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:

• How Too Much Salt May Lead To Organ Failure
• Vitamin D and Calcium: Too Much Of A Good Thing?

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):

Creatine-electrolyte supplementation improves repeated sprint cycling performance: a double-blind randomized control study

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!

Semaglutide for weight loss?

Semaglutide is the new kid on the weight-loss block, but it’s looking promising (with some caveats!).

Most popularly by brand names Ozempic and Wegovy, it was first trialled to help diabetics*, and is now sought-after by the rest of the population too. So far, only Wegovy is FDA-approved for weight loss. It contains more semaglutide than Ozempic, and was developed specifically for weight loss, rather than for diabetes.

*Specifically: diabetics with type 2 diabetes. Because it works by helping the pancreas to make insulin, it’s of no help whatsoever to T1D folks, sadly. If you’re T1D and reading this though, today’s book of the day is for you!

First things first: does it work as marketed for diabetes?

It does! At a cost: a very common side effect is gastrointestinal problems—same as for tirzepatide, which (like semaglutide) is a GLP-1 agonist, meaning it works the same way. Here’s how they measure up:

• Head-to-head study: Effects of subcutaneous tirzepatide versus placebo or semaglutide on pancreatic islet function and insulin sensitivity in adults with type 2 diabetes
• Head-to-head systematic review: Semaglutide for the treatment of type 2 Diabetes Mellitus: A systematic review and network meta-analysis of safety and efficacy outcomes

As you can see, both of them work wonders for pancreatic function and insulin sensitivity!

And, both of them were quite unpleasant for around 20% of participants:

❝Tirzepatide, oral and SC semaglutide has a favourable efficacy in treating T2DM. Gastrointestinal adverse events were highly recorded in tirzepatide, oral and SC semaglutide groups.❞

~ Zaazouee et al., 2022

What about for weight loss, if not diabetic?

It works just the same! With just the same likelihood of gastro-intestinal unpleasantries, though. There’s a very good study that was done with 1,961 overweight adults; here it is:

Once-Weekly Semaglutide in Adults with Overweight or Obesity

The most interesting things here are the positive results and the side effects:

❝The mean change in body weight from baseline to week 68 was −14.9% in the semaglutide group as compared with −2.4% with placebo, for an estimated treatment difference of −12.4 percentage points (95% confidence interval [CI], −13.4 to −11.5; P<0.001).❞

~ Wilding et al., 2021

In other words: if you take this, you’re almost certainly going to get something like 6x better weight loss results than doing the same thing without it.

❝Nausea and diarrhea were the most common adverse events with semaglutide; they were typically transient and mild-to-moderate in severity and subsided with time. More participants in the semaglutide group than in the placebo group discontinued treatment owing to gastrointestinal events (59 [4.5%] vs. 5 [0.8%])❞

~ ibid.

In other words: you have about a 3% chance of having unpleasant enough side effects that you don’t want to continue treatment (contrast this with the 20%ish chance of unpleasant side effects of any extent)!

Any other downsides we should know about?

If you stop taking it, weight regain is likely. For example, a participant in one of the above-mentioned studies who lost 22% of her body weight with the drug’s help, says:

❝Now that I am no longer taking the drug, unfortunately, my weight is returning to what it used to be. It felt effortless losing weight while on the trial, but now it has gone back to feeling like a constant battle with food. I hope that, if the drug can be approved for people like me, my [doctor] will be able to prescribe the drug for me in the future.❞

~ Jan, a trial participant at UCLH

Source: Gamechanger drug for treating obesity cuts body weight by 20% <- University College London Hospitals (NHS)

Is it injection-only, or is there an oral option?

An oral option exists, but (so far) is on the market only in the form of Rybelsus, another (slightly older) drug containing semaglutide, and it’s (so far) only FDA-approved for diabetes, not for weight loss. See:

A new era for oral peptides: SNAC and the development of oral semaglutide for the treatment of type 2 diabetes ← for the science

FDA approves first oral GLP-1 treatment for type 2 diabetes ← For the FDA statement

Where can I get these?

Availability and prescribing regulations vary by country (because the FDA’s authority stops at the US borders), but here is the website for each of them if you’d like to learn more / consider if they might help you:

Rybelsus / Ozempic / Wegovy