warmly,
P.S. If you are passionate about transforming healthcare through the power of functional medicine, we encourage you to learn more about our training program here.
To receive clinical tips like this one right to your inbox, click here to receive our weekly newsletter.
Like us on Facebook to stay connected to our rich (free!) content and be notified of our popular, monthly Facebook Lives.
© 2017-2024, The School of Applied Functional Medicine | Company Values | Legal/Privacy | Partners & Affiliates | Contact
web development by: Gordon Multimedia
How would elevated chloride, potassium, and sodium be interpreted? Could you provide more information on the electrolyte balance regulation?
The interpretation of any lab marker value can only be done in the context of the particular person and other lab values that are available. As for the electrolyte balance regulation here are a couple of publications that may be of interest to you:
https://pubmed.ncbi.nlm.nih.gov/31082167/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9363595/
Can you explain how aldosterone plays a role in frequent nighttime urination? Is it the body attempting to achieve a more balanced state by dumping sodium? Thank you!
Yes, it is the body’s attempt to keep a better electrolyte balance in response to the situation it is exposed to. Interestingly, nighttime urination increases with age and also can be an indication of decreasing renal function. You may appreciate these references on these topics:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4713267/
https://www.nature.com/articles/s41598-021-90166-x
Thanks Tracy for your continued low hanging fruit “pearls.” Despite learning these things in 2-3 years of studying with you, being “reminded” is always an ah ha moment.
I have recently lost about 50 lbs and halfway through the process I began experiencing something like what you’ve described as orthostatic or postural hypotension. I don’t exactly get dizzy but often fade to black when I get up quickly. This happened frequently in my teen years and then a couple times a year until 3 months ago. I am now 54. I thought it might be related to my weight loss or my renewed interest in cardiovascular activity but now you have me thinking otherwise. Is there anything practical I can do to combat this re-emerging problem?
Alas, we can’t offer personalized recommendations in this venue, but what you are describing sounds like a possible adrenal hormone imbalance and I’d like to encourage you to work with an FM-versed practitioner to uncover the root causes of your particular issue. Also, you may find this case study of interest:
https://schoolafm.com/ws_clinical_know/menopausal-client-where-to-begin/
This is so often missed by folks for sure. Thanks for the attention to the subject Tracy.
Following on the heels of this video, I’m wondering how the adrenals can affect magnesium levels. I understand that magnesium can alleviate stress in terms of relaxation, but not sure that stress depletes magnesium necessarily (I know that stress will increase blood sugar which chronically will yield the need for magnesium given insulin resistance). I have a client who has suffered massive stress for at least 20 years, due to a marriage and subsequent divorce. Her RBC mg levels are elevated above the reference range, and I was curious how the adrenals may be playing a direct role with this mineral.
Efflux of magnesium inside of a cell is controlled through membranous sodium-dependent and sodium-independent pathways and through genetic and neurohormonal regulations. Adrenal insufficiency often leads to loss of sodium and increase of potassium. Magnesium has been shown to follow the path of potassium in this scenario. However, the most common reason for elevated magnesium levels is the issue with the excretion of this mineral via kidneys. As you well pointed out, elevated cortisol can be a significant driver for insulin resistance, which in turn is damaging to the kidneys and could cause issues with magnesium excretion.
Here are a couple of in-depth articles if you’d like to explore this topic:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4455826/#bib37
https://www.sciencedirect.com/topics/food-science/magnesium
I enjoyed Tracy’s FB Live. I work with women in their 50’s to help reclaim the vitality and energy they had in their 20’s and 30’s. The area I’m often get stuck in is when they ask about hormones and how to get them on track without taking medication. I would love to be able to take the SAFM courses and deepen my knowledge in that area – as well as all-around health and nutrition.
My friend took an SAFM course last year and speaks very highly of Tracy as well as the program. She said it has been very beneficial in helping her feel confident and is now better able to attract women she really feels like she can help. I’d love to learn more – especially about hormonal health and gut health.