Balancing electrolytes on a meat-based ketogenic diet
As discussed in my Do we Need Salt blog post, most sodium in the body is found in the blood and lymph fluid. One way that sodium levels are controlled in the body is by a hormone released by the adrenals called aldosterone. The aldosterone amounts tell the kidneys to hold onto sodium instead of removing it from the body (e.g., urine or sweat).
Sodium is found in many foods, such as meats and vegetables. It also is in baking soda, in the form of sodium bicarbonate. Sodium is also in aspirin, laxatives, toothpaste and mouthwash.
Having the right balance of fluid (electrolytes) in the blood is important. Too little or too much can grow or shrink the cell’s structures and cause damage to the body’s nerves and muscles. This is why sodium imbalances can lead to adverse complications such as blood pressure fluctuations and brain swelling.
Yes, brain swelling.
So why do we need salt again?
We need salt. In Carnivore Cure, I talk about how too little salt has shown to cause insulin resistance. Our blood and tissues have life-giving salt. (If you want, taste your blood next time).
If you consume less than 500 mg of sodium daily (equivalent to about 1000 mg of salt, which is sodium + chloride or 0.18 teaspoons of salt), you risk insulin resistance and an increase of aldosterone. (I’ll talk about aldosterone shortly.)
Salt helps with electrical and chemical reactions that allow for things to go in and out of the cells, and one reason we have a sodium-potassium pump (a protein in cells that maintain the internal balance of potassium ions higher than in the surrounding fluid and maintains the internal balance of sodium ions than in the exterior of the cell).
The chloride part of salt is what we use to make hydrochloric acid (stomach acid) and chloride is not abundant in most foods. But we need hydrochloric acid to digest our foods and especially proteins. Hydrochloric acid also allows us to kill off unwanted, harmful parasites and bacteria.
Yes, if you follow a low-salt diet, your risk of parasites increases as HCl is the main protective barrier against them. No sodium chloride (salt) means less hydrochloric acid in the body. Sodium is also needed for healthy lung function. Maybe it’s not the time to be reducing salt.
Sodium from salt is needed for enzymes to convert carbohydrates into glucose. A meat-based diet has carbohydrates (galactooligosaccharides-GHGs) in tendon meat (nearly in all muscle meat). You’d want to ensure you have enough sodium in the body.
If we believe in the body’s innate wisdom, we have tastebuds that taste salt and these tastebuds tell the brain when something is salty and that it’s a good thing. (Of course, too much salt isn’t a good thing too). But we have these tastebuds because salt is life.
High blood pressure and aldosterone
When there is an insufficiency with our adrenals, the body tends to increase the production of aldosterone (a mineralocorticoid hormone). Mineralocorticoids regulate mineral concentrations in the body. They manage the body’s fluid levels and electrolyte balance.
Aldosterone’s role in the body is to help the kidneys retain sodium and excrete potassium. High aldosterone causes kidneys to retain sodium and dump potassium, which then causes the body to retain water.
This is how we get high blood pressure and bloat (bloat not from gut issues).
The underproduction of aldosterone causes low blood pressure and salt cravings.
In a 2011 study, lab rats showed that high levels of salt had a lower stress response than rats that had lower levels of salt. The high-salt group produced fewer stress hormones and maintained a lower heart rate under stress. They also returned to normal heart resting levels more quickly. This is likely because of the higher sodium levels in the body that then suppress the release of angiotensin II, a pro-stress hormone while increasing oxytocin, a stress-relieving hormone.
So if you swell with excess salt, are you sure it’s the salt and not the aldosterone (adrenal stress?)
Remember, humans require salt for many functions within the body, including blood volumes (balancing the fluid amount in the cardiovascular system), the nervous system and for digestion. Yes, we need salt for hydrochloric acid (salt is sodium and chloride).
NwJ Tip: Balance blood sugars and manage chronic stress (cortisol) triggers and blood pressure may be lesser of an issue. Don’t blame salt for what the aldosterone (possibly) did.
And with chronic cortisol output, you will get poor mineral absorption by the cells (read: electrolyte balance).
What kind of salt?
I talked about the kind of salt I prefer here.
One reason I prefer mineral salts and sea salts over table salt is because table salt has nearly no other trace minerals and can then result in mineral imbalances. Table salt can cause too much sodium and chloride, and not enough of other essential trace minerals—which are more abundant in sea salt and Himalayan rock salts. 
How much salt?
Trust your body but if you feel a headache or muscle weakness coming on, take ¼ tsp of salt with water or under the tongue. I recommend my clients prepare sole water the night before. (see below for recipe).
So let’s talk about added salt and how much to consume.
There are about 3 grams (3,000 mg) of sodium in 1 liter of blood.
One pound of meat has about 400 mg of sodium and if that’s all you are eating in a day, you are risking insulin resistance and other adverse health effects.
Studies show that people who consume less than 3 grams of sodium have a greater risk of heart disease and premature death than those that consume about 4 to 5 grams. You probably want to consume around 1 teaspoon (5,000 mg or 5 grams of salt) to 3 teaspoons of salt daily (15,000 mg or 15 grams of salt).
Most followers of a meat-based or ketogenic diet, use about 2 to 5 teaspoons of salt. If you are susceptible to migraines, you may need much more. Each individual body is different so there’s no exact number. Listen to your body. But if anything, too little salt isn’t a good thing.
As we’ve talked about the importance of managing fluids in the body, electrolytes help regulate heart and brain function, fluid balance, oxygen delivery and acid-base balance. The body has hormones that control the balance of sodium and potassium in the body. Remember, calcium is dependent on many other cofactors, and the body may throw out magnesium and potassium before throwing out the life-giving salt stores.
We need to fuel the body with the right fluids and salt to recalibrate electrolytes while on a low carb diet. The reason electrolytes become an issue on a low carb diet is because we retain less water without all the glucose molecules. Less water means fewer electrolytes. Does this mean we should be shoveling sugar into our bodies? No. Remember, aldosterone is essentially from adrenal imbalance. Too much sugar can cause chronic cortisol outputs, taxing the adrenals.
How do you know if you are deficient?
Do you experience:
- Adrenal imbalances
- Blood sugar imbalance, Diabetes
- Brain fog
- Gallbladder issues
- High blood pressure
- Irregular heartbeat
- Kidney stones
- Muscle weakness or lack of coordination
- Poor sleep
- Swollen joints
- Water retention, edema, swelling (likely from too little salt, not too much)
Benefits of Sole Water
Sole water is simply saltwater that is usually left overnight to allow the saturation of the natural salt with the water.
Sole water has been shown to benefit:
- Anti-histamine. The 84 minerals in sole water can work to support bodily functions.
- Blood pressure. Many carnivores have seen blood pressure drop even with an increase in salt consumption.
- Bone health. Usually, bone loss is not because of a deficiency in calcium but an issue with a cofactor. Sole water has a lot of minerals that can be spark plugs to better absorb calcium.
- Boosts energy. The minerals give a better balance of fluid in the body for energy output.
- Detoxification. Support the body to naturally detoxify.
- Electrolyte balance. Fewer leg cramps, heart palpitations, headaches and other electrolyte deficiency-type symptoms.
- Hydration. When we sleep, we use water for repairing and detoxifying. Sole water in the morning can help us to rehydrate.
- Muscle Cramps. Sole water + Magnesium spray has proven in my practice to be very effective to keep them at bay. Drink sole water in the day and magnesium spray at night (on the calves or any part of the skin you prefer).
- Varicose Veins. With the proper hydration of veins with mineral balances, varicose veins may reduce.
Sole Water Recipe
What you need
- Large mason jar
- 1-2 cups of Himalayan, Celtic and/or Redmond’s Real salt
- Drinking water
- Fill the entire jar with the salt and water
- Stir with a spoon
- Leave overnight to allow the salt to dissolve
- If there is salt at the bottom, the sole water is ready to use. If there is no salt, you may need to add more salt to the water before using.
- Add 1 tsp of the sole water to 8 ounces of water and drink as soon as you wake up. (you can sip it for 30 minutes).
- Have another tsp of sole water in the afternoon, or as needed.
Note: Do not use a metal spoon to get the 1 tsp (sole is active minerals!)
If you think you have an imbalance of minerals, you can get a hair tissue mineral analysis (HTMA). The HTMA test provides a detailed blueprint of your nutritional metabolic activity. Serum tests show a snapshot of minerals at the moment whereas hair tissue tests show a 3-month status of minerals in the cells.
The HTMA test is ultimately helpful in figuring out where your electrolytes may not be balancing and where you may need to do some root cause healing.
The HTMA test detects 36 elements. The results include 8 toxic metals, 14 nutritional minerals, 15 additional elements, 7 significant mineral ratios and 9 toxic metal ratios.
The 15 Essential Minerals include calcium, magnesium, sodium, potassium, copper, zinc, phosphorus, iron, manganese, chromium, selenium, boron, cobalt, molybdenum, and sulfur. These nutrients play significant roles in metabolic processes such as muscular activity, endocrine function, reproduction, skeletal integrity, and overall development.
The most important area to focus on are the 6 Significant Mineral Ratios: Ca/P, Na/K, Ca/K, Zn/Cu, Na/Mg, Ca/Mg, Fe/Cu. If the relationship between certain minerals in the body is disturbed, normal biological functions and metabolic activity can be adversely affected.
Just as we discussed aldosterone, these ratios can tell us a little more about adrenal status, thyroid and hormone health.
The following are two examples of what the significant ratios can imply.
Depression + Sodium and Potassium
Low tissue sodium to potassium ratio is related to many emotional changes including depression. The low sodium to potassium ratio may also be related to phobias, withdrawal, repression and indecision.
Diabetes + Calcium and Magnesium
Since calcium aids in the release of insulin in some way, low calcium to magnesium ratio may indicate a diabetic trend. It can also be that serum insulin may is low and with a family history of this disease, it may indicate a diabetic trend in the test results.
Most HTMA advocates are not fans of a meat-based diet. They believe that the core needs of minerals are oftentimes in plant-based foods. Additionally, to remove toxins, the thought is that the body needs fibrous vegetables to relieve toxins in bowel movements. As my clients rarely have comparative data, they freak out with their results and start questioning the diet.
We do need to detox toxins and one way is through a bowel movement. But as you can see, all four Carnivore clients have very different mineral profiles. The minerals that are out of range, the high bar chart items, are all in different areas.
So let’s not blame the diet for what the lifestyle and decades of a non-carnivore diet did.
If you are interested in the HTMA test, you can choose from the detailed report option or an additional HTMA Q&A consult with me (1 hour). You can find more details here.
Don’t just blindly supplement
I don’t recommend simply supplementing said-HTMA deficiencies. I highly recommend working with a practitioner before filling in gaps as it can exacerbate the problem. Remember, the HTMA test tells you what’s going on but not the why. If you remember aldosterone, the symptoms seem like sodium-excess but it’s oftentimes because of adrenal stress and an actual deficiency in sodium.
Let’s run through an example with magnesium. Most carnivores and keto advocates tend to supplement magnesium. Magnesium is the fad mineral as of late. (Vitamin D is another one but you can see my thoughts on Vitamin D supplementation in Carnivore Cure.) Magnesium is important but if you show any deficiencies in magnesium, you have to find out why, rather than buy the next supplement bottle of magnesium.
Did you know that magnesium lowers sodium in the body and can adversely affect the sodium/potassium ratios in the body? Yes, sodium and magnesium have an antagonistic relationship and when one goes up, the other usually goes down.
So if you are low in sodium and potassium and supplement with magnesium, you can experience worsening signs of potassium and sodium deficiency. And if your adrenals are imbalanced or what some call adrenal fatigue, then you need more salt, as salt supports adrenal health. Whereas, magnesium can lower cortisol and overall adrenal function.
So in a way, if you have adrenal fatigue or hypo-adrenal function, you may need more salt and not magnesium. If you are wired at night, your adrenals may be overly stimulated and maybe then, magnesium can help to calm the adrenals. The best way to support under-functioning adrenals from chronic cortisol output is more sodium throughout the day. And in this particular case, magnesium would just be lowering the sodium amounts in the body. (If you often crave salt, your adrenals are probably overworked. Look at managing stress and blood sugar levels).
This is why I’m more of a fan of using topical magnesium spray. From my practice, it seems to have fewer indications of messing directly with sodium levels in the body. Some studies have shown topical magnesium can increase magnesium levels by over 50% (whereas oral magnesium can take anywhere from 9 to 24 months.) In fact, I’ve seen many clients that feel better with magnesium from high doses of oral supplementation but in their HTMA results, the oral magnesium barely moves the needle.
Maybe this is why many of you feel balanced with electrolytes when taking supplements (or electrolyte powders and drops) but when you remove them, you immediately feel bad.
But why is this person deficient in magnesium in the first place?
Could supplementing magnesium be a temporary band-aid to a symptom? Sounds like standard medical care (allopathic care) and not a focus on the body as a whole (osteopathic care)?
Say you go to your naturopath or functional doctor and after running some tests, they essentially give you supplements for every deficient vitamin or mineral. You feel like something’s off. Well, you’re probably right.
This graphic depicts a mineral wheel. Every single arrow shows a mineral synergy, meaning minerals either work together or work against each other (antagonistic). So how can you know that a magnesium deficiency will be cleared up by adding more magnesium? What’s the true root cause? (sometimes it really is the magnesium).
The thing is that magnesium lowers sodium, potassium, calcium and manganese but it can also have a balance with them too. Potassium lowers calcium but is synergistic with sodium. Calcium lowers magnesium, potassium, manganese, synergistic with phosphorous and antagonistic with lead. And this doesn’t even start to cover any other minerals or vitamins. As an example, vitamin B6 can help raise potassium, lower copper, and is also imperative for digestion.
Can you see why it’s not always ideal to supplement individual vitamin or mineral deficiencies? And you can see why osteoporosis is not as simple as supplementing calcium. In Carnivore Cure, I talk in detail about the issues with calcium supplementation.
Or maybe you’re vitamin D deficient, as vitamin D can raise calcium levels. Or maybe it’s magnesium. Vitamin D might be low without magnesium.
You get the point.
Stick to healing the gut and eat foods that have a natural balance of minerals. If you have any deficiencies from the HTMA results, the test should help you to dig deeper and find any root cause imbalances. If your practitioner just tells you to fill the gaps (e.g., supplement every deficient mineral), I’d question the recommendations.
Nutrition with Judy Closing
Many low carbohydrate dieters take a concoction of electrolytes every day.
We should go back to trusting the body to find its natural balance. Every time we consume exogenous electrolytes, we continue to throw off the body’s internal balances. Sure, there’s a period we may need electrolyte drops or supplements, but over time, we should allow the body to recalibrate on its own.
Heal the gut and eat animal-based foods. Try some sole water and magnesium spray for leg cramps. Work on lowering cortisol triggers. These things have done wonders in my practice.
w️ith ♥ and hope for healing,
DISCLAIMER: The content is for educational purposes only. While I am a nutritional therapy practitioner and provide nutritional support, I am not providing medical advice. Whenever you start a new diet or protocol, always first consult with your trusted practitioner.
 Palmer, “Regulation of Potassium Homeostasis,” 1050–60.; Harvard Health Publishing, “Potassium and Sodium out of Balance,” Harvard Health, April 3, 2019, https://www.health.harvard.edu/staying-healthy/potassium_and_sodium_out_of_balance.