Salt and High Blood Pressure

By: Michael Lam, MD, MPH

Salt and high blood pressure problems have been associated for years, but new studies have proven otherwiseThe view on salt and high blood pressure was based on outdated research. More recent research pointing to this conclusion as flawed has often been ignored, even though it has been verified by independent researchers.

This whole concept of sodium being the “bad guy” is based on the water-loving characteristic of sodium. The theory is that an excess of sodium will cause retention of water in the intra- and extra-cellular fluids and thus raise the pressure on the blood vessel walls. The basis for low sodium consumption was started with a poorly designed study in rats wherein the rats were fed the equivalent of over eighty times the amount of salt a human would eat under normal conditions. This is clearly ludicrous, as even the most excessive consumer of salt would use only twice as much salt as the average person. There should be no parallels drawn between this study and the actual effects on humans.

The Truth About Salt and High Blood Pressure

The majority of the time, high blood pressure is a symptom of underlying chronic dehydration that is unnoticeable to us and not due to excessive salt intake at all. As the body becomes dehydrated (consumption of less than 6 to 8 glasses of water a day), the pressure in the vascular system falls due to insufficient fluid. The body reacts by secreting hormones that constrict the blood vessel. This is the body’s compensatory mechanism to increase blood and therefore oxygen to the brain. If the body is well hydrated, the constriction signal will be shut off and blood pressure will return to normal. So salt and high blood pressure are not directly related in these terms.

Separate studies published in 1982 and 1984 analyzed nutrient intake and concluded that sodium is harmless, but calcium, magnesium and potassium protect against hypertension. These three minerals are also powerful medicines that can help to lower blood pressure.

In 1997, a large scale study was published in the New England Journal of Medicine. It reported that those subjects who were given a diet low in dairy products and vegetables, which are high in calcium and other minerals, had higher blood pressure compared to those who had sufficient quantities of those foods. The difference can be as much as 5-6 mm of pressure among those who had normal blood pressure to start with and can go up to 11-22 mm of pressure among those who already had mild hypertension initially. Clearly salt is not the culprit, but deficiency in key minerals can play a significant role.

Therefore, if one is to look for the roots of hypertension in the diet, then the focus should be on calcium, magnesium and potassium, not sodium. A diet excessively low in sodium can instead lead to negative effects like decreased blood volume, low blood pressure (because of the loss of fluid volume of the blood), an upset in the acid-base balance in the body, constipation, just to name a few.

Excessive loss of sodium in the body can lead to lethargic, coma, and ultimately death. When people have low blood pressure together with chronic fatigue symptoms, it can be at least partly relieved by adding salt back into their diets.

Salt and high blood pressure and the adrenal glandsA common but often overlooked cause behind sodium deficiency is stress induced dysregulation of adrenal gland function, also known as Adrenal Fatigue. As an integral part of the body’s entire NeuroEndoMetabolic Stress ResponseSM, the adrenal glands are vital to maintaining homeostasis in the body so it can continue to live and function. If too much stress is experienced over too long a period of time, the adrenal glands can begin to function suboptimally. This suboptimal state of function is much more common than is realized because the symptoms in the early stage of dysfunction are very subtle and easy to miss.

Aldosterone is a key hormone produced by the adrenal glands that regulates fluid balance in the body. It’s main mode of regulation is controlling sodium resorption in the kidneys to influence excretion of fluid through urination. When the body is functioning in a healthy state, aldosterone is produced by the adrenal glands at sufficient levels to maintain both sodium balance and fluid levels at a healthy point. However, when stress is being experienced at a level too much for the body’s neuroendometabolic circuits to handle, and this can be a subtle distinction, the adrenal glands will not be able to produce the level of aldosterone needed to maintain a healthy amount of sodium in the body. Be sure to consult with your primary doctor if you feel you have issues with salt and high blood pressure.

Check with your doctor if salt and high blood pressure is an issue for you


  • Claudette says:

    Ever since i started drinking salt water in the morning i’ve noticed much improvement! I always thought salt was the enemy but it actually is something your body needs when you are in advanced adrenal fatigue

    • Dr.Lam says:

      Salt is depleted in those with advance AFS. Gradual and gentle replenishing is good but it should be temporary and provided your blood pressure and heart is healthy. Salt can be your good friend but it also can crash you, so you have to be careful. The weaker your state of AFS, the higher the risk of this happening.

      Dr Lam.