Tag Archive for: sodium

Paula’s Adventure: What Happened and What Can We Learn?

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Before we explore the cause and what lessons we can learn, Paula and I want to thank you for your support and prayers for us. I know that some of you were very concerned, especially because of the way I presented it one piece at a time. I’m sorry. It just seemed logical to me to keep each piece contained and keep the reading to less than two minutes for the Tuesday and Thursday Memos. Next time, and I really hope there’s no next time, I’ll let you know the outcome and then tell you the story.

What Caused the Sodium to Drop to Dangerous Levels?

The physician in charge thought the cause was a diuretic Paula had been taking for edema (fluid retention) since her 20s. He concluded that she became over-sensitive to it and it began to eliminate too much sodium. That leads to hyponatremia, low sodium levels. That happens to runners when they drink only water while training in hot weather; that’s why sports drinks have electrolytes, and why sports drinks (or Pedialyte for kids) are a good addition to your diet when you’re very ill and vomiting or not eating.

I can’t say for certain—it’s not my area—but I think factors involved with that chronic cough, the OTC drugs we used, and not eating and not drinking enough contributed to the problem. The altering of our taste buds happened to both Paula and me; nothing tasted normal, let alone good. Lower intake of fluids and food also lowered sodium intake. As for the OTC drugs, guaifenesin found in Mucinex helps reduce coughing, but it can also contribute to dizziness and drowsiness. Then we add the benzocaine and menthol in the throat lozenges and the acetaminophen, dextromethorphan, and doxylamine succinate in Nyquil, and who knows what all that adds up to when combined with everyday meds? While the primary cause was the diuretic, the other factors probably helped bring it to crisis level.

What Can We Learn From Paula’s Adventure?

The Rule and Some Additions
You’ve heard me say, “When in doubt, check it out!” Do it immediately if you think it’s related to your heart, or after two weeks if it’s a chronic condition that doesn’t go away. Paula saw the doctor after 10 days, and I happened to have my physical about the same time.

Here’s the addition: do what Paula did. Write out every symptom that you noticed since it began, plus the medications you take, the OTC medications you may have added, and any supplements you take. If you’re experiencing anything, write it down. If Paula hadn’t written about her blurry vision and hearing sounds that weren’t there, they may not have sent her to the ER. She could have had something more serious happen such as a seizure. Write everything down and call the doctor’s office!

Review All Medications and Supplements at Your Annual Physical
Once every year or so, you should review your medications with your physician to see if there are any known interactions. Maybe a symptom is related to too much or too little of something you’re taking. That’s why a yearly physical with a thorough blood test is important for everyone, but especially as we get older. Another factor we discovered from Paula’s many blood tests was that her thyroid medication was working too well, so the doctor reduced her dosage.

It may be that you should consult a pharmacist. They deal with a wider variety of drugs, and they hear first about whether there are known interactions. Remember, there’s no research on interactions between medications or supplements. Physicians and pharmacists report it to the adverse effects hotline and it gets added to the list, but I’m not sure how widely that info is spread.

The Bottom Line

Paula wants to say how grateful she is for the exceptional care she received at Blodgett Hospital; we feel very fortunate to have excellent medical care here in West Michigan. She’s still recovering, and her energy levels are lower than normal.

I hope her adventure helps you understand that our bodies are complicated. Under stress such as that severe cough and cold, our bodies may respond differently than we expect. Take what we’ve learned and apply it to your life. That would make the experience worth it.

What are you prepared to do today?

        Dr. Chet

P.S. The next Dr. Chet Nutrition in the 21st Century is going to be in Atlanta on March 22. More details tomorrow.

Paula’s Adventure: ER and ICU

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We arrived at the ER and Paula was checked in on Tuesday morning, February 4. The cough was obvious as well as the difficulty breathing. They took her vitals, and her blood pressure was very high. Most likely because of the hallucinations, they did a CAT scan of her head, but there were no apparent issues. Also, no cats (that’s a family joke from Paula’s dad). They also took an x-ray of her lungs: mostly clear but a little sign of pneumonia in a lower lung. That seemed about all.

Then the results of her blood tests came back, and yikes. Normal sodium levels are 135-145 mEq/L; hers was 105 mEq/L. Her potassium was also below the normal range. She wasn’t going anywhere because she was in danger of having seizures, and our doctor said she’s surprised she hadn’t had one.

They immediately began to replace sodium and potassium in the ER before her admission. The trick is that it must be done slowly; if it went up too fast, she would also have been in danger of seizures and heart problems. She was transferred to a room in the ICU, because she needed constant monitoring, frequent blood draw—every two hours around the clock for the first few days—and they needed to be sure she wasn’t contagious because of the cough that was still present. (She was not.) I asked about her sodium level after each blood draw, and it consistently went up over the next five days. Once it hit 135 mEq/L, she was ready to be released.

My observation was that she was vastly improved by the day after her admission. However, that didn’t mean she was out of danger and she wasn’t going anywhere until she hit that 135 number. By that time, I had to leave for a speaking gig in Nashville. She was organizing the room, so I knew she was close to normal; still a little shaky but normal. She was on a heart monitor the whole time, and as she was organizing the room, a nurse came in and said, “What are you doing? Your heart rate’s up.” He suggested she quit futzing and sit down for a while.

She was released and brought home on Saturday by one of our pretend daughters, and I got home a few hours later.

What caused the sodium and potassium loss? More than that, what can we learn from Paula’s adventure? I’ll let you know on Saturday. I’ll also tell you when and where my next Nutrition in the 21st Century Seminar will take place.

What are you prepared to do today?

        Dr. Chet

Readers Report on MSG

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Of the dozens of responses to the Memos on MSG, most readers reported the types of symptoms commonly attributed to MSG along with some interesting physical responses. Several people responded that they had always heard to avoid MSG, so they have. I thought one particular comment was interesting: upon looking at the foods that contain MSG, especially snack food, he wouldn’t eat them anyway so it was never an issue for him.

Many people get a true allergic response within minutes of ingesting MSG. This is the list of reactions: swelling, hives, itching, redness, headache, migraines, coughing, palpitations, shortness of breath, numbness around the mouth and cheeks, joint stiffness, pain in the arms, sleepiness, stupor, trouble sleeping, vomiting, and diarrhea. If they avoid MSG, they don’t have the symptoms.

There were a couple of unusual reactions I have to mention. One individual found that if he has MSG in food for dinner, he has vivid dreams, usually involving someone chasing him around or being in a struggle situation. He never gets them otherwise, so he avoids MSG.

Another person said when he eats food with MSG, he craves chocolate.

The common theme was that everyone used trial and error to find the culprit. Here’s your challenge, even if you’ve never attributed a problem to MSG: if you get some of the symptoms on the list, examine the content of the foods you eat. Can you narrow down a suspect for your symptoms? The goal is know yourself and the way to do that is to pay attention.

What are you prepared to do today?

        Dr. Chet

MSG Is Safe, But Be Wary

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The controversy regarding MSG certainly won’t end with this Memo, but I want you to know what the research says so you can make an informed decision. There’s no question that some people have sensitivities to certain food additives, and I’m not diminishing that response in any way. My point in doing this series of Memos was to dispel myths that have grown around some food additives such as MSG.

Why was the early research wrong? The Chinese Restaurant Syndrome grew from a single physician who described how he felt after eating Chinese food. More case studies were published, then small trials that seemed to support the observation. As time went on, trials with better controls over subjects and their reactions were done to test those responses attributed to MSG.

Regarding the excitotoxic brain damage, for the most part, that research injected glutamate (and not MSG) directly under the skin or directly into the digestive system. Because of its importance in so many chemical reactions, glutamate is tightly regulated and does not cross the blood-brain barrier. In other words, the research could have been done better. When it was, the results of those studies could not be duplicated.

Where does that leave you? Reading labels, I hope. I just checked the label of smoked ham: no MSG but there were at least three different sources of sodium. Same was true for beef jerky. That contributes to the high sodium intake we all have if we eat those foods.

You can’t really get away from MSG anyway; it’s naturally found in so many foods such as meats, cheeses, and even in tomatoes. There could be a benefit to using MSG: it may lower your overall sodium intake because it takes a lot less MSG to give the umami flavor than salt does.

But be wary. Umami flavor can become addictive. You know those chips I like so much? Some have MSG added, and they’re tough to eat in reasonable amounts. It may be best to avoid them altogether unless you can control the quantity you eat. That was why MSG was thought to cause weight gain; by itself, it doesn’t but it can cause a person to overeat, and that for sure will increase body weight.

Like anything else, unless you’re allergic, MSG can be a part of a reasonable diet to add flavor to food. If it helps make people want to eat broccoli and cabbage, I’m all for that because the benefits of the vegetables far outweigh any harm from the sodium.

Don’t forget to let me know if you’ve ever had a negative reaction to MSG. I’ll give the results next week.

What are you prepared to do today?

        Dr. Chet

References:
1. Questions and Answers about MSGhttp://bit.ly/32tvELS.
2. N Engl J Med 1968; 278:796.
3. Science. 1969 May 9;164(3880):719-21.

Early Research on MSG

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People have been ranting against MSG for decades, but I never paid attention until I read a study on a group of subjects who said they had a negative response to eating Asian foods. The subjects were tested under four scenarios consecutively, dependent on their response to the prior test results. The study demonstrated that when exposed to massive amounts of MSG versus a placebo, there were no consistent responses from this sensitive group of subjects. That’s meaningful because it challenged common knowledge.

That common knowledge began with a letter to the New England Journal of Medicine by a physician after reporting symptoms he felt after eating a meal of Asian foods; it wasn’t research, just a personal anecdote. At the same time, a researcher from Washington University in St. Louis began a series of studies on glutamate and other protein precursors that demonstrated the excitotoxicity affects on brain tissue; excitotoxicity (ex-SIGHT-o-tox-ISS-i-ty) refers to nerve cells being damaged or killed by excessive stimulation by the neurotransmitter glutamate. That was when the bulk of the negative research on MSG drew attention. However, over a period of years, other researchers attempted to duplicate those studies with unsuccessful results.

Where does that leave us? Other than a variety of conspiracy theories, MSG doesn’t seem to have the negative impact that has been attributed to it. I’ll finish this up on Saturday but my original question still stands: if you feel you respond negatively to MSG, reply to this email and I’ll let you know the results next week.

What are you prepared to do today?

        Dr. Chet

References:
1. N Engl J Med 1968; 278:796.
2. Science. 1969 May 9;164(3880):719-21.

A Closer Look at Monosodium Glutamate

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People these days love salty, and as I’ve said before many times, I especially love salty: nuts, chips of any kind, cured meats such as ham. I believe if bacon weren’t salty, it wouldn’t be as popular as it is. Mix salt with amino acids, especially glutamine, and it creates a taste called umami. It’s an almost irresistible flavor that some people, if not most, can’t stop eating.

Now what if I told you that monosodium glutamate (MSG) had been added to those specific foods to give it that umami taste? (It hasn’t, so don’t throw out the bacon or jerky just yet.) What would you think then? You might not be so enamored with those foods because MSG has been linked to headaches and brain dysfunctions. Some people attribute symptoms of allergic reactions to MSG that include breathing issues, the aforementioned headaches, and many other neurological-type issues.

Would you believe that MSG probably doesn’t cause those symptoms in most people? That the “research” showing that MSG is bad was poorly done, and to some degree, wasn’t even really research? For sure, you don’t want to miss Thursday’s Memo. Until then, let me know if you’ve responded negatively to MSG by replying to this Memo.

What are you prepared to do today?

        Dr. Chet

Reference: Questions and Answers about MSG http://bit.ly/32tvELS.

What Happens if You Give Up Salt?

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The next category of foods that you could give up for Lent is salt and sodium. Why do I mention both? Because they’re not exactly the same thing. Salt is sodium-chloride, a one to one proportion of sodium and chloride; sodium is just sodium. The typical American takes in over three grams or 3,000 mg of sodium per day. The upper limit is 2,300 mg and the goal is 1,500 mg. In past centuries, packing a food in salt was one way to preserve it, but with today’s refrigeration systems, we don’t need salt as a preservative. We just like it.

Where do we find sodium? Salt is added to all types of chips, nuts, processed meats, and deep-fried foods. But sodium is also added to many types of prepared foods. With the emphasis on reducing fat and carbohydrates, the flavor is often enhanced with sodium.

What could you expect to happen if you reduced your salt and sodium intake? You would probably lose some fluids. You body must keep sodium in a specific ionic balance, and reducing sodium would reduce the need for additional fluid. That could result in the reduction of blood pressure, something almost everyone could benefit from. That eases the strain on the heart, which won’t have to pump as hard because the resistance would not be as great.

As I’ve confessed before, I’m a salt-aholic so I’m going to work on reducing my sodium intake—no salty crunchy chips or roasted nuts, and no added salt to anything. I’ll also limit my intake of processed meats such as ham and bacon. We’ve become used to salt and sodium and it’s jaded our taste buds. No substitutions for this one. Time to retrain our taste.

What are you prepared to do today?

Dr. Chet

 

Sports Nutrition During Your Workout

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There’s probably more research on what sports nutrition products to use during workouts than any other area. The critical factor is to maintain fluid balance while working out; water is an essential part of these products but that’s not all.

The critical factor is to keep the brain, the nervous system, and the muscles all functioning during workouts; the longer the activity, the more important fluids become. We lose fluids readily as we work out. Part of that is our cooling mechanism, but another is a by-product of making energy using oxygen. Whether you burn carbohydrates or . . .

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Heat, Water, and Sports Drinks

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While I was in Austin doing a seminar this past weekend, I posted a thought on Facebook about drinking fluids when it’s hot. And it was hot in Austin; the temperature topped out at 100 degrees. It’s also been hot in Grand Rapids with temperatures hitting the 90s with some humidity to make it even worse. If you’re going to work outside in that type of heat and humidity, you have to drink fluids.

Water is important but when you sweat, you lose sodium and potassium as well. You should alternate four ounces of water with four . . .

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The Bottom Line on MSG

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When it comes to MSG, most people have their minds made up, and they don’t want anyone to create doubts about what they believe. That’s fine. If you’re one of them, read this anyway because I think you’ll read some things you won’t read anywhere else.

Let’s begin with the Letter to the Editor (1); there’s no research to support his opinion. In reality, it was more of an appeal to find out why this might happen after a meal in a Chinese restaurant. The symptoms were numbness of the muscles, generalized weakness . . .

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