Chezarae Beaty

Health 1020 10am

July 20, 2016

Water, Sodium, and Potassium: A Balancing Act

Water is the lifeblood of our bodies, our economy, our nation and our well-being.
- Stephen Johnson
Water is the only substance on earth that is naturally present in three different forms:
as a liquid, a solid (ice) and as a gas (water vapor). The oceans hold about 96.5% of all the
Earths water, covering 71% of its surface. Our bodies are also composed of mostly water,
where a man of 70kg has a body water content of about 42 liters (42kg). The average adult
human body contains between 50-65% water while this percentage can be as high as 78% in
infants. The amount of water is not distributed evenly though out the body. Each organ may
contain a different amount of water. The brain is comprised of approximately 75% water, while
the percentage of water in the skeleton (bones) is 22%.
The kidneys, which consist of 83% water, regulate the volume of water and sodium
within in the body. The balance of water and sodium is critical to your health. In order for the
body to function properly the amount of water consumed should remain in balance with the
amount expelled. When the body has a surplus of water, the kidneys will increase the urinary
output to bring the system back into balance. Likewise, the kidneys will conserve water if the
intake volume is low.
Dehydration is the inadequate intake of water to replace what has been lost via feces,
skin, lungs, urine, and sweat caused by prolonged physical activity and/or environmental
stressors. Experts have outlined three general stages of dehydration: mild, moderate and
severe. People experiencing mild dehydration have already lost 1-4 percent of their bodily

fluids by the time they feel thirsty. Additional symptoms also include headaches, slightly
decreased urine output (dark yellow), loss or decrease of appetite, and fatigue. Moderate
dehydration is generally defined as a loss of 4-8 % of body weight in fluids. Those suffering
from moderate dehydration may exhibit little or no urine output, increased heart rate,
decreased ability to sweat, faster breathing, nausea, or tingling in the hands and feet. A loss of
body fluids of 8-10% is considered severe dehydration; where a person may experience no
tears, muscle spasms, impaired vision, mottled or shriveled skin, seizures, or confusion. A loss
of greater than 10% of body fluids is considered critical with an increased risk of heatstroke or
death, especially in extreme heat and humidity, excessive exercise or illness. An interesting
example of the significance of proper hydration was displayed during the Six-day War of 1967,
where more than 20,000 Egyptian troops died from heat stroke while following strict water
rationing. Israeli troops in the area did not suffer the same casualties because they had better
access to water supplies and were commanded by superiors to drink plenty of water.
Dehydration can be dangerous; however, it can easily be remedied if addressed promptly,
through controlled rehydration in most cases or even hypohydration after certain activities.
At the other end of the spectrum is another potentially fatal condition known as water
intoxication or hypoatremia. This occurs when the intake of water exceeds the amount that the
kidneys can process (approximately 15 liters per day). Hypoatremia is a condition where the
sodium dilution in the blood has reached dangerously low levels causing the tissues in the body
to swell. This swelling of the tissues may produce an irregular heartbeat allowing fluid into the
lungs. The brain and nerves may swell resulting in headaches, followed by confusion, then
seizures, and finally coma.
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While regulating the amount of water is crucial to all body functions, ingesting pure
water (H2O) will not keep the body functioning properly. Minerals ions are also needed to keep
the body functioning properly. Ions are minerals which are either positively or negatively
charged that dissolve in water. These charged ions are called electrolytes and facilitate the
transfer of electrical current within the body. The four main electrolytes are sodium (Na+),
chloride (Cl-), potassium (K+) and phosphate (PO4-). Sodium and chloride is mostly found in the
fluid that exists between individual cells. This extracellular fluid (fluid that is outside the cells)
represents about two thirds of the total body fluid. The potassium and phosphate electrolytes
are the principle electrolytes found in the fluid contained within each cell, intracellular fluid,
and represent the remaining third of body fluid. Dr. F. Batmanghelidj, MD clarifies really well in
laymans terms how salt (sodium chloride), water (H20) and potassium (K) work together within
the body:
Sea salt contains about 80 mineral elements that the body needs. Water, salt,
and potassium together regulate the water content of the body. Water regulates
the water content of the interior of the cell by working its way into all the cells it
reaches. It has to get there to cleanse and extract the toxic waste of cell
metabolism. Once water gets in to the cells, the potassium in the cells holds onto
it and keeps it there. Even in the plant kingdom, it is potassium in the fruit that
gives it firmness by holding water in the interior of the fruit. Our daily food
contains ample potassium from its natural sources of fruits and vegetables, but
not salt from its natural source. That is why we need to add salt to our daily
diet. (Batmanghelidj, 2008)
Sodium ions are the major positively charged ions outside of the cells, they are essential
for muscle contractions. Sodium is fundamental to the brains operations enabling signals to
and from the brain. Senses would become dulled and the bodys nerves would not function
without adequate sodium.

Ingesting too much sodium stops the kidneys from releasing water into the urine. This
causes an increase in blood volume of the extracellular fluid which results in increased water
retention (swelling of the tissues or edema). When there is an increase in the blood volume
there is an increase in blood pressure. Over a long period of time this excess pressure can lead
to chronic disease called hypertension, or high blood pressure. Which in turn leads to much
higher risks of heart attack. Increased sodium levels also cause the body to release higher
amount of calcium into the urine, contributing to the development of kidney stones and
calcium depletion in the bones (osteoporosis).

On the other hand, when the body needs more sodium it can take it from the bones. At
this time calcium is also removed along with the sodium resulting in thinner, softer and more
brittle bones. Either way osteoporosis is a risk factor of the sodium levels being out of balance
in the body. The other effects of low blood sodium are the same and synonymous with
dehydration.

While sodium is mostly found in the extracellular fluid, potassium is the major positively
charged ion in the intracellular fluid. Potassium is also extremely important in regulating the
heartbeat and how our muscles function. Potassium is the other half of the electrical pump
that keeps electrolytes in balance between the intracellular and extracellular fluids. It allows
conductivity between cells, making potassium a critical part of neuron transmission.

Many Americans eat a diet that is low in fruits and vegetables and therefore is low in
potassium. Low potassium levels in the body cause no adverse effects at first, but as the levels
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become very low the lack of potassium may cause fatigue, muscle weakness and an irregular
heartbeat, known as arrhythmia. Interestingly, the symptoms of too much potassium in the
body are the same as to little. However, a body with properly functioning kidneys will not have
these overly high levels of potassium because they will excrete the excess without issue. When
the kidneys do not function properly, in instances of kidney disease, is when potassium levels
can become dangerously high.

A recent 15-year study reported in the Archives of Internal Medicine found that the risk
of developing or dying from heart disease had more to do with the ratio of sodium to
potassium than the level of each mineral individually. Dying from coronary heart disease was
twice as high among people who had a high sodium-to-potassium ratio (versus those with the
lowest sodium-to-potassium ratio). Of course, people who consume a lot of sodium and little
potassium may be less healthy in other ways. Even when accounting for lifestyle factors such as
weight, smoking habits and exercise levels, and demographics like race and education, the
sodium-potassium balance remained important.

Bibliography
Batmanghelidj, Fereydoon. Your Bodys Many Cries for Water: 3rd Edition. Global Health
Solutions, Inc., 2008.
Helmenstine, Anne Marie. How much of Your Body Is Water. About.com. About, Inc., 6 Nov
2015. Web. 20 Jul. 2016. http://chemistry.about.com/od/waterchemistry/f/How-MuchOf-Your-Body-Is-Water.htm
Gerstenblith, Gary, and Margolis, Simeon. Electrolyte Imbalance. Healthcommunities.com.
Remedy Health Media, LLC., 04 Jul 2013. Web. 20 Jul. 2016.
http://www.healthcommunities.com/electrolyte-imbalance/too-much-potassium-toolittle-potassium_jhmwp.shtml
Wardlaw, Gordon M., Smith, Anne M., Collene, Angela L. Contemporary Nutrition: 4th Edition.
MCGraw Hill Education, 2015.
Water and hydration: Physiological basis in Adults - Water in the body. H4initiative.com.
Hydration 4 Health, Web. 20 Jul. 2016. http://www.h4hinitiative.com/h4hacademy/hydration-lab/water-and-hydration-physiological-basis-adults/water-body