What if you don't need more water?
Most of us have been taught to think of hydration as a simple equation: feel thirsty, tired, headachy, or crampy? Drink more water. But water is only part of the story. Your body also relies on sodium, potassium, magnesium, chloride, and calcium to move fluid, fire nerves, contract muscles, and help your cells actually use the water you're drinking.
In this episode of Rise Above, I break down what electrolytes really are, how the sodium-potassium pump helps manage fluid inside and outside your cells, and why your electrolyte needs can change with exercise, low-carb diets, coffee, medications, stress, illness, and even the season.
We'll also dig into hydration clues hiding in routine lab work, the surprisingly interesting science inside a pickle jar, and one of the most misunderstood questions in nutrition: is salt really the problem?
The next time your instinct is simply to drink more water, the better question may be: does my body also have the minerals it needs to use that water well?
My son Leo plays hockey. Anyone who's spent time in a rink knows - that ice doesn't feel cold once a kid's been skating hard for twenty minutes. Leo sweats. A lot.
One practice a few years ago, I gave him two salt capsules - about 2,000 mg of sodium chloride, Redmond Hydration caps - before he skated out. No big production about it. I was studying water and electrolytes at the time in depth.
He got in my car after practice and the first thing he said was, “Mom, I skated the whole practice and I didn't get tired.” I looked at his undergarments - the ones that are usually soaked through by the time he gets in the car - and they weren't. Not even close.
That's not a coincidence. That's physiology.
Hi, I'm Dr. Emily Wheeler, and today we're talking about electrolytes.
Most people think hydration is just about how much water you drink. It's not. It's about whether your cells can actually use that water once it's in you. Let's get into it.
An electrolyte is simply a mineral that carries an electrical charge once it's dissolved in fluid. Sodium, potassium, magnesium, calcium, chloride - these are all minerals. And when they're dissolved in your blood, your sweat, or the fluid inside and outside your cells, they become electrolytes.
People think “minerals” and “electrolytes” are two separate categories. They're not. Every electrolyte is a mineral. What makes it an electrolyte is what it's doing - carrying a charge, moving fluid, sending a signal.
Every cell in your body has a pump built into its outer wall. Its job is to push sodium out of the cell and pull potassium in. It does this constantly, for as long as you're alive.
Why does this matter for hydration? Because water follows minerals. Wherever sodium and potassium go, water goes with them. This pump isn't just managing electricity - it's managing where water sits in your body.
These electrical gradients help your nerves fire, your muscles contract, and your heart beat. They also help your body manage where water goes and how it gets used.
Hydration isn't about volume. It's about whether the pump has what it needs to move that volume where it belongs.
You can drink a gallon of water a day and still be functionally dehydrated at the cellular level if you don't have the minerals to move it where it's needed.
Let's talk about who's most likely to be running low.
Kids and athletes. Active kids - especially ones sweating through practices and games multiple times a week - lose sodium, potassium, and magnesium right alongside water.
Winter - and this might surprise you. My hypothesis, based on what I see clinically, is that electrolyte needs may actually be higher in winter than in summer. Indoor heating, dry air, and lower thirst can create a steady, quiet fluid loss most people never account for.
Coffee and caffeine drinkers. Caffeine has a mild diuretic effect. Regular coffee drinkers build some tolerance over time, so it's not a one-to-one dehydration event with every cup. But combine daily coffee with dry winter air, indoor heat, and low water intake, and it can add up.
Low-carb, keto, and paleo dieters. When carbohydrate intake drops significantly, insulin drops and the kidneys release more sodium. As sodium exits, potassium and magnesium tend to follow. That's part of the mechanism behind the fatigue and headaches often called “keto flu.”
Certain medications can also affect electrolytes, sometimes significantly.
And chronic stress matters too. Your adrenal glands also make aldosterone, the hormone that governs how much sodium your kidneys hold onto versus release.
The pattern I want you looking for isn't always one red flag. It's the accumulation.
Fatigue. Headache. Muscle cramps. Dizziness. Waking up at night with a leg cramp that jolts you out of sleep.
Most people have felt at least one of these symptoms without ever connecting it back to electrolytes.
There are also causes of dehydration people don't think about. Diarrhea, heavy sweating, breathing through your mouth all night, and other forms of fluid loss can all matter. We take hydration seriously for our kids and almost never extend that same logic to ourselves.
Sodium, potassium, chloride, and CO2 show up on a basic metabolic panel or comprehensive metabolic panel.
Your body works extremely hard to keep serum sodium and potassium in a tight, stable range. That means you can feel symptomatic and still have a “normal” number on paper.
Two other conventional markers can offer useful hydration clues: the BUN-to-creatinine ratio and hematocrit. Hematocrit can run higher with dehydration because there is less plasma volume relative to the red blood cells - a phenomenon called hemoconcentration.
Functionally, I may also look at RBC magnesium versus serum magnesium, urine specific gravity, and serum or urine osmolality when a more precise picture is needed.
Here's the line I want you to remember: a normal basic panel doesn't necessarily mean your hydration status is optimal.
Several common medications can influence sodium, potassium, or other electrolytes.
Thiazide diuretics used for blood pressure are a well-known cause of low sodium. Examples include hydrochlorothiazide, chlorthalidone, and indapamide.
Loop diuretics such as furosemide, or Lasix, can increase losses of sodium, potassium, and chloride.
SSRIs used for anxiety and depression can also carry a risk of low sodium, especially in older adults and when combined with a diuretic. Examples include sertraline, escitalopram, and fluoxetine.
Some anticonvulsants - medications that may also be prescribed for nerve pain, migraine prevention, or mood stabilization - can affect sodium as well.
This isn't a reason to stop a medication on your own. It's a reason to know what to watch for and what to ask about.
Food first, always.
High-electrolyte foods include cooked spinach, avocado, bananas, baked potatoes with the skin, and pumpkin seeds.
Useful drink sources can include coconut water, pickle juice, bone broth, watermelon juice, and mineral water. The exact mineral content varies widely by brand and serving.
And mustard deserves its own mention. Mustard packets are an old athletic trick used around muscle cramps and are cheap, portable, and shelf-stable.
Most brightly colored sports drinks, on the other hand, can contain substantial sugar while providing only a modest amount of electrolytes.
There's actually a surprising amount of nutrition science hiding in that jar.
Brine simply means salt dissolved in water. With many pickles, vinegar and spices are added too. The salt traditionally helps preserve the food, control unwanted microbial growth, and keep the cucumber crisp.
That salty brine is also why pickle juice can be such a concentrated source of sodium - one of the major electrolytes we lose through sweat.
But here's where it gets interesting: there are two different ways to make a pickle.
With a vinegar pickle, you ADD the acid. Vinegar supplies acetic acid, which creates that sour flavor. Vinegar consumed with or around a carbohydrate-containing meal may help reduce the post-meal glucose rise and improve insulin sensitivity. But a vinegar pickle is not automatically probiotic.
With a fermented pickle, you MAKE the acid. You can start with cucumbers in a salt-water brine without adding vinegar. Lactic-acid bacteria ferment sugars in the cucumber and produce lactic acid. If the finished pickles haven't been heat-treated or pasteurized, they may also contain live cultures.
So remember:
Vinegar pickle = ADD the acid.
Fermented pickle = MAKE the acid.
The cucumber itself is naturally low in carbohydrates and sugar. The salt gives us sodium. The vinegar, when used, gives us acetic acid. And fermentation, when used, produces lactic acid and may provide live cultures.
Try an unsweetened vinegar-based pickle at the beginning of your meal or with your meal, especially when you're eating carbohydrates.
You're getting a low-carb food plus sodium, and the acetic acid may help blunt the glucose rise from the meal.
But check your pickle label, because not all pickles are created equal.
An unsweetened dill is typically very low in sugar. A bread-and-butter pickle is sweet and tangy and usually contains added sugar.
And despite the name, there's no bread and no butter in a bread-and-butter pickle. The name is associated with Illinois cucumber farmers Omar and Cora Fanning in the early 1900s, who reportedly traded jars of their sweet-and-sour pickles for staples including bread and butter.
When you're standing in front of the pickle aisle, think about what you actually want: electrolytes, low carb, live cultures, or vinegar-based blood-sugar support.
There's a whole lot more science in a pickle jar than you probably expected.
Leo's story is the one I keep coming back to, because it's the clearest real-world example I have. Two salt capsules before a single practice, and a visibly different outcome - sustained energy and dramatically less fluid loss.
That's not magic. That's giving the sodium-potassium pump what it needed to do its job.
Your water source matters too, not just the minerals you're adding through food or supplements. That's a full episode of its own, so I'll come back to it properly.
Myth: Electrolytes are only for athletes.
Not true. Stress, medications, low-carb diets, dry environments, and other factors can all influence electrolyte needs without a single workout involved.
Myth: More water always fixes dehydration.
Drinking large amounts of plain water without adequate sodium can dilute existing electrolytes further. In extreme circumstances, this is part of the mechanism behind hyponatremia.
Myth: Minerals and electrolytes are different things.
They're not. An electrolyte is simply a mineral doing electrical work once it's dissolved in fluid.
Myth: Salt causes high blood pressure - for everyone, always.
Salt and blood pressure deserve a more nuanced conversation than a universal rule. Individual salt sensitivity varies, and sodium is also physiologically necessary for blood volume, nerve signaling, and the sodium-potassium pump.
At the same time, this view differs from standard low-sodium guidance given to some people with hypertension or other medical conditions. If that's you, this is something to discuss with your own doctor before changing your sodium intake.
Hydration isn't just about how much water you drink. It's about whether your body has the minerals it needs to use that water well.
Could my medication be affecting my sodium or potassium levels?
Should we be looking at my BUN-to-creatinine ratio or hematocrit as part of my hydration picture?
Is my current sodium intake actually appropriate for my activity level and stress load - not just a generic guideline?
If I'm on a low-carb or ketogenic diet, how should I be adjusting my electrolyte intake?
So here's what I want you to remember: hydration was never just about water.
Sodium, potassium, magnesium, chloride, and calcium are doing quiet, constant work behind every heartbeat, every muscle contraction, and every signal your nervous system sends.
Sometimes the clue is a hockey kid who suddenly has the stamina to finish practice strong. Sometimes it's the afternoon headache you keep blaming on stress. Or the leg cramp that wakes you up at two in the morning. Those symptoms aren't random. They're information.
So the next time your instinct is simply to drink more water, pause and ask a better question: does my body also need the minerals that help it use that water?
Thanks for spending this time with me today. I'm Dr. Emily Wheeler. Your symptoms are data. Your body is talking. Let's keep listening.
Dr. Emily Wheeler
Dr. Emily Wheeler is a functional medicine practitioner, speaker, educator, and host of the Rise Above podcast. With nearly 20 years of clinical experience, she helps women uncover the root causes of chronic symptoms through personalized, science-based care. Her mission is to help women understand their bodies, restore their vibrance, and rise above the gaps in healthcare.
Learn how Dr. Emily currently works with patients and where to begin.