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Old 12-04-2012, 07:08 AM   #1
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NK and Salt - You must have it!

I was just reading through The Art and Science of Low Carb Living for a question about salt in our 80/15/5 thread and I thought it was important to make a general post for the quotes from Phinney on this issue.

This is the post and here is the salient text of it...

------------------------------------------------

Page 19 or location 458

"Salt deprivation leads to lightheadedness, fatigue, headache, and malaise."

Here is the part you are talking about, on page 20 or location 476: "High carbohydrate diets make the kidneys retain salt, whereas a low carbohydrate intake increases sodium excretion by the kidney (called 'the natriuresis of fasting')."

Another quote from that chapter's summary:

"3. Third, the body's metabolism of salt is uniquely different when one is adapted to a low carbohydrate diet. Salt and water are more efficiently excreted, which is a good thing as long as you maintain an adequate minimum sodium intake. Ignore this lesson and you are likely to suffer the completely avoidable problems of headache, fatigue, weakness, and constipation"

That is very interesting. If you are having a problem with regularity you could benefit from a close examination of your sodium intake.

Page 40 has more salty goodness. He remarks that adding 1 to 2 cups of bullion to your routine adds about 1-2 grams of sodium and being keto-adapted ensures that the salt moves right on through you.

Interesting. I think that he is saying that once you are keto-adapted you will not experience water retention from 'excess' salt. He says that 5 grams of sodium a day is about right for a keto-adapted person and that is a whole lot of sodium and a vast amount of table salt (which is not pure sodium).

On page 150 or location 2650, Phinney shows low sodium to be the culprit behind abnormal potassium sacrifice. "At some point, when confronted with this low sodium intake plus carbohydrate restriction, most people's defense mechanisms can't maintain normal mineral balances. So the body's next level of defense is for the adrenal gland to secrete the hormone aldosterone, which makes kidney tubular cells excrete potassium in order to conserve sodium. That is, the body wastes some of its intracellular potassium in order to cling to whatever sodium it can. However unless there is copious potassium coming in from the diet, this excess urinary potassium comes from the body's potassium pool inside cells. Two things then happen. First, nerve and muscles cells don't work well, leading to cardia dysrhythmias and muscle cramps. Second, because potassium is an obligate component of lean tissue, the body starts losing muscle even if there's plenty of protein in th diet"


Wow!!! So that fluttery heartbeat you experience is from a potassium deficiency brought about by too little sodium!! Dang.

And...Wow!!! So eat low sodium LC at your LBM's peril! That is very interesting too because it implies that you'd lose LBM without necessarily experiencing cramping.

This has an interesting implication.. Losing LBM has an impact on caloric requirements too. Less LBM means less calories burned because muscle mass burns calories just by being there. So you gradually lose LBM and your actual calorie needs diminish too. And ... you stall.

Page 150, and elsewhere, is where he says a total of 5 grams of sodium for an LC'r in some combination of food and added sodium (broth, bullion, etc).

Last edited by reddarin; 12-04-2012 at 07:09 AM.. Reason: clarification
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Old 12-04-2012, 09:48 AM   #2
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I totally concur with all the above. I know that when I feel a bit "iffy" anywhere in my body, I reach for the salt and it "cures me" of whatever it was. And I have been losing LBM for the last couple months, so took my "new" macros and have been really forcing myself to eat more calories and more protein (I was one eating on the low end) and have noticed a total change in how I feel. Before even stepping on the scale this morning, I feel "silly" and "giddy" and haven't felt that way in a long time. And the scale finally dropped! I'm even sillier/giddier after that! Eat your salt!!! (not the type in the grocery stores, but real salt, himalayan salt, gray salt, etc.)
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Old 12-04-2012, 02:34 PM   #3
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Whatever salt you eat - use it liberally!

I'm glad to hear that about the cals and protein Shelley
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Old 12-04-2012, 02:36 PM   #4
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Someone mentioned meds and salt in another thread. Always consider your health condition and whatever meds you may be taking before you make changes - salt or anything else.

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Old 12-04-2012, 02:43 PM   #5
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My morning routine now is a cup of black coffee with MCT. Once that's done I drink a cup of hot water with one beef bullion cube which contains 2 grams of salt. It's awesome. I usually then go out and run and when I get back home it's time for breakfast. Then I liberally salt my food. Candidly, without that bullion in the morning, I'm not sure I could get 2 grams of sodium in my diet. That's a hell of a lot of salt, but their is something about being in that beef broth that makes it seem not so salty.
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Old 12-04-2012, 03:34 PM   #6
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lol you got that right! I added sodium to my food log, googled the table salt to sodium conversion and then measured out the appropriate amount of table salt to get in 5 grams. Wow!!! That is a lot of salt.

I ate it all, a big chunk of it on my last meal because I'd neglected it ... I thought I was going to pass out heh.
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Old 12-04-2012, 03:47 PM   #7
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Quote:
Originally Posted by panabax View Post
My morning routine now is a cup of black coffee with MCT. Once that's done I drink a cup of hot water with one beef bullion cube which contains 2 grams of salt. It's awesome. I usually then go out and run and when I get back home it's time for breakfast. Then I liberally salt my food. Candidly, without that bullion in the morning, I'm not sure I could get 2 grams of sodium in my diet. That's a hell of a lot of salt, but their is something about being in that beef broth that makes it seem not so salty.
What kind of bullion do you use if I may ask? Most of the brands I've checked have MSG in it -- I know that is a form of sodium, but it gives me extreme headaches. I may have to make my own broth and add extra salt.

Thanks,
Arlene
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Old 12-04-2012, 05:10 PM   #8
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That is a great point about the possible problems with bouillon Arlene.

Here is Buffy's very simple and delicious chicken broth recipe for anyone that wants to do a homemade version.

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Originally Posted by Buffy45 View Post
Take a 8 qt souppot, throw in a whole chicken or the parts to equal at least one chicken and fill pan with water. Put in lots of sea salt and pepper. To this I add at least 1/2 lb butter and let it simmer on the stove all day. Simmering slowly will not boil off your water, which you want to keep, if it gets a little low, add some more hot water. Then, dip out all the chicken and bones, pull that meat off and store, I put mine in bags of 4 oz and strain your broth. Put in freezer containers. It is high fat, strong, salty broth.
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Old 12-04-2012, 11:03 PM   #9
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What kind of bullion do you use if I may ask? Most of the brands I've checked have MSG in it -- I know that is a form of sodium, but it gives me extreme headaches. I may have to make my own broth and add extra salt.

Thanks,
Arlene
MSG is a problem for me too. Some boullion's have SUGAR in them so watch out.
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Old 12-05-2012, 04:34 AM   #10
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What about the Wyler's brand? Thats what I normally use.. If it has sugar, it can't be more than 1g, since a cube is 5 calories.
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Old 12-05-2012, 04:54 AM   #11
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What kind of bullion do you use if I may ask? Most of the brands I've checked have MSG in it -- I know that is a form of sodium, but it gives me extreme headaches. I may have to make my own broth and add extra salt.
Knorr. I checked. MSG is the #2 ingredient. I will have to check out Whole Foods and see what they have. Until then, I have three more boxes of the stuff.
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Old 12-05-2012, 06:07 PM   #12
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Thanks for this thread! I used to wonder why I always seem to need way more salt than many others do, and "too much" salt never really caused water rentention issues for me. I also figured out that the occasional dizzyness/weakness/brain fog I used to get at times didn't have to do with hunger or blood sugar (I test my BG regularly) and instead had to do with electrolyte imbalance. On top of that I've always had low blood pressure. So this all makes perfect sense.

I no longer do NK, but without any effort, my normal woe lands me on a monthly average at 65-70% fat, and with 2-8g carbs or 25-35g carbs every other day, along with a protein range of 40-60g or 60-90g every other day, it is still fairly lchf so I sometimes stalk you guys in this new shiny forum. In any case, needing significantly more salt definitely applies to me. Homemade bone broth and Himalayan sea salt are good friends of mine.
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Old 12-05-2012, 07:52 PM   #13
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Thanks for stopping by, vilanteria.
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Old 12-05-2012, 08:11 PM   #14
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Cici, it's good to see you here! Hope you're doing well on NK.
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Old 12-06-2012, 06:54 AM   #15
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I though I would pop in and let you know the mechanism for the salt thing.

Geek alert!!

The body has to keep electrolytes in balance. That is, negative and positive ions have to be kept in a very narrow range to maintain life.

Positive charges pool= Cations

sodium - (Na+), accounts for 87%
potassium - (K+), accounts for 4%
Calcium, magnesium, unmeasured - (Ca+, Mg+, UC) , account for 9%


Negative charges pool = Anions

chloride - (Cl-), accounts for 68%
bicarb - (HCO3-), accounts for 13%
unmeasured -(UA), accounts for 19%


As you can see, Sodium and Chloride make up the bulk of the positive and negative ions in the blood and keeping them in range keeps the body in a certain acid/base balance.


When ketones are present and metabolized, they are broken down into a positive (+) and a negative (-) component. In order to eliminate these + and - ions, they have to be coupled with + or - ions in order to cross through into the urine. The neg. ketone segment is coupled with sodium (Na+).

When the total sodium content of the blood falls to a dangerous level, the body starts to use potassium instead. Potassium is very important for muscle and nerve function and the body MUST maintain usable levels in the blood. If blood levels fall, more is scavenged from inside the cells.

Aldosterone will cue the kidneys to save sodium and excrete potassium.
Insulin also affects sodium and potassium levels.

When we change from SAD to a ketogenic or NK type diet, we change insulin levels as well as ketone levels. Our Induction Flu is associated with the body shifting all these electrolytes back to normal levels with different mechanisms being responsible for that balance.

It"s no wonder our bodies go into a tail spin in the first week when we change the entire system so suddenly.
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Old 12-06-2012, 07:04 AM   #16
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Drjlocarb - thank you!!
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Old 12-06-2012, 07:14 AM   #17
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Yes, thanks for that, drjlocarb! It's really beneficial to know the reasonings behind this.
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Old 12-06-2012, 07:38 AM   #18
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Thanks, DRJ
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Old 12-06-2012, 07:54 AM   #19
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drjlocarb! What an awesome post! It is trillian worthy!



I'm gonna cross post it on our HF thread!
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Old 12-06-2012, 06:22 PM   #20
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Old 12-06-2012, 09:04 PM   #21
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I though I would pop in and let you know the mechanism for the salt thing.

*****

It"s no wonder our bodies go into a tail spin in the first week when we change the entire system so suddenly.
Wow...what a fabulous explanation!!! Gold stars to you!!! Thanks!!!!!

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Old 12-06-2012, 09:05 PM   #22
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Thanks for this thread! I used to wonder why I always seem to need way more salt than many others do, and "too much" salt never really caused water rentention issues for me. I also figured out that the occasional dizzyness/weakness/brain fog I used to get at times didn't have to do with hunger or blood sugar (I test my BG regularly) and instead had to do with electrolyte imbalance. On top of that I've always had low blood pressure. So this all makes perfect sense.

I no longer do NK, but without any effort, my normal woe lands me on a monthly average at 65-70% fat, and with 2-8g carbs or 25-35g carbs every other day, along with a protein range of 40-60g or 60-90g every other day, it is still fairly lchf so I sometimes stalk you guys in this new shiny forum. In any case, needing significantly more salt definitely applies to me. Homemade bone broth and Himalayan sea salt are good friends of mine.
You sound like me. I used to salt chips as they didn't have enough salt on them!!!!! (obviously this was before NK eating!) And yes, very low BP for me as well.
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Old 12-08-2012, 08:59 AM   #23
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Quote:
Originally Posted by wildflower View Post
What kind of bullion do you use if I may ask? Most of the brands I've checked have MSG in it -- I know that is a form of sodium, but it gives me extreme headaches. I may have to make my own broth and add extra salt.

Thanks,
Arlene
Herb-ox has no added MSG.
I use it because I also sometimes get headaches after eating a meal I thought might have MSG in it. Stands for "monosodium glutamate". That is the sodium salt of glutamic acid -- a 'non-essential' amino acid.
All proteins would be partially composed of glutamic acid, so you would get this from the normal digestion of protein. As to why (or if) eating a steak does not give one a headache but eating chinese food with a little MSG added to enhance flavor, I have no idea.

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Old 12-08-2012, 09:10 AM   #24
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Quote:
Originally Posted by drjlocarb View Post
I though I would pop in and let you know the mechanism for the salt thing.

Geek alert!!

The body has to keep electrolytes in balance. That is, negative and positive ions have to be kept in a very narrow range to maintain life.

Positive charges pool= Cations

sodium - (Na+), accounts for 87%
potassium - (K+), accounts for 4%
Calcium, magnesium, unmeasured - (Ca+, Mg+, UC) , account for 9%


Negative charges pool = Anions

chloride - (Cl-), accounts for 68%
bicarb - (HCO3-), accounts for 13%
unmeasured -(UA), accounts for 19%


As you can see, Sodium and Chloride make up the bulk of the positive and negative ions in the blood and keeping them in range keeps the body in a certain acid/base balance.
I may be missing something, but neither sodium nor chloride ions would have much effect on pH (acid/base). Bicarbonate, on the other hand is a buffer and is, I have been told, the mechanism via which your body controls the pH of blood.
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When ketones are present and metabolized, they are broken down into a positive (+) and a negative (-) component. In order to eliminate these + and - ions, they have to be coupled with + or - ions in order to cross through into the urine. The neg. ketone segment is coupled with sodium (Na+).
Eh? Ketone bodies would be oxidized to CO2 and water, just like glucose (pyruvate). Or do you mean before the body has fully keto-adapted and is still shedding ketones in the urine?

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Old 12-08-2012, 11:58 AM   #25
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Good questions Phillip.

Bicarb is the the first line of defence and is used first. CL- is plentiful and acts as a back up. Bicarb takes longer to make and will come back to normal range but it takes time. The Cl- will keep the acid balance (AG ratio) normalized until significant Bicarb can be produced to keep the slightly acidic range necessary for normal function. The acidic environment will remain normal because of an increased availability of the Cl- even when absolute Bicarb levels are slightly decreased. Therefore blood ph will be normal.

Ketones are oxidized to CO2 and water, but inside the cell (mitochondria) not in the blood. There are keto acids produced during production and breakdown of the ketones (ketone by-products) and the Bicarb and later Cl- take care of base parts and the Na+ and K+ takes care of the neg parts.

Things that will acidify the blood:
ketones
lactones
glucose
uremic acids
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Old 12-09-2012, 09:41 AM   #26
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Good questions Phillip.

Bicarb is the the first line of defence and is used first. CL- is plentiful and acts as a back up. Bicarb takes longer to make and will come back to normal range but it takes time. The Cl- will keep the acid balance (AG ratio) normalized until significant Bicarb can be produced to keep the slightly acidic range necessary for normal function. The acidic environment will remain normal because of an increased availability of the Cl- even when absolute Bicarb levels are slightly decreased. Therefore blood ph will be normal.
What I am not getting here is that if you had a solution of 0.1 M nitric acid made from concentrated nitric acid and water in one case, and concentrated nitric acid and 1M NaCl in the other case, my intuition is that the pH of both solutions would be the same. Yet one has a much higher concentration of Cl- ions in it.

Cl- is not a buffer, nor is it a base, so I don't see how it can play a role in changing the pH of blood.

Quote:
Originally Posted by drjlocarb View Post
Ketones are oxidized to CO2 and water, but inside the cell (mitochondria) not in the blood. There are keto acids produced during production and breakdown of the ketones (ketone by-products) and the Bicarb and later Cl- take care of base parts and the Na+ and K+ takes care of the neg parts.
The first part is correct. But I think you are mistaken with the second part. BHB and AcAc are converted to pyruvate which, of course, is burned completely to H2O and CO2. The reducing potential of this oxidation is captured in a chemiosmotic gradient across the inner mitochondrial membrane. This gradient is then used as energy to create ATP, etc. There may well be free acid generated by this process ( I don't remember ), however this is exactly the same pathway taken by pyruate derived from glucose. So I don't see it makes a difference whether you burn sugar or ketone bodies.

Also, just to be clear, there are no "keto acids" left over after ketone bodies go through the citric acid cycle -- unless you mean CO2. But again this is no different than pyruvate generated from glucose.

There are only 3 "ketone bodies" I am aware of -- acetone, acetoacetate and betahydroxybutarate. These are fuel that can be burnt inside cells. The latter two are carboxylic acids produced during beta oxidation of fat. But I think they would have to be buffered by bicarbonate (a buffer) in the blood. I don't see how metal ions, or chloride would play a role in maintaining blood pH one way or another.

Unless you are saying that in extreme cases (eg diabetic ketoacidosis) the kidneys can excrete them, but require an ion of opposite charge to do so? Then, yes, sodium and potassium would be needed. But not for neutralization per se, but to excrete the offending acids from the body entirely.

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Old 12-09-2012, 11:28 AM   #27
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What I am not getting here is that if you had a solution of 0.1 M nitric acid made from concentrated nitric acid and water in one case, and concentrated nitric acid and 1M NaCl in the other case, my intuition is that the pH of both solutions would be the same. Yet one has a much higher concentration of Cl- ions in it.

Cl- is not a buffer, nor is it a base, so I don't see how it can play a role in changing the pH of blood.


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Cl- is used to keep the Anion Gap in balance so Bicarb can be used to keep blood ph in balance. Na and Cl are used as ions not as NaCl.
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Old 12-09-2012, 11:53 AM   #28
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The first part is correct. But I think you are mistaken with the second part. BHB and AcAc are converted to pyruvate which, of course, is burned completely to H2O and CO2. The reducing potential of this oxidation is captured in a chemiosmotic gradient across the inner mitochondrial membrane. This gradient is then used as energy to create ATP, etc. There may well be free acid generated by this process ( I don't remember ), however this is exactly the same pathway taken by pyruate derived from glucose. So I don't see it makes a difference whether you burn sugar or ketone bodies.

Also, just to be clear, there are no "keto acids" left over after ketone bodies go through the citric acid cycle -- unless you mean CO2. But again this is no different than pyruvate generated from glucose.

There are only 3 "ketone bodies" I am aware of -- acetone, acetoacetate and betahydroxybutarate. These are fuel that can be burnt inside cells. The latter two are carboxylic acids produced during beta oxidation of fat. But I think they would have to be buffered by bicarbonate (a buffer) in the blood. I don't see how metal ions, or chloride would play a role in maintaining blood pH one way or another.

Unless you are saying that in extreme cases (eg diabetic ketoacidosis) the kidneys can excrete them, but require an ion of opposite charge to do so? Then, yes, sodium and potassium would be needed. But not for neutralization per se, but to excrete the offending acids from the body entirely.

--
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We need to go back further, to the point where the fat is metabolized. Acids are produced at that point (in the production of ketones), and H+ are produced all along the way (breakdown of ketones). And again the metal ions are used to keep the Anion Gap in balance and therefore the ph.

And, yes,my belief is at the beginning, we are in a very, very mild DKA-like state as the body adjusts to the duel fuel sources. Insulin is gone and ketones are produced and our bodies have to get used to using ketones.

The whole point being....we need more salt. I find I need less as keto-adaptation occurs.

I over simplified it for the rest of the crowd and that is what through you off. Sorry.
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Old 12-09-2012, 01:16 PM   #29
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WOE: Nutritional ketosis
Start Date: LC: 04/11 • NK 10/12
Bringing the conversation back to a level we humanities majors can understand...I'm rather glad to get this info. about the sodium. The tracking site I've been using has been screaming at me for my sodium levels (usually 2500-3000/day) and for a long time I was trying like mad to get my levels down. I really enjoy having miso soup for my afternoon snack, and now I find it's actually helping instead of hurting me.
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Old 12-09-2012, 01:25 PM   #30
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WOE: General LC then NK
Start Date: Feb 2012
Quote:
Originally Posted by drjlocarb View Post
We need to go back further, to the point where the fat is metabolized. Acids are produced at that point (in the production of ketones), and H+ are produced all along the way (breakdown of ketones). And again the metal ions are used to keep the Anion Gap in balance and therefore the ph.

And, yes,my belief is at the beginning, we are in a very, very mild DKA-like state as the body adjusts to the duel fuel sources. Insulin is gone and ketones are produced and our bodies have to get used to using ketones.

The whole point being....we need more salt. I find I need less as keto-adaptation occurs.

I over simplified it for the rest of the crowd and that is what through you off. Sorry.
I don't remember ever reading about 'anion gap'. Bizarre! I have to say it makes me uneasy thinking about it. Not sure why, except that it seems like you are trying to solve an equation with too many variables.

But, to the point you are making. Because our blood has a fair amount of BHB and AcAc, both of which are (1) acids and (2) negatively charged, you body has to balance (1) the pH of the blood and (2) the charge?

So would it actually do that by bumping up the sodium ion concentration by say, 3 mM, if your blood [BHB] is 3 mM? I guess that is a minor increase? (Looks like a normal figure is 135-145 mM.)

Anyway, very interesting. Thanks!
--
Phillip
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