Four lows, Na/K under 1
All four macrominerals below ideal, and sodium below potassium
The pattern workbook names a Four Lows chart with a sodium/potassium (Na/K) ratio under 1 as its own pattern. Below 1 sits under the floor of both laboratories' acceptable ranges.
The pattern workbook Eileen reads charts against defines this pattern as a Four Lows pattern, with calcium, magnesium, sodium and potassium all lower than ideal, combined with an Na/K ratio below 1. Analytical Research Labs (ARL) sets the four-low cutoffs at calcium below 40 mg%, magnesium below 6 mg%, sodium below 25 mg% and potassium below 10 mg%. Trace Elements (TEI) places the same four ideals at 60 mg% calcium (since 2008), 6 mg% magnesium, 24 mg% sodium and 10 mg% potassium.
An Na/K ratio below 1 means the sodium reading in mg% is smaller than the potassium reading. The ideal Na/K is 2.4 (TEI) to 2.5 (ARL), so a ratio under 1 is less than half of either ideal. TEI's acceptable Na/K range is 1.4 to 3.4 (Nov-Dec 2010 newsletter), and ARL's interpretive range is 2.5 to 4.1. A ratio below 1 is outside both.
A plain Four Lows pattern requires only the four levels below ideal, with no Na/K criterion.
ARL calls Na/K the "Vitality Ratio" and defines an inversion as any Na/K below 2.5 in an unwashed sample. Its trend table grades the inversion by depth:
| Na/K | ARL reading | Trends ARL lists |
|---|---|---|
| 2.5 | Ideal | - |
| 2 to 2.5 | Mild inversion | Beginning adrenal exhaustion trend |
| 1 to 2 | Moderate inversion | Kidney, liver, allergy, arthritis, digestive and low hydrochloric acid trends |
| Below 1 | Severe inversion | Heart attack, abnormal cell growth, arthritis, kidney and liver trends |
ARL's Fatigue Document adds two Na/K statements: "When the sodium/potassium ratio is less than 2.5:1, fatigue is always present to some degree," and a ratio below 1 is "an important indicator of chronic fatigue." Its low-ratio document links a ratio persistently below about 1.5 with a diabetes trend.
ARL pairs each mineral with an adrenal cortex hormone: sodium with aldosterone and potassium with cortisol, so Na/K reflects their balance. A low Na/K reads as cortisol high relative to aldosterone, which ARL places with chronic stress. A high Na/K reads as aldosterone dominance, which ARL places with acute stress and inflammation.
The workbook describes the cell mechanism behind the ratio: the sodium pump moves sodium out of cells and potassium into them, which maintains the osmotic balance and electrical charge of each cell. ARL lists potassium loss from breaking-down cells as one reason the ratio inverts: potassium reads high relative to sodium partly because cells are releasing it.
TEI reads the same ratio through Watts' stress model. Na/K at 5:1 or higher is the alarm stage, below 2.4 is resistance, and a return to 2.4 is recovery (May-June 1990). TEI's 2018 newsletter places Na/K below 1.4 in a potassium-dominant resistance phase, and its 1993 rule table lists Na/K below 1.8 among the criteria for increased adrenal catabolic dominance.
ARL's All-Four-Low Document states that "all-four-lows are exhausted fast oxidizers": people whose sodium and potassium fell below normal after prolonged stress. It records that a drop in sodium and potassium normally causes calcium and magnesium to rise as a buffer, and that in the four-low pattern this buffering does not happen.
ARL lists fatigue that is worse at rest as the characteristic complaint, and allergy trends "almost invariably," particularly with a concurrent high copper level or an Na/K inversion. ARL ranks the pattern, alongside extreme copper toxicity, among the most difficult mineral patterns to build a nutritional correction program for, and records that four-low cases can seldom handle a large supplement program.
The workbook reads Four Lows as collapse or exhaustion on an initial test, and as a possible healing reaction on a retest when the program is being followed. It describes the pattern as an exhaustion stage of stress, or a slow oxidation rate, followed by an alarm reaction, which it terms a secondary alarm reaction.
ARL's Stress Document (1988) computes the stage from three ratios. Na/K below 2.5 alone places a chart in the exhaustion stage of slow oxidation. Ca/K below 4 with Na/Mg above 4.17 and Na/K below 2.5 is the exhaustion stage of fast oxidation. The ratio ideals behind those cutoffs are Ca/K 4 (ARL) to 4.2 (TEI) and Na/Mg 4 (TEI) to 4.17 (ARL).
The same document flags exhaustion below an Na/K of 2.0 and states: "A continuing drop in the sodium/potassium ratio is indicative of a profound exhaustion." An Na/K under 1 is half of that 2.0 flag.
ARL records that "the elimination of a heavy toxic metal is the most common cause of a sodium/potassium inversion on a retest chart." Its case history of a 3-year-old gives the numbers. Retested after 4 months, Na/K fell from 0.4 to 0.27 and potassium rose from 16 to 59 mg%, while lead fell from 1.54 to 0.84 mg% and aluminum from 3.66 to 1.10 mg%.
ARL's explanation: breaking down poor-quality tissue releases potassium and magnesium, the main intracellular minerals, which raises their hair readings and lowers the Na/K and Ca/Mg ratios arithmetically. ARL calls low Ca/Mg with low Na/K a double inversion. The same Na/K figure therefore reads differently on a first test and on a retest that shows metals falling.
The four levels come first: calcium against 40 to 60 mg%, magnesium against 6, sodium against 24 to 25 and potassium against 10. All four must be below ideal. Then Na/K against 1, and against its 2.4 to 2.5 ideal.
Next: Ca/K and Na/Mg for the stress stage, the copper level, and whether the chart is a first test or a retest. On a retest, the toxic metals are compared with the previous chart, because a metal leaving is the most common cause of a new inversion.
The sodium reading in mg% is smaller than the potassium reading. The ideal is 2.4 (Trace Elements) to 2.5 (ARL), so below 1 is under half of either ideal.
Four Lows only requires calcium, magnesium, sodium and potassium below ideal. This pattern adds an Na/K ratio under 1, which ARL grades as a severe inversion.
Heart attack, abnormal cell growth, arthritis, kidney and liver trends, and its Fatigue Document calls a ratio below 1 an important indicator of chronic fatigue.
Yes. ARL names heavy metal elimination as the most common cause of an Na/K inversion on a retest, and its case history shows Na/K at 0.27 while lead and aluminum fell.
A full hair tissue mineral analysis reports calcium, magnesium, sodium and potassium with the Na/K, Ca/K and Na/Mg ratios, which are the readings this pattern is built from.
Published 2026-10-25 · Updated 2026-10-25
By Eileen Durfee — Practitioner, NBS (Nutritional Balancing Science), NASM-CPT; wellness educator, inventor and author.
These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease. Hair tissue mineral analysis is a screening test and is not diagnostic. This article is for educational purposes only. Wellness Shopping Online is operated by Nuco Enterprise Solutions LLC.
