AF, Hydration, Peeing and Electrolytes

[CDreamer]

There have been a few mentions recently of how often we need to pee when we are in AF and I’ve just revisited a few old threads which have reminded me what I’ve forgotten - I MUST DRINK MORE WATER.

This was brought home home also by an excellent TV programme recently called Your Body Uncovered looking at kidney stones, unfortunately I have passed a few! Most of us recognise that we are dehydrated when we become thirsty - but that means it’s too late.

What I didn’t know was these subtler signs of dehydration:-

A sweet tooth - so now instead of reaching for something sweet I’m drinking a glass of water and guess what, I’m losing weight, only a few pounds but I’ll keep going.

Bad breath

Dry mouth - indicates we are not producing enough saliva - which will exacerbate GERD

Dry or flushed skin

Muscle cramps - that’s me!

Colour of your pee - the lighter the better. If it is darker in colour then you need more fluids.

Peeing Frequently

For those who missed it there was an excellent thread on AF and frequent urination which also led to a reference to a previous excellent thread which describes why we pee a lot when in AF and why we also need to take salt to compensate for frequent peeing after AF.

I quote from JohnathonPittCricks reply and give a link to that thread:-

Hi, I'm rather late on this thread but I thought I should chip in because nobody mentioned WHY you pee more with AF – it's actually your body trying to correct the fluid problem and it's successful.

The heart function in AF is less efficient than in normal (sinus) rhythm so blood gets backed up trying to get into the heart which isn't pumping it forward fast enough. The back pressure causes stretching of the atria and they "think" the body is therefore overloaded with salt and water so they tell the kidneys to get rid of it (by producing a diuretic hormone ANP/BNP). So that makes you pee more until the back pressure has dropped to normal. If it didn't happen the back pressure would go up enough to cause congestion of your lungs (making you breathless on lying down) or oedema of your legs, so it's just as well the system works.

Of course when the AF stops you have some catching up to do so you can feel a bit fainty until you have had the chance to eat a bacon sandwich or something to boost the salt level back to what it was – especially if you have a POTS tendency.

One of the problems when AF is permanent is that after a year or so the system stops bothering to react and people gradually develop fluid overload – it is often called "heart failure" but actually can happen even when the heart is completely fine (apart from th AF). Anyway all they need is a regular low dose of diuretic to do the same job and everything is OK again.

healthunlocked.com/afassoci......

Worth remembering!

[Lizzie0205]

Thank you CD for pulling this info together. As newly diagnosed every post I’ve read adds something to the AF information jigsaw. It’s all so helpful and expertly researched. I now go to this thread every morning instead of reading the depressing news in my phone. I’m finding everyone’s comments very positive and uplifting and a good start to my day. Best wishes. Liz

[BobD Volunteer]

Thanks for that CD. As you know I am always banging on about good hydration. I am totally convinced that it was de-hydration which caused my PEA event in 2017 and I would not want anybody to have similar. I was lucky , others may not be.

[BobD Volunteer]

Out of interest CD I just re-visited the post from a few days ago about this subject and was very dissapointed to see how much ignorance there really is about it. Although quite a few people gave the correct answer there was still a worryingly large number who obviously have no idea why we pee in AF and even more worryingly had obviously had not read any previous posts in the thread where it had been explained. I guess all we can do is keep up the pressure. (joke intended.)

[CDreamer in reply to BobD]

Hence my post….

[LaceyLady in reply to BobD]

Well, I didn’t know either 😉 However I did know about drinking enough water, but BEWARE you can also drink too much and wash out your electrolytes. The amount each needs to drink is different from one person to another.

[CDreamer in reply to LaceyLady]

And that’s the point JPC was making - we also need to keep electrolyte intake up when we drink a lot of water. My father taught me that after his experiences in the dessert.

[queseyo in reply to LaceyLady]

Hi LaceyLady, interesting reading your post. I sometime think I am drinking far too much water, and as you stated it washed out the electrolytes, since I'm on a very low sodium diet (Meniere's condition). Complicated, I need to drink lots of water because of Constipation even though taking meds with electrolytes and plenty of fibre in my diet.

[CDreamer in reply to queseyo]

It’s all about balance and what is good for you.

[LaceyLady in reply to queseyo]

Some meds can make you constipated 😵‍💫The new med for my T2 has the opposite effect 🙄

[Singwell in reply to BobD]

Yes, I didn't know about the pressure aspect! I've happily been telling people it's about the need to jettison sodium...🙃

[CDreamer in reply to Singwell]

Love the way he said to eat a bacon sarnie………

[Singwell in reply to CDreamer]

Yes. It's something I noticed when in the early days I'd end up in A and E - they'd give me a pill and I'd still be going off. They'd offer me a cup if tea and a sarnie once they'd done the checks - and bye bye AF. Hospital food- loaded with salt and other nasties😉

[CDreamer in reply to Singwell]

Salt is now back in my diet in a big way and although I believe it’s the PM that has helped most, my whole circulatory system is in much better nick. I spent the whole of my adult life believing salt was bad for me when all along my father was correct - we NEED salt, just not too much of it.

[Singwell in reply to CDreamer]

6 gms I think you told me? I put some in an egg cup for a while to remind myself in the kitchen when cooking. I'd eliminated salt from my diet when I developed AF and they told me my BP was high too. You gave me great advice that time when I had a BP hypo!!

[BobD Volunteer in reply to CDreamer]

The cure for all things! Ever seen the Pob Landlord sketch about bacon?

[JaneFinn]

Thank you CDreamer, this is very very helpful xx

[10gingercats]

I have been prescribed(last Feb. 2021) a half tablet of Spirolactone and 20 mg of Furosimide daily .This was after heart started to play up with palps. and other related problems. plus 'heart failure'. Never been told this before.Now all seems well with no palps or other significant problems .Looks as if Jonathan Pitt Cricks may be correct. He is a cardio. after all.

[CDreamer]

Just in case no one recognizes the J Pitt Crick is a leading EP who occasionally offers very helpful insights and I am sure we are all grateful.

[doodle68]

In a recent programme with Dr Michael Mosley he advocated drinking a glass of water with every meal to stay hydrated which I now do.

[Tomred in reply to doodle68]

ive read of other drs who say not to drink with a meal as that will dilute digestive acids, so food may not break down properly, maybe its best to drink between meals.

[CDreamer in reply to Tomred]

True. No more than half a glass before eating but fine to sip after.

[Auriculaire in reply to doodle68]

I take with a pinch of salt Mosley's pronouncements. I agree with Tomred as well. Also drinking too much water alongside food can worsen bloating - not a good idea for fibbers.

[lovetogarden]

Thanks for pulling the info from that older thread. Always interesting things to learn about these blasted conditions! I was particularly interested in the last paragraph since my mother was in permanent afib for years and always had trouble with water retention, low sodium levels, and other problems. And great to know that JPIttCricks is a leading EP.

[Threecats]

That’s very helpful, thanks CD. Excellent explanation from JPC and as you say, a useful reminder. One of my cats always follows me into the bathroom if I get up in the night ( who needs privacy😊)but when I’m up and down every 10 mins when in AF, after a couple of visits she just shoots me a “are you being serious” look and ignores me😹

[CDreamer in reply to Threecats]

😂

[saulger]

Many thanks !

[Singwell]

Really helpful thank you! I'd not seen that explanation. In my profession - voice training - we say 'pee pale' to ensure good hydration. Amounts to make that happen vary between people due yo their BMI of course but usually its between 1.5-3 litres a day. Activity also makes a difference. I agree with you about feeling a need for something sweet. I don't need to lose weight but I try to be sensible about the amount of sweet treats I have each day.

[bassets]

Thanks for that! That is very useful information which explains a lot and will stop me wondering and worrying

[Jajarunner]

Great stuff. Also thirst can manifest (big word for so early in the day!) as hunger. I find I often get cravings when I'm thirsty.x

[Jajarunner]

And, as if by magic, this appeared in my new feed!

scitechdaily-com.cdn.amppro...

[mhoam]

Thanks for the reminder, it was interesting to read the reason why we pee more in AF. Unfortunately, I have an ileostomy, so no colon just a stoma at the end of my small intestine. Drinking large amounts of clear water just washes the electrolytes and salts straight out. I have been searching for advice on how to retain good fluid balance during my AF episodes. My cardiac nurse says avoid dehydration by drinking lots of fluid whilst my stoma nurse tells me to keep eating salty snacks I hate the taste of dialoryte !Any suggestions?

[CDreamer in reply to mhoam]

You will need to pass this by both your stoma nurse and Arrythmia nurse but I found Coconut water, the pure stuff not a drink, excellent & bit pricey & don’t like the taste but I mix with liquidised water melon - very high water content then delicious.

When I had COVID that cocktail was the only fluid I could retain (history of Ulcerative Colitis). The graph of my sodium/potassium levels looked like steep valley as I dehydrated, went into AF, couldn’t retain any fluids - until I drank that cocktail.

[mhoam in reply to CDreamer]

Thanks for the info CD, I will give that a try. Hope your UC is under control. Did you measure your sodium/potassium levels yourself or was it done by hospital/GP blood tests?

I had 20 years of struggle with UC before I became seriously ill in 2018 and had it all out!

[CDreamer in reply to mhoam]

Thankfully UC has been controlled since last flare in mid ‘90’s - that’s how I originally got interested in gut biome and nutrition. I came within a hair’s breadth of having to have it all out in 1970’s and rarely have had problem since until COVID destroyed all that! Thankfully it all came back within 6 weeks.

It’s just about finding something that works for you. Unsweetened apple puree was the other wonder food for me - green apples are higher in pectin content which is good for gut and I sweeten with unsulpherated sultanas which have high mineral content.

[Goosebumps]

I have low blood pressure, and one suggested correction to that is a salt tablet, which I don’t take by the way, I’m battling through med changes to try and get round it, cardiologist is going to move me off Bisoprolol. Also I had a tooth out in December and the recommended daily anti infection routine is 4 mouthwashes of heavily laden salt water. I can’t describe what that did to me. It took me a couple of days to work out what was going wrong.

[CDreamer in reply to Goosebumps]

Obviously it’s a matter balance but putting a good quality mineral based salt on food helped me a lot. That is the recommendation for controlling low BP - at least 6g of salt daily.

[Figbar]

This is great information.Thank you!

[JOY2THEWORLD49]

HiInteresting we awake dehydrated so reach for the water.

Directics unfortunately remove vital elements from body like potassium etc.

Eat banana with your pills and they go down amazingly.

cheri JOY

[kocoach]

Thank You so much for making it quite clear why I have to urinate so much when in afib, now I know and can make adjustments as you have written. Thanks again and have a Blessed Day.

[CDreamer in reply to kocoach]

You are welcome. So many people weren’t aware. I found it was useful revisiting the threads as I’d forgotten quite a lot!

Knowledge is so empowering, sad that we aren’t told this stuff on diagnosis - or even given a fact sheet.