Are Electrolyte Supplements Worth It?
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When To Take Electrolytes (And When We Shouldn’t!)
Any sports nutrition outlet will sell electrolyte supplements. Sometimes in the form of sports drinks that claim to be more hydrating than water, or tablets that can be dissolved in water to make the same. How do they work, and should we be drinking them?
What are electrolytes?
They’re called “electrolytes” because they are ionized particles (so, they have a positive or negative electrical charge, depending on which kind of ion they are) that are usually combined in the form of salts.
The “first halves” of the salts include:
- Sodium
- Potassium
- Calcium
- Magnesium
The “second halves” of the salts include:
- Chloride
- Phosphate
- Bicarbonate
- Nitrate
It doesn’t matter too much which way they’re combined, provided we get what we need. Specifically, the body needs them in a careful balance. Too much or too little, and bad things will start happening to us.
If we live in a temperate climate with a moderate lifestyle and a balanced diet, and have healthy working kidneys, usually our kidneys will keep them all in balance.
Why might we need to supplement?
Firstly, of course, you might have a dietary deficiency. Magnesium deficiency in particular is very common in North America, as people simply do not eat as much greenery as they ideally would.
But, also, you might sweat out your electrolytes, in which case, you will need to replace them.
In particular, endurance training and High Intensity Interval Training are likely to prompt this.
However… Are you in a rush? Because if not, you might just want to recover more slowly:
❝Vigorous exercise and warm/hot temperatures induce sweat production, which loses both water and electrolytes. Both water and sodium need to be replaced to re-establish “normal” total body water (euhydration).
This replacement can be by normal eating and drinking practices if there is no urgency for recovery.
But if rapid recovery (<24 h) is desired or severe hypohydration (>5% body mass) is encountered, aggressive drinking of fluids and consuming electrolytes should be encouraged to facilitate recovery❞
Source: Fluid and electrolyte needs for training, competition, and recovery
Should we just supplement anyway, as a “catch-all” to be sure?
Probably not. In particular, it is easy to get too much sodium in one’s diet, let alone by supplementation.And, oversupplementation of calcium is very common, and causes its own health problems. See:
To look directly to the science on this one, we see a general consensus amongst research reviews: “this is complicated and can go either way depending on what else people are doing”:
- Trace minerals intake: risks and benefits for cardiovascular health
- Electrolyte minerals intake and cardiovascular health
Well, that’s not helpful. Any clearer pointers?
Yes! Researchers Latzka and Mountain put together a very practical list of tips. Rather, they didn’t put it as a list, but the following bullet points are information extracted directly from their abstract, though we’ve also linked the full article below:
- It is recommended that individuals begin exercise when adequately hydrated.
- This can be facilitated by drinking 400 mL to 600 mL of fluid 2 hours before beginning exercise and drinking sufficient fluid during exercise to prevent dehydration from exceeding 2% body weight.
- A practical recommendation is to drink small amounts of fluid (150-300 mL) every 15 to 20 minutes of exercise, varying the volume depending on sweating rate.
- During exercise lasting less than 90 minutes, water alone is sufficient for fluid replacement
- During prolonged exercise lasting longer than 90 minutes, commercially available carbohydrate electrolyte beverages should be considered to provide an exogenous carbohydrate source to sustain carbohydrate oxidation and endurance performance.
- Electrolyte supplementation is generally not necessary because dietary intake is adequate to offset electrolytes lost in sweat and urine; however, during initial days of hot-weather training or when meals are not calorically adequate, supplemental salt intake may be indicated to sustain sodium balance.
Source: Water and electrolyte requirements for exercise
Bonus tip:
We’ve talked before about the specific age-related benefits of creatine supplementation, but if you’re doing endurance training or HIIT, you might also want to consider a creatine-electrolyte combination sports drink (even if you make it yourself):
Where can I get electrolyte supplements?
They’re easy to find in any sports nutrition store, or you can buy them online; here’s an example product on Amazon for your convenience
You can also opt for natural and/or homemade electrolyte drinks:
Healthline | 8 Healthy Drinks Rich in Electrolytes
Enjoy!
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Women’s Strength Training Anatomy – by Frédéric Delavier
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Fitness guides for women tend to differ from fitness guides for men, in the wrong ways:
“Do some squats and jumping jacks, and here’s a exercise for your abs; you too can look like our model here”
In those other books we are left wonder: where’s the underlying information? Where are the explanations that aren’t condescending? Where, dare we ask, is the understanding that a woman might ever lift something heavier than a baby?
Delavier, in contrast, delivers. With 130 pages of detailed anatomical diagrams for all kinds of exercises to genuinely craft your body the way you want it for you. Bigger here, smaller there, functional strength, you decide.
And rest assured: no, you won’t end up looking like Arnold Schwarzenegger unless you not only eat like him, but also have his genes (and possibly his, uh, “supplement” regime).
What you will get though, is a deep understanding of how to tailor your exercise routine to actually deliver the personalized and specific results that you want.
Pick Up Today’s Book on Amazon!
Not looking for a feminine figure? You may like the same author’s book for men:
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Which Tea Is Best, By Science?
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What kind of tea is best for the health?
It’s popular knowledge that tea is a healthful drink, and green tea tends to get the popular credit for “healthiest”.
Is that accurate? It depends on what you’re looking for…
Black
Its strong flavor packs in lots of polyphenols, often more than other kinds of tea. This brings some great benefits:
As well as effects beyond the obvious:
…and its cardioprotective benefits aren’t just about lowering blood pressure; it improves triglyceride levels as well as improving the LDL to HDL ratio:
The effect of black tea on risk factors of cardiovascular disease in a normal population
Finally (we could say more, but we only have so much room), black tea usually has the highest caffeine content, compared to other teas.
That’s good or bad depending on your own physiology and preferences, of course.
White
White tea hasn’t been processed as much as other kinds, so this one keeps more of its antioxidants, but that doesn’t mean it comes out on top; in this study of 30 teas, the white tea options ranked in the mid-to-low 20s:
White tea is also unusual in its relatively high fluoride content, which is consider a good thing:
White tea: A contributor to oral health
In case you were wondering about the safety of that…
Water Fluoridation: Is It Safe, And How Much Is Too Much?
Green
Green tea ranks almost as high as black tea, on average, for polyphenols.
Its antioxidant powers have given it a considerable anti-cancer potential, too:
- Green tea consumption and breast cancer risk or recurrence: a meta-analysis
- Green tea consumption and prostate cancer risk: a prospective study
…and many others, but you get the idea. Notably:
Green Tea Catechins: Nature’s Way of Preventing and Treating Cancer
…or to expand on that:
About green tea’s much higher levels of catechins, they also have a neuroprotective effect:
Green tea of course is also a great source of l-theanine, which we could write a whole main feature about, and we did:
Red
Also called “rooibos” or (literally translated from Afrikaans to English) “redbush”, it’s quite special in that despite being a “true tea” botanically and containing many of the same phytochemicals as the other teas, it has no caffeine.
There’s not nearly as much research for this as green tea, but here’s one that stood out:
However, in the search for the perfect cup of tea (in terms of phytochemical content), another set of researchers found:
❝The optimal cup was identified as sample steeped for 10 min or longer. The rooibos consumers did not consume it sufficiently, nor steeped it long enough. ❞
Read in full: Rooibos herbal tea: an optimal cup and its consumers
Bottom line
Black, white, green, and red teas all have their benefits, and ultimately the best one for you will probably be the one you enjoy drinking, and thus drink more of.
If trying to choose though, we offer the following summary:
- 🖤 Black tea: best for total beneficial phytochemicals
- 🤍 White tea:best for your oral health
- 💚 Green tea: best for your brain
- ❤️ Red tea: best if you want naturally caffeine-free
Enjoy!
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Younger Next Year – by Chris Crowley & Dr. Henry Lodge
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Is it diet and exercise? Well, of course that’s a component. Specific kinds of exercise, too. But, as usual when we feature a book, there’s more:
In this case, strong throughout is the notion of life being a marathon not a sprint—and training for it accordingly.
Doing the things now that you’ll really wish you’d started doing sooner, and finding ways to build them into daily life.
Not just that, though! The authors take a holistic approach to life and health, and thus also cover work life, social life, and so forth. Now, you may be thinking “I’m already in the 80 and beyond category; I don’t work” and well, the authors advise that you do indeed work. You don’t have to revamp your career, but science strongly suggests that people who work longer, live longer.
Of course that doesn’t have to mean going full-throttle like a 20-year-old determined to make their mark on the world (you can if you want, though). It could be volunteering for a charity, or otherwise just finding a socially-engaging “work-like” activity that gives you purpose.
About the blend of motivational pep talk and science—this book is heavily weighted towards the former. It has, however, enough science to keep it on the right track throughout. Hence the two authors! Crowley for motivational pep, and Dr. Lodge for the science (with extra input from brain surgeon Dr. Hamilton, too).
Bottom line: if you want to feel the most prepared possible for the coming years and decades, this is a great book that covers a lot of bases.
Click here to check out “Younger Next Year” and get de-aging!
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Is Chiropractic All It’s Cracked Up To Be?
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Is Chiropractic All It’s Cracked Up To Be?
Yesterday, we asked you for your opinions on chiropractic medicine, and got the above-depicted, below-described set of results:
- 38% of respondents said it keeps us healthy, and everyone should do it as maintenance
- 33% of respondents said it can correct some short-term skeletal issues, but that’s all
- 16% of respondents said that it’s a dangerous pseudoscience and can cause serious harm
- 13% of respondents said that it’s mostly just a combination of placebo and endorphins
Respondents also shared personal horror stories of harm done, personal success stories of things cured, and personal “it didn’t seem to do anything for me” stories.
What does the science say?
It’s a dangerous pseudoscience and can cause harm: True or False?
False and True, respectively.
That is to say, chiropractic in its simplest form that makes the fewest claims, is not a pseudoscience. If somebody physically moves your bones around, your bones will be physically moved. If your bones were indeed misaligned, and the chiropractor is knowledgeable and competent, this will be for the better.
However, like any form of medicine, it can also cause harm; in chiropractic’s case, because it more often than not involves manipulation of the spine, this can be very serious:
❝Twenty six fatalities were published in the medical literature and many more might have remained unpublished.
The reported pathology usually was a vascular accident involving the dissection of a vertebral artery.
Conclusion: Numerous deaths have occurred after chiropractic manipulations. The risks of this treatment by far outweigh its benefit.❞
Source: Deaths after chiropractic: a review of published cases
From this, we might note two things:
- The abstract doesn’t note the initial sample size; we would rather have seen this information expressed as a percentage. Unfortunately, the full paper is not accessible, and nor are many of the papers it cites.
- Having a vertebral artery fatally dissected is nevertheless not an inviting prospect, and is certainly a very reasonable cause for concern.
It’s mostly just a combination of placebo and endorphins: True or False?
True or False, depending on what you went in for:
- If you went in for a regular maintenance clunk-and-click, then yes, you will get your clunk-and-click and feel better for it because you had a ritualized* experience and endorphins were released.
- If you went in for something that was actually wrong with your skeletal alignment, to get it corrected, and this correction was within your chiropractor’s competence, then yes, you will feel better because a genuine fault was corrected.
*this is not implying any mysticism, by the way. Rather it means simply that placebo effect is strongest when there is a ritual associated with it. In this case it means going to the place, sitting in a pleasant waiting room, being called in, removing your shoes and perhaps some other clothes, getting the full attention of a confident and assured person for a while, this sort of thing.
With regard to its use to combat specifically spinal pain (i.e., perhaps the most obvious thing to treat by chiropractic spinal manipulation), evidence is slightly in favor, but remains unclear:
❝Due to the low quality of evidence, the efficacy of chiropractic spinal manipulation compared with a placebo or no treatment remains uncertain. ❞
Source: Clinical Effectiveness and Efficacy of Chiropractic Spinal Manipulation for Spine Pain
It can correct some short-term skeletal issues, but that’s all: True or False?
Probably True.
Why “probably”? The effectiveness of chiropractic treatment for things other than short-term skeletal issues has barely been studied. From this, we may wish to keep an open mind, while also noting that it can hardly claim to be evidence-based—and it’s had hundreds of years to accumulate evidence. In all likelihood, publication bias has meant that studies that were conducted and found inconclusive or negative results were simply not published—but that’s just a hypothesis on our part.
In the case of using chiropractic to treat migraines, a very-related-but-not-skeletal issue, researchers found:
❝Pre-specified feasibility criteria were not met, but deficits were remediable. Preliminary data support a definitive trial of MCC+ for migraine.❞
Translating this: “it didn’t score as well as we hoped, but we can do better. We got some positive results, and would like to do another, bigger, better trial; please fund it”
Source: Multimodal chiropractic care for migraine: A pilot randomized controlled trial
Meanwhile, chiropractors’ claims for very unrelated things have been harshly criticized by the scientific community, for example:
Misinformation, chiropractic, and the COVID-19 pandemic
About that “short-term” aspect, one of our subscribers put it quite succinctly:
❝Often a skeletal correction is required for initial alignment but the surrounding fascia and muscles also need to be treated to mobilize the joint and release deep tissue damage surrounding the area. In combination with other therapies chiropractic support is beneficial.❞
This is, by the way, very consistent with what was said in the very clinically-dense book we reviewed yesterday, which has a chapter on the short-term benefits and limitations of chiropractic.
A truism that holds for many musculoskeletal healthcare matters, holds true here too:
❝In a battle between muscle and bone, muscle will always win❞
In other words…
Chiropractic can definitely help put misaligned bones back where they should be. However, once they’re there, if the cause of their misalignment is not treated, they will just re-misalign themselves shortly after you walking out of your session.
This is great for chiropractors, if it keeps you coming back for endless appointments, but it does little for your body beyond give you a brief respite.
So, by all means go to a chiropractor if you feel so inclined (and you do not fear accidental arterial dissection etc), but please also consider going to a physiotherapist, and potentially other medical professions depending on what seems to be wrong, to see about addressing the underlying cause.
Take care!
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How To Clean Your Brain (Glymphatic Health Primer)
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That’s not a typo! The name “glymphatic system” was coined by the Danish neuroscientist Dr. Maiken Nedergaard, and is a nod to its use of glial cells to do a similar job to that of the peripheral lymphatic system—but this time, in the CNS. Today, we have Dr. Jin Sung to tell us more:
Brainwashing (but not like that)
The glymphatic system may sound like a boring job, but so does “sanitation worker” in a city—yet the city would grind to a messy halt very very quickly without them. Same goes for your brain.
Diseases that are prevalent when this doesn’t happen the way it should include Alzheimer’s (beta-amyloid clearance) and Parkinson’s (alpha-synuclein clearance) amongst others.
Things Dr. Sung recommends for optimal glymphatic function include: sleep (7–9 hours), exercise (30–45 minutes daily), hydration (half your bodyweight in pounds, in ounces, so if your body weighs 150 lbs, that means 75 oz of water), good posture (including the use of good ergonomics, e.g. computer monitor at right height, car seat correct, etc), stress reduction (reduces inflammatory cytokines), getting enough omega-3 (the brain needs certain fats to work properly, and this is the one most likely to see a deficit), vagal stimulation (methods include humming, gargling, and gagging—please note we said vagal stimulation; easy to misread at a glance!), LED light therapy, and fasting (intermittent or prolonged).
For more on each of these, including specific tips, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
- Ask Not What Your Lymphatic System Can Do For You…
- The Vagus Nerve (And How You Can Make Use Of It)
- Casting Yourself In A Healthier Light
- Intermittent Fasting: How Does It Work?
Take care!
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Oral retinoids can harm unborn babies. But many women taking them for acne may not be using contraception
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Oral retinoids are a type of medicine used to treat severe acne. They’re sold under the brand name Roaccutane, among others.
While oral retinoids are very effective, they can have harmful effects if taken during pregnancy. These medicines can cause miscarriages and major congenital abnormalities (harm to unborn babies) including in the brain, heart and face. At least 30% of children exposed to oral retinoids in pregnancy have severe congenital abnormalities.
Neurodevelopmental problems (in learning, reading, social skills, memory and attention) are also common.
Because of these risks, the Australasian College of Dermatologists advises oral retinoids should not be prescribed a month before or during pregnancy under any circumstances. Dermatologists are instructed to make sure a woman isn’t pregnant before starting this treatment, and discuss the risks with women of childbearing age.
But despite this, and warnings on the medicines’ packaging, pregnancies exposed to oral retinoids continue to be reported in Australia and around the world.
In a study published this month, we wanted to find out what proportion of Australian women of reproductive age were taking oral retinoids, and how many of these women were using contraception.
Our results suggest a high proportion of women are not using effective contraception while on these drugs, indicating Australia needs a strategy to reduce the risk oral retinoids pose to unborn babies.
Contraception options
Using birth control to avoid pregnancy during oral retinoid treatment is essential for women who are sexually active. Some contraception methods, however, are more reliable than others.
Long-acting-reversible contraceptives include intrauterine devices (IUDs) inserted into the womb (such as Mirena, Kyleena, or copper devices) and implants under the skin (such as Implanon). These “set and forget” methods are more than 99% effective.
Oral retinoids taken during pregnancy can cause complications in babies. Gorodenkoff/Shutterstock The effectiveness of oral contraceptive pills among “perfect” users (following the directions, with no missed or late pills) is similarly more than 99%. But in typical users, this can fall as low as 91%.
Condoms, when used as the sole method of contraception, have higher failure rates. Their effectiveness can be as low as 82% in typical users.
Oral retinoid use over time
For our study, we analysed medicine dispensing data among women aged 15–44 from Australia’s Pharmaceutical Benefit Scheme (PBS) between 2013 and 2021.
We found the dispensing rate for oral retinoids doubled from one in every 71 women in 2013, to one in every 36 in 2021. The increase occurred across all ages but was most notable in young women.
Most women were not dispensed contraception at the same time they were using the oral retinoids. To be sure we weren’t missing any contraception that was supplied before the oral retinoids, we looked back in the data. For example, for an IUD that lasts five years, we looked back five years before the oral retinoid prescription.
Our analysis showed only one in four women provided oral retinoids were dispensed contraception simultaneously. This was even lower for 15- to 19-year-olds, where only about one in eight women who filled a prescription for oral retinoids were dispensed contraception.
A recent study found 43% of Australian year 10 and 69% of year 12 students are sexually active, so we can’t assume this younger age group largely had no need for contraception.
One limitation of our study is that it may underestimate contraception coverage, because not all contraceptive options are listed on the PBS. Those options not listed include male and female sterilisation, contraceptive rings, condoms, copper IUDs, and certain oral contraceptive pills.
But even if we presume some of the women in our study were using forms of contraception not listed on the PBS, we’re still left with a significant portion without evidence of contraception.
What are the solutions?
Other countries such as the United States and countries in Europe have pregnancy prevention programs for women taking oral retinoids. These programs include contraception requirements, risk acknowledgement forms and regular pregnancy tests. Despite these programs, unintended pregnancies among women using oral retinoids still occur in these countries.
But Australia has no official strategy for preventing pregnancies exposed to oral retinoids. Currently oral retinoids are prescribed by dermatologists, and most contraception is prescribed by GPs. Women therefore need to see two different doctors, which adds costs and burden.
Preventing pregnancy during oral retinoid treatment is essential. Krakenimages.com/Shutterstock Rather than a single fix, there are likely to be multiple solutions to this problem. Some dermatologists may not feel confident discussing sex or contraception with patients, so educating dermatologists about contraception is important. Education for women is equally important.
A clinical pathway is needed for reproductive-aged women to obtain both oral retinoids and effective contraception. Options may include GPs prescribing both medications, or dermatologists only prescribing oral retinoids when there’s a contraception plan already in place.
Some women may initially not be sexually active, but change their sexual behaviour while taking oral retinoids, so constant reminders and education are likely to be required.
Further, contraception access needs to be improved in Australia. Teenagers and young women in particular face barriers to accessing contraception, including costs, stigma and lack of knowledge.
Many doctors and women are doing the right thing. But every woman should have an effective contraception plan in place well before starting oral retinoids. Only if this happens can we reduce unintended pregnancies among women taking these medicines, and thereby reduce the risk of harm to unborn babies.
Dr Laura Gerhardy from NSW Health contributed to this article.
Antonia Shand, Research Fellow, Obstetrician, University of Sydney and Natasha Nassar, Professor of Paediatric and Perinatal Epidemiology and Chair in Translational Childhood Medicine, University of Sydney
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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