Electrolyte drink mega-review

Usually my POTS* is content to take the back stage and let ME/CFS run the show, but recently it has been asserting itself in a rather forceful manner. Sitting on raised chairs, showering and just existing seems to send my blood rushing from my head to my feet, leaving me spending a lot of time on the floor or against my dresser with my legs up to get that pesky blood back where it belongs.

At this point it’s not a huge worry as I can generally manage my POTS with medication and lifestyle changes (unlike ME/CFS, which laughs in the face of intervention). One such lifestyle change is increasing water and salt intake in the form of electrolyte or hydration drinks. POTS patients are advised to increase fluid and salt intake to 2-3L and 3-5g** / day respectively. This decreases tachycardia by increasing blood volume (which is typically low in POTS patients) and thus blood pressure.

I have recently discovered that sports drinks such as Powerade, which I used to chug on a regular basis, are not the best choice for those with dysautonomia or even athletes due to their low electrolyte, high sugar content. So I ordered a variety of hydration drinks and even made my own to compare and find something palatable and salty enough to drink every day. My findings are as follows:

Nuun Active
Nuun active tubes.
The Nuun Active I bought on the left, and the seemingly equivalent Nuun Hydration from the Nuun website on the right.

Nuun effervescent tablets are extremely popular within the online dysautonomia community, to the point where POTSies are upcycling their old bottles for craft! I can see why – they are affordable and come in a wide range of flavours (13 currently listed on their website). The tri-berry, lemon-lime and orange I tried were about as pleasant-tasting as what is essentially flavoured salt water can get.

Some flavours contain caffeine, so that’s something to watch out for it if disagrees with you (not uncommon when you’re prone to tachycardia!). Stevia is another problematic ingredient which has a BP-lowering effect. They also take a LONG time to fully dissolve. (Note: I bought Nuun Active from iHerb.com, which seems to have been superseded by Nuun Hydration.)

Shotz Electrolytes

Shotz Electrolytes tubes.

An Aussie brand, Shotz Nutrition offers sugar-free electrolyte tablets designed to be used by athletes in combination with their energy/protein bars or energy gels. The orange vanilla was pretty tasty (and not in the slightest vanilla-ery), with the lemon flavour allowing the salt flavour to come through more. I was impressed with the next-day post and the fact that they provided an energy gel sample! (Mmmm, samples.) Would order again.

SOS Hydration

SOS Hydration box and sachet.

I really only tried SOS Hydration because they offered free-ish samples (you pay post). I was pleasantly surprised to find their formula is extremely high in sodium and in line with the World Health Organisation’s guidelines for oral rehydration (see below). Along with the usual berry and citrus, it comes in the more interesting flavours of mango and coconut – however, I found the flavours unpleasant and overly sweet (the product contains stevia as well as sugar).

Another downside to this product is that it comes in tiny sachets that dissolve in one cup (250mL) water, which quickly add up. It also makes it very difficult to prepare when I most need them (i.e., when in presyncope). This was my least favourite of the lot.

Hydralyte Ready to Drink
Hydralyte ready to drink bottle.
Yes, I bought the litre bottle, and yes, I regret it.

I know Hydralyte is designed specifically for dehydration recovery (eg from gastro), but SHIT is this stuff syrupy. I can’t understand why, as it has a low sugar content compared to juices, sports drinks and soft drinks. Anyway, the ready-made formula with a high electrolyte content means it’s handy in a pinch. Available at the chemist or supermarket.

Gastrolyte Ready to Drink

Gastrolyte pop-top drink bottles.

Much of a muchness to Hydralyte. I bought the pop top version, which is more convenient when I’m blacking out and don’t have time to pour a glass. Just don’t buy the strawberry flavour, unless you like the taste of cherry medicine.

Again, available at the chemist or supermarket.

Homemade rehydration drink

My aim was to create something approximate to the WHO Oral Rehydration Salts, whose composition is below:

A table detailing the composition of the new WHO ORS formula.
Source.

The recipe I used is as follows:

1 tsp lite salt (NaCl / KCl)
1/2 tsp Bi Carb soda
6 tsp table sugar (that’s 1.5TB Aus, 2TB everywhere else)
1L tap water***

This is a variation on the formula shared by the WHO and this rehydration site, using a combination of potassium and sodium present in lite salt rather than just sodium which is in regular salt. It was found on a chronic illness forum, though there are versions online referring to it as a WHO recipe (which I can’t confirm).

My drink was certainly tasty, thanks to the sugar content! There are lots of variations on a theme for this drink – you can add less sugar, or none at all, throw in a squeeze of lemon or lime juice for flavour, or dissolve a sachet of cordial. Many just add a pinch of salt or lite salt to water and call it a day.

I’m unsure of the provenance of this recipe, or the overall effect of using lite salt as opposed to the 1 tsp salt in the WHO recipe. For this reason, I can’t totally recommend it, as I don’t know if the electrolytes are in correct balance, or if the sugar content is appropriate. (WHO states that “glucose facilitates the absorption of sodium (and hence water) on a 1:1 molar basis in the small intestine”, but I don’t know if this applies to just those who are experiencing malabsorption due to a dehydrated state, or everyone.)

Other thoughts

Coconut water is a popular choice for rehydration due to its electrolyte content. But it only contains trace amounts of sodium, high levels of sugar and too little of other electrolytes to be of much benefit.

Banana Bag oral solution sachets are HUGE in the dysautonomia community right now. They advertise their drink as being equivalent to WHO ORS formula, which it is – so long as you mix 1 sachet in 240mL of water (not even a cup). Like the SOS Rehydration, the sachets add up, this shit isn’t cheap (a 5-pack of sachets – enough for just over 1L – costs $31.83AUD including shipping). I’m not particularly interested in buying something which is essentially a cleverly-marketed version of Gastrolyte for 3x the cost.

I have tried High 5 Zero Electrolyte Tablets in the past and enjoyed the taste – which is probably because they have a low sodium content comparable to regular sports drinks!

High Five Zero tube.
That’s a no from me.

 

Comparison table (based on 2014 AIS report, WHO ORS, product packaging, links below, and my own calculations***)

Product Sodium mmol/L Sugars g/L
WHO ORS (for comparison) 75 13.5
Banana Bag 67 15.4
Gastrolyte Effervescent Tablets/Sachets 60 16-18
SOS Hydration 59 12
Hydralyte Ready to Drink/Sachets/Effervescent Tablets 45 16
Gastrolyte Ready to Drink 45 15.8
Homemade solution 45 24^
Shotz Electrolyte Effervescent Tablet 37 0
Nuun Active Effervescent Tablet 33 2.1
High 5 Zero Electrolyte Tablets 15 0
Powerade Ion4 12 58
Cocobella Coconut Water 9.1 50

 

The clear winner for me was totally unexpected – homemade electrolyte drink! Most days I just add 1tsp of lite salt to 1L of water. It doesn’t really taste that bad – certainly nothing like the seawater analogue I was expecting – and is much easier to drink on a regular basis than the flavoured, sweetened drinks on the market.

When I want something different, I choose Shotz Electrolyte Tablets for their ease of use and pleasant flavour. And I always have some Hydralyte or Gastrolyte on hand for when I’m in presyncope and need a quick boost.

What are your favourite electrolyte drinks? If you can shed more light on this topic, or correct any misinformation I may have shared, please chime in!

 

 

Edited 12:36pm, 27/09/17 to add information regarding stevia’s hypotensive effects. Thanks to Claire for the tip-off.

 

 

*Postural orthostatic tachycardia syndrome, ie, tachycardia upon standing.

**Yes, that is GRAMS. Don’t try this at home, non-POTS people.

***The Nuun, coconut water, SOS Hydration, Banana Bag, and Gastrolyte tablets/sachets are calculated by me. It’s been a long time since high school chem, so this may be way off!

^I wonder if this value is so high as table sugar is sucrose, 50/50 glucose and fructose, so 24g assumedly contains 12g glucose.

Author: Siobhan S

20 something, living in country Australia. Spoonie profile: ME/CFS, dysautonomia, anxiety. All about sewing, knitting and food. Unapologetic feminist and disability advocate.

12 thoughts on “Electrolyte drink mega-review”

  1. As you know, having multiple conditions is a pain in the arse. With my CF comes the super-salty sweat and loss of both salt and electrolytes in the summer, also because of the whole ‘inability to properly digest and absorb nutrients’ thing. With the diabetes comes low sugars if I overheat (or get too cold) and high sugars if I have too much glucose or carbs. I have salt tablets on hand year-round for the saltiness issue as it can come up if I’m not well (especially with a tummy bug) and also just randomly. I usually crave McD’s french fries if I’m low in salt. However, I have found in summer that if I have one or two bottles of the sugar-free Powerade in the fridge I stay properly hydrated (electrolyte-wise) on those days when it’s just too damn hot even with our really good air-conditioning. I used to have to have electrolyte powder in my drinks as a kid and not matter how strong mum made the cordial, very little could hide the taste, although it certainly dulled it.

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    1. I didn’t know that about CF, Chantelle. Chips and other salty foods are a good way to up salt intake – I put so much salt on my meals!! Although I didn’t end up including it in the post, Sugar free Powerade is a pretty good option as it has a higher sodium content and obviously less sugar than regular Powerade.

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      1. Yeah. Mum says when she kissed my head as a baby and I’d been hot it tasted like I’d been at the beach. Same thing happens in the summer when I have a shower. I think it’s a good mosquito deterrent though because they don’t seem to like me much. There’s a CF blogger in the US (I think) who calls herself a ‘salty babe’.

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  2. I don’t have POTS but I dehydrate in a millisecond. I drink Powerade, but with my dietician’s tweaks…. water it down 1 part Powerade to one part water, then add a teaspoon of salt per litre. Added bonus of handy drink bottles. Otherwise I get Restore brand Oral Rehydration Salt sachets on a huge authority script (very affordable) and again add 1 teaspoon of salt per litre. It has an orange flavour that is not too sweet, very easy to drink. I try to get through 800-1000 mls of one of these each day, so it’s basically all I drink. Also add massive amounts of salt to the little I eat because my tastebuds are completely desensitised.

    A lot of people swear by St Mark’s solution, which sounds like your homemade recipe, but the sachets and Powerade are so easy to use I haven’t bothered. Thanks for these reviews… good to know I shouldn’t be having fomo over any of these products.

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    1. That Powerade recipe is a really interesting idea and not one I’d heard of before – thanks for sharing! It would dilute the sugar to an acceptable level and the added salt would give you all that electrolyte goodness. You’re definitely not missing out if you have something affordable that works for you!

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  3. I am pretty positive I have POTS as well. I know my sitting and standing pulse rates are much higher than my laying down ones, my normal pulse is almost always around or over 100, yet my blood pressure is normally quite low. I wonder if electrolyte issues aren’t genetic, because I remember being told about my grandmother being hospitalized for extremely low electrolyte levels.

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    1. Well, there is actually a very easy way to test this. Just look up “poor man’s tilt table test” to get an idea of what your HR is doing, and whether you need to follow up with a cardiologist. It is not uncommon to have issues with electrolyte levels, especially if you are in a health crisis, but that is not a feature of POTS. The idea of the drink is to increase sodium levels in your blood and keep fluids up, the potassium is helpful as many common POTS meds diminish potassium levels.

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  4. Yeah, I want to get the tilt table test done professionally, but I’ll have to check out the poor man’s version. When I was in the hospital recently they took my blood pressure laying down, then sitting up, then standing up, so I wondered if they suspected something like that. They didn’t say much about it other than asking if I got really dizzy when I sat up.

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  5. The rehydration mixtures meant to be given to dehydrated people usually is described to us (doctors) when we’re learning on Pediatrics as tasting like ass unless you’re dehydrated . Another recipe of homemade ORS is: 1 liter of water + 1 scant teaspoon of salt (aprox 3,5g) + 2 tablespoons of sugar (aprox 40g). This one was the recipe here in Brazil – according to Unicef “O soro não deve ser nem mais doce e nem mais salgado que água de côco ou lágrima”(the solution should not be sweeter nor saltier than coconut water or a teardrop) .

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    1. That’s the WHO recipe that the one I reviewed is based off! It’s interesting you say it should taste terrible….it doesn’t actually taste that bad to me, so perhaps I’m perpetually dehydrated? Thanks for your contribution.

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      1. The Unicef one shouldn’t taste that bad, since it’s mostly sugar, but things like Pedialyte 90 are said to taste icky if you’re not dehydrated.

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