useful babblings... gatorade, kidney stones, diet, and salt

This post is very apropos to the given name of this blog: "Constructive Babblings".  It's really just me babbling, but it's also organized information!  There's this lady I know whose daughter was throwing up like nobody's business.  We were talking about that and the question of whether gatorade is good or bad for you came up.  She said her nurse practitioner told her it's bad for one's kidneys but neither of us were sure of the veracity of that information.

So what did I do?  What Cassanndre does at all times when struck with curiosity about medical things... I went to Medscape and Google!  I read several articles and thought I would only link to one but then I did more reading... so there will be at least a few interesting links at the bottom of this post.  Check them out (some will not even be heavily laden with medicalese).

Alright, alright, to the point-- what did I learn?

Gatorade

I have come to the conclusion that, like many things, Gatorade is bad in excess.  It has a lot of salt, which is good and bad.  If you have been sweating a lot or experiencing diarrhea and lost a lot of electrolytes, the sodium (and other electrolytes) in gatorade is wonderful.  My neurologist also recommended using G2 as an abortive at the onset of a migraine.  I find that it is effective at least 1/2 the time.  Electrolytes are probably to thank for this.  [Migraine side note: I recommend drinking 16 oz of G2 with 2 magnesium supplements at the very first signs of a migraine.  If you find 15 minutes later that the migraine is still threatening to attack, then pursue your normal course of action, whether it be a triptan, painkiller, nap, or whatever.]
Now for the bad about Gatorade: if you haven't been exercising & sweating like crazy, or losing lots of fluid and electrolytes another way (eg: diarrhea), then Gatorade is not the drink for you.  Go for water.  Water is good and under regular circumstances it's all you really need to stay hydrated and happy.  There is evidence to say that Gatorade is bad for your kidneys, but according to what I've learned that is only the case if you drink too much or are prone to hypercalciuria (too much calcium in the urine).

This discovery led to some curiosity for the effect of excess dietary sodium on calcium production.  So, without further ado...

Sodium, diet, and hypercalciuria

Excess calcium in the urine can form stones and get lodged in the kidney or elsewhere along the urinary tract (kidney stones!).
First, about kidney stones and hypercalciuria:

About 80% of all kidney stones contain calcium, and at least one third of all calcium stone formers are found to have hypercalciuria when tested. Hypercalciuria contributes to kidney stone disease and osteoporosis... [1]

Consuming too much sodium (whether it be gatorade, potato chips, yummy sauces, or prepackaged foods) leads to an increase of calcium being released from your bones.  This also can be associated with lower bone density.  Here are a couple extracts from Medscape (probably my favorite place to research medical stuff):

Sodium intake is another significant dietary risk factor for kidney stone disease and hypercalciuria. High dietary sodium is associated with increased calcium release from bone, further contributing to any existing hypercalciuria.  It also causes an increase in urinary calcium excretion through a direct effect on the kidneys....  [2]

and

A high sodium intake promotes various effects that enhance urinary calcium excretion and increase overall kidney stone formation rates. These effects include a rise in urinary pH, higher urinary calcium and cystine levels, and a decrease in urinary citrate excretion. In healthy adults, a high sodium intake has been associated with higher fractional intestinal calcium absorption as well as increased parathyroid hormone (PTH) and vitamin D-3 levels.... 

Increased calcium excretion is thought to be due to an increase in the extracellular fluid volume, which ultimately results in an inhibition of calcium reabsorption in the distal renal tubule. Reducing dietary sodium has been shown to decrease urinary calcium excretion in hypercalciuric stone formers, whereas high dietary sodium is associated with both increased urinary calcium excretion and low bone density.  

Sodium intake among stone formers is equal to or higher than the intake in control groups of non–stone formers. Enhanced renal calcium excretion from high dietary sodium is thought to be due to an increase in the extracellular fluid volume, which ultimately results in an inhibition of renal tubular calcium reabsorption. Sodium and calcium share common sites for reabsorption in the renal tubules. Patients with recurrent nephrolithiasis and hypercalciuria are also the most sensitive to the hypercalciuric actions of a high-sodium diet. Finally, in postmenopausal women, high sodium intake has been directly associated with low bone density in calcium stone formers. [3]

What the heck does all of this mean?  Um... give me a moment to reread it and jot down a few notes so I can figure out how to explain it in layman's terms...  Alright, here's my sparknotes version:

Regularly eating a lot of salt increases your chances of getting kidney stones and having too much calcium in your urine.  Doing so also affects levels of other chemicals, such as calcium, cystine, parathyroid hormone, vitamin D-3, and even urinary pH; in your digestive and urinary systems.  In regards to calcium, medical evidence suggests that a high-sodium diet leads to extra released calcium from your bones and so if you have this kind of diet, not only are you more likely to get kidney stones and have hypercalicuriea, but you're also more likely to have lower bone density, which leads to osteoporosis.  

Isn't that interesting?  And a little bit frightening?  Footnote [4] takes you to this awesome slideshow which tells you things you never knew about salt.  It tells you some things that have a lot of salt in them (like TV dinners, cereals, vegetable juices, canned veggies, packaged meats, soups, spaghetti sauce, spices, headache and heartburn medicines, and more) and how to keep yourself within a healthy dietary sodium range.  It's kind of fun, I highly suggest checking it out.

So there you go-- all you may have never wanted to know about Gatorade, salt, and kidney stones.  Yay.

[1]  "Hypercalciuria: Overview of Hypercalciuria" from Medscape Referance
[2]  "Hypercalciuria: Overview of Dietary Factors" also from Medscape Referance
[3]  "Hypercalciuria: Dietary Management of Hypercalciuria" from the same article as the above two
[4]  "Salt Shockers Slideshow: High Sodium Surprises"  a very neat photo + commentary.  I highly recommend it.

those holes in my head

This is a picture of my face from the front.  You know, if you had CT-vision and were looking at me head-on this is what you would see.  I will explain some of what you are seeing.

The two big black holes in the middle are my maxillary sinuses.  You can see pointing to these sinuses a green captain saying "pus (yay!)".  The pus is from inflammation in my sinuses & nose and mucus not being able to drain.  My understanding is that the mucus turns into pus under these conditions.  (Don't take my word as law.)

Do you see the green captain that says "more pus?" ?  The arrows are pointing to my ethmoid sinuses.  I'm wondering if the gray splotches (not the lines- those are just dividing walls between sinuses) are pus, too.

Ah, "deviated septum".  That is one of the key features in this CT.  Notice the dotted line marked "A" by the radiologist?  That's the line my septum (the white line the green arrow points to) should follow, but doesn't.  Thus why my septum is called a deviated one.  See the blue circled part labeled "bad"?  I believe that is where my Dr said the septum is making contact with the bone or the turbinates or something.  Anyways, it's not supposed to happen and when it does it can cause pain along the trigeminal nerve pathway.

Which brings us to the trigeminal nerve.  I drew it for you since it doesn't show up on CTs.  As you can see, the trigeminal nerve has 3 major branches- one to the temples/sides of the forehead, one to the nasal area, and one to the jaw.  This nerve is a major player in migraine headaches and you can see why sinus or jaw problems might cause migraines, or why a migraine may involve facial pain and/or jaw stiffness.  This is because if something painful happens at one branch of the trigeminal nerve, the pain messages can get sent all along the other branches.  Youch!  This is the reason why my Dr thinks my sinus problems might be the problem that is sending my migraines and headaches over the top.

One last note, look at the yellow arrows labeled "R&L nasal passages".  You can see how the L nasal passage is half the size of the R one.  This is the reason why my mucus can't drain and also the reason why I get short of breath more easily when I'm breathing through my L nostril.

The abnormal size of my L nasal passage, plus all the collected mucus/pus in my sinuses aggravates my asthma and sleep apnea.  Since this picture (CT scan) was taken, I believe the pus in my R maxillary sinus has decreased... I wouldn't be surprised if it had disappeared.  This is because the magic Dr treated me for sinus infection and the R side of my face can actually drain, whereas the L still has problems.

I will note an interesting Cassanndre-Sinus-Migraine factoid: I can tell if a particular migraine is triggered by sinus problems because the pain is localized to the L side of my head (the side to which my septum deviates).

Fascinating, eh?

For a real lesson on sinus anatomy, see the American Rhinologic Society here.


UPDATE:  on account of the crazy snow storm which hit the seattle area, my surgery on the 19th was cancelled.  it is now scheduled for weds, feb 1st.  :)