Hot Topic: Do You Need Electrolyte Replacements?
Amid a record-hot summer, experts sort fact from myth and explain who needs a refill on electrolytes, and under what conditions
This article is part of a Wise & Well Special Report: Extreme Heat and Human Health.
If you believe the marketing around sports drinks and energy drinks, you’d think you’re dangerously low in electrolytes, particularly during the record-setting heat of a summer like this one.
Don’t believe the hype. Do aim to drink plenty of water and eat well, experts say.
Unless you are a long-distance runner or have certain illnesses, electrolyte replacement is likely to be the least of your worries on a scorching summer day.
“For a generally healthy individual, I do not recommend electrolyte replacement beverages or supplements,” said Cory Zenner, RD, a dietitian with the University of Washington School of Medicine’s healthcare system in Seattle. “You can get all you need from a well-balanced diet including a variety of fruits and vegetables, whole grains, and lean protein sources.”
Your body’s signaling system
Electrolytes are minerals your body uses to conduct electrical charges for such important tasks as thinking clearly or firing your muscles. Run short on electrolytes and you may experience confusion, headaches, fatigue or cramps. In worse cases, symptoms range from vomiting to loss of muscle control to heart arrhythmias.
Sodium, chloride, potassium, and magnesium are the most common electrolytes needed for good bodily function, and which are easiest to lose when we’re taxed by heat and effort.
But unless you’re an endurance athlete, or you work outside in the heat for an extended period, or you have a specific disease or take certain medications, you can get plenty of these minerals through food.
Electrolyte replacement can be useful during an illness that involves frequent vomiting or diarrhea, Zenner said. “You lose a lot of your electrolytes quite rapidly through the gastrointestinal tract when sick with a stomach bug and these drinks can help you stay hydrated if you’re having trouble keeping solid food down.”
Meanwhile, electrolyte replacements can be risky for some people.
“If you have any organ dysfunction such as chronic kidney disease or congestive heart failure these supplemental nutrients should be avoided,” Zenner told me. “When in doubt always ask to work with a registered dietitian or ask your doctor about any particular nutrients of concern for your condition.”
For most people on most days, here’s the bottom line:
“As long as you are eating at regular intervals throughout the day, focus simply on staying hydrated when you are out in the heat by assuring you are getting enough water intake,” said Salil Bhandari, MD, an emergency medicine physician with UTHealth Houston and Memorial Hermann.
When to consider electrolytes
For endurance athletes, and especially when working out in the heat, electrolyte replacement becomes important. The focus should be primarily on salt.
“When you sweat you lose both water and salt, which is composed of sodium and chloride,” Bhandari explained in an email. “If you are losing water and salt but only replacing water then the concentration of sodium in your body will decrease.”
If you lose too much salt, your blood becomes diluted, reducing the ability of cells to send and receive the vital electrical signals that keep you thinking and moving.
The need for electrolyte replacement kicks in after about an hour of vigorous effort, or less than an hour in intense heat, the experts say. Anything shorter, stick with water. The hour mark is also roughly when endurance athletes should be thinking about taking in carbohydrates. Sports drinks and gel packs are a common solution. They typically contain sugar in various forms and may or may not also include one or more of the important electrolytes. Some have caffeine, too.
Nobody needs these products, nor their much-hyped cousins, energy drinks, to get through a normal day.
“Many sports drinks have great electrolytes but also contain a lot of sugar that can make someone nauseated,” Bhandari said. “If you plan to use a sports drink, then diluting it with water in a 1:1 ratio is a better way to consume the drink.”
As a runner competing in long, sometimes hot trail races, I need the carbs and the electrolytes during competition and on long training runs. I’ve learned what works for me, and to save money I make my own drink for runs that will last more than an hour: A mix of 12 ounces of apple juice for the carbs with ¼-teaspoon of low-sodium salt which, unlike regular salt, contains potassium.
The advice for non-athletes
Dehydration can become a concern well before you need to worry about electrolytes.
To stay well hydrated, drink when you are thirsty, of course, and if you’re going to be out in the heat or engaging in intense physical activity, stay ahead of the need. That’s true year-round. But keep in mind that you can take in lots of water via fruits and vegetables, many of which are 90% or more water. Other fluids count, too, from soup to coffee.
“A good estimation for how well hydrated you are is your urine color,” Bhandari said. “For a normal person with normal kidney function, if your urine color is dark yellow, you’re likely quite dehydrated. If your urine color is clear, you are doing a good job of keeping yourself hydrated.”
Staying on top of your electrolyte intake may be a little trickier, but it’s not rocket science.
The recommended daily intake of sodium for the average person equates to 1 teaspoon of table salt, Zenner points out. Most Americans consume far more, so adding supplements is unnecessary for most people and unhealthy for many. However, some people don’t get enough potassium, he said.
A typical adult needs about 4,700 milligrams (mg) of potassium per day. A banana has around 422 mg, and there are plenty of other good sources.
“Aim for a minimum of four servings of vegetables and two servings of fruit daily as a good starting point,” Zenner suggested. “Nuts, low-fat cow’s milk or yogurt, and legumes are also excellent sources of potassium.”
And if like me you’re foolish enough to run in this heat, go ahead and supplement your electrolyte intake. Otherwise, spend your hard-earned money on something you really need, like sunscreen.
Learn more in this Wise & Well special report:
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