That is a good question. The amount of sodium and potassium needed by the cell is largely dependent on what stage the adrenal fatique is in.
Let me explain:
The amount of salt in the body is highly dependant and regulated by a chemical called aldosterone. This chemical is manufactured in the adrenal cortex under the direction of another hormone called ACTH (adrenocorticotrophic hormone). ACTH is produced by the anterior pituitary gland. ACTH stimulates the adrenal cortex to secrete a wide variety of hormones including aldosterone as well as cortisol. Like cortisol, aldosterone follows a diurnal pattern of secretion, peaking at 8 a.m. , and at its lowest betwee12-4am. Aldosterone is a very specific compound that is responsible to maintain the concentration of sodium and potassium in the cell as well as outside the cell. This in turn has a direct effect on the amount of fluid in the body. Aldosterone therefore plays a significant role in regulation of blood pressure.
It is important to note that in our body, sodium and water goes hand in hand. Where sodium goes, water follows. As the concentration of aldosterone rises in the body, the concentration of sodium and water rises, more fluid is retained in the body, and blood pressure rises. Conversely, when the level of aldosterone lowers, the amount of sodium and water in the body is reduced. The blood pressure goes down.
Unlike cortisol, aldosterone does not have its own negative feedback loop when there are excessive amounts. If the aldosterone level is too high, aldosterone receptor sites will be down regulated and its sensitivity to aldosterone is reduced. In the early phases of adrenal fatigue, the amount of cortisol and aldosterone increases in our body due to the ACTH stimulatory effect from stress. As a result, the sodium and water is retained in the body with a feeling of bloated. The baro-receptors ( receptors that are sensitive to pressure) of the blood vessels are triggered and blood vessels goes into a relaxation mode automatically and this is regulated by the autonomic nervous system. This auto-regulation helps to maintain a stable blood pressure at a time when the total fluid volume increases due to high level of aldosterone triggered by stress. With stress, the adrenal glands also secrete another hormone called epinephrine. This hormone constricts the blood vessels and increases blood pressure in order to ensure that our brain have adequate blood flow and oxygen to help us deal with impending danger. The sum reaction of aldosterone, epinephrine, and the autonomic relaxation response are some of the key factors that ultimately decide the final blood pressure at any point in time. During the early stages of adrenal fatigue, the resulting blood pressure is often normal if all bodily function is well balanced. If the body is unable to overcome the aldosterone and epinephrine response, then the blood pressure is elevated. It is common to find many under stress experiences increase in blood pressure.
As adrenal fatigue progresses to more advance stages, the amount of aldosterone production reduces. Sodium and water retention is compromised. Potassium is gained as sodium is lost. Excessive potassium can result. Extra potassium intake should therefore be cautioned. As the fluid volume is reduced, low blood pressure ensues. Cells get dehydrated and become sodium deficient.. Liberal sodium intake is encouraged as long as blood pressure is not high.
As with advanced adrenal fatigue reports a low blood pressure as well as a salt craving. The low blood pressure is due to the reduced fluid in the body. Salt craving is because the body is in a absolute deficiency of sodium. Both are due to the lack of aldosterone. In order to compensate for this, potassium is leaked out of the cells so that the sodium to potassium ratio remains constant. The loss of potassium is less then that of sodium, and as a result the potassium to sodium ratio is increased. The body’s level of potassium increases.
Those suffering from adrenal often have a low body fluid volume accompanied by a salt craving due to absolute deficiency in sodium as well as a normal to high potassium level. While lost fluids should be replaced, it has to be done carefully. When the fluid is replaced without adequate sodium, the amount of sodium in the body actually gets diluted, therefore resulting in an even lower sodium level. This is called dilutional hyponatremia, a dangerous condition that can be deadly. It is therefore important to add salt liberally to fluids that are taken in by anybody suffering form adrenal fatigue.
So the bottom line is that in early stages of adrenal fatique, there is excessive sodium and relative low potassium. In the late stages , the phenonoma reverses.