The sodium-potassium balance (Pt. 2)
The exchange pumps
The outward sodium current generated by the sodium-potassium pump must move back into the cell to complete a closed circuit. Sodium must do this through what is known as the ‘exchange pumps’. These pumps are also located on the cell membrane and their job is to regulate other functions of the cell: the ‘sodium-acid exchange acid pump (Na+/H+)’ controls the levels of acid inside the cell, and the ‘sodium-calcium exchange calcium pump’ (Na+/Ca2+) controls the amount of calcium inside the cell. This means that every cell in the body takes advantage of the sodium current generated by the sodium potassium pump in order to perform other functions. Like we said before, a slowing down of the sodium-potassium pump will have tremendous consequences on overall health, including these two pumps.
The sodium acid (Na+/H+) exchange acid pump
As we saw in previous blogs, cell detoxification is an essential part of health. We explained that as a normal part of a cell’s life, cells produce acid that needs to be removed on a regular basis; failure to do so would result in the shutting down of the energy machinery and the death of the cell. If there was no mechanism to pump acid out of the cell, since the inside is negative, compared to the outside, this would pull so much acid inside the cell that the pH inside the cell would go down to about 6.0, far too low to be compatible with healthy function. The ‘acid pump’, therefore, has the important job of removing excess acid (H+) out of the cell.
The acid pump gets its energy not from ATP but from the electrical current generated by the sodium-potassium pump (via sodium ions). It works by exchanging sodium for acid across the cell membrane, this means that sodium moves into the cell and an acid is taken out. Its main role is to keep acid from piling up in the cell, but it also has the important function of influencing the pH of the inside of the cell which in turn affects directly how enzymes inside the cell function. In turn, this regulates many cellular functions, one very important example is the hormone insulin.
Dr. Richard D. Moore, together with other doctors, obtained evidence that insulin increases the pH inside the cell via the sodium-acid exchange pump by moving acid outside of the cell and therefore increasing the pH inside the cell. They theorized that through this mechanism insulin stimulates glycolysis, the first step in the metabolism of glucose, as it enters the cell. Dr. Moore discovered that when there is no sodium outside the cell, the sodium-acid exchange pump runs backwards, pumping acid into the cell. Low potassium can also cause sodium to stay inside the cell. This shows once again how an imbalance between sodium and potassium inside and outside the cell can have catastrophic consequences for health.
Other aspects of health that are affected by this imbalance are:
- Protein synthesis
- Cell growth
- The manufacture of new DNA and subsequent cell division
This also explains how diet is crucial in this aspect, eating too many acidic foods can cause electrolyte imbalances, changing pH levels to a state of acidosis (3). A diet high in alkalizing minerals like kelp, garlic, found in the ‘Heart and Body Extract’, and green leafy vegetables can bring our bodies back to the balance it needs to function properly. What is important to remember here is that the pH inside the cell depends on the balance between sodium and potassium.
The sodium-calcium exchange calcium pump (Na+/Ca2+)
Another pump that uses the electrical current produced by the sodium potassium pump is the ‘sodium-calcium exchange calcium pump’ (Na+/Ca2+). This pump removes excess calcium from the inside the cell, by exchanging one calcium ion (Ca2+) for three sodium ions. This means it moves three sodium ions in and takes one calcium out. Since this pump is powered by the sodium-potassium pump, anything that slows this pump will slow the sodium-calcium pump, with tremendous implications for our health. How? Keeping the level of calcium inside the cell low is critical, because small variations in this low level of calcium influence cell function greatly. For example, a small increase in the level of calcium inside muscle cells causes them to contract more than needed, leading to hypertension.
The increase in calcium inside cells results in other imbalances like:
- Decreased effectiveness of insulin (inability of insulin to remove glucose from the blood, leading to diabetes)
- Disturbance of fat and cholesterol metabolism
- Narrowing of the smallest arteries leading to high blood pressure
- Increased growth and division of cells
All of this creates an increase in the pH inside cells through the body, possibly leading to the development of cancer.
Sodium-potassium imbalances, excess calcium and hypertension
Low potassium slows the sodium-potassium pump increasing sodium inside the cells and decreasing membrane potential across the cell surface. Dr. Moore warns about the ‘deadly’ consequences of a dietary imbalance between sodium and potassium, consequences that have only begun to be understood. This imbalance is seen mostly in people with hypertension, therefore high blood pressure is an indicator of low potassium (hypokalemia).
The level of sodium inside cells of hypertensive lab rats was found to be a 40% higher and the voltage of their membranes was decreased by 3%, compared to rats with normal blood pressure. Thus, high blood pressure can be used as an indicator of low potassium and high sodium inside the cells.
This imbalance also has consequences in the other pumps we looked at. The sodium-calcium exchange pump is very sensitive to increased sodium inside the cells. An increase of 5% sodium translates into at least 15-20% increase in the level of calcium, which could cause as much as 50% increase in resting tension of the small resistance arteries. For hypertensive rats this was observed to be much higher, up to 100-200% higher. In kidney cells this meant a 64% increase.
What does this elevated calcium translate into? First of all, in muscle cells this increase means the muscles contract more. In the smaller arteries this increased tone, narrows the artery, increases peripheral resistance and raises blood pressure. An increase in the calcium levels inside sympathetic nerves that regulate blood vessel contraction would also increase the release of transmitting hormones such as epinephrine (adrenaline). This causes further contraction of the smooth muscle cells of the small resistance arteries.
High calcium inside cells also means:
- Increase in growth and division of cells
- Increase in the production of collagen
- Alterations in protein synthesis
- Alterations on the rate at which proteins are made and the way they are assembled together into larger structures
We are out of balance
Since it is the balance of sodium and potassium that counts, our high sodium and low potassium diets put us at risk. Our bodies are not designed to withstand such an extreme dietary imbalance, especially when it is maintained through the years.
In practical terms, increasing the sodium-potassium ratio should be done always slowly according to Dr. Moore, because a body deficient in potassium takes more time to adapt to increased dietary potassium. The presence of hypertension, diabetes, kidney disease and some drugs can slow the body’s adaptation to increased dietary potassium. In these cases, changes in the potassium to sodium balance may require the advice of a physician.
Because the body has so many complex and interrelated regulatory mechanisms, once they are adapted to a situation they require some time to adapt to another. We should not make changes to the body too quickly, because it may not be able to adapt. Since sodium and potassium are interconnected with so many regulatory systems, changing the dietary level of these two minerals too suddenly, especially if they are changed at the same time, could be dangerous.
What is more, since the kidneys excrete excess potassium, an excessive elevation of potassium could result in kidney disease serious enough to involve an inability to excrete potassium. Therefore, Dr. Moore advises to consult with a doctor to rule out kidney problems before increasing the sodium-potassium ratio.
People with hypertension, on diuretics, with magnesium deficiency or hypokalemia, diabetes, kidney insufficiency, and metabolic acidosis all can have an inability to regulate potassium. This is also the case of users of certain drugs like beta blockers, potassium sparing diuretics, ACE inhibitors, etc. A good idea is to start by slowly reducing the intake of sodium through a period of one week, once it has been decreased significantly, one can start increasing potassium with an alkaline diet.
How out of balance are we?
Our dietary intake of potassium should be at least 4-5 times higher than that of sodium. Our ancestors used to have this ratio, even higher on potassium (16:1 ratio). However, our current dietary sodium is about ten times what it should be, around 4,000 mg/day. To make matters worse the average American diet gets about half the daily potassium necessary. This translates into a ratio of 0.6, much worse than 1:1.
How much sodium and potassium do we need?
Surprisingly, a lot less sodium than we think. Some health care professionals estimate we need from 50 mg to 230 mg per day. This points to a minimum required amount of sodium of not more than 100 mg-300 mg. The ‘National Academy of Sciences’ recommends a minimum daily intake of 500 mg. The FDA recommendation is of 2,500 mg a day. Other health care professionals using ‘hair tissue mineral analysis’ (HTMA) like Dr. Robert Selig, explain that ratios are very personal and should only be recommended based on a study of the person’s mineral ratios on a regular basis (twice a year). This is due to the fact that there are many factors influencing mineral ratios in the body like stress, environmental conditions, etc. For this, a hair sample of the patient is taken in order to study the present levels of minerals inside and outside the cell. Blood tests are not considered reliable according to HTMA practitioners because the blood is only a transport system, therefore it does not show how much is actually being used by the cells.
When it comes to potassium, Dr. Young estimates that healthy adults should consume as much as 10,000 mg/day. According Dr. Eric Berg, a minimum of 4,700 mg is needed, that is 7 to 10 cups of vegetables a day. This recommendation goes along the alkaline diet we discussed in previous blogs.
A simple solution
Decreasing the risk of hypertension, stroke, osteoporosis, and other salt linked health problems can be as simple as decreasing salt intake while at the same time increasing the amount of potassium rich foods. This can be done with a personalized hair tissue mineral analysis to better evaluate mineral levels in the person’s body.
An alkaline diet, together with a good nutritional supplement like the ‘Heart and Body Extract’ can support the body’s own regulatory mechanisms toward a balanced sodium-potassium ratio.
Electrolytes are electrically charged minerals that are significant for providing the infinitesimally small units of life called ‘cells’ with the electrical energy they need to do their work. They exist within cells as well as in the fluid that surrounds our cells, and they create an electrical flow when they are in the right balance. Potassium is a specially important mineral for a healthy heart that is usually missing in our diet. In today’s blog we learned that it is the right balance between sodium and potassium that is key for proper heart function. An alkaline diet and the ‘Heart and Body Extract’ can help you bring your body back to balance.
Thank you for reading.
(2) Boynton, Herb, et al. The Salt Solution. Avery, 2001.