Craving for Salt: Understanding Low Sodium

By: Michael Lam, MD, MPH


When the body experiences a craving for salt, it makes us seek out salty foods such as potato chips, driving up their desirabilityDo you have craving for salt? Do you know people that have craving for salt?  it is highly likely that if both of theses answers are not yes, then at least one of them is. Individuals often find themselves having a craving for salt, like potato chips. This seemingly innocuous craving for salt can actually be a symptom resulting from the condition of Adrenal Fatigue. The reason behind this is the body’s ability to retain salt decreases when you have weak adrenals, which tends to deplete the body’s store of sodium. As an automatic compensatory mechanism, the body tries to bring in more salt, with the result that sufferers experiencing salt cravings. So let’s explore some of the physiological effects that contribute to this effect and what you can do to reduce your craving for salt and increase your health.

The hormonal connection

Among the many hormones produced by the adrenal glands is one called aldosterone. Aldosterone is a mineralocorticoid, a class of hormones primarily concerned with electrolyte and water balance in the body. In fact, aldosterone is the primary mineralocorticoid and is largely responsible for regulating the balance of sodium and water. Aldosterone’s main site of activity is in the kidneys, where it acts to retain sodium in the blood, capturing it before it gets excreted as urine. Importantly, it does this by trading potassium to recapture sodium, consequently lowering potassium concentration in the blood. We’ll come back to why this is important soon and what impact it has on your craving for salt.

So when the adrenal function is low in Adrenal Fatigue, production of adrenal hormones is compromised, and we get lower levels of aldosterone, known as hypoaldosteronism. This Adrenal Fatigue mediated hypoaldosteronism means a weakening of our ability to recapture and retain sodium in the kidneys, and we lose more salt than if there were sufficient aldosterone to recapture it.

Now, this increased sodium loss through urine has some interesting secondary effects. The basic laws of thermodynamics state that salt concentrations will try to balance themselves out in solution. With the level of aldosterone inadequate to recapture sodium and move it back into the bloodstream, more water begins to flow into the kidneys to dilute the higher than normal concentrations of sodium, and you get a reduction in blood volume and pressure. People may also experience an increase in urination frequency.

Remember too that aldosterone has the effect of lowering potassium in the blood. This is important because potassium and sodium have antagonistic physiological effects; that is, the action of one opposes and balances out the other, and having a proper balance of the two in the body is necessary for optimal function. With the accelerated loss of both sodium and water experienced in adrenal fatigue, blood potassium remains normal, and even a little higher without aldosterone to thin it out. The imbalance in sodium and potassium, which normally should be in balance relative to each other, means the body feels the sodium loss even more strongly.

All of this comes back to the fact that the body doesn’t have as much sodium as it wants, initiating a craving for salt. The body signals the brain that sodium is in short supply, and more sodium needs to be eaten in order to meet demand. Blood pressure will tend to rise as the body starts a reactive vasoconstriction process in order to combat the dropping blood pressure.

Sodium, Good or Bad?

Salt is unpopular among health food fads now, but in reality, a craving for salt means the body doesn't have enough saltThe commonly accepted modern dietary guidelines today demonize sodium. Studies have linked high sodium consumption to cardiovascular problems such as hypertension. In all modern societies, where many foods are processed and refined and contain high enough levels of sodium to be a problem, this seems to make sense. So if we are feeling craving for salt, is it safe to eat more salt? Won’t it cause cardiovascular issues? Shouldn’t we be trying to lower salt intake?

Well, in the case of Adrenal Fatigue, the salt cravings you experience are a result of an actual deficiency in the level of sodium both compared to optimal levels as well as relative to potassium. Sodium is absolutely an essential electrolyte our bodies need to function. The nutritional crusade against sodium in western countries is a result of an epidemic of excessive intake.

In fact, more in-depth studies comparing sodium intake to cardiovascular outcomes sees a weak correlation between the two when subjects aren’t consuming excessive quantities and when sodium consumption is balanced with potassium consumption. Even more interesting, low levels of sodium intake were also correlated with higher incidences of cardiovascular events. So it seems it’s not just high amounts of sodium that cause health issues; sodium itself isn’t the problem nor is the craving for salt necessarily. Getting the right amount of sodium, and balancing it against potassium is the key to preventing sodium related cardiovascular health issues.

Craving for Salt: The Dangers of low sodium

Now for many sufferers of Adrenal Fatigue, the salt cravings are mostly an annoyance. This is the case when AFS is in the early stages, and the body can tolerate minor to moderate imbalances unhappily, but still functionally. If adrenal function weakens to more severe stages, aldosterone deficiency can become more pronounced and symptoms of hyponatremia (abnormally low blood concentration of sodium) can become evident. Sufferers of AFS therefore often do well with more sodium intake. In fact, those with high blood pressure and AFS will tend to see their blood pressure normalize as sodium repletion is underway.

At the most severe end of the spectrum, we have studies of individuals with Adrenal Insufficiency, a medical condition not connected to Adrenal Fatigue but similar to it and much more severe with respect to a lack of adrenal output. Such individuals with severely impaired aldosterone production experience a debilitating array of hyponatremia symptoms such as nausea, vomiting, muscle weakness, spasms and cramps, and short-term memory loss. At its most severe, hyponatremia can produce life-threatening symptoms including kidney failure, seizures, heart failure, and even coma. In such cases, prescription medications that help the body retain sodium may be required.

Failure to properly balance electrolytes can also worsen adrenal fatigue. This usually is a consideration for those in advanced AFS. Unfortunately, this happens much more frequently than one thinks. Extensive clinical experience is needed when sodium and potassium balance is in jeopardy. Self–navigation efforts often fail and can backfire, triggering frequent adrenal crashes.

Following the body’s instructions

Fortunately, most people dealing with Adrenal Fatigue will never need to experience the worst of these symptoms. The solution, of course, if you are experiencing salt cravings, is to consume a bit more salt. The extra intake of salt will offset the extra loss due to lower than normal aldosterone, and reduce stress by resolving or reducing the electrolyte imbalance.

A craving for salt and Adrenal FatigueWe mentioned earlier that a lot of people reach for potato chips or other satisfying salty snacks like pretzels when the craving strikes. While they may be feeding the body’s need for more sodium, the problem with many such snacks is they have little nutritional value and can be saturated with oils and refined carbohydrates. For those with Adrenal Fatigue, proper nutrition and diet are important components to recovery, so these kinds of snacks may address one aspect of Adrenal Fatigue but in the end do more harm to the body than good.

Properly addressing the salt cravings shouldn’t involve much more than adding more salt to your normal meals. With the caveat that there are no preexisting heart problems or blood pressure problems, adding as much salt as you feel comfortable eating until you notice the salt craving symptoms decreasing should be considered. When the body has enough salt internally, more salt will lead to unpleasant symptoms such as nausea. Reduce salt intake if you experience this.

We do have to recognize that just liking salty foods or having the occasional hankering for something salty isn’t exactly a smoking gun for Adrenal Fatigue. However, Adrenal Fatigue is a gradual and insidious condition, often taking many years to develop to the point symptoms can be noticed. If you have multiple signs that seem to correlate with one another, it’s time to educate yourself. Get a better understanding that little things like salt cravings might be clues the body is trying to get you to recognize there’s some underlying dysfunction, which may very easily turn out to be Adrenal Fatigue.

© Copyright 2016 Michael Lam, M.D. All Rights Reserved.



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Hi Dr Lam

First I should say that I will never forget your help a few years ago. I was in a very bad place and you gave me hope and peace that I would be ok. You were patient when I was anxious and nonfunctional. I have read a large amount and, just from my battle, can tell that you are as good and experienced as they come. I have actually had many nightmares that you were not available and I would never be able to find help. I still think you are my best bet. My biggest take home message is that I am thankful for your past help. I have not forgotten the times that you worked me in during my times of panic. I am thankful for the knowledge you gave me. Thank you and I appreciate your past efforts!




3 Comments

  • Abi says:

    Dr Lam, does it mean I have a sodium/aldosterone deficiency if I’m unable to taste salt unless I eat large amounts such as up to about 1 tsp per meal? I often cannot taste salt at all and get severe lecture about the amount of salt I eat. I have no blood pressure issues.

    • Dr.Lam says:

      The body has a self-regulatory mechanism when it comes to salt. It depends on many factors. Taste bud threshold also varies from person to person. I don’t have enough information about you to be able to give you an accurate reply. Sorry.

      Dr.Lam

  • Renato says:

    Can drinks like pedialyte, gatorade, and powerade help out with electrolyte deficiency?