Recuperat-ion.  Is it Worth it’s Salt?

Recuperat-ion is a mineral supplement for fibromyalgia.  It’s inventor has claimed that he cured his fibromyalgia with it.  Is there any reason why this supplement would work better, or differently, than other mineral supplements?  Let’s look at the minerals it contains: (Note: There is a sugar sweetened version that contains lower amounts of these minerals).

Mineral

Amount per Packet

Total per day (4 packets)

%RDA (4 packets)

Sodium (mostly Sodium Citrate)

740 mg

2960 mg

           128%

Potassium (Potassium Chloride)

200 mg

800 mg

             17%

Magnesium (Magnesium Carbonate)

15 mg

60 mg

             15%

Calcium (Calcium Phosphate)

15 mg

60 mg

               6%


Even if one used 4 packets a day of this supplement, one would still not obtain a significant amount of magnesium or calcium,.  The RDA for calcium is 1000mg, so the amount of calcium in this supplement is especially small.  The RDA for magnesium is 400mg.  So with respect to the RDA, there is relatively more magnesium than calcium.  However, many alternative doctors and magnesium researchers believe that the RDA for magnesium is too low.  This is why many some people recommend taking significantly more magnesium than the RDA.  A high amount of magnesium intake, using a well absorbed form, is possibly the key to properly using magnesium to treat conditions.  A small amount of magnesium, is unlikely to do much, unless your intake is very low to begin with, which is the case for the average western diet.

The amount of potassium in this supplement may seem like a lot.  But the recommended daily amount of potassium for adults is 4700mg.  The 800mg of potassium which you get in 4 packets of this supplement, is only about 1/6 the recommended daily amount.  Additionally, a diet with a good amount of vegetables and fruits, can readily reach or exceed the daily recommended amount.  (A medium sized banana contains about 450mg.)

On the other hand, the amount of sodium in these packets is very significant.  The recommended daily amount for the average person is 2300mg.  For people with salt sensitive hypertension, the recommended daily amount is only 1500mg.  4 packets of this supplement by itself, easily exceeds the daily recommended amount for the average person.  Add in the amount of sodium from one’s diet, and the total will be even greater.

Note that the form of sodium contained in this supplement, is mostly sodium citrate, with only a small amount of sodium chloride.  It is sodium chloride that increases blood pressure in salt sensitive people, not sodium citrate.  Other than that, sodium chloride and sodium citrate appear to have similar effects.  Sodium citrate, however, has a salty sour taste, which is why sodium chloride is the more common additive in foods.

Sodium intake decreases the production of angiotensin II and aldosterone.  Angiotensin II and aldosterone both help to control the body’s ratio of sodium to potassium.  Increasing one’s sodium intake, will cause a decrease in the production of angiotensin II and aldosterone, leading to increased sodium excretion and water retention.  A study using 4000mg of sodium on normal subjects demonstrated that significant decreases in angiotensin II and aldosterone can occur.  This study also demonstrated one of the other known effects of sodium, which is that it can lower the activity of the sympathetic nervous system, resulting in decreased urinary and plasma noradrenaline.  Since some studies have shown that the sympathetic nervous system is in a hyperactive state in fibromyalgia, and that injections of noradrenaline causes pain, we wonder whether the reduction of noradrenaline from increased sodium intake, could be significant enough to have an effect on fibromyalgia pain.

Another effect of increasing sodium intake, is a decrease of insulin resistance.  This may be due to the reduction of angiotensin II, as angiotensin II is known to increase insulin resistance  Moderate salt restriction has been shown to aggravate both systemic and vascular insulin resistance.   One consequence of this, is that sodium intake increases insulin’s vasodilatory effects, resulting in improved blood flow in limbs.

If insulin resistance is decreased by sodium intake, then this might lead to increased intracellular magnesium levels, as insulin resistance is known to depress cellular levels of magnesium.  Cytokines, hormones, and neurochemicals, all influence the intracellular levels of minerals.  Taking the best absorbable mineral supplement, is only going to be of marginal help, if other factors are interfering with the intracellular levels.

Another interesting effect from increased sodium intake is increased cortisol elimination, resulting in lower plasma cortisol levels.

One of the more important effects of increased sodium intake for people with CFS and fibromyalgia, may be the increase in blood volume that can occur.  This can be of help for orthostatic disorders and low blood volume, that lead to symptoms such as dizziness.  Such problems often occur in people with CFS and fibromyalgia.   It is well known that increasing sodium intake helps these conditions.  For many years, doctors treating CFS and fibromyalgia patients have been recommending salt as a remedy.  Regarding this, it’s possible that potassium may be able to somewhat offset this effect from sodium.  We think then, perhaps that it’s a good thing that this supplement doesn’t contain a high amount of potassium.

Another possibly important effect from increased sodium intake, is the resulting decrease in angiotensin II.  Angiotensin II has both inflammatory and oxidative properties, which can cause or influence a host of problems.  Drugs that block or lower angiotensin II can have numerous benefits for many different conditions, with new uses seemingly being discovered on a daily basis.   The elevation of angiotensin II which results from salt restriction, is one of the reasons why some people believe that sodium restriction should not be recommended, unless there is a clear reason for it.  The increase in angiotensin II may be one of the reasons that one study not only didn’t find any decreased risk of mortality from a low sodium diet, but actually found an increased risk of moratlity in many of the studied groups.

Even though Recuperat-ion contains very low amounts of calcium and magnesium, it may still have a significant effect on their balances.  Low sodium intake increases aldosterone.  Excess aldosterone increases urinary excretion of magnesium and calcium.  And a low salt diet, which increases aldosterone absorption, has been shown to increase urinary magnesium and calcium.

However, it’s not clear if manipulating aldosterone via salt intake, can have much influence on mineral balance.  This is mainly due to the fact that sodium itself has it’s own direct effects on mineral retention.  It’s been well documented that salt increases urinary calcium.  However, this applies to salt, and not to all forms of sodium.  Sodium citrate has the opposite effect, as it decreases urinary calcium, improving calcium balance.  This occurs, due to the fact that the PH of urine affects calcium absorption.   Acidic urine increases urinary calcium.  Acidic urine can occur due to a high protein diet, and this will increase urinary calcium.  However, in a study on such a diet, it was found that sodium bicarbonate alkalinized the urine, and reversed the urinary calcium loss.  Sodium citrate has similar effects on PH, and it can also reduce urinary calcium.

Sodium citrate may also be able to affect urinary magnesium via a similar effect, as urinary magnesium loss in acidosis conditions has been corrected by sodium bicarbonate.  This may be one of the reasons why one study has shown that the magnesium balance for the average person is significantly coorelated to calcium balance, but not to magnesium intake.  This doesn’t mean that magnesium supplementation doesn’t have an effect.  Hundreds of studies on magnesium supplementation have proven that it can have an effect on magnesium status.  But many of the factors that affect calcium balance, such as vitamin D and urinary PH, not only affect calcium retention, but also magnesium.  And so perhaps for the average person with the average western diet, with low magnesium content, that an effect that improves magnesium retention, may be able to significantly change one’s magnesium status.

In any event, we suspect that some of Recuperat-ion’s beneficial effects, may be due to the alkalinizing property of sodium citrate, which will then increase calcium and magnesium retention.

As an aside, it should be noted that the person who created Recuperat-ion, and who claims to have cured his fibromyalgia with this supplement, was also diagnosed with Ankylosing Spondylitis.  Ankylosing Spondylitis is a form of chronic inflammation of the spine and the sacroiliac joints.  Coexisting conditions such as this, are commonly found with fibromyalgia.  However, many times in such cases, the fibromyalgia is actually caused by the other condition.  In such situations, fibromyalgia is secondary to the other condition, and this “secondary fibromyalgia” is often harder to treat than primary fibromyalgia.  This is because, unless the primary condition is treated, it will continue to aggravate the fibromyalgia symptoms.  However sometimes, if the primary condition is properly treated, the fibromyalgia symptoms will also subside.  While other doctors dismissed the diagnosis of Ankylosing Spondylitis, he obviously did have some sort of other condition, as when he recovered from fibromyalgia he stated that “my symptoms of ankylosing spondylitis have also let up, of which I don’t have any traces."

As an aside, it’s interesting to note that while Ankylosing Spondylitis can be just as bad (or worse) than fibromyalgia, it’s documented in the medical leisure, and on the web, that remission occurs in a small percentage of cases.  However, the treatments that caused this to occur in those people, don’t necessarily help other cases.   This is similar to fibromyalgia.  If you search the web, you will find numerous stories of remission from fibromyalgia, via different methods.  Yet these same treatments don’t cause remission in other people. 

In any event, rgardless of why this person was helped by his supplement, the medical literature definitely does document several effects from sodium citrate intake, that may be helpful in treating fibromyalgia, CFS, and possible other chronic conditions.  IMHO, this is more likely the main reason why it helps.

Mark London
MRL@PSFC.MIT.EDU

The creator of Recuperat-ion has posted comments about my web page to the AlfredblasiprotocolFMSCFS yahoo discussion group.  To read my response, follow this link.