Showing posts with label menopause. Show all posts
Showing posts with label menopause. Show all posts

Friday, May 8, 2026

electrolytes abound

It seems like there are ads for electrolytes everywhere you look, and the more you look, the more ads find their way to your eyeballs. The interest and availability of electrolyte packets has exploded into a $40B industry. The market is projected to double by 2034. However, there are risks associated with overconsumption. A balanced diet often provides enough electrolytes. Looking at my most successful diet of all time (the IVF diet by Zita West), I was regularly getting 1000mg Na from the food, and on some days as much as 3500mg Na. The contributors to high sodium were soy sauce, capers, olives, canned green beans, and shrimp or fish fillets.

Supplements I have or still take (or haven't tried yet)
The items in bold are the things I used during the marathon.

SaltStick Chewables: 100mg Na, 30mg K, 6mg Mg, 10mg Ca, 1g carb
LMNT: 1000mg Na, 200mg K, 60mg Mg, 0g carb
Prime: 600mg Na, 400mg K, 75mg Mg, 10mg Ca, 2g carb
Electrolit: 330mg Na, 370mg K, 20mg Mg, 40mg Ca, 10g carb
Venture Pal: 500mg Na, 280mg K, 20mg Mg, 104mg Ca, 8g carb
Tailwind: 620 mg Na, 180mg K, 24mg Mg, 54mg Ca, 50g carb
Liquid I.V.: 510mg Na, 390mg K, 12g carb
Skratch: 400mg Na, 49mg K, 48mg Mg, 54mg Ca, 19g carb
Gatorade Zero: 380mg Na, 110mg K, 2g carb
Gatorade: 270mg Na, 80mg K, 35g carb
Powerade Zero: 240mg Na, 80mg K, 0g carb
Powerade: 250mg Na, 60mg K, 35g carb
Nuun: 300mg Na, 150mg K, 13mg Mg, 13mg Ca, 4g carb
Solgar liquid: 300mg Mg, 600mg Ca, 2g carb
NOW Ca&Mg softgels:  333mg Mg, 667mg Ca, 25mg Zn, per 2 softgels
365 Ca&Mg capsules: 500mg Mg, 1000mg Ca per 3 capsules

NOW Ca&Mg tablets: 500mg Mg, 1000mg Ca per 2 tablets

TUMS: 1000mg calcium carbonate

Coconut water: 50mg Na, 646mg K, 24mg Mg, 53mg Ca, 15g carb

"Astronaut Juice": 145mg Na, 12.5g carb per 8 oz serving

Coca-Cola: 40mg Na, 42g carb

Pickle Juice shot: 470mg Na, 20mg K, 2mg Zn, 0g carb

Nerds gummy clusters: 15mg sodium, 71g carb

Gu: 55mg Na, 30mg K, 20mg Ca, 23g carb

Clif bloks (3): 50mg Na, 18mg K, 24g carb

Biscoff (4 cookies): 115mg Na, 23g carb

Stroopwafel: 75mg Na, 18g carb

Clif bar: 230mg Na, 225mg K, 40mg Ca, 42g carb

McDonald's salt packet: 280mg Na

Heinz mustard packet: 65mg Na


For me, learning about electrolytes has been a trial-and-error process. When you train with a friend or a group, someone will see you suffering and lean over to whisper about their favorite bonk-breaker. I was told about Gu from a running friend when the mileage climbed above 9 miles for a long run. We would stop to take a gel at mile 7. I remember refilling a water bottle during a 60-mile bike ride in 2010, and someone quietly slipping a Nuun tablet into my bottle. At the time, I was primarily concerned with drinking water, and I thought it was enough to quench my thirst. 


Martys Toms Farms
Marty's Tom's Farms ride


When I was hiking in the Verdugos, I got food poisoning in 2012 from my own self. I had probably put a Nuun tablet into a hydration bladder and then let it fester. The next time I tried to use it, it was full of pests, which infested my GI tract. I vowed then and there to NEVER contaminate my hydration bladder again. I've heard people put flat Coca-Cola into their water bottles, so I've added Coke for comparison. But I'm too scared of not being able to fully wash it out to put anything other than water in my hydration vest/belt bottles. I remember examining Nuun's ingredients, and in terms of macronutrients and micronutrients, it was similar to the growth medium used to culture fungi.


The kicker for me came when I cramped during the 2024 Santa Monica Classic. I called my sister to complain, and she asked me what type of electrolytes I was taking. When I told her none, she said it was incredible that I lived in such a hot climate and that nobody had taught me about the importance of replenishing electrolytes. To be honest, every time I think about this race, it still burns me that I skipped the 10k and only finished a 5k. The course was shortened due to the heat.


I've been wanting to write a blog about salt for a long time, but it seems like I'm always staying so busy. I had to take a break from grading student work because hackers disrupted our access to the LMS, Canvas. It's been unavailable for just over 24 hours, which is pretty much the timeline I predicted. But it still sucks that I lost about 8 hours of productivity. Although it did give me the opportunity to write and read a little about salt.


What I can say is that during the 2025 LA Marathon, I took two SaltStick chews every 30 minutes and ended up feeling gross at mile 17. I adjusted that to one SaltStick chew every 30 minutes in 2026, and it was perfect. I felt amazing up until mile 25.


MyFitnessPal 2018-2026
MyFitnessPal all time data

LA Road Runners Chat #9 Dietition Serena Marie - Part 2 (10-30-2025)

https://youtu.be/f5gXdJ4i4yQ?si=KmMON9FYyumPI4ux 


Serena Marie on sweat rate
LA Road Runners Thursday Night Coach's Zoom


You can calculate your sweat rate, and a dietitian who spoke to my running club explained that you should track all of this, including the weather. To convert sweat rate to sodium loss, multiply your sweat volume (in liters) by your sweat sodium concentration (typically 200–2,300 mg/L, with an average of ~950 mg/L). A typical, moderate sweat rate is 1.2 L/h, which, at an average concentration, results in ~1,000 mg (1 gram) of sodium lost per hour. I've never done it, but maybe I can make this a summer project.

Sodium to Salt Conversion: 1 gram of sodium equals ~2.5 grams of salt (NaCl).
Range: Most people lose 200–2,300 mg of sodium per liter of sweat.
Factors: Sweat concentration is mostly genetic, but sweat volume depends on intensity, temperature, and acclimation. You can use this worksheet to calculate your sweat rate, then use that to determine how much sodium you need. I don't feel like I'm a heavy sweater, but at the Naughty Girl Fitness workout, I was dripping sweat, so maybe I just don't notice it when I'm running.
https://koreystringer-institute.media.uconn.edu/wp-content/uploads/sites/3814/2024/08/Sweat-Rate-Calculator.pdf 


I am mindful that we need more magnesium as we age. I wonder how much magnesium from supplements is bioavailable. I still take a lot of supplements, pushing calcium and magnesium as I have since pregnancy and postpartum. But because of the cost, I sometimes wonder if I should stop. Also, I wonder if I'm putting myself at increased risk of kidney stones by overdoing it on electrolytes. In all, the body is pretty great at maintaining homeostasis. But I have heard of people overdosing on TUMS and ending up with stones.

Cost of Racecations in 2024, 2025 and 2026

I have heard of people taking salt packets from McDonald's, as well as mustard packets. Some people love Nerds gummy clusters. I guess I spent a lot on food/fuel when I was first getting started running, but now that I'm more settled on what I like (what works for me), I don't spend as much. I included fuel and all the food from the race weekend in this calculation. Someone in my running group suggested signing up for ALL the races. Like YOLO. They justified it by saying, "What is your health worth?" And that got me thinking about how much I spent on running in the past few years.


For sure, running has been crucial to my mental health, now and at various previous times in my life. The American Heart Association recommends a sodium intake of less than 1,500 milligrams per day. The form matters. Salt tabs called "buffered" seem to contain sodium citrate, not just sodium chloride. The buffer helps balance lactic acid and possibly other amino acids produced in anaerobic pathways. In fact, some athletes take sodium or potassium bicarbonate prior to intense efforts, such as sprinting.

A future post could explore branched-chain amino acids (BCAAs), another fitness craze, as well as ketones such as beta-hydroxybutyrate. I feel like I'm not interested in doing fasted exercise. I'm trying to fuel while training to avoid dipping into ketosis. What I can say is that I took BCAA Complex in my smoothies this past training cycle. Not by choice. My son wanted to put them in there because he loved making a rainbow smoothie with many different ingredients. But I did feel a difference in my energy throughout the day. It felt similar to taking a high dose of B vitamins. He also put in Nature's Superfruits powder (which does have insane amounts of B-vitamins).

Looking at the literature, it seems that a lot has been discovered about metabolism since I left grad school. I remember discovering that ketones and branched-chain amino acids are produced by plants under low-oxygen stress. I'm not saying I'm responsible for these discoveries, but I remember finding these findings and reporting them, and the people in the plant hypoxia world saying it just wasn't possible. Records are being broken every day by athletes who are figuring out better fueling strategies, and I'm sure some of that has to do with electrolytes, too.

I haven't been taking my collagen powder, creatine powder, or my MCT powder supplements in my coffee. For some time now, I've been drinking it black. But I do take a creatine capsule at bedtime with all my other supplements. Not that you should take my advice. We're all out here doing the best we can. My race results: https://www.athlinks.com/athletes/85696593/results I'm not trying to win my age group. I am trying to run sustainably so I can continue doing this. It helps balance my mood, and I feel like it's helping me ease the menopause transition.

One strange thing I did notice was: I kind of feel like my belly fat is decreasing now that the marathon is over. It's been two full months now. I feel like longer walks, lower stress, and more cross-training are actually making a big difference. I started running to get rid of the belly fat and lose weight. But running long distances hasn't really lowered the number on the scale much. I'm trying to revisit the idea of cortisol. Doing workouts that raise cortisol will increase belly fat. Doing workouts that lower stress may actually have a larger impact in the direction I would like to go. 

I've been enjoying the off-season, following the Fit4Mom 5k plan A, which is really chill. I've been doing Royal Core 4.0 from RunFitMama and some workouts here and there from Naughty Girl Fitness. I am thinking that the long walks and some weight lifting are revving up my metabolic engine. I think I might need to keep lifting heavy shit. I'm in pain every day anyway, from my joints aching. Why not add some muscle soreness? Dietarily, I've tried to reduce my intake of fried foods and increase my intake of dietary fiber from fruits and vegetables.


My previous posts about salt:

Other References:


The use of buffered salts as anticoagulants for the maintenance of true cell volume and for the determination of plasma proteins. Chorine, V. Revue d'Immunologie (1940), 6, 193-208.

Magnesium: Exploring Gender Differences in Its Health Impact and Dietary Intake
By: Mazza, Elisa ; Maurotti, Samantha ; Ferro, Yvelise ; Castagna, Alberto ; Pujia, Carmelo; Sciacqua, Angela ; Pujia, Arturo; Montalcini, Tiziana. Nutrients (2025), 17(13), 2226.

Magnesium in Obesity, Metabolic Syndrome, and Type 2 Diabetes. Gabriele Piuri, Monica Zocchi, Matteo Della Porta, Gian Vincenzo Zuccotti, Luciano Pinotti, Valentina Ficara, Michele Manoni, Jeanette A. Maier and Roberta Cazzola. Nutrients (2021), 13, 320.

Perspective: Ketone Supplementation in Sports—Does It Work? Pedro L Valenzuela, Adrián Castillo-García, Javier S Morales, Alejandro Lucia. Adv. Nutr. (2020) Oct 22;12(2):305–315.

Effects of a commercially available branched-chain amino acid-alanine-carbohydrate-based sports supplement on perceived exertion and performance in high intensity endurance cycling tests
Marco Gervasi, Davide Sisti, Stefano Amatori, Sabrina Donati Zeppa, Giosuè Annibalini, Giovanni Piccoli, Luciana Vallorani, Piero Benelli, Marco B L Rocchi, Elena Barbieri, Anna R Calavalle, Deborah Agostini, Carmela Fimognari, Vilberto Stocchi, Piero Sestili. J Int Soc Sports Nutr. (2020) Jan 20;17:6.

Tuesday, December 2, 2025

Sparkle Season

I am already exhausted. The pressure to create the holiday magic is so real. I don't know if it actually brings me joy or am I a product of my culture. Like, am I just acculterated to feel like I must do these things:

Bake cookies
Decorate a tree
Buy gifts for people
Wrap the gifts
Hang stockings
Get stocking staffers
Plan a holiday meal / menu
Plan holiday experiences
Watch holiday movies
Drink holiday drinks

All while teaching six classes, leading a run club, and doing normal stuff like laundry, dishes, grocery shopping, meal prep, and trying like hell to drink enough water and not forget to do anything important.

I surround myself with calendars and to do lists. I am literally terrified of forgetting something. Thoughts flit into my consciousness and then right back out again just as quickly. I can't write them down fast enough and I can't remember what I already forgot.

I want the holidays to sparkle but I am not home enough to enjoy the decor. I have no idea what gifts I have already. I may have sent gifts to people. I bought holiday cards and stamps but I don't know when I will have the chance to address them, write a message, and put them in the mail.

My eye is twitching. It has been doing this for about 4 days. I'm worried it's due to stress and dehydration.

Wednesday, December 4, 2024

Women are not small men

The general guideline is 150 minutes of activity per week. This advice is about 20 years old.

What's important are the ratios of estrogen and progesterone, ratios change as you enter menopause.

Menopause causes a demise in sensitivity of receptors, change in gut microbiome, bone and muscle loss.

How can we do super high intensity work to cause epigenetic changes in the muscles as we become more insulin resistant?

Lifting heavy has a CNS effect. It stimulates muscle protein synthesis. Strength and power. Faster nerve signaling, stronger muscle contraction, in the absence of estrogen.

Raising cortisol is a danger zone. We already have elevated baseline cortisol. Resistance training with 10-12 exercises can just raise cortisol. 

Muscle fatigue is caused by the load? or the volume? Women tend to under-load. If you want to gain lean mass, you can just do a volume to fatigue. But if you want to prevent falls, you need the heavier load to engage proprioception. Do 5-7 reps of heavier load rather than 10-12 reps of lighter load. You can do 5 sets of 5 with good mechanics. 

Periodization is important for the rest of your life. It doesn't stop at one competitive event. You want cycles of building up and off-season. First 3 months is base building. Then add load.

Sprint-interval training. Not HIIT. Working at 95-110% of VO2max. You can only hold it for <30 seconds. Not more than 1 minute. HIIT is 1-2 minute intervals. In sprint-interval training, you're having longer 2-3 minute recovery periods. It yields more metabolic and CNS adaptations, which are more beneficial to perimenopausal women. More impactful than hormone therapy.

Metabolism, cardiovascular risks, bone density. Improves muscle uptake of glucose. Controls blood pressure. 

Protein is super-important! For even sedentary, obese or normal-weight women. 1 gram per pound which is compared to 0.6 grams per pound. Higher protein intake allows reorganization of body composition. If you add strength training, you can do it even faster. Recomposition.

Anabolic resistance happens in perimenopause. Taking in protein every 3-4 hours is important for recomp and protein synthesis. Without taking in protein, you can't recomp your body.

Men age linearly while women have a big change point in the mid-forties. We have some anovulatory cycles. We have estrogen without progesterone. We see significant changes including loss of lean mass, increase in adiposity. We don't have signals to keep lean mass. We are confused and therefore pack on body fat to prepare for hibernation. We lose strength and power.

We have to look at gut diversity. Because our hormones are digested in the gut. 

The tendency is that when women start storing fat, they just eat less. Downregulating thyroid, increasing bone catabolism, increasing muscle catabolism. You should not do fasted exercise. You should not be skipping recovery meals. Manipulating body comp is done by fueling training and eating less at night when you're not training.

If you fuel properly, you will have more energy, which will feed forward more quickly, and you will see results. Fasted training can work for men but not women, especially when we're going through menopause. Even for women who are in their reproductive years, fasted training is not good for us. We have a system for using free fatty acids in our mitochondria. We already have estrogen shuttling carbohydrates away from muscles, just by being born female. 

The recommendations are 100-150 calories, 15-20g protein preworkout before strength training drops cortisol and allows the body to have access to blood glucose. Pre-workout 15-20g protein with 30g of carbs before cardio training. Which allows us to train harder and recover.

Fasted women end up with more hormone dysfunction. Kisspeptin neurons. Men have more fatty acids available if they train fasted, but this does not work for women. Kisspeptin neurons regulate metabolism (fasting leads to low energy availability). The other Kisspeptin neurons regulate appetite and nutrient density. Keto and/or fasting can be counterproductive.

ROAR was first published in 2016 and updated in 2023. Oral contraceptives and hormone replacement. Different times in the cycle have either great or poor resilience to infection. Track your cycle and heart rate variability. Biohacking can lead to better understanding. Natural vs. synthetic hormones and how they are digested in the gut.

Bleed patterns will change when you approach menopause. If there's ovarian failure, you will have an extended follicular phase. You may get heavier or shorter periods, which is indicative of approaching menopause. When you have perimenopause symptoms, you need to get into sprint-intervals. If you're training 3x per week, do 2x per week sprint-intervals. Even if you're endurance training, do some sprint-intervals for metabolic control.

Even doing a sprint-interval once every 10 days, it's better than not doing any at all. You can go to the gym and do it in a group situation. You might find it hard to get the motivation to sprint. Doing two in one session is better than not doing it at all. Within reality, go for the 80/20 rule. Try to do it all the time and then it's okay to give yourself permission to skip 20% of the workouts.

Two weeks of focused training, then one week of recovery. Do what you love. Undulating periodization. "Focusing" could be heavier load on squats. Focus could be something else in the next 3-week block. As we get into perimenopause, we need more recovery. 

Estrogen without progesterone is responsible for how strong myocin bonds to actin. So we don't have as strong of a muscle contraction when progesterone is present. Acetylcholine (muscle depolarizing) is also effected by estrogen. No estrogen, less acetylcholine, less strong muscle contraction. Estrogen helps with strength and power. But progesterone limits strength and power. Progesterone is catabolic. It uses the resources to build endometrial lining. Estrogen is anabolic.

In the women's health initiative study, late post-menopausal, 8 or 10 years beyond menopause, women were studied that were manifesting major symptoms like bone loss, cardiovascular issues, and muscle loss. Adding synthetic hormones at that point had more risks than benefits. But there are lots of other things that can be done that can mitigate these things, other than taking exogenous hormones, for example in early perimenopause.

What supplements would you suggest? Adaptogens like maca, ashwagandha, reishi. SSRIs even can bring back a woman's sex drive, which is opposite of during the reproductive years if women are taking SSRIs for anxiety. Because menopause effects dopamine and serotonin signaling. 

Diindolylmethane (DIM) is a natural compound found in cruciferous vegetable family, which includes broccoli, Brussels sprouts, cauliflower, and cabbage. DIM can reduce the severity of hormone swings through the menstrual cycle making it more even throughout the month. Magnesium, zinc and omega-3 fatty acids to counter prostaglandins. Shisandra can address high stress and lack of focus. Holy basil and Rhodiola can specifically be helpful for perimenopause.

Insulin resistance makes us need to be more aware of when we take in carbohydrates. They help with gut microbiome and energy. As long as you are using a wide variety of colorful fruits and veg, you're getting quality carbs. Think more about when you take in carbs. 1g/kg per hour for refueling. 3-5g/kg per hour for moderately heavy training loads. 5-8g/kg per hour for the heaviest training loads.

Creatine 1/2 tsp (3-5 grams per day) women have 70-80% as many creatine stores than men. You will have fatigue if you don't get good sleep. Creatine can address low sleep or depression symptoms. Women tend to eat less of foods that contain creatine. Men tend to go through more creatine because they have more fast twitch muscles. Women tend to eat more endurance-related foods. Get more in and have it available. Creatine helps maintain gut integrity also, by maintaining the mucosal lining of the gut. 

Have a 12-h fasted window. Stop eating after dinner. Let your body focus on repair.

"Hit play not pause" group. Have conversations about normal aging. Vocalize to your doctor that you might be going through perimenopause. 

The Dr. Gabrielle Lyon show (podcast)

https://podcasts.apple.com/us/podcast/can-womens-health-get-better-with-age-stacy-sims-phd/id1622316426?i=1000597402794

Dr. Sims' TED talk


Graphic from