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<QUOTE author="gbolduev" post_id="4362" time="1510874720" user_id="90"><s>
gbolduev post_id=4362 time=1510874720 user_id=90 said:
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Met alkalosis will not drive chloride wasting.( unless it is potassium deficiency) Chloride loss can cause met alkalosis.( vomitting) Manganese toxicity can causes chloride wasting by increasing acetylcholine.( resp acidosis) Potassium loss from the cell can lower chlorides, this is what I see in most cases.<br/>
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Chloride deficiency causes potassium to shift inside of the cell. It is not hypokalemia. Potassium stores are fine. But actual hypokalemia will cause chloride wasting. <br/>
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Why would metabolic alkalosis cause chloride waste? metabolic alkalosis is a compensation for potassium loss. and in most cases it is super stupid to give acids to people. Since potassium will be totally wasted from the cell. <br/>
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Metabolic disorders cant be looked as PH imbalances only. <br/>
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Cortisol causes metabolic alkalosis with sodium retention , as cortisol wastes potassium and outside fluid needs to be alkaline , otherwise - crash will happen. It is not about correcting PH. it is about understanding what the body is doing.<br/>
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Uric acid can waste chlorides by wasting potassium.<br/>
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Most chlorides imbalances have nothing to do with chlorides themselves<br/>
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Current medical practice most of the time is wrong on what they are doing. Thus they never balance a person. Most of what I see they take one person from one imbalance to a less severe imbalance by giving them chlorides etc and other things, instead of fixing the real problems
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I said resp acidosis with some compensation causes chloride wasting, not metabolic alkalosis.<br/>
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And that is well known:<br/>
<URL url="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3142351/">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3142351/</URL><br/>
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"The kidney responds to chronic hypercapnea by increasing the strong ion difference. In early rat studies, chronic respiratory acidosis resulted in hypochloremia with selective increases in the filtered urine chloride but not sodium excretion (Carter, Seldin, & Teng, 1959; Polak, Haynie, Hays, & Schwartz, 1961). In dogs, exposure to 8% CO2 for 24 hours resulted in chloruresis and negative balance of chloride while sodium balance was unchanged (Levitin, Branscome, & Epstein, 1958). Yet, another study in humans demonstrated acute respiratory acidosis to have little variation in urinary sodium and chloride concentrations (Barker, Singer, Elkinton, & Clark, 1957). In a more recent study by Alfaro and coworkers (1996), it was demonstrated that hypercapnea and hypoxia in human patients with chronic obstructive pulmonary disease were associated with a decrease in plasma chloride without a significant change in plasma sodium, showing that these changes in SID were not due to hydration issues, but rather acid-base disorders. "<br/>
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" Both fractional excretion of chloride and that of sodium increased in response to respiratory acidosis; however, the increase in fractional excretion of chloride exceeded that of the fractional excretion of sodium."<br/>
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"This study is the first to document increased renal chloride excretion with respect to sodium within 30 minutes of the onset of acute hypercapnea. "<br/>
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And bicarb and chloride exchange is very well known. They have their own ionic transport protein in RBCs, it's well documented. HCO3- displaces Cl- and vice versa depending on the circumstances. Typically in resp acidosis there is movement of CO2 to inside the cell, converted to HCO3- and the HCO3- is moved out of the cell while Cl- is taken in. But what happens if there is constant rapid cycling of resp acidosis and met alkalosis? E.g. Someone is kyphotic and retaining CO2 (like while sitting) long enough for some bicarb compensation, then they stand up, start ventilating properly, and bicarb is still a bit elevated? At that point you have some minor hypochloremia and that aggravates the cellular alkalosis by keeping HCO3- in the cells, as it doesn't have enough Cl- for a fast exchange. People live like this every day - eat a ton, go sit down with shit posture and are kyphotic and possibly have some minor scoliosis (functional scoliosis very common in athletes), and then eventually get up and maybe exercise or walk around.<br/>
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I am not looking at metabolic disorders as simply pH issues - of course things are systemic, that's obvious. That's not what this discussion is about.<br/>
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There is utility in supplementing chloride when there is chloride wasting. This was the biggest intervention that helped me regain digestion and stop getting hives, undoubtedly. And you have to keep in mind, when I say supplementing I mean with foods - one thing about chloride is that it is almost always accompanied with lots of K+ in most foods, so the increased acid load (if paired with H+ sources) can be compensated. I hate supplements, avoid most like the plague, they imbalance everything.<br/>
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I think this is silly to pretend there is only one route to fixing these things. The body is a large system, you can affect it via many inputs - there are not single solutions to single problems. There are many solutions to single problems.
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