Electrolyte supplements are everywhere. Who benefits from them and when?

NASHVILLE, Tenn. — Social media is full of influencers reviewing electrolyte supplements or even telling their followers how to make their own. But experts say many of the claims about the health benefits of these drinks should be taken with a grain of salt.

Electrolytes are electrically charged substances that help regulate chemical reactions in the body. In the context of hydration, they balance fluid levels inside and outside cells, said Julia Zumpano, a registered dietitian at the Cleveland Clinic.

We lose certain electrolytes through sweat, mainly sodium chloride, contained in table salt. Drinking too much plain water when you’re sweating a lot can dilute the salt in your body even more, throwing things out of balance. Electrolyte drinks and powders are intended to hydrate and replace lost salt. They often contain other electrolytes like potassium and magnesium. Many also contain some form of sugar.

In general, a healthy person’s kidneys do an excellent job of maintaining our electrolyte balance. The extras simply come out in your urine, said Hunter Huston, a nephrologist at Vanderbilt University, who also consults with a U.K.-based company that offers electrolyte replacement plans for endurance athletes.

Taking “an electrolyte-enriched drink, purely for health purposes, probably doesn’t do much,” he said.

Today, “rapid hydration” and “advanced hydration” drinks are all the rage, but who really benefits from them and when?

It was 1965 at the University of Florida, and Dwayne Douglas, then an assistant football coach for the Gators, had something on his mind. As Robert Cade, the school’s first kidney researcher, later explained, Douglas asked him, “Doctor, why don’t football players pee after a game?”

“This question changed our lives,” Cade said.

The obvious answer was that football players couldn’t urinate because they lost a lot of fluid through sweat. Cade’s research team determined that a player could lose up to 18 pounds (8.16 kilograms) over the course of a game. But the players weren’t just losing water. They sweated sodium and chloride and lost both plasma volume and blood volume. Losses sapped their strength and endurance.

Cade mixed a briny solution to replace the water and salt the players were losing. Sugar would help the intestine absorb sodium. The first batch made him vomit. A little lemon juice made it taste a little better. It still wasn’t delightful, but soon the team’s improved performance could no longer be ignored, especially in the second half of games, when the opposing team’s players began to wilt in the Florida heat and humidity.

Cade, who died in 2007, said he never imagined Gatorade would be purchased by regular consumers.

Although it seems like everyone is drinking electrolyte supplements these days, not everyone actually needs them.

A good rule of thumb is that if you exercise for less than two hours, plain water will probably do the trick, said Vanderbilt’s Huston. The average healthy person can tolerate a loss of about 2 percent of their body weight in sweat before they really start to feel it, he said. “It’s increased thirst, it’s fatigue, cramps.”

But everyone is different. Some people sweat a lot or have particularly salty sweat.

In the world of extreme sports like ultramarathons, athletes often seek the help of a professional to test their sweating and obtain a tailor-made nutritional plan.

“Most people who exercise, who do, say, a marathon, will be well past those two hours, and then it makes sense to ask, ‘What will my fluid and electrolyte replacement plan be?'” Huston said.

Darren Rovell has followed the rise of sports drinks from a niche market to the mainstream. He is the author of “First in Thirst: How Gatorade Turned the Science of Sweat Into Cultural Phenomenon” and is an investor in the sports drink Bodyarmor.

When he was a high school runner, he said, they were given Gatorade to drink and told the reason it tasted bad was because it was healthy. “And then at some point in the ’90s, it must have been sweet.” After PepsiCo bought the brand in 2001, “it really became the first time where you saw Gatorade everywhere in front of your face, including in a pizza place, and it started to be, ‘OK. Is this just a different type of soda?'”

Rovell says electrolyte brands market the idea that drinking their products will make you an athlete or, if you already are, give you a performance advantage.

“It all starts with aspiring to be better, but you know we have to control ourselves,” he said.

Supplements available today have an incredibly wide variety of electrolyte concentrations, said Patrick Burns, who practices emergency medicine at Stanford Health Care and occasionally competes in ultramarathons. With some supplements containing five times more sodium than others, consumers should not assume that all supplements are the same.

Burns also warned that people should be careful about potassium supplementation because it can be dangerous in large amounts.

He noted that many brands now offer sugar-free varieties, even though the glucose in sugar allows for rapid sodium absorption.

“They’re not internally consistent at all with what they’re trying to sell you,” he said. “For optimal absorption, you need a little sugar with your salt.”

“Electrolytes can help, especially with heavy sweating or exercise, but for most people, they’re not something you need every day, and you certainly don’t need them in large quantities,” said Zumpano of the Cleveland Clinic.

For a healthy person who isn’t sweating intensely, the drinks probably won’t hurt you, but they won’t help you either.

“You’re consuming more sugar, and there’s no reason (for) rapid absorption of sodium because you’re not sodium depleted,” said Mark Segal, professor of nephrology at the University of Florida School of Medicine. Most people get all the salt and potassium they need from their diet, he said.

When it comes to making your own electrolyte powders, experts said it’s possible, but you have to know what you’re doing. They advised against using a recipe from an influencer.

“How do you know how much you need?” » » asked Zumpano. “There’s a lot of room for error there. I’d probably prefer to avoid it.”