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Do You Need to Replenish Electrolytes? A Doctor Weighs In

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Michael  W. Smith, MD - Blogs
By Michael W. Smith, MDBoard-certified internistSeptember 20, 2019

As if plain water weren’t good enough for our bodies, now many of us are attempting to take water to the next level by adding electrolytes. But do you really need those extra electrolytes? Let’s dig into that.

The term “electrolyte” refers to a class of minerals you’re likely familiar with: Sodium, potassium, chloride, bicarbonate – all carry an electric charge and affect the pH balance of the fluids in your body, making them electrolytes. They perform critically important functions. They’re involved in most everything your body does, especially ensuring your muscles and nerve function properly. Your life depends on them. So tanking up on extra electrolytes makes sense, right?

In most cases, no. You are getting all the electrolytes you need from food. Not only are extra electrolytes usually unnecessary, in high doses cases, they could even be harmful. Our bodies are fine-tuned to get rid of electrolytes your body doesn’t need (yes, that means you’re likely just peeing out the electrolytes you just drank), but too much can overwhelm your body’s abilities. For example, too much sodium could raise your blood pressure. Too much potassium could cause heart rhythm problems. The risk is small, as our bodies are well-oiled machines to tackle the potentially harmful things we throw at it. But it’s still a waste of money except in a very few cases.

Let’s take exercise, one of my favorite topics. Electrolyte-enhanced waters are often targeted at fitness fanatics (I can use that term since I am one). Truth is, the overwhelming majority of people only need plain ol’ water. Even if you’re drenched after your 30-minute workout, water is your drink of choice. With a good sweat, your body loses mostly water. You may taste salty, but that’s because the water has evaporated, leaving behind a layer of salt on your skin.

Here are a couple of exceptions when it comes to exercise. In these situations, electrolyte water is a good idea.

  • When you partake in high-intensity exercise for more than 45 to 60 minutes, such as running, your body loses a lot of electrolytes. We’re talking about a level of exercise where it’s tough to speak more than a few words without pausing to take a breath. Opt for sugar-free electrolyte waters. No need to drink the calories you just burned off.
  • If you’re a heavy sweater during exercise AND have particularly salty sweat, electrolytes are for you. How do you know? Salty sweaters may notice salt stains on your clothes.

On to another favorite topic – weight loss. Specifically, I’m talking about low-carb diets that put you in a fat burning state called ketosis. Ketogenic diet sound familiar? When you’re in ketosis, your body loses water but also electrolytes early on, especially sodium. This can contribute to that “keto flu” feeling some people feel the first few days. Others may even experience muscle cramps, especially in the legs. In this case, extra electrolytes may help (without sugar, of course). You likely only need them temporarily. Go back to drinking plain water after a few days and see how you’re feeling. Remember, water is one of the best weight loss tools you have.

Another exception is vomiting and diarrhea. What’s coming out of you is rich in electrolytes. In this case, plain water might not be your best choice. But remember, while you want to replenish electrolytes, you don’t necessarily need the extra sugar found in some waters. Opt for one with no added sugar unless your doctor advises otherwise.

What about after a night of being over served? Hangover bars are popping up all over the place, offering to inject you with electrolyte solutions, so they must be onto something, right? The real benefit here again is … good ol’ water. One reason you feel so awful is dehydration. Rehydrating is key. But I get it – water doesn’t always sit that great when your stomach is all jacked up from a night of partying. If the taste of the electrolytes helps you rehydrate, do what you need to do.

Lastly, I feel compelled to throw in a quick mention of the popular alkaline waters (also known as a bunch of hooey). What you drink – or eat – isn’t going to raise or lower the pH levels in your body. It just ain’t gonna happen. That’s because your body very tightly controls your pH levels. (Thankfully!) Our body doesn’t tolerate even a very small change in pH and will do everything it can to correct that. So in other words, the minerals (many of which are electrolytes) they put in the water to alkalinize it are just an expensive way to alkalinize your pee for no reason at all.

Electrolyte waters may sound appealing, but they offer no benefit for the vast majority of us most of the time. Stick to water and drink plenty of it.

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About the Author
Michael W. Smith, MD

Michael Smith, MD, CPT, is a board-certified internal medicine doctor and WebMD’s Chief Medical Editor. He is also an American Council on Exercise certified personal trainer with a passion for helping people live a healthy, active lifestyle. He appears regularly as an expert on national and local broadcast media.

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