Can anyone help discover the cause of my electrolyte imbalance that is damaging my skin?

loot

I've been having a problem with thirst since winter last year where I have increased thirst, particularly during the night since I can't drink anything while I'm asleep except when I wake. I tend to wake 1-3 times during the night, sometimes more. The problem mainly manifests in skin damage due to extreme dryness. I wake up with deep lines in my face mostly in places that would not get wrinkles. Many are more like dents. These marks are all formed by groups of greatly enlarged pores. These marks mostly fade during the day since I am able to consume fluids (mainly a home made electrolyte drink rather than plain water, or milk/juice/fruit etc) but they are becoming more and more permanent.

At that time I'd started a fat loss regime but it was only a slight caloric deficit with only about 300g of weight lost per week so not sure it can explain this amount of electrolyte imbalance especially since my diet seems very nutrient rich. I used an app to track the weight loss so I know exactly what the rate was.

What are the possible causes for chronic low electrolytes considering the following factors:

Blood tests reveal normal kidney function
Not due to sweating, no sweating or intensive exercise undertaken
No diarrhoea or excessive urination
Increased thirst but blood sugar normal according to HbA1c blood test

I've tried eating at maintenance for 1-2 weeks during this time where weight did not decrease, even increased but the symptoms did not subside.

Diet

Goats Milk, goats cheese
White fish
Raw honey
Orange juice
Oranges
Beef mince 15-20% fat
Organic eggs
Honeydew melon
Chicken feet
Ox tendon
Sometimes chicken breast
Sometimes carrots cooked for quite a while to make a bone broth soup
Sometimes lamb liver, chicken livers, lamb heart, lamb kidneys

Previously short grain white rice or waxy potatoes but recently eliminated since they may be causing bloating. Previously other fruits like dates, grapes, mangoes, nectarines etc but eliminated in case they are causing issues. Grapes eliminated because they possibly have mould and I noticed I often have a stuffy nose after eating them. I can wipe off the mould but just to be safe I've eliminated them for now. Mangoes removed since apparently they are high FODMAP so just in case.

Oranges and orange juice seem the safest for me especially since when I eat oranges I don't consume the flesh, only the juice.

Salt is added to taste.

Calories 2200-2400

Supplements

Vitamin K, vitamin B1, Vitamin D, T3 12.5-25 mcg, 6.25 with each meal throughout the day

Blood tests

TSH 2.6. I've had a not so great thyroid for a while but eating what I consider to be pretty decent and using T3 has not helped much in raising temperatures. Rising temperatures tend to be 36.5-36.7, not awful but could be better. But it doesn't tend to rise after breakfast, it tends to stay the same or drop. The afternoon temperature is around the same as the morning.

Serum free T4: 15.1 pmol/L normal

Vitamin D 62. Started 10000 IU vitamin D after getting the result although it is in the normal range of 50-375

HbA1c 37 normal.

Blood Pressure 118/76

Renal profile normal

Liver function normal

Full blood count also normal. I can give more details of the exact values in these other tests if required. I do have some gut issues like certain foods that I've now eliminated cause bloating and flatulence but that is nothing new. Can it really be caused by weight loss or is there some kind of absorption issue?

TLDR: What, you didn't read it? How are do you suppose you're gonna be able to help then? But seriously: electrolyte issue causing dehydration and skin damage during the night, diet seems good to me, nutrient rich so can't explain why it's causing an electrolyte imbalance. Blood sugar is normal.

LucH

Hi,
If you don't drink enough water (1.5 liter) + vegetables, you won't recover. Water is worth more by what it takes away than what it brings.
For skin problems, mind the following nutrients:
Monitor vitamin A (Retinol) and vitamin B-co-enzymed (notably B3 Niacinamide and B5 Panthenol) + zinc (10 to 15 mg; double the dose for a few days). + GLA (evening primrose oil 500 mg if you're a girl).

But you have first to deal with dysbiosis.

Otherwise, it won't succeed.
And I 'd take digestive enzymes to help.
Fruits must be eaten apart. When OK, may be eaten at first (salad), following 15' later by other macronutrients.
It's like a treasure hunt, search for elements that helps or harm.
And your temp won't be OK without appropriate protein (from meat preferably).
See Dr overtone why you need more thiamine (B1) to help carburation. But not now.
Hope it can help.

loot

@LucH Yes increasing water intake to combat the increased thirst of course makes sense but what's causing the greatly increased need for water in the first place, that's what I want to find out. And like I said, even though I'm drinking more water than I used to during the day, I can't drink water while I'm asleep so the skin gets damaged during the night. The skin problems are directly connected with the dehydration, that I'm sure of. I don't really eat vegetables.

Fruits must be eaten apart.

You mean separate from other food types? Why would that help?

And your temp won't be OK without appropriate protein (from meat preferably).

Check my list under diet above, more than adequate protein is being consumed.

See Dr overtone why you need more thiamine (B1) to help carburation.

Under supplements above, B1 was listed.

@LucH

But you have first to deal with dysbiosis.

Not sure if I do have dysbiosis or not but that could be causing malabsorption if I did.

LucH

The skin problems are directly connected with the dehydration. That I'm sure of. I don't really eat vegetables.
=>

If you drink enough during the day light, you can’t be dehydrated because of sleep unless there is another problem.
You don’t take into account what I’ve said about supplement for skin repair: GLA and Zinc are the most susceptible to lack. And don’t tell me you’ve got enough zinc when eating red meat (not the other kinds) because you’ve got a problem of assimilation: bad digestion and low-grade stomach inflammation.
You’ve got a problem with potassium if you don’t eat vegetables. Problem with electrolytes.

Fruits must be eaten apart.
You mean separate from other food types? Why would that help?
=> Fruits bring soluble and insoluble fibers and sugar. Sugar raises fermentation. As you suffer from bloating, so it’s easy to make the link.
Most fruits and vegetables are digested in less than half an hour. If you eat first starch and meat, fibers will remain longer (2-3 hours) in the first part of the colon than what is needed.

And your temp won't be OK without appropriate protein (from meat preferably).
Check my list under diet above, more than adequate protein is being consumed.
=>Your list is approximate and doesn’t say much about the quantity and the frequency. And what about the balance from amino acids:
“Beef mince 15-20% fat, organic eggs, chicken feet, ox tendon, sometimes chicken breast, sometimes lamb liver, chicken livers, lamb heart, lamb kidneys”.
=> Red meat: 2x/wk (I suppose), liver or meat organs 1x/wk, chicken 2x or 3x/wk.
Advice: See how much protein (amount in grams) with cronometer.com.
0.8 gr minimum / body weight. 1 gr target.
I would add: duck.

See Dr overtone why you need more thiamine (B1) to help carburation.
Under supplements above, B1 was listed.
=> You didn’t say how much and what type. It’s not with 50 mg Thiamine HCl you’re going to re-connect the brain and the microbiota through the vagus nerve.

But you have first to deal with dysbiosis.
Not sure if I do have dysbiosis or not but that could be causing malabsorption if I did.
Yes, you have if you bloat and have flatulence. Your digestion is problematic.

Final note:

I won’t discuss any longer why and how. You’re not receptive enough and I need to see the person accessible to optimize my “time invest”.
You should have asked why or how if you didn’t perceive the reason instead of arguing. Sorry to be hard but …
Take care of you and stay open-minded.

loot

@LucH

If you drink enough during the day light, you can’t be dehydrated because of sleep unless there is another problem.

Well yes of course, that's true of every human, the issue is what constitutes enough? Why is it I went from consuming x amount of water and now need to consume several times that amount for the same result. This would treat the symptoms but not the cause. I'm not necessarily looking for treatment whether the root cause, or the symptoms but rather trying to find out what is causing this all to happen in the first place.

Most fruits and vegetables are digested in less than half an hour. If you eat first starch and meat, fibers will remain longer (2-3 hours) in the first part of the colon than what is needed.

Ok that is useful information if I decide to consume vegetables or more fruit again, thanks. Currently I'm consuming fruit juice and the juice from oranges only. But I'll note that with melons and such. Maybe I'll just separate the juices anyway to be sure.

@LucH

Check my list under diet above, more than adequate protein is being consumed.

Well I consume 0.6-0.8 g per pound of body weight which is what Mike Fave and Jay Feldman recommend. Peat changed his stance on high protein towards the end and describes high protein as being anti metabolic.

I would add: duck.

Ok I don't understand that either, duck is full of pufas. You didn't explain that and it's not obvious. I suppose I should just take this for gospel otherwise I would be "arguing".

@LucH

You didn’t say how much and what type. It’s not with 50 mg Thiamine HCl you’re going to re-connect the brain and the microbiota through the vagus nerve.

True, I take 200-300mg Thiamin HCL.

Yes, you have if you bloat and have flatulence. Your digestion is problematic.

True but I had that before this issue began with severe flatulence but no skin or dehydration issues.

I won’t discuss any longer why and how. You’re not receptive enough and I need to see the person accessible to optimize my “time invest”.

Ok you seem somewhat authoritarian in your advice and much of it seems anti peat. It's normal for me to ask for an explanation. You seem to be offended when anything you say is questioned so as you say it's probably best to leave it.

You should have asked why or how if you didn’t perceive the reason instead of arguing.

I did ask why. Quote from above: "You mean separate from other food types? Why would that help?" You even responded to that. Not sure what you want to say there.

Sorry to be hard but …

Ok hope you feel better soon. Thanks for the help anyway.

Take care of you and stay open-minded.

Normally you work with someone to find solve their problems instead of just telling them what will work for them without question. Problems are very individual and context dependent, there's no blanket advice that will work for all. Of course you have no obligation to help as you say, for what it's worth I did get some useful info from you.