I Read Every Electrolyte Study. The Industry Is Lying.

Chapters:

00:00 Intro

00:49 Electrolyte supplements

01:29 Electrolytes for performance

02:43 Hyponatremia

03:05 Average sodium consumption and loss

04:16 Evolution and historical sodium intakes

05:03 Cardiovascular risk

06:24 J-curve

08:35 Conclusion

09:35 Outro

Transcript:

Based on the latest science electrolyte supplementation constitutes a significant health risk and offers no performance benefits for the vast majority of people watching this. There are genuine use cases to electrolyte supplementation such as ultra endurance athletes, ketogenic diets, and certain medical conditions that predispose people to hyponatremia risk. However, the current boom of electrolyte supplementation is arguably not just a fad, but a public health concern.

I would note that I’m personally very reluctant to make this video, because multiple of my friends in fitness actually make a lot of money off of these supplements. I was personally also offered a very lucrative affiliate deal by one of the largest producers of electrolyte supplements, but I had to turn it down because I genuinely believe that for the majority of people it’s not just a fad, but actually a health risk. First and foremost, what you need to realize is that electrolyte supplements are simply a multimineral supplements. Electrolytes are literally just minerals.

Now most people would actually benefit from a multimineral supplement, at least one that is targeted to supplement exactly the minerals that they lack in their diet. However, in the case of electrolytes, most electrolyte supplements are largely just sodium. That’s the same sodium found in your table salt with some other trace minerals added to it. This means that for most of your electrolyte supplements, you are literally just supplementing salt. The effects are almost biologically equivalent to just taking a whole bunch of extra salt from your table salt can. It is true that these electrolyte minerals have performance benefits, especially for ultra endurance athletes. This is why drinks like Gatorade have these electrolytes in them, and they are drunk by athletes that, for example, do a tour de France or an Ironman. As we exercise, we sweat. In our sweat is sodium, so exercise causes sodium depletion.

However, sodium supplementation only starts actually augmenting performance in very extreme contexts. The latest review of the scientific evidence of sodium supplementation for athletes concluded that most of the claims of supplement manufacturers are “…clearly not based on evidence…” and “There is no evidence that athletes need to supplement with sodium on a daily basis.” Many studies have looked at the effects of electrolyte supplementation on exercise performance, and it is specifically the ultramarathons, Ironmans and events where you exercise for four plus hours, especially in the heat, that electrolyte supplementation, in particular sodium supplementation, actually starts to make sense.

If you look at the following decision tree, for example, from the review, they concluded that it really specifically is context in which you’re exercising for 4+ hours, at which point it usually becomes beneficial or even potentially beneficial to supplement sodium along with drinking water. Ironically, even hyponatremia, the condition of actually having depleted levels of sodium in the blood, is mostly caused by excessive water intake, not insufficient sodium intake. Hyponatremia is a real health concern and has a lot of side effects, but it’s mostly caused by people drinking so much water because they’re afraid of these risks, then that they actually have insufficient sodium intakes.

The picture becomes very clear when we look at the numbers of how much sodium people actually lose during exercise, and how much sodium most people consume. Most people consume 3 to 5g of sodium, including athletes. This number is remarkably consistent across multiple populations and cultures, meaning that most people are just driven by their taste to consume a decent amount of sodium. This amount of sodium is significantly in excess of the recommended daily intake from most official health organizations, which is 2 to 2.4 grams.

Athletes, however, benefit from higher intakes because they lose around a gram of sodium per hour of exercise. For example, one study found 0.7g of sodium loss in a 40 minute indoor strength training workout and 75 minutes of cardio in the sun caused a loss of 1.4g of sodium. Outdoor sports matches of tennis and soccer cause sodium losses in the range of 1.2 to 2.7 grams per match. This is a very wide range because people differ substantially in how much they sweat and how much sodium is in their sweat, so total sodium losses vary a lot per person, even under identical conditions. This is why for professional endurance athletes it’s very important to quantify individual levels of sodium requirements.

Even if you are at the extreme end of sodium losses, though, it’s highly unlikely that you fall in the range where most people’s conventional intake of 3 to 5g does not cover the recommended daily intake, plus the buffer that you need for exercise. For context, we humans have evolved on sodium intakes below a gram a day throughout much of our evolutionary history. Estimates of sodium intake in hunter gatherer societies are often below one gram of sodium per day, and many hunter gatherer societies currently still live on less than a gram of sodium per day. Until we actually had salt accessible to season our food, sodium was just gotten from the diet, and it’s very difficult to consume a lot of sodium when you’re actually just getting it from food. So it really is the advent of table salt that caused us to dramatically increase our sodium intakes versus our evolutionary history. Okay, so most people that are not running marathons in the heat are consuming far more sodium than they need for their bodily requirements, plus exercise.

However, what’s the harm in supplementing a little bit more if you feel good on that? Unfortunately, there is actually a significant problem of consuming electrolyte supplements when you don’t need them. One packet of LMNT, for example, contains a gram of sodium. This pushes most people’s sodium intake into the range where there is established cardiovascular risk. High sodium intakes have a very well-documented effect on blood pressure. The more sodium you consume, the higher your blood pressure. The effect is relatively linear.

Sodium is highly osmotic. In simple terms, sodium attracts a lot of water, so when there’s more sodium in the blood, it attracts water in the blood as well, and your blood volume increases. When blood volume increases and there’s a certain amount of blood in circulation, the pressure on the whole circulatory system increases, hence higher blood pressure. It’s quite similar to pumping more water through a garden hose. Now, the body does increase sodium excretion over time to regulate blood pressure. However, this capacity is very limited and as a result, we see in most research that higher sodium intakes do proportionally increase blood pressure.

High blood pressure, hypertension is known as the silent killer because it doesn’t have any clear side effects, but it is actually a real risk. It increases the risk of stroke, damage to the blood vessels, and almost all cardiovascular complications. While many studies have found that the higher your sodium intake, the higher the blood pressure and the higher the cardiovascular risk, I will concede that there is some research supporting a J curve.

J curve basically posits that very low intakes of sodium are also harmful because of the low levels of sodium and the corresponding lack of benefits that you get from these electrolyte. After you reach a certain point, you do start getting an increase in actual side effects as you get excessive sodium intakes for body requirements, but you do get the increase in blood pressure. However, this whole J curve is from observational research and it has significant problems. Most of this research was based on spot urine analysis. Spot urine analysis basically means that you just collect a urine sample per day once, and you extrapolate total daily requirements at intake from these small samples.

Errors of 85% have been found in research using spot urine collection to establish sodium intakes, compared to more accurate measurements. The second major problem with these observational data is that when you look at people with very low sodium intakes and they have higher risk of certain cardiovascular conditions, you observe what’s called reverse causality. In a purely observational analysis you might see that these people on a low sodium intake actually have very high cardiovascular risk, therefore making it plausible to conclude that the low sodium intake causes cardiovascular risk, whereas in reality it was the high sodium intake that caused the cardiovascular risk, and caused them to see a doctor, which caused them to be prescribed the low sodium intake.

Subsequent research has improved on these methods, with more detailed urine collection and control for potassium intake. This research finds that the higher the sodium intake, the higher the risk.

A 2020 meta analysis found that an intake of one gram additional sodium leads to a 6% increase in cardiovascular disease. To reiterate, most official health organizations recommend sodium intakes below 2 to 2.4 grams per day. Most electrolyte supplements have a sodium intake of 0.5 to 1g per packet. That means that one packet of many electrolyte supplements, such as LMNT contains about 50% of your maximum daily sodium intake.

For the record, many researchers, myself included, would argue that the current recommendations for sodium intake are unrealistically low. However, that’s not an argument to add a gram of sodium to your diet. In conclusion, most people consume far more sodium than we have consumed as a species throughout our evolutionary history. Most people also consume far more sodium than we need for our bodily requirements + the requirements of exercise. Increasing our sodium intake further from this level for most people constitutes a significant cardiovascular risk.

Higher sodium intakes have a relatively linear effect on blood pressure, which is known as the silent killer because it contributes to a lot of cardiovascular risks. Conversely, the electrolyte supplements do absolutely nothing for performance for most people. If you’re exercising for more than four hours, especially if it’s in the heat, yes, you may generally need electrolyte supplementation. If you have a medical condition that predisposes you to risk of hyponatremia, you may also benefit from electrolyte supplementation. Certain people potentially on ketogenic diets may also benefit. If you’re not in one of those categories, the chances are very, very high that electrolyte supplementation constitutes an all risk, zero reward strategy.

If you enjoyed this type of evidence based, unbiased video, you may also like my other videos on which supplements are best for muscle growth and collagen supplementation. And if you’re a serious listener or a fitness professional that wants to know everything about fitness, check out my online PT certification in the link below.