#81

If I may ask, what are your sources of citrate and how do you calculate the amount?

#82

Best to go to the right thread for this. The question as to what quantities to take when and in what mix is sadly really quite complicated although to some extent you can try things and see what happens. The balance between the 4 cations does matter.

#83

They seem to increase serum sodium.
I wouldn’t use drugs for this, it seems risky to mess with kidney / water / sodium balance unless you’ve read a lot on the drugs you want to use and monitor it.
As far as I understand it, it is hard to mess with your sodium levels so they go too low with diet if you are healthy and not using drugs, and not doing long exercise sessions where you overhydrate.

Doctors might be neurotic about eating sodium since they see patients on polypharmacy, unhealthy, probably metabolic syndrome, with hyponatremia.

#84

It doesn’t make any sense that it would be a diet problem causing such conflicting results, by extremely increasing BP, with hyponatremia, as the Yanomani indians had low BP (100~) throughout their lives asymptomatic. My BP has slightly been trending downwards ever since I started low sodium diet (again). I also doubt most people are able to get to an extremely low sodium diet, especially people who are unhealthy in general and on polypharmacy.

The reason for contradictory results is confounding, simply.
But I the dilution aspect of things is interesting.

#85

In fact looking at my records my peak day for supplementing with Citrate was 75g of Citrate. That is perhaps 50g of Citrate with Sodium which means likelihood is about 15g of Sodium in the form of Sodium Citrate (without doing precise calculations).

My night time BP-HR after this was a bit high at 130/76-52, but morning it dropped to 119/71-52
The next day I had 40g citrate so perhaps around 8g sodium, but I had had a drink (or n) of alcohol so my night time BP-HR was 110/62-54.

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#86

Stay hydrated to protect your kidneys. Dr Rick Johnson says you can watch urine color. A little yellow is good (or blue if you do MB).

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#87

One has to pee in a cup to see a true color. Toilet is full of water and it dilutes the color.

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#88

@AlexKChen I think you higher up on the chain were saying that SGLT2is can help achieve similar benefits to low sodium?

@adssx - do you have any understanding of this?

@AnUser Thanks. For context cana is very attractive to me based on a wealth human mortality and disease data and the ITP longevity results and mechanistic rationales. So it would not be because of the sodium effects Per Se

#89

None, sorry. Here’s what I’ve just found after a quick research:

  • SGLT2 inhibitors, sodium and off-target effects: an overview 2020: “Actually, sodium and water depletion may contribute to some positive actions of SGLT2i but evidence is far from being conclusive and the real physiologic effects of SGLT2i on sodium remain largely unknown. Indeed, no study has yet investigated how SGLT2i change sodium balance in the long term and especially the pathways through which the natriuretic effect is expressed.”
  • Metabolic Communication by SGLT2 Inhibition 2023: “SGLT2i reduced microbiome formation of uremic toxins such as p-cresol sulfate and thereby their body exposure and need for renal detoxification, which, combined with direct kidney effects of SGLT2i, including less proximal tubule glucotoxicity and a broad downregulation of apical transporters (including sodium, amino acid, and urate uptake), provides a metabolic foundation for kidney and cardiovascular protection. […] SGLT2i reduce the early proximal tubule uptake not only of sodium and sugar but of many other metabolites, which decreases cardiovascular risk factors such as hypertension, volume retention, and hyperuricemia.”
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#90

It is a very small increase. Probably due to higher excretion of water (along with glucose and sodium)?

#91

It seems to me from below that the effect is likely to go in the other direction - that they are lowering sodium in the body similar to how they lower sugar levels?

That would be inline with @AlexKChen comment

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#93

Hydration is probably the key, and low sodium helps with that but might not be necessary. It would be very nice if that is not the case, which might be so. I do suspect that hydration removes many side effects of sodium.

#94

@AnUser do you have any more color on your statement above?

I spent more time trying to look at it and it really seems to be the opposite to me - but since you said it so matter of fact I want to double check if I’m missing something?

  1. We have the papers that @adssx shared and that @AlexKChen usually seems to be correct when he says something asa fact

  2. The very name suggests it - it even has sodium before it has glucose…. Sodium-glucose cotransporter inhibitor/inhibition (SGLTi)

  3. Here is how Peter Attia described it:

The other important question here is, *Are there other benefits associated with be it Canagliflozin or other SGLT2 inhibitors that go beyond the glycemic control? *

  • In addition to weight loss, we’re also seeing a greater reduction in blood pressure

  • Why might this happen? ⇒ when you block SGLT2, you’re preventing the kidney from reabsorbing not just glucose but sodium

  • As a patient is excreting more glucose and sodium in their urine, you would think they have obviously less sodium within their plasma.

  • That may explain the benefits we see on the blood pressure front as well

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#95

I searched “serum sodium SGLT2 inhibitor” on google and this is what showed up:

https://www.sciencedirect.com/science/article/pii/S0928098723000465

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#96

Thanks I’ll take a look

Have those of you who already are on SGLT2is seen any differences in you sodium levels on your blood tests?

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#97

Seems that it did not increase sodium in healthy volunteers, and only perhaps in this specific group suffering from low sodium levels

Currently, there are relatively few studies on SGLT 2i and hyponatremia, and little clinical evidence of significant serum Na+ elevation with SGLT 2i. However, based on the studies previously discussed in this paper, particularly the double-blind placebo-controlled trial by Refardt (Refardt et al., 2020), SGLT 2i may be a viable new treatment for hyponatremia, but its efficacy and safety need further confirmation. The following section provides a brief summary of the potential mechanisms by which SGLT 2i restores the sodium balance in patients with hyponatremia.

So this seems more in line with restoring sodium balance in a specific sodium related disease population than increasing it across the board or in healthy individuals

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#98

That’s good. I don’t know how to measure serum sodium properly anyway if that’s worthwhile when using SGLT2i.

It seems dumb for instance, to get the blood test after a meal at McDonald’s, for example.

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#99

I still believe that any raise of serum sodium is due to hemoconcentration. But mostly there is no raise in studies despite signs of hemoconcentration which is a good sign, meaning that more sodium is excreted.

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#100

I might be placeboooing way too hard, but I’ve really tried hydration but higher sodium diet, and it doesn’t seem to work. (1) it’s annoying to have to drink water all the time to offset higher sodium, for me, serum sodium doesn’t seem to affect my thirst response appropriately (2) I think I feel the effects of sodium after a meal, it’s similar to wanting to have a nap after a meal. The dark side is so seductive though, that McDonald’s, highly palatable food…

I have most likely an outlier response to sodium, it doesn’t make that much sense to me.

+1 point to Blueprint and the Yanomami Indians.

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#101

I checked when I had a peak experience and it was around 20th October last year, when I was on a low sodium diet (lite blueprint protocol), so healthy diet might facilitate peak experiences. It was only a 4 of 10 on the pleasure scale though.

true_pleasure_scale
true_pleasure_scale930×1230 123 KB

Eating junk food is between 0 and 1 of 10. Hence the “Happiness Under The Curve”, might be increased with healthy diet. I would think I would trade at least 30 junk food meals for that experience.

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