Ask the doctors: Diet, hydration the best way to get electrolytes

Q: My husband was given a small jar of electrolyte powder by a friend and has decided to take it on a daily basis. He is 76 years old, sedentary, a bit overweight and has high blood pressure. Might taking electrolytes cause him problems?

A: Electrolytes are minerals that, when dissolved in liquid, carry an electric charge. The main electrolytes are potassium, magnesium, calcium, sodium, phosphate, chloride and bicarbonates. They are found dissolved in blood, lymph, urine, sweat and other bodily fluids.

Many of the body's automatic functions, which you need to survive, are powered by a small electric current. That's where electrolytes come into play. The charge they provide is vital for proper nerve and muscle function, maintaining cardiac rate and rhythm, moving nutrients and waste across cell membranes, and managing blood pressure. Electrolytes also keep an optimal fluid balance in the body and maintain the proper pH level in the tissues and bodily fluids. That's extremely important, considering the human body is about 60% water.

You can get the electrolytes you need by eating a balanced diet. Minerals are found in vegetables, leafy greens, fruit, nuts, seeds, legumes, dairy products, certain fish and seafood, and lean meats. Unless specifically fortified, like some breakfast cereals, you won't find electrolytes in processed and ultra-processed foods, which lean hard into sugar, salt, fat and refined carbohydrates.

We lose electrolytes in sweat and excrete them in urine. But unless you're engaged in prolonged or intense physical activity, the daily intake from a healthy diet balances out the loss. Electrolytes are also lost through vomiting or diarrhea. If either are excessive or prolonged, it can cause an imbalance. This is particularly true in children. In older adults, the ability to absorb and excrete certain electrolytes, including sodium, can wane. This can adversely affect fluid balance.

Symptoms of an electrolyte imbalance include fatigue, headache, nausea, muscle cramps or spasms, heart arrythmia, changing blood pressure, numbness or tingling in the fingers or toes, irritability and confusion. Diagnosis is with a simple urine or blood test, which can pinpoint the specific cause. Treatment focuses on replenishing missing electrolytes via supplements, medications and, in acute cases, IV fluids. The patient will also be counseled about diet.

When it comes to electrolyte powders, we have found quite a bit of variability in their composition. Some contain a lot of sugar, both real and artificial, and can also include additives that are not necessarily beneficial. Depending on the specific product, it is possible to inadvertently skew your electrolyte balance. If using one of these supplements leads to side effects such as swelling of the feet or ankles, dizziness, unusual weakness and changes to mood, it is wise to discontinue its use.

In the absence of the type of intense physical activity that leads to a copious loss of electrolytes through sweat, we advise leaving the powders, as well as the liquid supplements, alone. Unless your husband has been diagnosed with an electrolyte imbalance, staying hydrated and eating a balanced diet will provide the electrolytes his body needs.

Treating diabetes with stem cells

Q: My 11-year-old granddaughter was recently hospitalized for two days and diagnosed with Type 1 diabetes. This came as a shock. Her cord blood has been stored since her birth. Is there any way it can be used to help with this disease?

A: Diabetes is a disease in which the body is unable to adequately manage blood sugar. It falls into three categories — Type 1, Type 2 and gestational diabetes. Although the causes and mechanisms of impaired glucose control differ with each type of the disease, they all involve insulin, a hormone produced by the pancreas. Insulin helps glucose move from the blood into the cells, where it is used for energy.

In Type 1 diabetes, the beta cells of the pancreas are either unable to produce insulin, or they produce very little. This allows glucose to build up in the bloodstream, which is damaging to the body. Treatment of Type 1 diabetes involves the use of injectable insulin, managing the diet and close monitoring of blood sugar levels to avoid episodes of low or high blood sugar.

In asking about your granddaughter's cord blood, you echo a question that has led to recent groundbreaking research into a cure for diabetes. The focus is on stem cells, which are present in cord blood.

For those who are not familiar, the term "cord blood" refers to the blood that remains in the umbilical cord and the placenta following an infant's birth. It contains stem cells, which are immature cells with the potential to develop into many different types of specialized cells. Stem cells can be used to treat lymphoma, sickle cell anemia, leukemia and some inherited disorders.

Researchers are now studying if the components of cord blood may be useful in treating a wide range of conditions and disorders. This includes cerebral palsy, stroke, spinal cord injury, diabetes, birth asphyxia, age-related cognitive decline and both Type 1 and Type 2 diabetes.

A number of recent studies exploring the use of stem cells to treat, manage or even cure Type 1 diabetes are yielding promising — and sometimes remarkable — results. In a small clinical trial in Sweden, certain components of cord blood were used to slow the progression of Type 1 diabetes in patients newly diagnosed with the disease. In another study, a biotech firm in San Francisco used genetically altered stem cells to successfully treat mice with Type 1 diabetes. The notable aspect here was that the stem cells were rendered "invisible" to the immune system, and thus did not provoke an immune response that could have derailed the treatment. At the University of Chicago, researchers used stem cells from cord blood to "teach" the immune system not to destroy the pancreatic cells that produce insulin.

Although promising, these advances remain in the research phase. There are no stem cell-based treatments for Type 1 diabetes available at this time. However, recent breakthroughs, not only in stem cell therapies, but also in immunotherapy and transplantation of insulin-producing cells, offer real hope for the near future.

• Dr. Eve Glazier is an internist and associate professor of medicine at UCLA Health. Dr. Elizabeth Ko is an internist and assistant professor of medicine at UCLA Health. Send your questions to askthedoctors@mednet.ucla.edu.