Optimal - The Blog

May 21, 2019

Know Your Biomarkers: Sodium Potassium Ratio

In this video, Dr. Weatherby will be focused on the sodium: potassium ratio because it’s such a good biomarker to analyze. In previous posts, we talked about serum levels of sodium and potassium being under the influence of aldosterone and cortisol, both hormones produced by the adrenal glands. Aldosterone causes the body to retain sodium by causing a decreased excretion of sodium from the kidney.

Aldosterone has the opposite effect on potassium causing the body to excrete potassium by increasing the excretion of potassium from the kidney.

The sodium:potassium ratio is determined from the serum sodium and serum potassium levels. Both of these biomarkers are under the influence of the adrenal glands. I like to see the sodium: potassium ratio in the blood be between 30 and 35.

We calculate this automatically in the ODX Application so you don’t have to worry about doing the calculation.


Here are some clinical implications when the values drift outside of the optimal range:

High Sodium:Potassium Ratio

Increased sodium:potassium ratio is associated with acute stress. Acute stress causes an increase in adrenal activity and an increase in aldosterone output. Aldosterone causes sodium to be retained in the body and an increase in serum sodium. This also causes the potassium to be excreted thus lowering the serum potassium levels. The net effect is increased sodium:potassium ratio.

An increased ratio is also an inflammatory indicator. As just mentioned, elevated sodium:potassium ratio is an indication of a higher aldosterone output. Aldosterone is often considered a pro-inflammatory hormone and cortisol is an anti-inflammatory hormone so an increase in aldosterone, as seen in high sodium:potassium ratio is seen as an inflammatory indicator associated with inflammation and pain.

Low Sodium:Potassium Ratio

A decreased sodium:potassium ratio is an indication of chronic stress, adrenal fatigue, and adrenal insufficiency. Chronic stress weakens the adrenal glands and causes a decrease in adrenal activity and a decrease in aldosterone output. Low aldosterone causes sodium to be excreted by the body (hence the low serum sodium) and causes the potassium to be retained thus increasing the serum potassium levels. The net effect is a decreased sodium:potassium ratio.

Catabolic Indicator

A decreased sodium:potassium ratio is also an indication of a higher cortisol output than aldosterone output. Cortisol is a hormone associated with tissue breakdown and catabolism. A decreased sodium:potassium ratio is an indication of catabolism, i.e. the body may be breaking down tissue faster than it is regenerating it.

So that’s the sodium:potassium ratio. It’s easy to calculate (just divide the sodium value by the potassium value) or just input the 2 values into the ODX application and we’ll calculate it for you!

Tag(s): Biomarkers

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