A simple 10-step arthritis treatment plan

What are the most important things we can do to stop and reverse the degeneration, and alleviate the stiffness and pain of arthritis? You can be sure that no matter how bad things are, there are many things that will help, and they don’t involve pharmaceuticals.

We looked in some detail at how to treat arthritis in Treating Arthritis I and II, and have at least one of our readers, an artist, Catherine Bath, who has been able to alleviate a great deal of her stiffness and pain, and recover a good amount of mobility and ease of movement by following the various recommendations we made there and throughout this blog.

Here, prompted by a request from a good friend who needs it, we present a simple treatment plan with the most important elements, and just the essential details needed to understand why the interventions are useful, and how to put them into practice right away.

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Illustration of painful, inflamed, arthritic joints. (Image taken from Everyday Health)

1. Hydrate and alkalise

This is the most important point of all. Without it nothing will work, really. Every joint works thanks to the cartilage that allows the bones to move within it without rubbing against one another. Arthritis is always characterised by the degradation of this cartilage and the pain associated with the inflammation caused by the bones not moving properly or rubbing inside the joints. Cartilage is water (85% by weight) held together in a matrix made mostly of collagen, and chronic dehydration is the first cause of cartilage breakdown (details in Your Body’s Many Cries for Water).

Metabolic acids (mostly uric acid) can only be excreted efficiently by the kidneys when there is an excess of both water in which to dilute the acid, and salt to help carry it out in the urine. Without excess water, the kidneys will prioritise retaining as much of it as they can. Without excess salt, the uric acid will be recycled instead of being excreted in order to to maintain the concentration gradient in the medulla of the kidney that ensures its ability to reabsorb as much water as possible. Chronic dehydration and avoidance of salt, coupled with the drinking of acidic liquids and eating of acid-forming foods inevitably leads to chronic acidosis.

To maintain the pH of the blood at 7.365 in spite of the continuous flow of acids into it from the muscles and digestive system, two main coping strategies are available: 1) The body’s main acid buffering mechanism using the reserves of alkalising minerals stored in the bones and teeth to counterbalance the acid load. If you don’t quite understand the implication here, this means erosion of the bones and teeth to put into the blood some of the alkalising calcium, phosphate and magnesium as acid-buffering minerals. 2) The crystallisation of the uric acid to pull it out of circulation, but then storing it into tissues, of which the joints, regrettably for arthritis sufferers, seem to be used preferentially, even though all tissues can be used for this to a certain extent.

The strategy is simple: drink alkaline water (either naturally so, or made to be with pH drops) on an empty stomach, and allow at least 30 minutes before eating. Aim for 3 litres per day. One litre before each meal, drank over a period of one to two hours, is a simple rule of thumb and easy schedule to remember. And aim for 2 full teaspoons of unrefined salt with your meals.

2. Magnesium chloride and sodium bicarbonate baths

Magnesium is at the very top of the list of supplements for anyone in any circumstance. We explored and explained why in Why you should start taking magnesium today.

Transdermal magnesium and bicarbonate therapy is the best way to simultaneously replenish magnesium stores in the cells, while alkalising the tissues directly by transdermal absorption of magnesium and sodium bicarbonate. If you have a bath tub, do this once or twice per week, or more if you can or need it. Add two cups of each magnesium chloride and baking soda, and soak for 45 to 60 minutes.

I also recommend that in addition to this—but crucially if you don’t have a bath—you take magnesium supplements. I take a fat-bound magnesium supplement called L-Threonate. Another alternative is the amino acid-bound supplement called magnesium glycinate (using glycine). Both of these form maximise absorption. Take it with meals.

3. Silicic acid, collagen, hyaluronic acid, and proteolytic enzymes

An essential constituent of hair, skin, and cartilage. Absorption is poor and slow. This means you need to take small amounts every day for long periods of time. Every morning, first thing, with your first glass of water. You will need to do this in cycles of three months on, three month off. I take Silicea, a concentrated water-soluble silicic acid gel by the German brand Huebner.

Collagen and hyaluronic acid will help greatly in rebuilding the damaged cartilage. Look for type II collagen for better absorption. Now Foods has good products at good prices. Also, glucosamine, chondroitin, MSM have all been shown to be useful for joints.

Proteolytic enzymes are responsible for breaking down, building, and repairing tissues. They can be amazing in accelerating a healing process, no matter what it is. Therefore, this is an essential supplement to take in treating arthritis.

4. Vitamin D3 and K2

These are the two vitamins that control and regulate the availability and deposition of calcium. Vitamin D3 makes it available, and vitamin K2 directs it to the bones and teeth.  Lots of vitamin D3 without K2 will lead to calcification with calcium being deposited all over the place in the arteries and soft tissues. Lots of K2 without D3 will lead to a depletion of available calcium in the bloodstream because it will be stored away in the bones and teeth. K2 is also used to decalcify soft tissues by pulling out and redirecting the deposited calcium from the tissues to the bones.

Vitamin D deficiency is universal in the west, and so is vitamin K2 deficiency. Arthritis sufferers need large doses of both for extended periods of time (at least a year). I recommend taking a combo supplement containing both in an optimal ratio, and take as many capsules as needed to bring vitamin D intake to 20 000 – 50 000 IU per day with breakfast and lunch. For years I took DaVinci’s ADK combo, which I think is one of the best. Now I take Life Extension’s D and K combo, without vitamin A, because its presence dampens the activity of vitamin D3. However, vitamin A promotes the healing of tissues. You can take both, alternating between the two.

Another of our readers who had his entire adult life an arthritic wrist that caused him pain and trouble whenever he used his hand for anything at all, followed my suggestion of taking 50 000 IU of vitamin D3 per day, together with the appropriate amount of vitamin K2 to match in the D3 intake, for six months. Within the first month, he found incredible improvement, something he had never been able to achieve using all the methods and drugs that had been proposed to him by MDs. After three months, his wrist was completely healed. He continued for the entire 6 months just to be sure, and now, his painful, debilitating, arthritic wrist that he was living with for more than 20 years, is a thing of past, a bad memory.

5. Vitamin C

Whole food vitamin C is essential for healing and keeping tissues and cells healthy. And there is definitely a difference between whole food C and ascorbic acid. We discussed this in Vitamin C is not vitamin C. This is not specific to arthritis, but everyone with arthritis should be loading up on it. I take The Synergy Company’s Pure Radiance C. You should take at least three capsules, but better 6 capsules per day, split evenly with each meal.

6. Turmeric extract

Turmeric is one of if not the most powerful natural anti-inflammatory. And inflammation is a hallmark of arthritis. You should take an extract that concentrates the curcuminoids, but you should also think of making yourself hot turmeric drinks, adding as much turmeric to your soups and curries as the flavours and combinations of foods will allow. It always needs to be taken with a lot of fat to maximise assimilation.

7. Food

Naturally, you will have guessed that my recommendations for food are the same as always, but even more important in this case when we are trying to bring inflammation as low as possible, and maximise healing:

  • no simple or starchy carbs because they cause inflammation, tissue damage, and metabolic disorder, except for berries once in a while;
  • unlimited unprocessed saturated fats from coconut oil, butter, and animal sources;
  • enough high quality protein from healthy animals including organ meats, especially liver; and
  • as many green veggies as you like, especially leafy like spinach, kale and lettuces, watery like cucumbers, fibrous like celery and broccoli.
  • Avocados are fantastic to eat as often as you want. Walnuts and hazelnuts are excellent health-promoting nuts (either roasted, or raw and soaked, subsequently dehydrated or not).

8. Sunshine, fresh Air, exercise and sauna

Go out in the sun, go for long hike, expose your skin, breath deeply, run up the hills, work your muscles at the gym if you can, go to Pilates and yoga classes, do lots of stretching whenever you can, and go to the sauna when you can. Make sure you stay 15 minutes to get really hot and for the heat to penetrate into the tissues and joints.

9. Iodine

Iodine is the universal medicine. Everyone needs it, and everyone should be supplementing with it. You can read for yourself why in Orthoiodosupplementation. Start at 12.5 mg and work your way up to 50 mg per day. Increment by 12.5 mg each week. Take the supplements on weekdays and give the kidneys a break on weekends. I take Iodoral, and recommend that. Using the generic Lugol’s solution is as good but less convenient.

10. Melatonin and good sleep

Good sleep is absolutely essential for repair and healing. Make sure you get plenty every day. Melatonin has, in addition to its effects in helping you sleep, many other amazingly health-promoting effects that we will explore in another article sometime soon, I hope.

Last words

Are there more supplements you can take? Of course there are. I personally take all of the above and several others. I wanted to stick to the things which I believe most essential. If I were to recommend additional supplements, I would say to take

  • omega-3’s, which are useful for lowering inflammation, as well as tissue healing and repair. I take Life Extension’s Mega EPA/DHA. Don’t take more than the recommended dose. Omega-3’s are very easily oxidised, and should always be taken in very small quantities.
  • Niacin in the form of niacinamide is also a universally useful supplement because it provides molecular building blocks needed by every single cell to produce energy. I take 500-1000 mg/day, but you could take 3000 mg (1000 mg with each meal). Niacin supplements will also do wonders for your mood (see No more bipolar disorder?).
  • Ubiquinol, the active form of Co-enzyme Q10, is also essential in cellular energy. I would recommend at least 50 mg per day, but more (like 100 or even 200 mg) would probably be better.
  • Vitamin B12 is crucially important for health. And the older we get, the more critical it becomes. I get an injection of 5 mg every month, and recommend that for everyone (see B12: your life depends on it).

Keep in mind that the timescale for improvements is long: on the scale of months. If you think that is too slow, ask yourself how old you are, and how long it took to get to the state you’re in. Now, with the answers in mind, remind yourself to be patient. You need to be determined to get better, consistent with your new regimen, and patient. But I assure you that you will get better. And please, keep me posted on your progress.

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Case study: old man can’t walk

Some time ago, a childhood friend of mine sent me this message:

I want to help this man. He has a problem with his tendons in both legs. In the morning, he can’ t stand up. Can you recommend some minerals and vitamins? Maybe some exercises that can help? Your advice is important.

oldMan

The old man that can’t walk from the pain in his legs.

That’s all he wrote. So, I replied:

How can I give any advice? I don’t know anything about him. I help/treat people with a complete eating and drinking programme. Vitamins and mineral supplements are only used as adjuncts to correct deficiencies. So, before saying anything, I need to know some basic things:

How old is he? What work does he do or did? How long has this problem been developing for? Does he drink water and how much? What does he drink? What does he eat every day? Does he have other complaints? How is his digestion? How is his skin (any rashes or dry skin or eczema)? What kind of other problems has he had in his life? And anything else about this health that could be useful?

Here’s what I got back:

  • How old is he? What work does he do or did?  He’s 81. He was a manager.
  • How long has this problem been developing for?  The problem started when he was around 65. It has gotten much worse in the past 2 years.
  • Does he drink water and how much?  He drinks little water, 0.5 litres a day.
  • What does he eat every day?  He eats meat, potatoes, tomatoes, some cheese, and a lot of bread.
  • Does he have other complaints?  Heart, kidneys.
  • How is his digestion?  He has problems going to the bathroom every day. He goes once every three days.
  • How is his skin (any rashes or dry skin or eczema)? His skin is fine.
His doctor told him to exercise, but he can’t even stand up or move properly.

With this info, I was able to get a better idea, and I replied:

Here is my diagnosis:
This man has been chronically dehydrated for most of his life. Being chronically dehydrated is one of the most health-damaging situation we can be in, but because it is not acute, the consequences are manifested over long periods of time. 
The lack of water first leads to a deterioration of the digestive system and digestive function: of the stomach (poor digestion and ulcers), and of the intestines (damaging of the lining, ulcers, and leaky gut), constipation and from it toxins and pathogenic bacteria going back from the colon into the bloodstream. 
Second, it leads to deterioration of the kidneys and the nephrons (little filters in the kidneys), because the only way to get the acids out of the blood is to dilute them in water, but if there is a lack of water, then the kidneys do everything they can to keep this water, because water is more important to keep than to get rid of acid. Therefore, not only do the kidneys get destroyed little by little, but the body accumulates the uric acid everywhere in the soft tissues, starting in the joints, and then in the tendons, ligaments and muscles. This leads to incredible stiffness, pain, and eventually to not being able to move.
Third, because our diet is usually rich in calcium but very poor in magnesium, everyone tends to be over-calcified and to accumulate calcium everywhere in the blood vessels, soft tissues of the joints, and in the muscles. This is made much worse by over-acidification and chronic dehydration. Calcification also leads to stiffness, pain, and eventually, to not being able to move properly.
Therefore, the most important things to do in order or priority are the following:
  1. Drink a lot more water (at least 3 litres per day), on an empty stomach (at least 20 minutes before eating), and making sure it is alkaline water (high pH 9-10).
  2. Take baths with 2 cups (500 g) of sodium bicarbonate and 1 cup of magnesium chloride (or magnesium sulphate). The bicarbonate and magnesium will be absorbed into the body through the skin, and will dissolve uric acid and calcium deposits throughout the body. 
  3. Drink juice of green vegetables to remove acid buildup in the body, and clean out the intestines.
  4. Take supplements of magnesium (the best form is L-Threonate, because it is bound to fat and is 100% absorbed) in order to help remove build-up of calcium.
  5. Take supplements of vitamins A-D-K2 (I recommend DaVinci’s combo supplement because of the high concentration of K2), as these are the most important fat-soluble vitamins, and K2 is the only nutrient that can effectively de-calcify blood vessels and soft tissues.
  6. Take supplements of vitamin C and collagen to help rebuild the cartilage and heal the damaged soft tissues, especially the blood vessels and the joints. It is essential to take whole-food vitamin C, and high quality collagen.
  7. Stop eating sugar, bread, cheese, yogurt, and eat basically very big salads and fatty meats like lamb, veal and porc (only outdoor-living animals).
Good luck, and make sure to let me know how things evolve. If you don’t understand something, just ask.

 

Three weeks later, I got his note from him:

Today I called the old man’s wife. She told to me that since yesterday he has no pain, and can move his arms and legs a lot better.  He drinks more than 2 litres of water per day, eats and takes the supplements as you prescribed. His grandson translated your message for him. I am very impressed. Thank you so much for you help. Your method works.

It’s a nice feel-good story, isn’t it? Here’s the thing, though. How many millions of people do you think are in the same situation as the one in which this man was? Suffering like he did, for decades growing older, stiffer, less mobile, and in more pain, until the end, which by that point comes as a relief from this difficult and painful life. And from what? Dehydration. Simple dehydration. Long-standing, chronic dehydration.

How much water do you drink each day? What’s the pH of the water you drink? How much salt do you eat each day? How much bread and potatoes do you eat? How is your digestion? How often do you go to the bathroom, and how is the wipe? Such simple things, so crucial to health.
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Treating arthritis II: cleansing, nourishing and rebuilding

Preventing arthritis is easy. Unfortunately, everything everyone does, or almost, promotes arthritis. But not just arthritis, all inflammatory degenerative conditions. The amazing thing is that what must be done to prevent any of them is quite well known. We have covered a lot of material relating to this already, and it was made clear at the start of Treating arthritis I, that natural healing, even when motivated by the healing of a particular condition, is done through healing the entire organism—all cells, all tissues, all organs, all parts—all at once. Therefore, we could just as well entitle this article “treating arthritis and all other inflammatory degenerative disease conditions” because the approach is fundamentally always the same.

Treating arthritis after it has already developed is not as easy as preventing it, but the extent to which it can be reversed and cured depends firstly on our own dedication and determination, and secondly on the state of the body and amount of damage it has sustained. The first article on arthritis was posted a while back. Its writing was motivated by my wish to help a friend who suffers from a highly debilitating form of arthritis for which conventional approaches are mostly inadequate—as inadequate as they are for all other degenerative chronic conditions.

It is useful for me to know that even if these efforts of were in vain in the sense that they were not acknowledged and didn’t motivate in them to make the recommended changes in lifestyle and diet, the article must have made some difference to some people because it has at this point been viewed more than 4600 times, and is the most viewed of all the posts on the blog after the Welcome page. If you are among the millions of people who suffer from arthritis, and also happens to be one of those who read Treating arthritis I, I hope you found it useful, and you are most welcome to let me and every other reader know how.

There is an obvious difficulty in overcoming any state of disease, especially one like arthritis. It is that everything about our success depends on our efforts to foster and nurture the conditions under which the organism can heal and repair itself. This is the only way to regain health. I want to emphasise this more explicitly:

It is only by creating, fostering and maintaining the biochemical, hormonal and physiological conditions under which the organism has the ability to clean, repair and rebuild its cells, tissues and organs that disease conditions—no matter what they are—can be prevented, overcome, reversed and recovered from. What we are required to do is provide the organism what it needs to do this.

The fundamental elements we concentrated on in the first part were: hydration, alkalisation, and magnesium. As was underlined, these are essential for everyone, but primordial for arthritis relief. The detailed recommendations were intended to help establish good habits. Their essence should be understood as follows.

Every day, from the moment you get out of bed, your primary concern should be to hydrate and alkalise. This is particularly important in the morning and the first part of the day. There is a natural daily cycle governed by the circadian rhythm which controls all processes in the organism by a delicate balance of a vast number of different hormones. A good example relating to the hydration-dehydration cycle, is that the hormone calcitonin whose role is to put calcium from the bloodstream into bones and teeth, is active at night as dehydration sets in: as the water content of the blood decreases, the kidneys release renin and angiotensin, calcitonin is activated, and can thus do its work for fixing calcium where it is needed, subject to adequate amounts of the all-important fat-soluble vitamins D and K2. There are surely many more hormonal processes that depend on the diurnal cycle than those we currently know of. The point to remember is that we have to make hydration and alkalisation a priority in our life, and repeat this every day, while allowing dehydration during the night by typically having our last drink of water between 19 and 20 hours and nothing else until the morning.

Hydration and alkalisation are most effectively done when there is no food in the stomach, and both depend critically on maintaining a balanced intake of water and unrefined salt. An easy way to keep track of both and ensure optimal balance, is to prepare capsules filled with unrefined sea salt, taking one capsule for every half liter of water tea or green juice. This is particularly useful when doing a cleanse. In normal circumstances, it can also easily be achieved by having watery veggies like cucumber, celery or kohlrabi with liberal amounts of salt a couple of times a day. It is ideal to finish drinking about 30-45 minute before eating and not drink for two to three hours after. This leads to a natural rhythm of drinking, waiting, eating, waiting, and repeating this pattern throughout the day.

As this is so, it is easiest to hydrate and alkalise thoroughly each day by adopting a regime based on having only one big meal in the late afternoon or early evening, leaving the rest of the day before that to focus on these crucial aspects of our optimal health without the constraints of the timing surrounding eating. Snacking on raw veggies and salt is perfect and can be done at any time regardless of drinking, because it is also a kind of drinking: watery veggies are basically water with minerals, enzymes, phytonutrients and some fibre. Intermittent fasting, as is called, has many metabolic and physiological benefits not least of which is natural detoxification.

We have looked at some of the key aspects of this practice in The crux of the intermittent fasting, and I plan to deepen this investigation in the future, but maybe the most useful consequence of it, which should also come across as a rather obvious, is that if the body is getting food of any kind that requires processing, then it will immediately engage in doing just that: processing it to extract what it can from it.

Food processing is prioritised and mobilises much of the body’s energy and resources: blood supply (directed to the stomach), secretions from the digestive organs (acid and enzymes from the stomach; insulin, bicarbonate and more digestive enzymes from the pancreas; and bile produced by the liver and stored in the gallbladder), active transport across the intestinal wall into the bloodstream, increased workload on kidneys and liver in filtering metabolic wastes out of the blood, and although you don’t feel it, you can be sure that this does indeed require a lot of energy and bodily resources.

Allowing the body to rest from all this food processing related physiological activity leaves all this energy for other tasks which generally fall in the category of “clean and repair”. This is the natural detoxification that the body desperately needs to engage in as often and regularly as possible but unfortunately cannot because we are, from the time we wake up to the time we go to bed, almost constantly eating. As soon as we take the foot off the gas pedal and give the system a much-needed break from food processing, the organism immediately begins to clean and repair itself. This is why fasting is so good.

Now, if you, in addition to that, provide the organism with a supply of vital nutrients—enzymes, vitamins, minerals—in a form that requires no digestion and is immediately absorbable from the intestines into the bloodstream in the form of vegetable juices, this becomes an amazing way to bring about self-healing in what will indeed look like a most miraculous manner depending on how sick we are at the onset. This is what happens during a juice fast or cleanse, and although fasting has been practiced for centuries, and juice fasting for many decades, both with awe-inspiring results, one recent and vocal advocate of juicing cleanses for healing is the Englishman Jason Vale who runs the Juicy Oasis retreat and healing centre in Portugal (see Superjuice Me on FMTV).

Arthritis sufferers would do extremely well to consider doing such a juice fast as well as adopting intermittent fasting as a long-term daily practice. These measures—in and of themselves—could resolve the problem permanently in a relatively brief period of time.

The importance of magnesium was also emphasised in Treating arthritis I. The best is to have baths with one cup of nigari and one cup of baking soda at least once a week (a couple of times is great, and in some circumstances you may want or need to have them every other day). We should soak the whole body for 45–60 minutes. Magnesium oil, a saturated solution of nigari in water, is also very effective. Putting it on the skin of the arms, upper back and neck, chest and belly, legs and bum, avoiding sensitive skin of the armpits and genital area, and leaving it at least 30 minutes before showering. It can work wonders to loosen tight, achy or cramping muscles, and will often do this quickly from the first application. It doesn’t need to be done every day, but it can for several months without risking overwhelming the system with too much magnesium. Oral supplementation with liposomal (fat-bound) magnesium is also a very good idea.

Once we have understood the importance of these elements of health, healing and recovery that are hydration, alkalisation, magnesium, juicing green vegetables and intermittent fasting, and incorporated them into our life as fundamental pillars of optimal health, then we can and must turn to the question of what to eat when we do eat.

When we consider what to eat from the perspective of eating to most effectively promote health, the considerations can be very different from what they might be were we to take any other point of view as to our primary motivation. For optimal health, the first and foremost important consideration is the old and well-known principle first do no harm. This means what it says, but more explicitly means to not eat anything that has or may have detrimental effects on the organism. Using “has” implies negative effects have been identified and demonstrated to a lesser or greater extent, whereas “may have” means that even though there may be little, inconclusive or no evidence, there are nevertheless reasons to be skeptical or at least cautious about its safety or health benefits. Simple examples include cigarette smoke that is well established to have multiple negative impacts on our health, and industrial pesticides demonstrated to be endocrine disruptors or neurotoxic: a new brand of cigarettes or a new yet untested agricultural pesticide should therefore also be considered as potentially harmful. This is just common sense.

Following this principle encourages us to eliminate industrial chemicals and additives from our food and drink, but also from our cleaning and body care products. This can sound as an obvious and simple first step, but it is not so easy nor so simple without considerable care and attention to detail. Moreover, it also implies, right from the start, no industrially processed products of any kind, and that is a major step for most people given the state of affairs and average dietary regime of the bulk of the population in industrialised countries.

Assuming you are reading this because you are already on the lookout for better ways of doing things, as well as already feeding yourself with real food, this is not such a big deal. And in practice, it means this: buy and eat only whole organically grown or raised food, use only the simplest and most benign organic cleaning and body care products, drink the highest quality filtered or natural spring or mineral water that is certified to be free of known major and minor pollutants, and take only the highest quality supplements. Doing only this ensures an already excellent base for a healthy lifestyle, and it is already enough to avoid and prevent a lot of potential health disorders.

It is, however, not enough if our goal it to be optimally healthy, never have any health disorders at all, and live strong and vibrant to 100, 120 or 140 years of age. It is, also, not enough if we are trying to stop progression, reverse already existing damage, and eventually recover from our own arthritic condition that may have been causing us pain for years or decades. In either case, we need to go further.

The statement in the opening paragraph about the universality of the natural healing approach to treatment and prevention of disease conditions is here both appropriate and necessary to emphasise:

the most fundamental characteristic of but also driver in progressively worsening arthritis symptoms and degeneration is chronic systemic inflammation;

the most fundamental characteristic of but also driver in progressively worsening cardiovascular heart disease symptoms and degeneration is chronic systemic inflammation;

the most fundamental characteristic of but also driver in progressively worsening cardiovascular brain disease symptoms and degeneration is chronic systemic inflammation;

the most fundamental characteristic of but also driver in progressively worsening Alzheimer’s disease symptoms and degeneration is chronic systemic inflammation;

the most fundamental characteristic of but also driver in progressively worsening multiple sclerosis symptoms and degeneration is chronic systemic inflammation;

the most fundamental characteristic of but also driver in progressively worsening Crohn’s disease symptoms and degeneration is chronic systemic inflammation;

and, of course, the most fundamental characteristic of but also driver in progressively worsening type II diabetes symptoms and degeneration is also chronic systemic inflammation,

even if we know that the root cause of this diabetes is chronically elevated glucose and insulin levels, that this leads to systemic inflammation, which in turn leads to the pathological symptoms and degeneration, something that is underlined by the fact that diabetics suffer all other chronic diseases listed above 200-400% more than non-diabetics.

This was a forceful, repetitive, heavy-handed way to express and highlight this fundamental characteristic that is shared by so many disease conditions. But it is, I think objectively, the most important point to have in mind when our intention is to really understand health and to be ourselves, at all levels, an expression and embodiment of health. Because whether it is inflammation in the joints as in arthritis, in the arteries supplying the heart or brain as in cardiovascular disease, in the brain itself as in Alzheimer’s disease, in the nerves throughout the body as in multiple sclerosis, in the lining of the gut as in Crohn’s disease, or basically everywhere in the body as for diabetes, this inflammation—in all cases—is chronic and systemic. Hence, it is this which must be addressed and corrected, and it is addressed and corrected in exactly the same way in every case.

Taking into account differences and thus tuning the treatment, especially in what concerns reversing and repairing existing damage, is important. But it is definitely secondary with respect to the root cause of degeneration that is systemic inflammation. And even these differences whose importance varies depending on the specificity of the condition we aim to address, all of them—when working with natural, nutrition-based medicine—are useful and health-promoting for all conditions: none are detrimental to the treatment of any other specific disease.

For example, supplementing with organic silicic acid, collagen, vitamin C, and vitamin D is essential for repairing and rebuilding cartilage and soft tissues, and thus essential in the treatment of arthritis. It is, however, greatly beneficial for everyone to supplement with these micronutrients because all will benefit from it. It is essential to supplement with and maintain very high levels of vitamin B12 (>1200 pg/ml) when treating multiple sclerosis or Parkinson’s disease, but it is excellent for everyone to do the same. It is essential to supplement with L-Carnosine when treating Crohn’s disease because it is particularly useful for healing the lining of the gut. But it is also very beneficial for everybody to take because it helps to stop and repair the damage caused by glycation, which affects everyone to a greater or lesser extent depending on circulating glucose and insulin concentrations.

And thus, the first principle is to eliminate from our life what causes inflammation: everything that triggers an inflammatory reaction in the body. This obviously includes all allergens which, even if there are some well-known foods that have been recognised as causing allergic reactions, mild or severe, in a large fraction of the population, and could, therefore, be eliminated from our diet directly in order to minimise unnecessary exposure to potentially harmful substances, it is nevertheless ultimately an individual assessment and testing of food intolerance that is needed.

The foods most likely to cause an inflammatory immune system response are gluten-containing grain products and animal milk products. Estimates of intolerance for these two classes of foods—grains and dairy—range between 50 and 75% in most countries, although evolutionary adaptations can have an important effect. Good examples are the indigenous Swiss mountain dwellers and the African nomadic tribe called Masai, who, by consuming most of their daily calories from milk and milk products for thousands of years, have developed the genetic adaptations for the immune system to tolerate the proteins in milk that cause mild to severe allergic reaction in close to 75% of the world’s population, with the most extreme proportions of 90-95\% in the Chinese and other Asian populations that have never, throughout their history, consumed milk products.

The other two classes of foods that are established as inflammatory—highly inflammatory—even if they rarely cause intolerance or allergic reactions, are insulin-stimulating carbohydrates and omega-6 fats. In the case of these substances, it is not inflammation triggered by a reaction to them of the immune system. Rather, they themselves trigger inflammatory biochemical pathways: several hundred inflammatory pathways! These foods should therefore be eliminated from the diet: all simple and starchy carbohydrates, and all vegetable oils. Nuts and seeds, which contain omega-6 oils, can be had whole in small quantities. Olive oil is mono-unsaturated and is the best vegetable oil to use for salads. No omega-6 rich vegetable oil should be used.

I don’t think it’s necessary nor useful to discuss the inflammatory effects of industrial chemicals because we already know that they only cause harm and should be eliminated from our food supply, avoided at all costs in all their other forms by everyone who is even superficially concerned with their health.

This is our first conclusion: to minimise inflammation, it is essential to eliminate inflammatory foods; and the most inflammatory classes of foods are dairy, grains, insulin-stimulating carbohydrates and omega-6 oils. To overcome or prevent inflammatory disease conditions, arthritis but also all others, we have to stop eating these foods. It is as simple as that. And although it is true that we could potentially supplement with adequate types and amounts of enzymes to try to ensure that all types of proteins found in these foods are actually broken down properly during digestion in order to avoid triggering an immune response, it does seem silly to eat or drink something that we know cannot be metabolised correctly and which is, for this reason, harmful to the organism, but still try to mitigate the harm it causes by taking a supplement of those enzymes needed to digest it that do exist even if our body’s genetic and evolutionary makeup doesn’t produce. This reflection applies to dairy and grain proteins to which we are intolerant. It doesn’t apply to insulin-stimulating carbohydrates or omega-6 fats, because these seldom cause allergic reactions in people, but are nevertheless universally inflammatory.

The second principle is to consume anti-inflammatory foods. It should not be a surprise to find out that the most anti-inflammatory foods (think of them as soothing to the body), also tend to be the most alkalising: raw, green, chlorophyl-rich plant foods, and especially green vegetable juices. The most anti-inflammatory and anti-oxidant fat is the miraculously beneficial, highly saturated (96%), and medium chain triglyceride-rich (50%) coconut oil. Hence, without any additional considerations, we already know that an optimally anti-inflammatory and healing diet should be based on mostly raw vegetables and salads, in particular green ones, green juices, and lots of coconut oil from all coconut products.

Also not surprisingly, we can have as much of these nutrient-rich foods as we want, and the more the better. This, it turns out, is an extremely useful selection criterion to determine the level to which something can be good or bad: how much of it we can eat, and what are the consequences, if any, of having increasingly larger quantities; is there an upper limit in the sense that above a certain amount we can expect negative consequences, or is there only a lower limit below which therapeutic value is not noticeable? For what concerns green juices, greens and coconut oil, I would say that there are only lower limits to the minimum we should all intake in order to be perfectly healthy, and no upper limits within what can be considered reasonable through the body’s auto-regulation mechanisms of satiety and digestive function.

For instance, we can drink a 250 or 500 ml of green juice, and that’s great. We can drink 1000 ml and that’s much better. We can drink two or three litres of green juice per day, and that is truly amazingly therapeutic, something that would be done during a juice cleanse. For coconut oil and milk, we can have one or two tablespoons per day, and that’s really good (apparently enough to slow down cerebral degeneration). We can have five to seven tablespoons per day, and that’s far better (apparently enough to reverse early stage dementia and Alzheimer’s). We can have as much as 200 or 300 ml (between 13 and 20 tbsp) of oil per day, and that’s better still. In the case of coconut oil and milk, eating such large quantities amounts to a lot of calories, all from fat which makes us feel really full and not willing to eat anything. This is the body’s natural hormonal messaging system to prevent over-eating and it works perfectly well in this case. It also works well for protein. Only for sugars and starches does it not work so well because we evolved having very few carbohydrates and thus didn’t have to develop the mechanism to avoid overeating them—what pretty much the whole world is doing nowadays.

Most nuts and seeds can be considered as superfoods because of they are very concentrated sources of minerals, antioxidants, unique phytonutrients, vitamins, as well as fat and protein. Because they are seeds, they also have anti-nutrient—phytates and enzyme inhibitors—without which they would not keep for months on end as they do, and would spoil much more quickly. These are not as strong as they are in cereal grains, which have can keep for thousands of years, as they have in some pyramids, and then sprout after soaking in water for a while. This is nature’s very clever way to ensure dry seeds retain the nutrients needed to grow the plant when the conditions are suitable. But it implies that we must do something to them before we can consume them and know that they are wholly beneficial and health-promoting rather than only partially so.

The solution is simple: soak the dry seeds or nuts in water for 24 hours to hydrate them and activate the biological mechanisms responsible for sprouting—to get the seed ready to produce a new plant by making inactive the enzyme inhibitors and phytates—and making all of its nutrients fully available. Soaked nuts and seeds can definitely be eaten hydrated, and are much more filling that way because they hold as much water as their dry weight (they double in weight and volume when fully hydrated), but they can also be dehydrated after having soaked for 24 hours, and be preserved for much longer than the couple of days they can in the fridge before going bad when hydrated. This is what I do at home: 24 hours of soaking with rinsing and changing of the water a couple of times in between, and 24-36 hours of drying in the dehydrator at 45 C to keep all enzymes alive.

Roasting or otherwise heating the nut or seed also neutralises the anti nutrients, but this also destroys the enzymes, making it a dead food that will require the pancreas to produce the necessary enzymes for digestion, as well as cause digestive stress and acidification. Nonetheless, roasted nuts are nutritious and delicious, and thus great to have once in a while. Either way, sprouted or not, nuts and seeds are by their nature nutrient-rich concentrated food and should generally only be had in relatively small quantities (a handful or two). Doing this will also prevent excessive intake of omega-6 fats that make up about 50% of their weight, even if whole nuts and seeds have their own anti-oxidants that give additional protection from free-radicals in the body.

Having a somewhat different status as food, but being naturally most anti-inflammatory, are the trio of ginger, turmeric and garlic. Some may have difficulty digesting garlic (as is the case with onions as well), but ginger and turmeric are generally very easy to digest and actually digestive aids. It is important in the treatment of arthritis to consume them often, even daily, and in liberal amounts. Ginger is very easy to have in relatively large quantity by cold press juicing it in your daily green juice (that’s what we do), which guarantees you a good therapeutic amount on a daily basis. For turmeric, it is also possibly to find it fresh in some places, but it stains everything that it comes in contact with. Mostly for this reason, we take it in capsules, where it can even be concentrated further to be more potent still. The beneficial compounds in turmeric are most effectively absorbed when taken with plenty of fat (coconut fat is perfect).

Animal protein other than from dairy—eggs, meat and fish—is important for the body but also highly acidifying and therefore inflammatory. In addition, the proteins need to be completely broken down first by the acidic gastric juices in the stomach and then by the digestive enzymes in the intestines in order for the amino acids of which they are made to be available to the brain and other organs, but also prevent partially digested proteins from finding their way into the bloodstream and causing additional inflammatory immune responses.

Therefore, we have to eat only small quantities of the highest quality grass-fed or wild caught animal products, give the organism plenty of time to cleanse the metabolic byproducts of their digestion, and, I recommend, supplement with digestive enzymes when eating animal foods. In fact, I recommend taking digestive enzymes whenever you eat cooked foods: we do not want to get anywhere close to exhausting the pancreas’ enzyme-producing potential, because enzymes are far more important for all other molecular repair and rebuild processes than they are for digesting cooked food, and we need to keep them for these purposes if we aim to live healthy for a long time.

This is our second conclusion: to minimise inflammation and maximise repairing and rebuilding of damaged tissues, it is essential to consume the most powerfully anti-inflammatory, nutrient-dense and anti-oxidant foods. The diet should therefore be mostly raw, primarily green vegetables, green juices, special anti-inflammatory foods such as ginger, turmeric and garlic, unlimited amounts of coconut products rich in coconut oil, some sprouted nuts and seeds, and small amounts of clean animal flesh products accompanied with plenty of time for metabolic cleansing on a continual basis. The supplements most important in treating and reversing arthritis are organic silica, collagen complex (Reverse Aging), whole food vitamin C (from The Synergy Company), magnesium (L-Threonate; both from Mercola), B12 (Thorne), the fat soluble vitamins A-D-K (DaVinci), turmeric extract (Organic India and Gaia Herbs), niacinamide (Thorne), and the universally needed but universally deficient iodine (in Lugol’s solution). In addition, it may be really beneficial to take high doses (50000 IU/day) of vitamin D3 for at least three and maybe up to six months or more, in order to set the body on its course to intensive healing and recovery from years of arthritic degeneration. This has been found to be very effective in some people. Supplementing with proteolytic enzymes is also very important to accelerate healing and repair of damaged tissues.

Incorporating these principles and specific recommendations into one’s life, not as a special diet, but as a comprehensive way of taking care of this amazing organism that is the human body mind, will not only treat, reverse and cure arthritis to the greatest extent, and maybe even completely depending on the level of degeneration, but will do the same for all inflammatory conditions, which underlie all degenerative diseases. In addition, the immune system will grow to be so strong that no infectious diseases will be able to take hold or develop within your body: never get a cold, never get a flu, never catch anything at all.

Finally, there are two crucially important factors which are not related to diet, and that in many ways can overshadow all other efforts to heal and remain in optimal health: lack of sleep and psychological/emotional stress. They are more than important: they are foundational. Without good sleep and minimal stress it is impossible to become and remain vibrantly healthy, no matter what else we do or don’t do.

This shouldn’t be understood to mean that if we don’t sleep well or are overstressed there is no point doing anything else. On the contrary! It is all that much more important to do everything else we can. However, it means that if we are already doing everything else, then without correcting the conditions causing us stress and preventing us to get enough restful sleep, we will never reach our optimal health potential.

Having said that, you can be sure that they go hand in hand: optimal nutrition and biochemistry promote less stress and better sleep; better sleep and less stress promote more balanced biochemistry, digestion, cleansing, and cellular rebuilding and repairing. They are the two sides of the same coin, one that is measurelessly priceless: optimal health.

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Intensive natural healing

It is always very difficult to find out what’s wrong, to find out what’s causing our health problems, to find out what is the reason for the stroke or the heart attack we just had, the diabetes or the cancer we were just diagnosed with. It is always very difficult as long as we think of the body in terms of a collection of separate parts pieced together; as long as we think that it is possible for the arteries supplying the brain or the heart to have a pathology that is not shared by every other organ and tissue; as long as we think that it is possible for the pancreas, the prostate or the mammary glands of the breasts to be defective in their function independently of every other cell throughout the body. The moment we see this, we recognise the absurdity of this point of view and the obviousness of the inter-relation of every cell to every other cell, tissue, organ and system.

There is only one whole body mind, and everything that happens to it affects everything else that takes place within it.

Looking at things from this new perspective, there are always only two possible alternatives: healthy or diseased, ranging from one to the other on a continuous scale with every possible point in between along the line. From this perspective, every medical intervention or treatment that is not intended to correct or remedy something acute—to fix a broken bone, to save someone whose kidneys or liver just failed, to stitch up a wound to prevent the loss of too much blood—but instead attempting to address a chronic disease condition—treating heart disease, diabetes, cancer, arthritis, Alzheimer’s, etc—is bound to fail.

The failure comes from the misunderstanding that stems from the misguided premise that views the body as a collection of parts working to specific ends more or less independently of one another. If we are to ever overcome our health problems and thrive throughout a long and happy life, it is this basic premise—this misguided and erroneous premise—that must be thrown out and replaced by the clear understanding that there is only one whole body mind, and that everything in it affects and is affected by everything else.

We are sometimes, maybe most often, faced with a major health issue that is acute because it is an end point to a degenerative disease condition that has been developing over decades throughout our entire life. Stroke and heart attack are good examples. Sometimes, maybe most often, it is these events that shake us up enough to move us into action, and if we have the luck to have been exposed to sensible information, we can have the chance to begin anew and change the course of the rest of our life, steering it towards recovery and optimal health.

When an event of this kind happens—when we have a stroke or heart attack—we must act fast to recover as quickly as possible and reduce as much as we can the possibility of having another one within weeks or months, something that could easily be fatal. The fact is that this is usually quite likely to happen, and it’s therefore important to take it to heart.

How can we take the most important and extreme measures to reverse this course of progressive degeneration and set ourselves on the course to recovery as quickly as we can? What would I suggest should be done with the greatest sense of urgency based on the understanding that it is our life that is at stake? What are the most important and effective ways to help the body heal and repair itself?

Cleanse, detoxify, heal the gut because everything that circulates in the body comes and goes through what circulates in the bloodstream, and everything that circulates in the bloodstream comes and goes through what enters the intestines. It is in the gut that everything about our health starts and ends, where all nutrients are absorbed and most metabolic wastes are discarded. This is why it must be the foundational focus of the healing process.

There is no better way to cleanse, detoxify and heal the gut than to drink fresh green vegetable juices while at the same time getting a series of colonics: the hydro-colon therapy cleans stuff out of the gut, the juice cleanses, alkalises and nourishes the blood and body. Doing these separately is very good. Doing them together is great. Give yourself two weeks—fourteen days—during which to do this. Every day drinking between two and three litres of fresh green vegetable juice, and every other day getting a colonic (on Monday, Wednesday and Friday, for example).

For the juice, you can make it or buy it, but it must be cold pressed in a slow masticating juicer, and it must be free of sugar, i.e., containing only green watery, fibrous and leafy vegetables. Any amount of sugar will fuel the proliferation of pathogenic bacteria and yeasts like candida, and one of the most important aspects of this gut cleansing and healing is the elimination of the candida which undermines the function and health of our gut and our entire organism. In many modern cities there are small cold pressed juiceries where it is possible to buy very good quality all-organic green juice. Doing it at home is less expensive but requires you to do the work. You can also make some yourself and buy some as well (that’s what I tend to do).

In addition to the juicing and hydro-colon therapy, there are three kinds of supplements that should be taken: probiotics (Prescript-Assist is what I take), L-Carnosine (Paradise Herbs is what I take), and enzymes (I’ve used pHi-Zymes by Baseline Nutritionals and Heal-n-soothe by LivingWell). The probiotics replenish and heal the flora, carnosine helps heal the lining of the gut and glycated tissues, and the enzymes promote accelerated repair of damaged cells. They should all be taken three times a day, morning, noon and late afternoon, always on an empty stomach. Take each time one capsule of probiotics and two of L-Carnosine.

To avoid being too hungry, but also to ensure an important intake of the miraculously healing coconut oil, you should have a coconut milk based smoothie, pudding or ice cream: a small glass, two or three times per day. And to make sure you have a good intake of salt and minerals, you should either put unrefined salt in the green juice or eat cucumber and celery sticks with salt, as much as you feel like depending on taste, once mid-morning and once mid-to-late afternoon. Sometimes you may want to drink salty green juice, and sometimes you may prefer to eat salty, crunchy veggies. Just follow your inclination.

(See the work of Dr Norman Walker for more details about the importance of colonics and juicing.)

Enzymes are proteins with specialised functions. They are the things that do stuff in the body. Most of us have heard that enzymes are made in the pancreas and are needed for digestion because they break down the nutrients into their constituents: starches are broken down into glucose by amylase, fats are broken down into glycerol and free fatty acids by lipase, and various proteins are broken down into amino acids by various proteases. These building blocks of foods can then be absorbed from the gut into the bloodstream and carried all over the body to where they are needed. But enzymes also do practically everything else that needs doing, and, in particular, heal and repair damaged cells and tissues.

All raw foods contain enzymes, some more than others. Fresh juices which contain a high concentration of minerals and nutrients, also contain a high concentration of enzymes. Because the more enzymes are available, the better it is for the body to heal and repair itself. Hence, our strategy for recovering from this stroke, heart attack we just had, is to flood the body with enzymes. The fact is that in western countries, most people live on processed junk food that is not only totally devoid of minerals and micronutrients, but also completely dead and devoid of enzymes. If we don’t survive on processed junk food, then we typically hardly ever eat anything raw. Therefore, even if the food we eat is not as bad as processed fast food, it is still cooked, dead and devoid of enzymes.

Eating this way leads to two major problems. The first is that the pancreas is continuously manufacturing enzymes in a desperate attempt to cope with the digestion of cooked and dead food, and over time, like within a few decades, begins to get exhausted and eventually becomes unable to produce any enzymes. It typically also stops being able to produce insulin at the same time, just because it is simply exhausted. The second is that because all enzymes are used for digesting processed and cooked dead foods, there are hardly any enzymes available for anything else that needs doing, healing and repairing.

In our healing programme, to flood the body with enzymes, we—in addition to drinking all this juice loaded with enzymes of all sorts—will supplement with more enzymes. There is no upper limit to the amount we can take, and the more the better. It is really just a matter of what we can afford and are willing to take on a short, medium and long term basis. It is important to start slowly and increase gradually. This is to allow the body to adjust to the presence of more enzymes, but also because they will immediately start their cleanup of the body, breaking down scared and dead tissues that inevitably accumulate over time, as well as both benign and cancerous tumours. The breakdown products are toxic and need to be eliminated quickly. Hence part of the importance of the initial 14 day juice cleanse with intensive hydro-colon therapy.

The amazing thing about enzymes is that they know exactly what to do, what to break down, what to build up, what needs help repairing and what needs help healing. This can be considered a miracle of nature. But it is just life: the self-organised life of living organisms that has been evolving and having its means and methods refining themselves over the 4.5 billion years of evolution on the planet. Self-organised, synergistic and symbiotic co-dependent emergence and evolution. Miraculous and amazing, but from the perspective of an enzyme, a chloroplast or mitochondria, it is utterly simple, obvious and straight forward: adaptation for improved survival.

(See the work of Drs Cichoke and Gonzalez for more on enzyme therapy.)

Iodine is an element that is needed in every cell. According to statistics from the WHO, 97% of the world’s population is iodine deficient. And according to David Brownstein, M.D., a physician who has spent a good portion of his medical career studying iodine, testing for it, and treating his patients’s deficiencies of salt and iodine, the figure is probably closer to 98 or even 99%. In any case, this means that we can conclude that everyone should be supplementing with iodine to ensure the body an appropriate supply.

Iodine is found in the highest concentration in the thyroid gland, mammary glands, and then other glands of the body. For all glands, but especially for the thyroid and breasts, it is simply crucial. Brownstein has treated with total success a large number of women suffering from fibrous cysts or cancerous tumours in the breasts, and a large number of both men and women suffering from thyroid-related dysfunctions using basically only iodine supplementation and dietary modifications (including, most importantly, increased unrefined sea salt intake). He states his belief that most if not all cystic breast disease and cancers, and that most if not all thyroid problems, regardless of whether they are hypo or hyper thyroid dysfunctions, are caused by iodine deficiency, and are always corrected with appropriate supplementation.

One of the reasons why iodine deficiency is so problematic is that because it is so important in its role in every cell, and because it is part of the halogen family of elements (F, Cl, Br, I, At), it is replaced in the cells by other much more abundant but toxic halogens like fluorine, chlorine and bromine. All of these being common industrial chemicals far too abundant in our environment, water and food, and that find their way into the body, slipping into those slots in the cells intended for iodine. It is only by supplementing and providing the body with the adequate amounts it needs, that these other halogens can be gradually replaced by iodine and excreted from the body.

Brownstein recommends using Lugol’s solution, which is sodium iodine and iodide dissolved in water. It is generic and inexpensive, as it has been around for almost 200 years (first made in 1829), and it is a safe and effective way to replenish iodine stores. For most people (as it was for Brownstein himself and for me) it will be necessary to take 50–100 mg per day for about a year. It should be taken in water or juice on an empty stomach. I took it with water for many months before starting to put it in the green juice, in which the taste cannot be detected. I use a 15% solution (18.75 mg per drop) and took between two and four drops per day (37.5–75 mg; two drops at a time, once or twice per day).

After almost a year, I felt two days in a row an immediate surge of energy and light butterflies in the stomach, which I knew were caused by the iodine stimulating the thyroid because I had read about it. Therefore, reacting to it with such sensitivity, I knew that I had finally replenished, after all these months, the iodine stores. Now, I take one drop in my green juice, which sounds like an infinitesimally small amount, but it is important to maintain supplementation because iodine is needed every day by all cells and it is water soluble making it easily excreted with the urine. It has been estimated by iodine researchers that the body needs a minimum of 12.5 mg per day. Therefore it is best to take a little more than that; one drop of 15% solution which provides 18.75 mg. Iodine is of fundamental importance. Supplementation with it is essential, especially in a detoxification and healing programme.

(See Brownstein’s book for more on iodine, and The Guide to Supplementing with Iodine, for additional details about supplementation)

Magnesium and sodium bicarbonate support the cleansing, detoxification and—very importantly—alkalisation of the gut, blood, tissues and organs of the body. The easiest and most effective way to get these into the tissues is to have a 60 minute bath with one cup of nigari flakes and one cup of baking soda. You should do this every other day (Sunday, Tuesday and Thursday, for example) for the first two weeks. This will help pull out accumulated acid, chemical toxins and heavy metals. It is very pleasant and relaxing to lie in a hot bath for an hour reading a book, listening to music or just lying there quietly, adding hot water to maintain a comfortably hot temperature. It is also an essential part of the detoxification programme. After the first two weeks, you can reduce the number of baths to one to two per week.

(See the work of Drs Dean and Sircus for more on magnesium chloride and sodium bicarbonate.)

Eating for rejuvenation and optimal health is a matter of choosing between health and life or sickness and death. After these first two weeks, you will start to eat more solid foods, keeping the juice as the pillar of your new way of nourishing and taking care of the body. In fact, every day the focus of the first half of the day will be to hydrate, cleanse and alkalise by drinking green juice, one litre in two 500 ml portions, at around 9–10 and then 11:30–12:30. Lunch around 14 will be a green smoothie made of avocado and/or coconut milk, together with other green leafy veggies (kale, celery, cucumber, spinach, etc), and coconut water for the liquid part. You can add salt, black pepper and/or cayenne, other spices, superfood powders or extracts, making the smoothie as nutritious and tasty as you can using your resourcefulness to come up with new ideas and recipes.

Having a smoothie of this kind provide lots of enzymes and nutrients, essential oils and excellent fats, together with the naturally occurring fibres but because they are chopped up and blended smooth, they are very easy to digest and thus cause very little digestive stress; this is second to juicing which removes all the fibres for maximum absorption of nutrients and minimum work by the digestive organs.

In the late afternoon, have another green juice if it’s possible. You should drink one to two litres of alkaline water per day, whenever you feel like it. (You can either buy it, making sure the pH is above 8, or you can add alkalising drops to your high quality filtered water. I use Young pHorever’s PuripHy.) Remember that water and juice intake must be balanced with salt in order to hydrate well and not dilute the blood sodium levels and causing the kidneys to excrete more water. We want to drink lots and eat lots of salt in order to super-hydrate. For each litre of water/juice you need about half a teaspoon of salt.

Stop drinking around 18 or so, approximately 45 minutes before dinner: a big leafy green salad of your choice (baby greens, baby spinach, romaine, oak leaf, kale, mixed lettuces and greens) with some nuts and seeds, plenty of cold pressed organic olive oil or some kind of nut or seed butter dressing, and with this big salad, have a small amount of grass fed meat or wild/organically raised fish every other night (one day on, one day off).

That’s it. This is how you should eat for all the months during which you are recovering until you are in perfect health and perfect shape. You can eat like this for the rest of your life. This is more or less what I do. Some variations, will include creamed vegetable soups with coconut milk in the winter (cauliflower, brocoli, celery, spinach), cold soups like gazpacho in the summer, different kinds of salads (celery-fennel, red cabbage, white cabbage, chopped up cucumbers, tomatoes and red peppers in the summer, soaked nut and seed parsley salad, etc), and different lightly steamed vegetables like brocoli, romanesco, cauliflower and green beans. Of course, you are welcome to experiment in this way depending on the season and on personal taste, mood and circumstances.

Supplements that you should take as soon as you start eating, some with lunch and some with dinner, are the following.

With lunch:
(2) Liposomal Magnesium (L-Threonate; Mercola)
(2) Liposomal Vitamin C (Mercola)
(2) Krill oil (Mercola)
(1) Astaxanthin (Nutrex Bioastin 12 mg)
(2) Turmeric extract (Gaia Herbs)
(1) Cinnamon extract (Stop Aging Now)
(1) Tulsi extract (Source Naturals)
(1) Vitamin B12 (Thorne Research Bio-B12)
(2) A-D-K (DaVinci)
(2) Niacinamide (Thorne Research)
(2) Synergy7 (Stop Aging Now)
(2) Zinc (Source Naturals OptiZinc)
(1) Ubiquinol (Mercola)
(1) Huperzine A (Source Naturals)

With dinner:
(2) Liposomal Magnesium (L-Threonate; Mercola)
(2) Liposomal Vitamin C (Mercola)
(2) Turmeric extract (Gaia Herbs)
(1) Cinnamon extract (Stop Aging Now)
(1) Vitamin B12 (Thorne Research Bio-B12)
(1) A-D-K (DaVinci)
(2) Niacinamide (Thorne Research)
(2) Zinc (Source Naturals OptiZinc)
(1) Ubiquinol (Mercola)
(1) Iron bisglycinate (Thorne Research; depending on blood test results)

You will have noticed the obvious absence of some classes of food products that are eaten by most people most of the time: there are no sugars of any kind and no starches, both of which are known to increase the probability of cardiovascular events by their instantaneous triggering of more than 300 inflammatory pathways, all of which cause the blood to thicken and become more viscous; there are also no dairy products, which are highly acidifying and usually the cause of negative immune responses from mild to severe intolerance or allergies; and there are no commercial foods or drinks, all of which should simply be avoided by everyone for their lack of nutrition and chemical toxic loads. These are detrimental to our health in several ways and therefore have no place in a healing programme or in a diet for optimal health and longevity.

You will also have noticed that there is a strong emphasis on green juices and green vegetables, coconut fat from coconut milk, and just enough healthy and clean animal protein and fats to provide the body with everything it needs to thrive. It is perfectly fine to have berries either on their own or with coconut milk, as well as 80-85% organic chocolate once in a while (and not later in the day than about 15). You can have organic green tea in the morning (until about 12), but stop drinking coffee (if you’re a big coffee drinker, you have to do this gradually). The adrenal glands—the very important stress and sex hormone producing glands—in this day and age are almost always overstimulated from our busy and stressful lifestyles, and therefore usually dysfunctional to a greater or lesser extent. They also need to be healed and for this, they need a break.

You should continue the probiotics, L-carnosine, and enzymes as long as necessary to regain total health. You can continue indefinitely. You should continue the iodine supplementation with 50–100 mg per day for a year (might be anywhere between 8 to 12 months), after which you should reduce to one drop of 18.75 mg, and maintain this indefinitely. You should continue all supplements for as long as the healing process continues, and will benefit from taking them to the end of your days, reducing the quantity to once per day instead of twice (dropping the evening supplements with dinner), and remembering that there are only benefits from taking more depending on the circumstances in your life and your body’s needs. Of course there are plenty of other supplements that we can be of benefit, but the ones listed are those that I consider most important.

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Updated recommendations for magnesium supplementation

Daily magnesium supplementation is definitely more than a no-brainer, it is really very important, and this, for everyone. I hope that I managed to convey just how important it really is in Why you should start taking magnesium today, Treating arthritis Ias well as in At the heart of heart disease. In terms of supplementation, however, I would like to refine my recommendations.

Nigari, or magnesium chloride, is excellent because it is inexpensive and easily absorbed. I continue to stand by this, and also continue to use it very regularly. However, I now only use it trans-dermally (on the skin), and recommend you do the same. The reason for this is very simple. Taking it internally, is fine, but because absorption goes through the digestive system, the most that will be absorbed is estimated at 25%, and the rest will be eliminated.

And how will it be eliminated? Well, naturally, through the stools. And I, after using a 2% nigari-water solution orally for supplementation for several months (even with some breaks as recommended by proponents of this manner of magnesium supplementation), found that my colon gradually became more and more irritated (which could be felt when passing stools and wiping). When I would stop supplementation for a few days, the irritation would go down; when I started again, it would come back. Therefore, after a couple of times checking this, it became clear that it was indeed oral supplementation with magnesium chloride that was the cause of the irritation in the colon.

But why even bother taking magnesium chloride orally when it is far better absorbed through the skin? Magnesium oil (20-30% nigari-water solution) that you must leave on for 30 minutes, works great, but the most pleasant is definitely a 30 minute bath spiked with a cup of nigari flakes. This is without a doubt the most effective and most agreeable way to supplement, while ensuring maximum absorption by the body of the magnesium ions so importantly needed by cells in tissues throughout the body.

Having said that, I recognise that having baths every day is time consuming, only really tempting when the weather is cool, and also wasteful in terms of water usage. Therefore, we don’t have baths when it is hot, and should restrict it to a max of three times per week in the cold season, using the least amount of water, and having really short showers on the days in between in order to keep water consumption as reasonable as we can. In the end, magnesium oil is far more environmentally friendly, because it works all year around and does not result in accrued water consumption.

As an aside relating to hot water usage and energy efficiency, because heat loss is always directly proportional to the difference in temperature between ‘inside’ and ‘outside’ , we should set the temperature on our hot water heater to the minimum useable temperature. This minimise heat loss, and consequently, energy consumption for water heating.  I have determined that temperature to be 41-42 C. These temperatures are also perfect to wash the dishes, wash your hands or face, shower, and also to run a bath that is hot (but not too hot) when you get in, and after 25-30 minutes is still hot enough for you to feel comfortable in the water without any hint of feeling cold, but not too hot such that you can’t stand it any longer, or be sweating for half an hour after you’ve gotten out. (Actually, 40 C is perfect for a shower, dishes, hands and face, etc, we need 1 or 2 degrees more for a bath due to heat losses into the tub and air.)

Naturally, the exact ideal hot water temperature is a personal thing that depends on many factors, surely most importantly on body composition and especially basal body temperature, which in turn depends on metabolism. In my case, basal body temperature is as low as can be, since my metabolism runs almost exclusively on fat, and you’ll remember that fat burns cool while carbs and protein burn hot. Anyway, you need to experiment a little, but I’m pretty sure that you will find your ideal hot water temperature between 40 and 43 C.

Because magnesium is water soluble and used up as it is needed every day throughout the day, it is necessary to supply the body with it on a daily basis. Naturally, eating foods rich in magnesium is essential (almonds and greens are the best), this is typically not enough, and oral supplementation is quick and easy. Fortunately, the perfect magnesium supplement is now available. This is ReMag, designed and marketed by Dr. Carolyn Dean (the doctor who wrote The Magnesium Miracle), and who guarantees that it’s 100% absorbed by the cells because it is in a form that is small enough to pass through the 400-500 pico metre sized ion channels that regulate mineral absorption and excretion through cell walls, and therefore, that none of it is eliminated through the digestive system as are most forms of magnesium supplements. (You can read her e-book about it here, and watch this recent video on Mercola’s site.)

So, these are my updates recommendations for magnesium supplementation:

  1. Magnesium oil on the skin for a couple of months to quickly replenish cellular magnesium levels,
  2. Bath with 1-2 cup of nigari flakes, once or twice a week, and
  3. L-Threonate (liposomal) or ReMag (pico sized) taken orally.

This is really important for everyone, but crucial for any person suffering from any kind of illness or disease condition whatsoever.

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Treating arthritis I: super-hydration, alkalisation and magnesium

This is entitled Treating arthritis I, because I want to highlight that it is the first phase of what I think is of the most fundamental importance for people suffering from any form of arthritis. It should really be entitled Treating and preventing any and all disease conditions in everyone I, because these measures are truly fundamental to optimal health in all respects and for everyone throughout life. So even if you don’t have arthritis, you should read on.

This first phase should be viewed as one during which you train yourself to acquire new habits. It is not a treatment per se, but rather a prescription for the basis of a new daily rhythm where hydrating and cleansing the body are of the most fundamental importance. In the end, it is really very easy and very simple. It’s just that we need to get used to it.

Arthritis is a word that means joint (arthro) inflammation (itis). There are tons of different types of arthritis (in the hundreds), but all of them are manifestations of the same thing in different joints and somewhat different ways. And the symptoms: the stiffness, the breakdown of cartilage and other tissues, the ossification or rather calcification, the crippling pain, are all related to the inflammation. But what if there were no inflammation? Would there be no arthritis?

what-arthritis-pain-feels-like-722x406

Illustration of painful, inflamed, arthritic joints. (Image taken from Everyday Health)

Without inflammation there is no tendonitis where a tendon gets inflamed like in the well known tennis elbow. Without inflammation of the lining of the arteries there is no plaque and no atherosclerosis, and thus no heart disease and no stroke. Without inflammation there is no Multiple Sclerosis (MS), the inflammation of the myelin sheath that covers nerves, and no Crohn’s disease either, inflammation in the gut. We could go on and on like this because inflammation is at the heart of almost every single ailment from which we suffer. The reason is simple: inflammation is the body’s way of responding to injury in our tissues.

We sprain an ankle and it swells up by the inflammation that follows the partial tearing of ligament and tendon: this is essential for bringing plenty of blood carrying all the specialised molecules and nutrients necessary to repair the injured tissues. What is the best course of action? Just rest and allow the ankle to heal. The more we use it, the slower the healing will be, the longer the inflammation will last, and the more we will increase the chances of causing some more serious or even permanent damage to these fragile tissues. Without the body’s inflammatory response mechanisms, healing would be impossible.

In fact, repair and growth would also be impossible; muscle growth would be impossible. The process is rather simple: stress and tear (injury) followed by inflammation and repair or growth. This applies to body builders who develop enormous muscle mass over years of intense daily workouts, but it also applies to a baby’s legs kicking and tiny hands squeezing your index finger tightly. It applies to their learning to hold their head up and pulling themselves to their feet with the edge of the sofa to then take those first few steps. It applies to me, to you and to every animal. So, once again: repair and growth of tissue depends on the body’s inflammatory response mechanisms. In a well-functioning metabolism, this process takes place continuously in a daily cycle regulated by activity during the day and rest during the night: stress, tear and injury to tissues during activity; repair, growth and cleaning during the night.

Difficulties arise when inflammation becomes chronic. Either a low-grade inflammation that we can ignore completely and go about our business until it manifests in the form of a serious health concern, or a sustained,  sub-acute state of inflammation that does indeed make it difficult to go about our business, but that we can nonetheless learn to ignore or cope with hoping that it will eventually disappear. Unfortunately, this is how it is for most of us to a greater or lesser extent, whether we are aware of it or not. If it weren’t the case, there wouldn’t be hundreds of millions of people suffering from arthritis the world over, and atherosclerosis-caused heart attacks and strokes would not be claiming the lives of more than one quarter of the population of industrialised countries.

As an aside, for those of you who are interested in measurements and quantifiable effects, among the best markers of chronic inflammation are C-Reactive Protein (hsCRP) and Interleukin-6 (IL-6). The number of white blood cells relate to immune response, and if elevated mean the body is fighting something. Elevated concentrations of Ferritin and Homocysteine (HcY) are also associated with chronic inflammation much elevated risks of heart attack and stroke. You can easily get a blood test to check those numbers among other important ones (see Blood analysis: important numbers).

So what is it that causes a person to develop arthritis at 50 or even 40 years of age, while another person only begins to have mild signs of it at 80? What is it that causes a teenager to develop the crippling Rheumatoid Arthritis (RA) at 16, while none of her friends do? Why does only 1 in 400 develop Ankylosing Spondylitis (AS) or bamboo spine, characterised by the chronic inflammation of the spine, the ossification and gradual fusion of the vertebrae? Who knows?

But, for example, approximately 90% of AS patients express the HLA-B27 genotype and exhibit the HLA-B27 antigen, which is also expressed by Klebsiella bacteria. Could it be the bacteria that causes the damage and injury to spinal tissues and structure, which then follows by inflammation that over time becomes chronic, and since the bacteria remains and continues its damaging activities, the inflammation continues to grow together with all the awful symptoms? Maybe. The debilitating effects of certain bacteria and viruses such as Epstein Barr or HPV for example, that persist in the bloodstream over years and decades, are well known. And the chronic inflammation that results of the activity of infectious agents such as these is also a well established effect, even claimed by some to be among the primary causes of arterial disease (see Fat and Cholesterol are Good for You in the Bibliography page.

But whether it is AS or arterial disease, MS or tendonitis, what is common to all is inflammation, and what needs to be addressed are the causes of the inflammation, not the inflammation itself, which is what we do with anti-inflammatory medication. The inflammation is the body’s response to the injury. What we need to do is find and stop the process causing damage and injury to our tissues, and once the tissues have healed, the inflammation will disappear of itself.

There are many things that cause injury to our tissues, and we will look at all the most important ones in greater detail in subsequent posts, but it is fundamental to address first order issues first. Among the most fundamental issues of all are therefore those with which we concern ourselves in the first phase of treatment:  super-hydration, alkalisation and magnesium. But the truth is that these fundamental elements are what everyone concerned with optimising their health should actually concern themselves with first, before everything else.

Super-hydration

Chronic dehydration is at the root of so many health problems that it is hard to know where to begin. I’ve written a few posts on the importance of water that you can identify by their title. If you’ve read them and want to know more, you should read Your Body’s Many Cries for Water (see Bibliography). In relation to arthritis, however, water is not only the primary means to reduce inflammation of stressed cells and tissues, but it is also what gives our cartilage suppleness and flexibility.

Cartilage a very simple tissue. It is water, 85% in healthy cartilage, down to 70% or less in compromised cartilage and in most older people, held within a matrix of collagen and other proteins that consists of a single type of cell called chondrocyte. These cells have very special electrical properties that give cartilage its amazing resistance to friction and pressure. Without sufficient water, however, the chondrocytes cannot work correctly, cartilage dries out and breaks down, and calcification grows.

What is totally under-appreciated is that because cartilage does not have a blood supply, nerves or lymphatic system, water makes it into the cartilage through the porous end of the bone to which it is stuck, and the only way water can make it into the bone in order to get to that porous end to which the cartilage is attached is through the blood that makes it into the bone.

Since there is, within the body’s functions, a definite hierarchy in water usage in which the digestive system is naturally the first served since it is through it that water enters, even the mildest dehydration can be felt in the function of the most water-sensitive tissues like those of the lungs (90% water) and muscles (85% water), (something any athlete who has drank alcohol the night before a race or even training run or ride will have noticed), it is unfortunately often the cartilage that suffer the most.

Dehydration will make it such that the soft conjunctive tissues at the ends of our bones, in every joint, and that allow us to move will not get the water supply they need to remain well hydrated, supple and flexible. This is really the most important point to remember. What is also highly under-appreciated is the vital importance of silica in the form of silicic acid in the growth, maintenance, repair and regeneration of all connective tissues, including and maybe especially bones and cartilage (here is a good article about it). Silicic acid should therefore be included in all arthritis treatment programmes.

How do we super-hydrate? By drinking more, as much as possible on an empty stomach, and balancing water with salt intake. You should read How much salt, how much water, and our amazing kidneys, and make sure you understand the importance of a plentiful intake of water, an adequate intake of salt, and the crucial balance of these for optimal cellular hydration and function. Detailed recommendations are given below.

Alkalisation

Chronic acidosis, some would argue, is not only at the root of innumerable health complaints and problems, but that it actually is the root of all health disorders. The reading of Sick and Tired, The pH Miracle and Alkalise or Die is, I  believe, enough to convince most readers that that premise is in fact true. Not surprisingly though, it is not possible to alkalise bodily tissues without optimal hydration. And so we immediately understand that chronic dehydration is the primary cause of chronic and ever increasing tissue acidosis. Therefore we address both simultaneously, and in fact, cannot do otherwise.

Briefly, what is essential to understand is that healthy cells thrive in an alkaline environment, and indeed require an alkaline environment to thrive. Conversely, pathogens such as moulds, yeasts, fungi, viruses and bacteria thrive in acidic environments. Healthy cells thrive in well oxygenated aerobic environments, whereas pathogens thrive in anaerobic environments deprived of oxygen. Since this is so, we can say, crudely speaking, that if the tissues and inner environment of the body—its terrain—is alkaline, then pathogens cannot take hold nor develop nor evolve nor survive in it. On the other hand, if the body’s terrain is acidic, then they thrive, proliferate, and overtake it, sometimes slowly and gradually, but sometimes quickly and suddenly, causing sickness and disease.

Everything that we eat and drink has an effect that is either alkalising, acidifying or neutral. This is after digestion, and has little to do with taste. All sweet tasting foods or drinks that contain sugars, for instance, are acidifying. I will write quite a lot more about pH and alkalisation in future posts. For now, we are concerned with alkalising through super-hydration, and this involves drinking alkaline water and green drinks. By the end of phase I, drinking your 2 litres of alkaline water and 2 litres of super-alkalizing green juice should be as second nature to you as brushing the teeth before bed.

Magnesium

As I attempted to express and make evident the importance of magnesium for every cell and cellular process in the body in Why you should start taking magnesium today, and thus show that we all need to take plenty of magnesium daily in order to both attain and maintain optimal health, for someone suffering from arthritis it is extremely important, it is crucial. And the reason is very simple: arthritis is characterised by inflammation, stiffening and calcification. They come together, of course, and it is useless to even wonder if one comes before another. Regardless, the best, most effective, most proven treatment or antidote for inflammation, stiffening and calcification is magnesium.

Magnesium, injected directly into the bloodstream, can almost miraculously stop spasms and convulsions of muscle fibres, and release, practically instantaneously, even the most extreme muscular contraction associated with shock, heart attack and stroke. This is used routinely and very effectively in birthing wards and surgery rooms. Magnesium is the only ion that can prevent calcium from entering and flooding a cell, thereby causing it to die, and magnesium is the best at dissolving non-ionic calcium—the one that deposits throughout the body in tissues and arteries, and over bone, cartilage, tendons and ligaments—and allowing all this excess calcium to be excreted: precisely what we must do in treating arthritis.

In addition, magnesium is very effective at chelating (pulling out) both toxic heavy metals like mercury and persistent chemicals that bio-accumulate in blood, brain and other tissues. For too many unfortunately unsuspecting people, heavy metal toxicity is the cause of a plethora of various symptoms, wide-ranging in nature, hard to understand or associate with some known and easily identifiable condition, but that cause them often immense discomfort up to complete disability.

Putting all of this into practice

When you get up in the morning, you go to the bathroom, undress and spray or spread on your legs, arms chest and belly, neck and shoulders, the 20% magnesium chloride solution (4 teaspoons of nigari with 80 ml of water for a total of 20 g in 100 ml of solution). You wash your hands and face well, put your PJs back on, and head to the kitchen to prepare your water and green drinks for the day.

Line up three wide-mouth 1 litre Nalgene bottles. In each one put: 5 drops of alkalising and purifying concentrate (e.g. Dr. Young’s puripHy) and 10 drops of concentrated liquid trace minerals (e.g. Concentrace).

In the first bottle, add 50 ml of the 2% solution of magnesium chloride (made with 4 teaspoons of nigari dissolved in 1 litre of water), 50 ml of aloe vera juice, 20 ml of liquid silicic acid, fill it up with high quality filtered water, shake well to mix, and take your first glass with 1 capsule of Mercola’s Complete Probiotics. You should drink this first litre over the course of about 30 minutes, taking the third or fourth glass with an added 1-2 teaspoons of psyllium husks. (The aloe vera and psyllium husks are to help cleanse the intestines over time.)

In the second and third bottles, add a heaping teaspoon of green juice powder (e.g., Vitamineral Green by HealthForce), 1/2 to 1 teaspoon of fine, grey, unrefined sea salt, 1/4 teaspoon of finely ground Ceylon cinnamon, a heaping mini-spoonful of stevia extract powder and a single drop of either orange, lemon or grapefruit high quality, organic, food-grade essential oil. Shake well. One of them you will drink between about 10:00 and 12:00, the other between 15:30 and 17:30. Shake every time you serve yourself a glass or drink directly from the bottle to stir up the solutes in the water. You should take these two bottles with you to work and/or keep them in the fridge until needed: the drink is really nice when it’s cool.

Now that the magnesium has been absorbed through the skin—this takes around 30 minutes, you can go have a shower to rinse off the slight salty residue that feels like when you let sea water dry on your skin without rinsing it off. You should wait at least 30 minutes after you have finished your first litre of water before you eat anything.

By about 10 or 10:30, depending on when you finished breakfast, you should start to drink your first litre of green drink and continue until about 12:00 or 12:30. Make sure you finish drinking 30-45 minutes before you eat. Wait at least couple of hours after eating. Then start drinking the second litre of green drink by about 15:30 or 16:00 until about 17:30 or 18:00. Again, make sure you stop drinking always at least 30 minutes before eating. Depending on when you eat dinner, you should drink a half litre of plain water 30 minutes before the meal. The general rules for drinking you should follow are: 1) always drink at least 500 ml up to 30 minutes before eating, and 2) do not drink during or within 2 hours after the meal.

Before going to bed, take a small glass of water with 50 ml of 2% magnesium chloride solution. And that’s it for the day. And tomorrow and the next day and the day after that, keeping to this schedule, until it becomes perfectly natural and customary. After four weeks, you should do another blood test and see how the numbers compare to those before starting. In addition, if you are interested in this from the scientific standpoint, or just curious, or both, you should get Doppler imaging of your coronary and cerebral arteries, as well as an MRI of the joints in your body, including the spine, before you start and at then end of every phase. It will also be extremely informative to test and record the pH of at least your first urine every morning; any additional urine pH readings will be very useful and tracing the progress of the gradual de-acidification of your tissues and the days and the weeks progress. And finally, the transdermal magnesium therapy (putting the 20% solution on your skin), should last 6-8 weeks. By that time, you intracellular magnesium stores should have been replenished. We continue taking the 2% solution indefinitely, and use transdermal magnesium once in a while (once or twice per week).

The great advantage of the transdermal magnesium is that almost all of it is absorbed into your tissues and bloodstream. The oral magnesium is absorbed a level between 25 and 50%, and this depends primarily on the amount of magnesium in the blood when you take it. This is why it is very important to take it first thing in the morning when magnesium is at its lowest, and then in the latter half of the afternoon and before bed, those times when concentrations are lowest. You don’t have to worry about too much magnesium because any excess will be excrete in the urine and faeces.

You should just worry about not enough: that’s the real problem. Incidentally, the fact that almost all the magnesium that you put on your skin is absorbed underlines the importance of carefully choosing what we put on our skin. Because in the same way, anything we put on it will be absorbed into our system. So putting coconut and almond oil is just as good for our skin and our health, as it is bad to put on creams and lotions with synthetic chemicals and compounds that all make their way into our blood. General rule: if you cannot eat it, don’t put it on your skin.

Update: read these Updated recommendations for magnesium supplementation.

That’s it for the first phase: mostly drinking a lot more than you used to, with a few special tweaks to what and when you drink. I haven’t mentioned anything about food even though you can obviously know from the rest of the articles on the blog that this will come in time: in the second phase. We first deal with the first order terms, then the second order terms, and after that with the third and fourth order terms. That’s very important to grasp: what has the most and what has the least impact and thus importance.

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How much salt, how much water, and our amazing kidneys

Salt, the one we put on food, is composed almost exclusively of sodium chloride (NaCl) that very easily dissolves in water into positively charged sodium (Na+) and negatively charged chloride (Cl-) ions. And there is something very special and unique about these ions: in our blood, Na+ and Cl- are present in the highest concentrations and maintained in the narrowest of ranges. This is very revealing, and means, quite plainly, that sodium and chloride are the most important  extracellular electrolytes. This is a simple fact. Now, forget everything you’ve heard, been told, or read about salt being bad for you, and consider this:

Our blood is made of red blood cells (45%) and white blood cells and platelets (0.7%) floating in blood plasma (54.3%). Blood plasma shuttles nutrients to cells around the body and transports wastes out. It consists of 92% water, 8% specialised mostly transporter proteins, and trace amounts of solutes (things dissolved or floating in it). And although circulating in trace amounts, the solutes—especially sodium—are vital. The concentration of solutes in blood plasma is around 300 mmol/l (don’t worry about the units for now). In the highest concentration of all is sodium at 140 mmol/l. In the second highest concentration of all is chloride at 100 mmol/l. The sum of these is 240 mmol/l. So, from these numbers alone, we see that blood plasma is more or less just salty water.

glass-of-water

Pure alkaline water

Don’t you find this amazing? Don’t you find it amazing that nobody has ever told you this straight out in this way? And isn’t it amazing that we have been and continue to be told to avoid eating salt because it is bad for us: that it causes hypertension that predisposes us to heart disease? It really is completely amazing and ridiculous and also rather sad. But misunderstandings of this kind are unfortunately much more common than they should, as you may remember from What about cholesterol and Six eggs per day for six days: cholesterol?, but also from Minerals and bones, calcium and heart attacks and A diabetic’s meal on Air France. As you will understand for yourself in a few moments, the problem is not too much salt; the problem is not enough water:

Hypertension is not caused by excessive salt consumption. It is caused primarily by chronic dehydration, magnesium deficiency, and calcification.

Taking a look at the other electrolytes, bicarbonate (HCO3-), the primary pH regulator, is the third most highly concentrated molecule in plasma at 20 mmol/l. Potassium (K+) is the fourth at 4-5 mmol/l, then calcium (Ca 2+) and magnesium (Mg 2+) both at about 1 mmol/l. Therefore, the concentration of sodium in the blood is 7 times higher than that of bicarbonate, 40 times higher than that of potassium, and about 140 times higher than that of calcium and magnesium. And as with everything else in our body’s exquisite physiology, there are very good reasons for this:

Every cell in every tissue and in every organ of our body relies on an electrical potential difference between the fluid inside the cell membrane and the fluid outside of it in order to function: produce energy and transport things in and out. This is particularly important in active “electrical” tissues such as muscles and nerves, including neurones, that simply cannot work—cannot contract and relax in the case of muscle fibres, and cannot fire off electrical pulses in the case of nerve fibres and neurones—without a well-maintained and stable potential across the cellular membrane.

This resting potential across the membrane results from the delicate balance of the equilibrium potential and relative permeability through the cellular membrane of the three most important ions: Na+, K+ and Cl-. The potential is maintained by the sodium-potassium pump: a specialised protein structure in the membrane that ensures the concentration of potassium (K+) stays low outside the cell and high inside the cell, and conversely, the concentration of sodium (Na+) stays high outside the cell and low inside. This is the main reason sodium is so important and why it is so carefully monitored and scrupulously reabsorbed by the kidneys, but there are plenty more.

Obviously, this is not an accident. Nothing about the way our body functions is an accident, and no matter how well a particular physiological function or mechanism is understood or not, we can be confident that it is as perfect and finely tuned as it can be because each and every bodily function is the result of adaptations and refinements over billions of years of evolution. This is not a typo: I really did mean to write billions of years. Because every single cell of which we are made has evolved from all of its predecessors as far back as the very first organic molecules that eventually organised in the very first cell: a group of more or less self-organising organelles that developed a symbiotic relationship with one another just because it benefitted them in some way, and found it safer to cluster together behind a fatty membrane through which they could interact with the outside on their own terms.

The aim of every single self-organising entity, from the simplest virus, bacterium or organelle like the mitochondria (our cellular energy-production furnaces), to highly specialised cells in the brain, in the liver or lining a part of the microscopic nephron tubule of one of the millions of these specialised filtering units in our kidneys, to largest groupings of cells in tissues, organs and systems of organs, has always been and always will be the same: survival. Therefore, to understand living systems objectively we have to understand them from the fundamental perspective of the cell itself, the tissue, the organ and the system of organs itself because every adaptation it undergoes is always aimed at improving its own odds of survival. It is very important to keep this in mind and know that everything that happens in a living system always does so in relation to something else and always for good reason, even when we don’t understand the reason, which in itself is also very important to remember.

I use this opportunity to whole-heartedly recommend Lewis Dartnell’s book Life in the universe. Almost every page for me was a delightful discovery of things I was unaware of and found the book truly illuminating.

Coming back to salt, even though we look mostly at sodium and chloride that are the principal constituents of any kind of salt we put on our food, I very strongly recommend always and exclusively using a real salt: any kind of unrefined sea salt (French, cold water, Atlantic salt is particularly clean and rich in trace minerals), Himalayan salt, Smart Salt or Real Salt (the last two are registered trade marks and very rich in trace minerals). On the contrary, I strongly discourage eating chemically manufactured table salt or even refined sea salt, which are not only stripped of trace minerals found in natural, unrefined salts, but contain varying amounts of chemical additives such as whitening agents, for instance.

Sel-gris_prod

Unrefined sea salt from the Atlantic coast – Sel de Guerande.

Now, without regard for polemical disputes, pseudo-scientific discussions and debates, or otherwise unfounded views and opinions about salt, can we answer the simple question: how much salt should we generally eat? I believe we can, but although it may seem so, it is not that simple a question. So let’s first ask a simpler one:

How do we make a solution with the same concentration of sodium and chloride as our blood plasma?

To answer this our approach is simple: use the mean concentrations of sodium and chloride in the blood to calculate how much salt we need to match these such that drinking our salt water solution will neither increase nor decrease their concentration. It might seem a little technical at first, but bear with me, it is in fact quite simple.

This approach is rather well motivated physiologically because the kidneys’ primary function is to maintain blood pressure and concentration of electrolytes—sodium above all others, and each within its typically narrow range of optimal concentration—while excreting metabolic wastes. The kidneys do this by efficiently reabsorbing most of the water and electrolytes from the large volume of blood that goes through them continuously throughout the day and night, getting rid of as much as possible of the metabolic wastes, and carefully adjusting the elimination of ‘excessive’ amounts of water and electrolytes. (You will soon understand why I placed quotation marks around the word excessive.) Let’s start.

You already know that the mean concentration of sodium in the blood is 140 mmol/l. What we haven’t mentioned is that it must be maintained in the range between 135 to 145 mmol/l. You also know that the mean concentration of chloride is 100 mmol/l, and it must be maintained between 95 and 105 mmol/l. The atomic mass of Na is 23, hence one mole (abbreviated mol) is 23 g, and thus one millimole (abbreviated mmol) is 23 mg. The atomic mass of Cl is 35.5, hence one mole is 35.5 g, and therefore one millimole is 35.5 mg. The molecular mass of NaCl is the sum of the atomic masses of Na and Cl, which implies that one mole of NaCl is 58.5 g, and a millimole is 58.5 mg. (A mole is the amount of substance that contains 6×10^23, Avogadro’s number, elementary entities, in this case, atoms. The molar mass is the same as the atomic or molecular mass.)

Multiplying the concentrations in mmol/l by the molar mass in mg/mmol we get the concentration in mg/l. For Na this equals 140 x 23 = 3220 mg/l or 3.22 g/l, and for Cl it is 100 x 35.5 = 3550 mg/l or 3.55 g/l. This is the mean concentration of sodium and chloride there is in our blood. For a small person like me, weighing, say, 56 kg, there are 4 litres of blood that contain a total of 13 g of Na and 14 g of Cl. This is equivalent to about 2 tablespoons of salt.

It is important to note that this is truly quite a lot in comparison to other ions or molecules in our blood. Glucose, for example, which many—probably most people—mistakenly think as the ‘energy of life’, giving it such great importance, is ideally maintained around 80 mg/dl or 0.8 g/l. This is, therefore, also the amount we would need to add to our salt and water solution to make it have, in addition to that of the salt, the same concentration of glucose as that of our blood. And 0.8 g/l for 4 litres of blood makes a total of 3.2 g of glucose in that (my) entire blood supply. This is about 10 times less than the amount of salt!  What does this tell you about their relative importance in our system?

Now, given that Cl (35.5) is heavier than Na (23), NaCl will have a higher mass fraction of Cl: its mass will be 60% chloride (35.5/58.5) and 40% sodium (23/58.5). This just means that 10 g of NaCl or salt has 6 g of Cl and 4 g of Na. So to get 3.22 g of sodium, we need 8 g of sodium chloride, which provides 4.8 g of chloride.

The simple conclusion we draw from this calculation is that dissolving a somewhat heaping teaspoon of salt in one litre of water gives a solution that has the same concentration of sodium as that of our blood (with a little extra chloride).

Does this mean that we should generally drink such a salt and water solution? No, I don’t think so. Are there times when we should? Yes, I believe there are. But say we drink 4 litres per day, 8 g of salt per litre adds up to 32 g of salt just in the water we drink! If we add even half of this amount to our food, we are looking at about 50 g of salt per day! Isn’t this utterly excessive, especially since we are told by the medical authorities to avoid salt as much as possible, with some people today consuming nearly no salt at all? (This article here takes a sobering look at the evidence—actually, the lack thereof—of the claimed benefits of salt reduction.) And more questions arise: What happens when we eat less salt? What happens when we eat more? What happens when we drink less water? What happens when we drink more?

Eating more or less salt. Drinking more or less water.

Remember that the kidneys try very hard to maintain the concentration of solutes in blood plasma—to maintain plasma osmolarity. Also remember that sodium is by far the most important in regulating kidney function, and it is also in the highest concentration. It is nonetheless total osmolarity that the kidneys try to keep constant, and besides sodium, the other important molecule used to monitor and maintain osmolarity by the kidneys is ureathe primary metabolic waste they are trying to eliminate.

As an aside to put things in perspective about the importance of sodium, plasma osmolarity is typically estimated by medical professionals using the sum of twice the concentration of sodium with that of urea and glucose: calculated osmolarity = 2 Na + urea + glucose (all in mmol/l). Since sodium is typically around 140 mmol/l whereas glucose is less than 5 mmol/l and urea about 2.5 mmol/l, it’s obvious that we could just forget about the latter two whose contribution is less than 3% of the total, and look exclusively at sodium concentration (2 Na = 280; glucose + urea = 7.5, so their contribution is 7.5/(280+7.5) = 2.6%).

Eating anything at all, but especially salt or salty foods, raises plasma osmolarity. In response—to maintain constant osmolarity—the kidneys very efficiently reabsorb water and concentrate the urine. Drinking water dilutes the blood and therefore lowers its osmolarity. In response, the kidneys very scrupulously reabsorb solutes and eliminate water, hence diluting the urine.

If we eat nothing and just drink plain water, beyond the body’s minimum water needs, every glass will dilute the blood further and thus cause the kidneys to try to retain more of the sodium while eliminating more of the water. We are drinking quite a lot, but as the day progresses, we are growing more thirsty. We drink more but go to the bathroom more frequently, our urine grows more diluted, and by the end of the day we find ourselves visibly dehydrated, with chapped lips and dry skin. This seems paradoxical in that while drinking water, we are getting increasingly dehydrated. But it is not paradoxical. It is simply the consequence of the kidneys doing their work in trying to maintain constant blood plasma concentrations of sodium (and solutes). For those of you who have fasted on plain water for at least one day, you mostly likely know exactly what I’m talking about. For those who have not, you should try it and experience this first hand for yourselves. Avoiding dehydration in this case is simple: eat salt to match water intake.

If, on the other hand, we do not drink, then the blood gets more and more concentrated, the concentration of sodium and other ions, urea, and everything else for that matter, rises with time, and the kidneys keep trying, harder and harder with time, to maintain the osmolarity constant by retaining as much as they possibly can of the water that is present in the blood. You might think: why not just eliminate some of the solutes to lower their excessively high concentration? But eliminating solutes can only be done through the urine, which means getting rid of water that, in this state of increasing dehydration, is far too precious, and the kidneys therefore try to retain as much of it as possible, hence concentrating the urine as much and for as long as possible to make full use of the scarce amount of water that is available for performing their functions. But here is a crucial point to understand and remember:

In order to reabsorb water, the kidneys rely on a high concentration of solutes—hyperosmolarity—in the interstitial medium through which passes the tubule carrying the filtrate that will eventually be excreted as urine. This is how water can be reabsorbed from the filtrate: the higher the difference in concentration, the more efficient the reabsorption. If there is plenty of excess salt—sodium and chloride ions—then these solutes is what the kidneys prefers to use to drive up and maintain the hyperosmolarity of the interstitial medium, and urea can be excreted freely. If, however, there is a scarcity of sodium and chloride ions, then the kidneys will do everything to reabsorb as much of the precious ions that are in circulation to maintain adequate concentrations of these in the bloodstream, and at the slightest sign of water shortage and dehydration—to ensure the hyperosmolarity of the interstitial medium for maximum water reabsorption—the kidneys will begin to recycle urea, excreting progressively less of it as dehydration increases.

Most of you will have experienced a long day walking around, maybe while on a trip visiting a city, during which you did not drink for several hours. You might have also noticed that you probably didn’t go to the bathroom either, which you may have found unusual compared to the frequency with which you usually go pee when you’re at home or at work. You will have noticed that your mouth was drier and drier as the hours passed, but also that you felt more and more tired, heavy-footed and without energy.  Eventually it struck you just how thirsty you were, or you were finally able to find water to drink, and drank to your heart’s content. As you drank, you might have felt a surge of energy within as little as a minute or two or even immediately following the first few sips. Soon after, you finally did go to the bathroom, and noticed how incredibly dark and strong smelling your urine was. Now you understand what was happening in your kidneys, why you didn’t go pee for these long hours, why your urine was so dark and smelled so strong. However,  the reason why you felt your energy dwindle as the hours passed, and then return when you drank is still unclear.

Water in the blood regulates its volume. And volume in a closed system determines internal pressure. Our circulatory system is a closed system in the sense that there are no holes where blood either goes in or comes out. Yet at the same time it is not a closed system because water enters and leaves the system: it enters the bloodstream through the wall of the intestines, and leaves it through the kidneys and out into the urine. All physiological functions depend intimately on blood pressure: whether it is shooting up through the roof as we face a huge brown bear towering over us and growling at the top of its lungs, and priming us in this extremely stressful fight-or-flight situation for some kind of high-energy reaction in response, or whether it is as low as it can be during our most soothing and restful sleep deep into the night, when the body is repairing and rebuilding itself. And what is the primary regulator of blood pressure? The kidneys.

I will address the details of how the kidneys function and regulate pressure and osmolarity in another post. For now, what is relevant to understand why your energy faded as the hours passed or, more precisely, as the body got progressively more dehydrated, is straight forward:

As water content decreases, blood volume decreases. As the volume decreases, blood pressure drops. And as blood pressure drops, energy levels go down. It’s as simple as that.

It does not help that as soon as the kidneys detect dehydration and drop in pressure, they release hormones to provoke the contraction of the blood vessels in order to counter the pressure drop. This works to a great extent, but since the arteries and veins are constricted, blood flow throughout the body decreases, which in turn contributes significantly to our feeling increasingly heavy-footed and sleepy. With every passing minute, dehydration increases, pressure decreases, blood vessels contract more and our energy level drops further, to the point where we just want to sit down, or even better, lie down, right here on this park bench, and have a long nap.

Interesting, isn’t it? And here again there is nothing strange or paradoxical in this self-regulating mechanism that eventually puts us to sleep as we get increasingly dehydrated. It is simply the consequence of the kidneys doing their work in trying to maintain constant osmolarity and blood pressure. Avoiding dehydration in this case is even simpler: drink water.

If you’ve read this far, you know that both solutions to prevent dehydration are intimately linked: if we don’t drink enough water we get dehydrated, but if we drink too much water without eating salt we also get dehydrated. So let’s now ask another question:

Precisely how much water?

An adult human being needs on average a minimum of 3 litres of water per day to survive for more than a few days (Ref). This depends on climate and level of activity and a bunch of other factors, but in general the range is well established to be between 2 litres in cooler and 5 litres per day in the hottest climates. As suggested from our previous considerations, minimum water intake is also related to salt and food intake. And although this was obvious to me from my own experience of fasting rather regularly between 1 and 3 days at a time, I had not read about it. But as it turns out, the NRC and NAS both (independently) estimated minimum water intake as a function of food intake to be between 1 and 1.5 ml per calorie. For a diet of 2000 calories this would amount to between 2 and 3 litres. But this obviously does not mean that if we don’t eat anything, we don’t need any water! So, what is the very strict minimum amount of water the body needs before physiological functions break down? The short answer is 1.1 litres. For the slightly longer answer, here is a excerpt from page 45 of The Biology of Human Survival:

If obligatory losses are reduced to an absolute minimum and added up, the amounts are 600 milliliters of urine, 400 milliliters of insensible skin loss, and 200 milliliters of respiratory water loss, a total of 1.2 liters. Because maximum urine osmolarity is 1200 milliosmoles/liter, if diet is adjusted to provide the minimum solute excretion per day (about 600 mOsmol), minimum urine output may fall, in theory, to 500 milliliters per day and maitain solute balance. Hence, the absolute minimum water intake amounts to just more than 1 liter (1.1) per day.

(This is also taught in renal physiology lectures such as this one. If you are interested, you will learn a lot from this longer series of 13 segments on urine concentration and dilution here, as well as from this series of 7 segments on the renin-angiotension-aldosterone system here. I found all of them very instructive.)

Keep in mind that 1100 ml of water per day is the very bare minimum for survival, and that there are absolutely no other water losses: basically, you have to be lying, perfectly calm and unmoving at an ideal room temperature where you are neither hot nor cold, not even in the slightest. That’s not particularly realistic unless you’re in a coma. And to show just how extreme it is, let’s see how much of the water the kidneys need to reabsorb to make this happen:

For someone like me weighing 57 kg, the mass of blood is 57*7% = 4 kg. Since the density is almost equal to that of water, 4 kg corresponds to 4 litres. Of this, we know that plasma accounts for a little more than half (54.7%) by volume which makes 2.2 litres, and since plasma is 92% water, the volume of free water in the blood supply is almost exactly half: 2 litres. Blood flow through the kidneys is, on average, around 1.2 l/min. This amounts to more than 1700 litres per day, and means that for 4 litres of blood in the body, every drop of blood goes through the kidneys 425 times in 24 hours, each and every day.

In the kidneys the first step in filtration is the “mechanical”, particle-size-based separation of the blood’s solids from its liquid component. Water makes up half the blood volume, and therefore represents half the flow through the kidneys: 0.6 l or 600 ml/min (850 litres per day). But only 20% of the total flow goes through nephron filtration, which makes 120 ml/min. In the extreme case we are considering, urine output is taken to be 500 ml in 24 hours, equivalent to 20.83 ml/hour or 0.35 ml/min (500 ml/24 h/60 min). Therefore, to achieve this, the kidneys must reabsorb 119.65 ml of the 120 ml flowing through them every minute. This translates to an astounding 99.7% reabsorption efficiency! I’m very skeptical that your average person’s (generally compromised) kidneys could achieve this, but the point was to quantify how extreme this situation at the limit of human survival really is, and as you can see, it is indeed as extreme can be.

Also, keeping in mind that these minimum vital physiological water losses in these circumstances would occur at a more or less uniform rate throughout the day, it would probably be much better to drink a little at regular intervals during our walking hours than to drink everything at once and nothing else during the remaining 24 hours. But what would be the ideal rate at which we should replenish our water in these extreme circumstances?

Assuming the theoretically minimum combined water losses of 1100 ml are lost evenly over the course of the 24 hours, this corresponds to a water loss rate of 0.76 ml/min (1100 ml/24 h/60 min). This is therefore the ideal rate at which to replenishing it. In practice, we may not have an IV system to do this for us, and we will probably be sleeping long nights as our heart rate and blood pressure will have hit rock bottom. Drinking 1100 ml in 11 hours (to work with round numbers) could be done by taking 100 ml, (half a small glass), every hour. This would be the simplest and most reasonable way to maintain solute balance as best we can.

Naturally, with such a minimal water intake, the kidneys are struggling to maintain osmolarity by retaining as much water as possible. Any additional intake of salt (or food) would make things worse in the sense that it would raise the concentration of sodium (and solutes) in the blood whose balance the kidneys will not be able to maintain without additional water. But remember that eating a 200 g cucumber, for example, supplies nearly no calories as it contains virtually no sugar, fat or protein, while proving almost 200 g (ml) of water. And that, conversely, any drink containing caffeine or alcohol will actually dehydrate as those substances are diuretic and cause the excretion of free water.

A somewhat more realistic scenario is one in which we are not eating, but very moderately active at comfortable temperatures. In this case, most experts would agree that the minimum water requirements would be around 2 litres per day. Since we are fasting, these additional water needs are due to greater water losses through evaporation and physiological activity; not to offsetting increased water needs due to food consumption. Consequently, we should ideally drink about 10 glasses of 200 ml, one approximately every hour from 7h to 19h, and we should not eat any salt.

More realistic but still not so common, is that you are doing a 24 hour fast. The purpose of the fast is to give a break to the digestive system, rehydrate bodily tissues, stimulate more fat burning and flush toxins out of the system. Say we drink 4 litres instead of the minimum of 2. In this case we should, in fact, eat some salt in order to ensure good hydration of tissues by supplying plenty of water through a well hydrated bloodstream without diluting the sodium and thus causing the kidneys to excrete more water. And this brings us back to the basic question that set us on this rather long  investigation:

Precisely how much salt?

But you already know the answer to this question: 1 teaspoon per litre in 2 of the 4 litres. Because we don’t drink during the night for about 12 hours, the body inevitably gets dehydrated. Therefore, the best strategy is to start with plain water to rehydrate the concentrated blood and bodily tissues dehydrated from the night, and end with a litre of plain water in preparation for the dry night coming. You should take the equivalent of 1 generous teaspoon of salt with each of the additional litres of water during the day. This will ensure proper hydration of tissues by preventing excessive dilution of blood sodium levels, and maximum urea excretion. Excess sodium, chloride and any other electrolyte will be readily excreted in the urine.

Finally, the far more realistic scenario and, in fact, the one that for most of us is the everyday, is that we are normally active and eating around 2000 calories a day, typically over the course of about 12 hours. In this case we need the basic 2 litres to offset minimum evaporation and physiological losses, and between 2 and 3 litres to offset the 2000 calories. This makes between 4 and 5 litres, 2 of which must be plain water, and 2 or 3 of which must be matched by a good teaspoon of salt per litre that will most naturally, and maybe also preferably, be taken with the food.

Keep in mind that this is the total salt requirements and many prepared foods contain quite a lot already. The hotter or drier the climate, the more water we need. The more we exercise, the more water and the more salt we need. The more we sweat, the more water and the more salt we need. The more stress we experience, the more water and the more salt we need. And in all of these cases, we also need a lot more magnesium.

By the way, it is interesting but not surprising that this conclusion on the amount of salt per day: about 10-15 g, is also the recommendation of the late Dr Batmanghelidj, the “Water doctor”, as well as that of Drs Volek and Phinney, the “Low-Carb doctors” (see References  for details), although the former emphasises the importance of an abundant water intake, while the latter hardly mention it if at all.

So this is it. We know how much water we should generally drink, and we know how much salt we should generally eat:

We should always drink the bare minimum of 2 litres per day. Ideally we should drink 4-5 litres every day. If for some reason we drink 2 litres or less, we should not take any salt (or food for that matter!). If we drink more than 2 litres, we should match each additional litre of water with 1 teaspoon of salt, taking into account the salt contained in the food we eat. It is always better physiologically to drink more than to drink less. And remember that we hydrate most effectively on an empty stomach by drinking 30 minutes before meals.