I read a lot of recommendations for electrolytes but found all of the explanations kind of vague, so I did 2 hours of digging (plus more research from Eli Tyre). This is what I found
What are electrolytes?
An electrolyte is a substance that produces an electrically conducting solution when dissolved in a polar solvent, such as water. When applied to humans and health, it typically refers to sodium (Na+), potassium (K+), calcium (Ca2+), magnesium (Mg2+), chloride (Cl−), and is used for nerve signals and maintaining the right osmotic pressure in cells.
Additionally, too much fluid can throw your electrolyte balance off, so if you’re following the advice to hydrate without taking electrolytes, you can make things worse.
What’s so bad about low electrolytes?
Your nerves will be worse at firing, leading to cramps, mental issues, and cardiac issues.
In extreme cases it can lead to spasms of the muscles in the throat (leading to difficulty breathing), stiffening and spasms of muscles (tetany), seizures, abnormal heart rhythms, and kidney failure (hypocalcemia, hypoatremia, hypokalemia). But you’re not going to let it get that far.
Not. Electrolytes are part of the standard routine in hospitals forCOVID-19andfevers in general.
Can I hurt myself with this?
Yes, but not easily. There is a level at which too much of any electrolyte is bad for you. My experience and the experience of many people I know is that you can tell by taste- electrolyte-enhanced water tastes amazing when you need them and unpleasantly salty when you don’t. Also barring certain specific problems like hypothyroidism, your body is pretty good at evening out your electrolytes as long as you give it the raw materials and time, so this is another reason to space out your fluid consumption.
The theory seems sound, what about the practice?
I looked for RCTs of electrolyte supplementation vs. not, but what I found was mostly studies of different types of rehydration therapies, always in children, and most for diarrhea induced imbalances rather than fever. The best I found was this meta-review showing isotonic IV fluid led to low sodium less often than low sodium IV fluid did
If you’re curious about the pediatric diarrhea studies...
The literature was not very forthcoming on this, and I’m not a great person to ask because I put salt in my water by default. My folk wisdom is to add it to your water that you should also be drinking to taste.
Thanks to Eli Tyre for help with the research for this comment.
AFAIK Pedialyte is a perfectly good solution for the problem of electrolytes, if maybe on the expensive side. I’ve heard more complaints about its flavor than the other options, but if you know you like it that’s not an issue. The liquid form is also bulky, so if it were me I’d get a powder or drops, but maybe you have lots of space in which case it doesn’t matter.
mostly studies of different types of rehydration therapies, always in children, and most for diarrhea induced imbalances rather than fever.
Any electrolyte losses due to having a fever for a few hours/days is not clinically significant which is why you can’t find relevant studies. The body is capable of coping with a bout of pyrexia.
Plain water is usually sufficient to maintain hydration during a a fever + a little salt if sweating a lot. (I have said this before but it was voted down out of view - too simple and practical?).
Taking electrolytes (within recommended dosage) isn’t going to hurt but it is not necessary for a fever.
I read a lot of recommendations for electrolytes but found all of the explanations kind of vague, so I did 2 hours of digging (plus more research from Eli Tyre). This is what I found
What are electrolytes?
An electrolyte is a substance that produces an electrically conducting solution when dissolved in a polar solvent, such as water. When applied to humans and health, it typically refers to sodium (Na+), potassium (K+), calcium (Ca2+), magnesium (Mg2+), chloride (Cl−), and is used for nerve signals and maintaining the right osmotic pressure in cells.
How does illness affect electrolytes?
Electrolytes are lost in sweat, including from fevers, environmental heat, and exercise. They can also be lost through diarrhea and vomiting- a big problem with bulimia.
Additionally, too much fluid can throw your electrolyte balance off, so if you’re following the advice to hydrate without taking electrolytes, you can make things worse.
What’s so bad about low electrolytes?
Your nerves will be worse at firing, leading to cramps, mental issues, and cardiac issues.
In extreme cases it can lead to spasms of the muscles in the throat (leading to difficulty breathing), stiffening and spasms of muscles (tetany), seizures, abnormal heart rhythms, and kidney failure (hypocalcemia, hypoatremia, hypokalemia). But you’re not going to let it get that far.
More speculatively, because calcium-based signalling is a key component in immune response activation, low calcium may weaken your immune system.
How speculative is this?
Not. Electrolytes are part of the standard routine in hospitals for COVID-19 and fevers in general.
Can I hurt myself with this?
Yes, but not easily. There is a level at which too much of any electrolyte is bad for you. My experience and the experience of many people I know is that you can tell by taste- electrolyte-enhanced water tastes amazing when you need them and unpleasantly salty when you don’t. Also barring certain specific problems like hypothyroidism, your body is pretty good at evening out your electrolytes as long as you give it the raw materials and time, so this is another reason to space out your fluid consumption.
The theory seems sound, what about the practice?
I looked for RCTs of electrolyte supplementation vs. not, but what I found was mostly studies of different types of rehydration therapies, always in children, and most for diarrhea induced imbalances rather than fever. The best I found was this meta-review showing isotonic IV fluid led to low sodium less often than low sodium IV fluid did
If you’re curious about the pediatric diarrhea studies...
Should you include zinc?
Glucose versus amylase resistant starch
Oral vs IV
How much do I need and when do I need it?
The literature was not very forthcoming on this, and I’m not a great person to ask because I put salt in my water by default. My folk wisdom is to add it to your water that you should also be drinking to taste.
Thanks to Eli Tyre for help with the research for this comment.
is something like pedialyte a reasonable OTC solution for electrolytes or would you suggest mixing out own concoctions?
AFAIK Pedialyte is a perfectly good solution for the problem of electrolytes, if maybe on the expensive side. I’ve heard more complaints about its flavor than the other options, but if you know you like it that’s not an issue. The liquid form is also bulky, so if it were me I’d get a powder or drops, but maybe you have lots of space in which case it doesn’t matter.
easy way is (per litre of water)
1 tsp nusalt or no-salt (potassium chloride)
1⁄2 tsp salt
1⁄8 tsp epsom salt (food grade) (it’s okay to eyeball small amounts of this, high therapeutic index)
6 tsp sugar
Any electrolyte losses due to having a fever for a few hours/days is not clinically significant which is why you can’t find relevant studies. The body is capable of coping with a bout of pyrexia.
published in 1938: ELECTROLYTE BALANCES DURING ARTIFICIAL FEVER WITH SPECIAL REFERENCE TO LOSS THROUGH THE SKIN
Plain water is usually sufficient to maintain hydration during a a fever + a little salt if sweating a lot. (I have said this before but it was voted down out of view - too simple and practical?).
Taking electrolytes (within recommended dosage) isn’t going to hurt but it is not necessary for a fever.