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Electrolytes and Dehydration

Reducing carbohydrates in our diet can have a positive impact on our overall health and wellbeing. It can also specifically contribute to our capacity to better manage Idiopathic Hypersomnia (IH) and Narcolepsy symptoms. Carbs operate a lot like sugar in the body by contributing to spikes in blood sugar. Spikes in blood sugar lead to dips in blood sugar which lead to afternoon crashes - something people with IH and narcolepsy certainly don't need!

One of the most important things to consider when living low carb is electrolyte intake. Ketosis has a diuretic effect, which means it flushes water and sodium from the kidneys. We need to manually supplement our electrolyte intake to avoid dehydration and ‘keto flu’ (headaches, nausea, tiredness, etc).

Dehydration can cause electrolyte imbalances. Aside from the importance of replenishing electrolytes when living low carb, people with IH and narcolepsy are particularly susceptible to dehydration and therefore electrolyte imbalances. This is due to;

1. Medications. First, they can cause you to focus on one specific task, at the detriment of others, so you just forget to drink water. Second, they (all amphetamine-based drugs and modafinil) are diuretics, which means they can dehydrate you by making you urinate more. Learn more about amphetamine-based medications here “Why is my dex not working”

2. Sleeping for long periods and/or just not taking care of our hydration needs because we often neglect our wellbeing because we are too tired to even notice the effects of that. We often just attribute it all (negative effects) to IH or narcolepsy. But it’s not all IH or narcolepsy all of the time.

Dehydration and electrolyte imbalances cause many of the symptoms people with IH and narcolepsy experience including headaches, dizziness and light-headedness, cognitive dysfunction (confusion, trouble following a conversation, forgetfulness, etc), and feeling tired or fatigued. It can also cause irregular or fast heart rate, muscle cramps, muscle spasms or weakness, nausea, and vomiting.

I can (and I know others can too) experience all that with sleep drunkenness but nausea and vomiting are not directly related to sleep drunkenness.

I have spent years where there have been days where I don’t feel like I shake the ‘sleep drunkenness’ at all. Fortunately, this has improved somewhat since switching to a low carb lifestyle (and intermittent fasting) which includes making sure I'm regularly replenishing my electrolytes. Its also important to delay that first cup of coffee (or tea) for at least 90mins after waking. Doing so allows adenosine levels to rise slightly, making caffeine more effective at blocking receptors and keeping us alert throughout the day. Also, our body naturally makes cortisol, a hormone that wakes us up. This starts as soon as we open our eyes. By delaying caffeine intake by 90-120 minutes, we allow the body to wake up naturally and produce cortisol without interfering with its natural rhythm.

I have now added a bottle of electrolyte-replenishing water to my morning routine (read more about my morning routine and other 'tips' here). I’m still horizontal and half-asleep when I take my first dose of medication in the morning. Then, I continue to sleep for another hour or so before attempting to wake up for the final time. I then start drinking the electrolyte water as soon as I can when I wake up, even before I am properly up (ie: vertical and out of bed). It is still extremely difficult for me to wake up but adding the electrolyte water has helped with the morning nausea and headaches. The length of the ‘sleep drunkenness’ has reduced slightly too – provided I keep my fluids and electrolytes up throughout the day and keep my carbs down. I no longer have whole days where I feel overwhelmed by ‘sleep drunkenness’. I’m sure this isn’t just because I replenish my electrolytes as soon as I can after waking and regularly throughout the day. It would be a combination of all the things I have done to improve my overall health* but it’s certainly playing a part.

*this requires a post of its own…. stay tuned!

How much water should you drink every day? It is recommended that you drink 240mls every hour for the first 10 hours that you are awake. How much of that should be electrolyte replenishing water will depend on the amount of sodium, potassium and magnesium in your diet.

Here are the recommended electrolyte intakes whilst on a low carb/ketogenic diet (thanks to Keto for Beginners Australia):

Sodium: 5000-7000mg spread throughout the day. This is usually best taken as broth, sole water, or simply putting some salt on the tongue and swigging down with water.

Potassium: 1000-3500mg per day. Spinach, Broccoli, Avocado, Pork, and ‘Lite-Salt’ are great sources of Potassium.

Magnesium: 300-500mg per day. Avocado, Spinach are great sources of this, but it can still be difficult to get enough. Magnesium Citrate tablets are also a great option, but if you suffer from loose stool as a result, you may benefit from trying magnesium glycinate, malate or taurate.

For more information about starting a low carb lifestyle check out Keto for Beginners Australia. Start with their FAQ.

** It is important to note that nothing I do takes away my IH symptoms completely but I have identified some things that do make them worst or certainly a lot harder to manage. By identifying these triggers, I have been able to develop effective strategies for managing my symptoms, which had had a noticeable positive impact on my overall wellbeing.** Michelle Chadwick


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