[conspire] attempting polite request to keep sodium levels down

[Deirdre Saoirse Moen]

On Aug 7, 2023, at 11:47 PM, Steve Litt <slitt at troubleshooters.com> wrote:
> 
> Every doctor I've ever seen told me to cut down
> the salt and salt containing stuff, so I've minimized my salt since the
> 1970's. Not everyone's high blood pressure goes up with increasing
> sodium, but a lot do. I'm taking no chances.

I’m not suggesting this is something you should change, but I wanted to bring this up in case others are in a similar boat and don’t know it: 

1. In at least 1% of people, reducing salt *raises* blood pressure.
2. Norepinephrine reuptake inhibitors, which many anti-depressants are, raise blood pressure. (But depression can kill faster than high BP, so that may be a trade off one needs to make.)

For years, I minimized my salt. My peculiar condition got worse with Covid, and I had the oft-heard about “random” racing heartbeat. It’s not random, it happens when standing (starting after a minute or two), or after sitting for a long time. Six months after Covid, a walk around the block raised my heart rate to 167. Because my heart rhythms were normal, cardiology was like, “Welp, not our department.”

It’s a vicious cycle:

* When humans stand, the blood vessels are supposed to tighten to prevent blood pooling in the feet. Some people never had adequate wiring, some people have it damaged due to injury or disease. Mine came on when I was about 11, probably autoimmune from celiac disease.

* When the blood pools, there’s not enough in the upper body, so the brain sends out frantic signals, hoping for more oxygen and glucose delivery. This raises serum norepinephrine, which raises heart rate and (in some) blood pressure. Note that there’s a small raise in BP in almost everyone while standing, but in those of us with POTS, it can be higher due to higher, possibly 4x normal, serum norepinephrine while standing.

* Meanwhile, kidneys see too much fluid in the lower abdomen, so mark some fluid for yeeting. That will further reduce the amount of blood volume in the upper body, exacerbating the problem, so brain norepinephrines harder. Because of this, many with POTS have too little blood volume by 10-15%.

The solution is to trick the body into storing more water by adding lots of salt. Since the kidneys regulate blood volume by salt levels, this hacks the body into appropriate blood volume.

In short, it’s important to understand *why* BP is high. For years, I was doing myself no favors by reducing salt.

Anyhow, Guanfacine (or Clonidine, same med family) helps treat both POTS and ADHD, the rare med that helps both things rather than helping one and aggravating the other.

Deirdre