Hi all - I’m finishing up my first shipment and I’ve realized my energy has both increased and stabilized after adding Huel into my routine (1 or 2 Huel meals / weekday). It’s a pretty obvious difference and I’m curious about why that is - is it a vitamin thing? Or a blood sugar thing? If anyone has an explanation for me I’d be interested to hear it! Thanks
Well, there could be many reasons for this. And a lot of it may depend on what you were eating previously and are now substituting with Huel.
My first guess would be the low glycemic index but substantial glycemic load of Huel. The starches, resistant starches, and fiber from the oats and flaxseed combination make it so that it provides a longer-lasting digestive source of complex carbohydrates. You get the benefits of carbohydrates, but without the serious spike in blood sugar that can come with very high glycemic index foods or foods with lot of added sugar.
Perhaps it’s an improvement in the way the body handles food and macronutrients. Perhaps you are experiencing an improvement in insulin response, IGF1, glucagon-like pepetide, ghrelin, etc.
It may be because you aren’t eating as much meat or dairy now that you are having Huel for about half or more of your total intake.
As far as vitamin deficiency… most people who get enough food generally get their micro-nutrients. Vitamin deficiency that results in actual clinical symptoms is pretty rare. I’ve worked for 19 years as a hospital pharmacist and almost never see any of our patients with a xxxxxxxx vitamin deficiency. Exception: the kidney failure patients have some. And some chronic conditions may have some malabsorption or a wasting syndrome. But in patients who are getting enough food, the vitamins “go along for the ride” and we almost never see anyone with an isolated vitamin A, vitamin B6, vitamin C, etc deficiency. There is no one at my hospital with scurvy or beri beri or rickets. Every once in a while we see the pernicious anemia from people who’s stomach cells don’t make enough intrinsic factor needed to absorb B12, but that’s not because of a dietary deficiency. And “iron deficient anemia” is usually caused by blood loss, sometimes imperceptible blood loss. So they need to supplement with iron. But they didn’t become anemic because they happen to not get enough iron in their food.
In general, vegans need a once weekly B12. Everyone needs about 10 min a day (average) of sunshine to get their vit D. (Although almost all milks,including plant milks, fortify with vit D). Everything else is made in plants and can easily be obtained from a simple vegan diet, or by killing and consuming the animal which got its vitamins by eating the plant food. (Vitamins are not made in the cells of mammals like cows. They have to eat the plants to get their vitamins. Or they get B12 from the microbes they eat. Cows, pigs, and chickens generally need the same “essential” nutrients that we do. They can’t make the essential amino acids and have to eat it from the original source, which is plants. When we eat meat we are essentially recycling nutrients originally made in plants.)
Thanks for providing excellent insight. As a Vegan, I do try to carefully watch exactly what I eat to make sure all my daily vitamin and nutrients are covered. Never had a problem…
Except, my BP recently went out of whack – lots of tests – finally, blood came back with a Potassium deficiency caused by my BP meds.
The fix was to put me on Potassium CL 20MEQ ER for a bit, and my vitality and strength immediately returned, and my foot swelling disappeared.
My question is what is the best method for getting enough Potassium every day? My cardiologist told me to eat a banana every day, but that doesn’t get me to 100% coverage. My cardiologist also doesn’t want me to stay on the Potassium pills.
I know coconut water has three times as much Potassium as a banana, but that still only covers 15% of DV – and a daily multivitamin only boosts you 2%.
Do you have any recommendations for getting enough daily potassium? My cardiologist isn’t concerned about it, but I’m sort of obsessing about it – because it seems naturally impossible to achieve 100% daily coverage via diet alone without the medical intervention of a pill.
Side Note: My cardiologist told me, 50 years ago, in India, the would do “coconut water IVs” right in the field. From coconut to needle! Now that’s some rural creativity right there!
Well, to be honest, a sustained release potassium chloride supplement is the easiest way to get there. Are you on some kind of diuretic like hydrochlorothiazide? If so, that will be constantly causing your kidneys to excrete more potassium and thus you’ll always need to increase your daily potassium intake. A KCl pill is about the simplest medication out there, with a very low side effect profile. So long as you’re not going too high on potassium and your stomach can tolerate it (sustained release is easier to tolerate), then IMO it’s much easier to take that than to conscientiously try to get enough potassium in the diet.
Also, many patients in our ICU are on 40 to 80 mEq of potassium per day supplement, so 20 is pretty low.
I myself take a potassium citrate prescription tablet. For the citrate, not the potassium. The potassium goes along for the ride. Citrate excreted by my kidneys raises the pH of my urine and has been shown to reduce incidence of kidney stone formation. (I’ve had several.) Now, the original studies for adding citrate were done by having the patients drink a lot of lemonnade or lemon juice. This was shown to reduce kidney stone formation. But I’d have to drink a lot of lemon juice to get the citrate load needed to alkalinize the urine. So, I just take it in pill form. I still drink some lemon water since it tastes good. But I cannot drink the volume needed.
I’m all about using dietary therapy first, especially if diet was the cause, such as Type 2. But in the case of replacing a lost electrolyte as a side effect of a med, you’ll find it much easier to use the K-dur (or whatever brand name) tablet than trying to measure you potassium. That’s a lot of bananas, oranges, sweet potato, avocado, spinach, and watermelon. You can certainly eat those listed foods because they are good for human health. But you need a specific nutrient for a specific condition and are being monitored to a specific goal range (I assume your goal blood potassium level is 3.5 to 5 range). That’s the job of a drug.
Pills when it makes sense. Diet changes when it makes sense. Both can be used for better health.
My dad has been on Hydrochlorothiazide and K-dur for, what, 4 decades now.
Terrific answer, thanks!
Yes, that’s one of my medications, and my vascular doppler duplex kidney guy told me the potassium problem was certainly because of my BP meds. Everything is fine with all the tests, my cardiologist just wants a baseline for future reference.
Maybe my potassium levels aren’t terrible – the tabs he gave me were a month’s supply to be taken every day for a week and then every other day – and when I asked him if the potassium tab would be permanent, he told me, “no,” which I didn’t understand, and will ask him about the next time I see him.
Next, is the Nephrologist on Monday, just for a routine “second opinion” double-check of all my tests, to make sure everything is fine and stabilized and nothing was missed – my cardiologist set it up for me.
Maybe the Nephrologist will have a different opinion on the potassium angle, and I’ll ask him, because what you suggest about needing more than diet makes sense to me. If you have a specific set of questions I should ask him about this, please let me know!
Is potassium stored in the body? Or does it always have be actively replaced every day?
Well, most of our total body’s potassium is intra-cellular. So although our blood levels (which are part of the extra-cellular compartment) measure 3.5 - 5 meq/Liter, the concentrations in the cell are about 150 meq/Liter. It’s the opposite of sodium, which is the body’s main extra-cellular cation. The sodium/potassium pump sets up this concentration gradient and this powers a lot of cellular processes. sodium and potassium channels open and passively diffuse across according to their respective gradients and then the cell actively pumps them back to re-create this gradient. It’s the circle of cellular life, I suppose. This is used for all kinds of things including action potential for nerve conduction, electrical conduction in heart muscle, fluid balance and fluid elimination in our nephrons of the kidneys. Many of our diuretics such as hydrochlorothiazide work by blocking these sodium/potassium pumps and thus cause more water (and potassium) to be lost… well they actually prevent the water and sodium from being reabsorbed, hence water and potassium are lost. Some diuretics work in the distal part of the nephrons (like HCTZ) and some work in the loop of Henle (“loop diruretics”, like furosemide).
But as fascinating as this all is, you don’t need to worry about the details. Yes, the body can “store” potassium. And during periods of water fasting the body has ways to conserve it’s potassium and sodium stores. But, most of the time we are intaking at least some potassium in the diet and the body carefully regulates and moves potassium into and out of the cells as needed, removed in the urine as needed, etc. But during certain disease states our total potassium stores can be depleted. Diabetic keto-acidosis is one of these.
Did you know that when insulin acts on the cell, potassium is pulled into the cell as part of the process to pull glucose into the cell? Pretty cool, hey?
For most patients, the most important labs involving kidney function are going to be Serum creatinine and BUN (blood urea nitrogen).
Here’s a little formula you can use once you know your serum creatinine value
[(140 - your age) x ideal body weight in kg] / [72 x Serum creatinine] = clearance
So for me, let’s say my serum creatinine is normal, like 0.8. I am 43 years young. And let’s say my ideal body weight is 68 kg, I can calculate my estimated creatinine clearance.
Numerator is [(140 - 43) x 68] = 6596
Denominator is [72 x 0.8] = 57.6
6596 / 57.6 = 114 ml/min
The creatinine clearance number will be in milliliters per minute. This is the amount of serum that your kidneys are filtering each minute. A “normal” clearance is prorated with age. A guy my age should have a creatinine clearance of at least 80 ml/min. Young people should be at least 100 ml/min. 120 ml/min is like the ideal and max that most humans can filter. In general, if creatinine clearance is 50 ml/min or above, there’s no immediate concern. Below 50 and we start to get concerned. Below 30 and you’ll see some clinical manifestations. If the kidneys are consistently filtering less than 30 ml/min, some form of renal replacement therapy is usually needed.
But back to the potassium replacement drug. Here’s my take on it. If you have a specific target goal for blood potassium level (3.5 - 5) and you are taking a diuretic drug at a specific dose every day, then the amount of potassium lost in the urine should be pretty predictable. Your doctor will then “titrate” the dose of your potassium tablet in order to achieve the goal potassium level. Doing this as a drug is easy. Trying to ensure that you weigh and measure and look up dietary potassium and keep it consistent most days in order to replace a constant loss from the diuretic is going to be tricky. ANd think of it from the perspective of the physician. The doctor feels more comfortable prescribing a specific dosage rather than leaving the intake up to you. (And as long as you have normal kidney function, there’s not much danger in going over a little on your potassium intake from the med and diet. The kidneys can eliminate excess should you happen to eat a lot of sweet potato that particular day.)
Such a fantastic reply! Thank you for all the detail. This took a lot of time, and intellect, and compassion to compose. You’ve helped me a great deal, and I’m sure, many others now – and those who will find you in this thread in the future.
I’m printing out all your replies so I can do Dr. prep, and self-learn as much about this as possible!
When I was young, my grandfather – a small town pharmacist in Nebraska – had to always eat a daily banana for the potassium. We grandkids would always ask him, every day, “Grandpa, did you have your banana yet?” But, now I know – one banana is never really going to be enough.
Thanks for all your replies, Deron! Exactly what I was looking for (and fun for a fellow bio nerd to read).
Here’s a fun fact.
The conversion of potassium chloride tablets meq into mg
20 meq of potassium chloride equates to 1500 mg of potassium chloride, which contains 780 mg of elemental potassium. (Source: Lexicomp)
1 medium banana has about 420 mg of potassium per Google. I am assuming this is elemental potassium. So roughly 2 bananas will give you similar results.
Caveat: your potassium chloride tablet is almost always a sustained release tablet/capsule that will release it’s contents over a period of about 24 hours. Whereas the body can absorb the potassium from the banana in, what, 30 min? Give or take, depending on stomach contents. When minerals like potassium or magnesium or sodium are aborbed quickly, the kidney will often excrete some of it soon afterwards. I know in our hospital we began slowing the infusion times for many of our electrolyte replacements in order to minimize this “renal loss” and it improved our ability to correct low electrolyte levels. So, even though 2 bananas may have the same rough amount of potassium as a 20 mEq tablet of K-dur, their effects on replacing potassium stores in the body are not the same.
It’s like comparing apples to oranges… or bananas to sustained-release matrix.
Another fun fact… K-dur tablets have a sustained release matrix and the potassium salt slowly dissolves within it as it travels through your intestines, then absorbs across the mucosal lining. Sometimes, the matrix stays intact while the potassium is gone. So it can actually come out the other end looking like a fully intact tablet. Rest assured, the drug got into your system. No need to fish out the remnant tablet from the stool and bring in to show the pharmacist. Yes, this has happened to my colleagues in retail.
Six bananas a day, and I’m covered! SMILE!
Again, I thank you for this exquisite detail. I feel better prepared for my monday Nephrologist meeting!
The science eludes me on a single read-through, but what a fun and informative thread. I too am noticing nice (and non-jittery) energy gains. Thanks Deron and all!
I have pretty serious ADHD and, after starting on Huel early this year, have found the same as you: more, and more steady, energy (which, for me, leads to a little better focus).