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Sodium, Potassium, and Thyroid Health

Published April 1 2013

Note: Most people reading this currently take nutritional supplements, and yet most people don’t have a good understanding about the vitamins and minerals they’re taking.  Because of this, what I’ve decided to do is to write some articles which discuss the different roles of each of the vitamins and minerals in the body, and since this website focuses on thyroid and autoimmune thyroid conditions, I figured it would be a good idea to briefly discuss how they relate to thyroid health.  This article will focus on the importance of sodium and potassium.

Sodium and potassium have very important roles in fluid and electrolyte balance, neuronal transmission, along with other vital functions.  Potassium is the main intracellular (inside the cell) cation, while sodium is the main extracellular (outside of the cell) cation.  The adrenals also play an important role in the regulation of sodium and potassium transport (1) [1].

More Facts About Potassium:

Besides playing an important role in fluid and electrolyte balance, as well as neuronal transmission, potassium has other functions.  It is necessary for the conversion of glucose into glycogen, as well as membrane polarization, muscle contraction, and hormone secretion.  Because it is important with regards to fluid and electrolyte balance, it also helps to regulate blood pressure.  If someone has a deficiency in potassium they may experience symptoms such as fatigue, weakness, nausea, vomiting, palpitations, an increase in blood pressure, tachycardia, and muscle spasms.

I see many of the above symptoms with my patients who have Graves’ Disease and Hashimoto’s Thyroiditis.  With someone who has a hyperthyroid condition, having a potassium deficiency can potentially exacerbate their cardiac symptoms.  So while taking antithyroid medication, beta blockers, or herbs such as Bugleweed and Motherwort may help with these symptoms, it is important to make sure they have a sufficient amount of potassium.  Many people with hypothyroidism and Hashimoto’s Thyroiditis are also deficient in potassium, which in turn can cause some of the symptoms listed above.

However, one needs to be cautious about taking large doses of potassium, as this can lead to symptoms such as diarrhea, along with other gastrointestinal symptoms.  Plus, hyperkalemia (too much potassium in the blood) can lead to cardiac arrhythmias.  This is rare in healthy people, but is definitely possible in people with renal insufficiency, people taking certain medications (i.e. beta blockers), and in certain endocrine conditions.  On the other hand, certain herbs such as licorice (which I commonly give to my patients) can deplete potassium levels if consumed in excessive amounts, or if someone takes this herb for a prolonged period of time (2) [2].

Food Sources Of Potassium

Some good sources of potassium through the food include bananas, grapefruit, apples, avocados, squash, spinach, most dairy products, meats, poultry, fish, and legumes.  Boiling some of these foods can cause up to 50% loss of potassium, and so it’s preferable to steam vegetables and other foods to preserve most of the potassium.  With regards to supplementation, in the textbook “Nutritional Medicine”, Dr. Alan Gaby states that over-the counter potassium products are limited by law to 99 mg per tablet.  If necessary you can get higher doses through a prescription, but I find this to be unnecessary in most cases.

More Facts About Sodium:

Like potassium, sodium is important in regulating fluid volume and electrolyte balance, and is also involved in neuronal transmission.  Sodium also is involved with intracellular osmotic pressure, ion transport across cell membranes, and has other important functions.  A deficiency in sodium can cause symptoms such as fatigue, weakness, nausea, and muscle cramps.  Many people are concerned about the potential side effects of too much sodium, such as high blood pressure.

Excess intake of sodium can cause high blood pressure, and can also cause other health issues as well.  As a result, many of my patients become surprised when I recommend for them to take natural sea salt.  Most people can benefit from taking at least 1/4 to 1/2 teaspoon per day of natural sea salt, and some people can benefit from ingesting higher amounts.  This is especially true with those people who have compromised adrenal glands.  But it’s important to take natural sea salt, and not refined salt (3) [3], as the latter is more likely to cause problems with blood pressure.  Plus keep in mind that for those who have high blood pressure, the reason usually isn’t due to excessive salt intake.  For those who are concerned about consuming iodine, most natural sea salts such as Celtic Sea Salt do not contain any iodine.

Another reason why I recommend for many people to take sodium is to help regulate the pH of the body.  Taking natural sea salt will help to maintain the alkalinity of the body.  Of course natural sea salt also contains other minerals which are important to our health, but sodium is the most predominant.

How Does Sodium and Potassium Affect Thyroid Health?

As I mentioned earlier, potassium can be an important mineral for anyone with cardiac symptoms such as palpitations or tachycardia.  These are common in people with hyperthyroidism and Graves’ Disease, although some people with Hashimoto’s Thyroiditis have palpitations as well.  Of course a potassium deficiency usually isn’t the primary cause of this, as with hyperthyroid conditions the excess secretion of thyroid hormone causes these symptoms.  But if someone also has a potassium deficiency then it can worsen these symptoms, and therefore it is important to correct such a deficiency.

Thyroid hormone biosynthesis depends on the presence of a sodium-iodide symporter (4) [4].  Thyroid hormone in turn has been shown to modulate the gene expression of cardiac potassium channels (5) [5].

In other articles and blog posts I’ve discussed how compromised adrenal glands can affect thyroid health.  Sodium and potassium are both regulated by the adrenal glands.  So weakened adrenal glands can cause an imbalance in the sodium and potassium levels.  Aldosterone is a steroid hormone which helps to regulate the levels of these minerals.  This hormone helps to preserve the sodium levels, and secretes potassium.

When someone has weakened adrenal glands, this doesn’t only affect the hormone cortisol, but will also affect the hormone aldosterone.  And if these levels become depressed, sodium is removed from the bloodstream and gets excreted (as a side note, antihypertensive medications actually work by decreasing the aldosterone levels, which in turn reduces sodium and water retention, while increasing the levels of potassium).  In order to maintain the ratio of potassium to sodium, when sodium is excreted, potassium begins to migrate out of the cell to help keep the ratio intact.  In this situation, taking potassium without sodium can actually make the adrenal condition worse.

While the adrenals help to regulate the sodium and potassium levels, imbalances in these minerals can also affect the adrenals, and thus directly or indirectly affect thyroid health.  For example, if someone has depressed cortisol levels, and as a result takes licorice, if they’re not careful this can deplete the potassium levels, and actually worsen the person’s condition.  Not consuming enough sodium can also affect the adrenals.  As mentioned previously, a high potassium or sodium intake can also cause problems.

In summary, both sodium and potassium play very important roles in the body.  With regards to thyroid health, these minerals have both direct and indirect roles.  The adrenals help to regulate sodium and potassium levels, and so problems with the adrenals can lead to imbalances in these minerals, and the reverse is true as well.  Although some people try to do everything they can to avoid salt, most people can benefit from adding natural sea salt to their food.  Natural sea salt is an excellent source of both sodium and potassium, along with other minerals.