People with low adrenal function will need to constantly deal with mild dehydration caused by sodium depletion.
Signs and Symptoms of Adrenal Fatigue
Salt cravings, increased thirst, muscle weakness,
decreased force of heart contractions, irregular heart beat, light-headedness when stand up; lethargy (fatigue or sleepyness).
The Adrenal glands regulate the mineral balances in the body and therefore affect your water balance and blood pressure. If your adrenal function is low, you will not get enough salt into your cells and will build up potassium in your body. You can develop chronic and severe dehydration.
Cortisol effects the cardiovascular system in many ways. It controls the contraction of the walls of arteries which helps regulate blood pressure. If you do not have enough cortisol, then arteries will be relaxed and your blood pressure will be low. Cortisol directly affects the heart. It helps regulate sodium and potassium in the heart cells and increases the strength of contractions of the heart muscle. Calcium and magnesium counter the effects of Cortisol by relaxing muscles.
Aldosterone is the major Mineralocorticoid produced by the adrenal glands. It is responsible for the maintenance of fluid (water) and electrolyte balance (the mineral balance of sodium, potassium, magnesium and chloride) both within the cells and in the body fluids. Electrolyte balance is essential for proper biochemical reactions within the cells and therefore helps avoid muscle cramping and gives you more energy.
If you adrenal function is low, your aldosterone levels fall and therefore sodium is removed from your bloodstream and excreted in urine taking water with it. Over time you can become more and more dehydrated. When your blood sodium falls to 50% of normal concentration, even a small loss of sodium can have severe consequences and lead to cell dehydration.
Aldosterone can be replaced if there is a deficiency by taking fludrocortisone . The dose is 0.1 to 0.2 mg of this replacement hormone. It is taken just once a day since it long lasting. If you have normal hydration and do not have orthostatic hypotension (dizzy when stand), then you are taking enough fludrocortisone. If you begin to have high blood pressure (hypertension) you may need to reduce the dosage or starting a nondiuretic antihypertensive. Some clinicians tend to give too little fludrocortisone in an effort to avoid use of antihypertensives. Sometimes an alternating dosage of .1mg one day then .15 the next day may be needed.
Fludrocortisone will need several days to one or two weeks to establish stable electrolyte, water, and blood pressure levels. Taking your blood pressure several times a day will assist in determining the correct dose. If your blood pressure becomes too high or you begin retaining water, it will take a few days at a lower dose before you will lose the water and lower your blood pressure.
It is important that you do not skimp on salt in your diet. You might even feel better if you add a little salt to your water. Salt will help to raise blood pressure. If you are struggling with low blood pressure (as most people with low adrenal function are) more salt will help you feel better, help decrease your fatigue, and help restore electrolyte balance within cells.
Monitor your blood pressure and if it rises to over 140/90, then cut back on salt and/or fludrocortisone. You may feel best if you avoid fruit until later in the morning since they are high in potassium. It will also help to rehydrate your body if you drink non-chlorinated water.
The body must have a balance of sodium and potassium. Drinking lots of water can cause the electrolytes in your blood to become diluted since you lose electrolytes in urination. This may make you feel worse. It may help to add 1/4 to 1/2 teaspoon of salt to each glass of water. If you are feeling very fatigued, add more salt to your water. If it makes you feel nauseated, you have too much salt for your body. If you salt your water and food to taste you will get what your body needs. Remember that if you are craving salt, your body needs it. Giving your body the salt it needs,will help you feel better. It is especially helpful to have salted water as soon as you wake up to help you feel better in the mornings, and around 2pm to help avoid afternoon fatigue.
If taking Fludrocortisone, you will need to also take potassium since Fludrocortisone eliminates potassium from your body. Drink water, but not sports drinks which do not have the mineral balance you need and will make your dehydration worse. Electrolyte drinks contain large amounts of potassium, magnesium, chlorine and sodium. They are especially high in potassium and low in sodium which is the opposite of what we need. They also contain sugars.
Fruit juices and soda are high in potassium may further unbalance your potassium/sodium ratio. They will also raise your blood sugar and cause a stress on your body. Since you may not be able to adequately utilize large amounts of sugar, you may end up more dehydrated. Soda is not a good rehydrating drink.
If you are severely dehydrated, sipping salted water sprinkled with kelp powder which is high potassium and sodium, or salted vegetable juice may help. Within one or two days your hydration and electrolyte balance should be stabilized. You will need to drink salted water two to four times each day and avoid high potassium foods in the morning when your aldosterone levels are low. Alcohol and coffee will deplete electrolytes and should be avoided.