Subject: Electrolytes (from the Iron Disorders Institute maillist (see bottom!))

Although the blood volume lost in a phlebotomy is replaced within 12 hours
with adequate fluid intake, we wondered what ELSE, besides blood is lost in a
phlebotomy - that is NOT replaced as quickly.  There are at least five people
that I'm aware of on the list who have difficulty maintaining adequate hgb/hct
to allow regular phlebotomy.  Maybe in addition to a good vitamin regimen, it
might be a good time to look at what ELSE is affected by blood loss.
(Experimenting with one of the electrolyte replenishing sport drinks might be
worth a try - can't hurt anything!)

The human body consists of mostly water, the total percentage differing due to
factors including age and sex. To make sure that our organs and bodies
function at a healthy level, we need to maintain the correct balance between
fluid and electrolytes in the bloodstream. IV Fluid therapy becomes necessary
when the body's ability to regulate this balance becomes compromised due to
sickness or injury.


If you're low on magnesium, your bones give away part of their magnesium to
the body's fluid to keep the blood level of magnesium up. This means that by
the time your blood level drops, you're really low on magnesium in your body
overall. It can then take up to 6 months to build your magnesium stores back
up.

Sodium  fluid and electrolyte balance. Hyponatremia, a lower than normal blood
sodium level, is characterized by muscular weakness, headache, hypotension,
tachycardia.

Chloride Hypochloremia, an abnormally low level of chloride in the blood,
results in muscle spasms, alkalosis, depressed respirations, and coma.

Potassium helps to maintain fluid volume in cells and regulates pH. Potassium
has an important role in nerve impulse conduction and muscle contraction.
Hypokalermia, loss of potassium, results in cramps and fatigue, mental
confusion, increased urine output, shallow respirations, and changes in the
electrocardiogram.

Magnesium is important for the sodium-potassium pump which controls the volume
of the cells. Without the function of this pump, most cells of the body would
swell until they burst. The pump activates enzyme systems needed to produce
cellular energy. It is the basis of nerve function to transmit signals
throughout the nervous system. Hypomagnesemia, manesium loss, results in
increased neuromuscular and nervous system irritability leading to tremor,
periodic painful muscular spasms and tremors, caused by faulty calcium
metabolism, loss of magnesium through diuretic use can result in cardiac
arrhythmias.

Blood Urea Nitrogen (BUN) and Creatinine are tests of normal kidney function;
the electrolytes (Sodium, Potassium, Chloride and Carbon Dioxide) maintain
chemical balance in the body.  These are affected by dehydration, weight loss
and other symptoms.


Some info from Philip's site tpph.html

Low hemoglobin
When there are problems with a low hemoglobin level there are a number of
possibilities.
One of these possibilities could be a folic acid or vitamin B12 shortage. To
prevent this problem some doctors advise to take a vit B complex and, (or
including) about 200-800 mcg folic acid.
Other possibilities of a low hemoglobin can be a testosterone shortage, low
erythropoiesis, too frequent phlebotomies, etc. And remember always exclude
iron deficiency due to excessive phlebotomies (13)! If the cause can not be
found, a hematologist should be consulted.

The hemoglobin will usually reach a "new normal" that will be somewhere from
1.0 to 2.0 g/dL lower than it was before the phleb was started.

In some cases when the hemoglobin can not get higher, desferal is used
(usually secondary hemochromatosis). Desferal is an iron chelator that binds
iron that is then excreted mainly in the urine. Desferal is injected
subcutaneous and has some side effects. Desferal is also (sometimes) used in
patients with heartproblems, mostly in combination with phlebotomy. I heard of
a patient with heart problems who had a phlebotomy of appoximately 80cc,
depending on HB level, per (weekly) visit. In this case 10cc vacuum tubes were
used.

Drinking enough before the phlebotomy is usually enough to solve the problem
of losing fluids during a phlebotomy.
But if there are problems for the patient to lose half a liter of fluid, often
an IV of Saline is jused just before or during the phlebotomy.
In some cases erythropheresis can be used. Erythropheresis is a method where
the blood is filtered and the red blood cells are removed. The rest of the
blood is given back to the patient. Advantages of this method are the loss of
less fluids and not loosing other components of the blood. It is also possible
to remove more blood with one treatment (about 1 liter). Two disadvantages are
the higher costs and the availability. (More info on this treatment: A recent
article advocating for the use of (very expensive) Epo combined with
Erythropheresisx(15) / Erythropherese (in German) or go to
http://www.pheresis.org/
Another option is a simple Volume replacement therapy. Here the fluids are
given back using the other arm using a saline drip(?)
Some links on dehydration:
Dehydration
Dry air plane air can cause dehydration

What role do electrolytes play in our lives?


  Body fluids are comprised of water (the universal solvent), and solutes
(electrolytes and nonelectrolytes) that are dissolved or suspended in a
solution. The majority of our blood is made up of water, which is essential
for metabolism. Total body water is approximately 80% of an infants body
weight, 60% of an adults, and as little as 40% of an elders. However water
alone cannot conduct the electrical current we need to live. Electrolytes are
mineral compounds that are dissolved in the extracellular and intracellular
fluid in our bodies. These solutes then become charged particles known as
ions. These are split into two categories. The positive charged ions known as
cations: sodium, potassium, calcium, and magnesium; and the negative charged
ions or anions: chloride, bicarbonate, and phosphate. These ions dissolved in
body fluids create an electrical charge (similar to a battery) which is needed
for the human body to function. Electrolytes are a vital part of our body
fluids which help maintain: homeostasis (interrelated processes that maintain
equilibrium inside and outside of our cells), a pH (acid/base) balance, the
proper volume of blood for efficient circulation, and stable blood pressure.
They facilitate the transport of nutrients, amino acids, lipids, hormones,
proteins and other molecules into cells. This solution also regulates body
temperature, aids in the detoxification of metabolic waste products, provides
lubrication to the musculoskeletal joints and acts as a component in the
pericardial, pleural, spinal, and peritoneal fluids. Electrolytes play an
important and essential role in all of our lives!
   How do we lose electrolytes?
  Normal loss of body fluids (which include electrolytes) occurs through the
kidneys (urine), bowels (feces), skin (perspiration), and breathing
(respiration). For a healthy adult the total body fluids lost in a day are
approximately equal to their daily fluid intake. Abnormal fluid and
electrolyte losses occur and are usually linked to disease, trauma, and
medical intervention. Any illness in which you have symptoms such as diarrhea,
and vomiting can cause electrolyte losses. Other examples of abnormal fluid
losses are: kidney conditions, cardiovascular problems, cancer, depression,
blood loss, surgical procedures, the use of alcohol, prescription and non
prescription drugs (especially diuretics and chemotherapy). Some of these
problems can cause a decrease of appetite and fluid consumption, which will
result in fluid and electrolyte losses.
 How do we replace electrolytes?

  Normally we get electrolytes, water and nonelectrolytes (body fluids) with
food and fluid intake, or by epidermal absorption. When we have electrolyte
imbalances, supplementation may become necessary. Your health care
practitioner could prescribe: intravenous solutions, which contain
electrolytes and other solutes, blood volume replacements, colloids (e.g.,
albumin or dextran) or total parenteral nutrition. However it is always
preferred to get electrolytes by non-invasive methods, when medically
possible. Therefore your health care practitioner may suggest an oral
replacement of electrolytes.

---------------------------------------------------------------------------
A blank message to these addresses performs the following -
  ExcessIron-on@mail-list.com gets you on the list.
  ExcessIron-off@mail-list.com gets you off the list.
  ExcessIron-switch@mail-list.com toggles you to/from the fancy digest version.
  ExcessIron-vacation@mail-list.com toggles you to/from the vacation list.
 
  Post your message to the list by sending it to ExcessIron@mail-list.com.
 
  To contact the list owner, send your message to ExcessIron-list-owner@mail-list.com.

Join us ...  and together, we will have a major effect on world health and disease prevention!  Visit the Iron Disorders Institute's website at www.irondisorders.org