Busting the Myth of the Low Sodium Diet

For more than three decades, health professionals and organizations including the American Heart Association and the American Diabetes Association have promoted a low-sodium diet to prevent hypertension, or high blood pressure. However, as Dr. David Brownstein explains in his book Salt Your Way to Health, research shows that a low-sodium diet does not actually lower blood pressure for the vast majority of people.

In fact, when people on low-sodium diets reintroduce salt in the form of unrefined salt—which contains over 80 essential minerals and elements—they experience recovery from high blood pressure, food allergies, low energy, poor sleep, muscle cramps, chronic fatigue syndrome, fibromyalgia, migraines, and even seizure disorders.

Based on a great deal of research and many case studies, Dr. Brownstein makes the case that we should ditch refined table salt and replace it with unrefined salt in our diets. And in the book Metabolical, Dr. Robert Lustig explains why high insulin levels and insulin resistance have a greater effect on blood pressure than salt intake.

The important difference between refined and unrefined salt

Salt is first obtained from salt mines or harvested from the sea. In the refining process, salt is treated with chemicals (including sulfuric acid and chlorine) that remove the healthy minerals which it naturally contains. These minerals are then sold to industry, as they fetch a higher price when sold separately.

Then, anti-caking and conditioning agents are added to the salt. These include sodium ferrocyanide, ammonium citrate, aluminum silicate, and dextrose, none of which are good for our health. The salt is then bleached to become more appealing to the consumer. The end result of the salt refining process is a lifeless product that can sit on a shelf forever.

Iodine is typically added to food-grade salt, but as you learned in my article on iodine, only 10% of that iodine is bioavailable, and that amount has a minuscule positive effect on our health. We are much better off getting our iodine from other sources.

In contrast, unrefined salt has not been exposed to harsh chemicals or processed or altered in any way. It contains over 80 minerals and elements that are essential for life. Humans evolved eating unrefined salt, and the enzymes and hormones in our bodies are designed to use salt in its whole, pure state. We need the minerals and elements to be ingested along with the sodium and chloride (the main components of salt) so that our bodies can use them all effectively.

The problem with high-sodium diets is not salt itself—it’s been that people have been consuming refined salt instead of unrefined salt. The animal studies on which the low-sodium diet myth is based began in the early 20th century, and these studies gave large amounts (10-20 times the recommended dosage) of refined salt to the animals to raise their blood pressure.

Refined salt is a foreign substance to the human body. When we eat it, not only can blood pressure rise, but we retain water, our kidneys are stressed, our immune system is weakened, our body becomes acidic, our adrenal glands can’t function properly, and we become depleted of many essential minerals and elements.

What happens when we don’t consume enough salt?

Low-sodium diets can contribute to many health problems, including hypertension, heart disease, high cholesterol, insulin resistance, acidity in the body, adrenal exhaustion, nervous system dysfunction, hyponatremia, thyroid disease, and bromine toxicity.

Hypertension, Heart disease, and High cholesterol:

Research shows the opposite of what we have been told. In a study of nearly 3,000 hypertensive people, the men who had the lowest sodium levels had a 430% higher incidence of heart attacks than those with the highest sodium levels. Why would this be? Dr. Brownstein explains that low-sodium diets lead to multiple nutrient deficiencies—like calcium, magnesium, potassium, and B-vitamins—which are crucial for maintaining heart health.

The National Health and Nutrition Examination Survey (NHANES), conducted by the U.S. government every 10 years, confirms this. NHANES I (1971-73) found that potassium and calcium deficiencies were the best predictor of hypertension. The study also found that low-sodium diets, rather than high-sodium, were associated with higher blood pressure.

NHANES III (1988-1994) and NHANES IV (2001-2002) also found that hypertensive people tended to be deficient in magnesium, calcium, and potassium. And like NHANES I, these two studies found that low-sodium diets were associated with high blood pressure. The researchers concluded that the best predictor of high blood pressure was inadequate mineral intake.

A 2003 review and a 2011 study found that low-sodium diets actually increased LDL (bad) cholesterol and triglycerides, both of which increase the risk of heart disease and stroke.

Dr. Brownstein explains that a low-salt diet stimulates the kidneys to retain more sodium. This increases levels of certain hormones, which in turn stimulate the sympathetic nervous system. If the sympathetic nervous system becomes overstimulated (stressed) it can trigger a cardiac event.

Insulin resistance:

In a 2011 study of 152 people, those on a low-salt diet for seven days showed an increase in insulin resistance, which is a risk factor for type 2 diabetes. The study authors explain that a low-salt diet “activates the renin-angiotensin-aldosterone system and sympathetic nervous systems, both of which can increase insulin resistance.” Dr. Brownstein reports that it is nearly impossible to treat diabetes and insulin resistance if the patient is on a low-sodium diet, especially if they are consuming only refined salt.

In Metabolical, Dr. Lustig explains that insulin resistance and high insulin levels are to blame for the current epidemic of hypertension. He reminds us that our ancestors used to consume more than 15 grams of salt per day, as it was used to preserve meat and fish. Now, most of us consume less than half that amount each day, yet our blood pressure continues to rise.

Our kidneys are very good at excreting excess sodium—but insulin resistance prevents our kidneys from doing this important job effectively. And hyperinsulinemia (high insulin levels) raise blood pressure, even on a low-sodium diet. Sugar consumption directly increases blood pressure by increasing uric acid. Dr. Lustig recommends cutting down on sugar in order to lower blood pressure, lower insulin levels, and reverse insulin resistance.

Acidity in the body:

Our bodies are designed to function optimally at a neutral pH of around 7.2. When our body becomes too acidic or too alkaline, our health declines. An acidic pH occurs much more commonly than an alkaline pH, and it is associated with cancer, arthritis, osteoporosis, candida, and hormone imbalances.

Processed foods, which have had their minerals, vitamins, and enzymes removed, make up the bulk of many people’s diets. Eating food that is devoid of nutrients forces us to use up the nutrients that are stored in our bodies. As those nutrients are used up, and not replaced with the food we eat, we become deficient in necessary nutrients. Our body becomes acidic and we develop chronic disease.

When you add unrefined sea salt to water, it increases the pH, making it more alkaline. When you add refined salt, it decreases the pH, making the water more acidic. This is what happens in your body when you consume unrefined versus refined salt. So in addition to eating whole, unprocessed foods, a simple way to neutralize the pH of our bodies is to eat unrefined salt.

Adrenal exhaustion:

The adrenal glands sit atop the kidneys, and they secrete many hormones that are responsible for maintaining energy, blood sugar levels, blood pressure, muscle strength, the fight or flight response, and more. The adrenal glands are also responsible for regulating salt absorption in the body. The adrenal glands need unrefined salt in order to function optimally.

If you eat refined salt and processed food and the adrenal glands do not get the nutrients they need, it can lead to adrenal exhaustion: fatigue, low blood pressure, immune system disorders, brain fog, muscle and joint pain, inability to exercise, hair loss, eczema, thyroid problems, and more.

Nervous system dysfunction:

Sodium regulates electrical charges that are transmitted by the nervous system. Magnesium, calcium, and potassium—all found in unrefined salt—are also involved in the transmission of electrical messages by the nervous system. If our sodium levels are too low or too high, the nervous system may send abnormal electrical signals. In some cases, this can lead to a seizure disorder. Dr. Brownstein reports that many of his patients with seizure disorders have significantly improved their condition by eliminating refined salt and incorporating unrefined salt into their diets. Switching to unrefined salt can also improve memory and alertness.


Hyponatremia is a condition in which sodium levels in the blood become dangerously low. This can cause the brain to swell, leading to nausea, vomiting, fatigue, headache, confusion, and seizures. In some cases, low sodium levels can cause coma and even death.

Dangerously low sodium levels can be caused by an illness, medication, not consuming salt, and excessive water intake without adequate sodium intake (which most commonly occurs in athletes who sweat a lot).

Thyroid disease:

The thyroid gland is very sensitive to nutrient deficiencies, and it needs an adequate amount of selenium, magnesium, iodine, and other minerals so that it can convert the inactive hormone T4 (thyroxine) into active T3 (triiodothyronine). The minerals found in unrefined salt are essential for the thyroid to do its important jobs.

Unrefined salt is also necessary for the body to detoxify from bromine. Bromine toxicity affects the thyroid gland because high levels of bromine replace iodine in the thyroid gland. Without adequate iodine, the thyroid cannot function optimally, and thyroid disease often results.

As I wrote in my article on iodine, if you have a thyroid condition and you are iodine deficient, you must take iodine supplements along with the accompanying nutrients. This is especially important when you stop eating refined salt, which contains iodine.

Bromine toxicity:

Bromine is a toxic chemical that has been shown to cause cancer. It is used in the commercial baking industry, and added to vegetable oils, sodas, sports drinks, toothpaste, and cosmetics. Bromine is also used as a fire retardant in rugs, upholstery, mattresses, stuffed animals, cars, and electronics. This toxic chemical is virtually unavoidable in our lives.

Bromine competes with iodine for absorption and receptor binding in the body. Taking an iodine supplement will help to dislodge bromine, but then the bromine needs to be excreted from the body—and that’s where salt comes in.

Salt contains 40-50% chloride. Chloride and bromine compete for re-absorption in the kidneys; so when chloride consumption is low, more bromine is reabsorbed into the body. But if we consume more chloride in salt, it helps to force the kidneys to excrete more bromine in urine. Dr. Brownstein reports that it is nearly impossible to lower bromine levels while consuming a low-salt diet.

So—how much salt should we be consuming?

The FDA recommends that adults consume up to 2,300 mg of sodium per day. This is equivalent to one teaspoon of refined table salt. However, the FDA reports that Americans consume 3,400 mg per day—almost 50% more than recommended.

Dr. Brownstein recommends that the average person should consume ¼ teaspoon of unrefined salt for every quart (32 ounces) of water they drink per day. For a 150-lb person drinking the recommended amount of water (half of body weight in ounces, so 75 ounces), this amounts to 0.6 teaspoon of unrefined salt per day. Celtic sea salt contains 480 mg of sodium in a ¼ teaspoon, so 0.6 teaspoon contains 1,125 mg of sodium—well below the FDA recommended daily amount. Add the delicious sea salt to your food at mealtimes, and you will likely end up ingesting the right amount.

Substituting unrefined salt for refined salt on your table is just one step you should take. Many packaged, processed foods contain excessive amounts of refined salt. These include, but are not limited to: soup, cheese, cured meat, lunch meat, canned meat, pickles, sauces and dressings, frozen dinners, many bread products, and snack foods like chips, pretzels, and nuts. If you want to cut down on your refined salt intake, you must cut way back on or eliminate these processed foods. Always read ingredient labels and check the sodium content of food you’re buying—and be aware that the salt they contain is refined salt, unless the ingredient label specifically says “sea salt.”

It’s important that you choose a high quality sea salt, as they are not created equal. The sea salt that is most frequently recommended, and my personal favorite, is Grey Celtic Sea Salt. The salt has some moisture content, which makes it difficult to use in a grinder. You can either sprinkle it directly on your food or dry it out (in an oven or on the countertop) before putting it in your grinder.