@gbolduev @mattyb I notice some electrolyte supplements contain 'chloride' as a separate ingredient to potassium chloride, sodium chloride etc - is the chloride on it's own different to the potassium chloride etc? (i.e. is is like TUDCA where this is this is basically ursodeoxycholic acid [UDCA] with a taurine molecule attached, but does not have the actions of taurine even though taurine is part of it?)
Just wondering because reading about alkalosis here it says in this study, which is focused on chloride depletion alkalosis admittedly, that replenishing potassium will not resolve the alkalosis on it's own unless it's in combination with chloride?
It Is Chloride Depletion Alkalosis, Not Contraction Alkalosis
So are we getting the chloride by supplementing with potassium chloride etc, or is it best to look for a supplement with standalone chloride too?
If it says there's potassium in there, and it doesn't say citrate, but it lists chloride, then it's potassium chloride. Potassium, sodium, etc. always need to be attached to something - they don't come on their own.
The first line treatment for volume expansion alkalosis is IV potassium chloride and water. We add magnesium because we're doing it orally, and magnesium helps with potassium absorption. Often in the IV solutions they'll have other electrolytes like magnesium, calcium, and sodium as well - all attached to chlorides.
If that doesn't work, they do a central line with HCl, because this provides additional chloride, but the primary reason is because it directly counteracts the alkalosis by increasing proton concentrations (H+, since the H from HCl always dissociates in the body, leaving H+ and Cl-). They don't do an IV, because the HCl can cause vascular damage when injected into those veins, but with a central catheter the body can handle it.
If that doesn't work, they use acetalozamide + IV, since this dramatically increases proton concentrations (AKA H+, acidity, low pH), directly reversing the alkalosis.
And the last approach that is tried is oral lysine HCl + IV solution. This works because when lysine is metabolized it releases an excess of protons, acidifying the blood and reversing the alkalosis. The dosages they use are crazy stupid, like up to 10g of lysine spread out over a few days.
So if you are resistant to all other approaches, oral lysine + electrolytes may be worth trying out.
All these treatments do one simple thing (except the very first one) - they directly increase acidity (AKA proton/H+ concentrations), causing efflux of unwanted minerals out of the cell and reduction of bicarb, and replenishing those minerals with the proper dominant intracellular minerals (K+ and Mg+).