On Salt: Sodium, Trace Minerals, and Electrolytes

There has been a lot of debate about salt lately. The mainstream view originated from little actual scientific evidence. It wasn’t well-supported. But research since then has been mixed.

The isn’t limited to disagreement between mainstream and alternative thinkers. Paleo advocates such as Dr. Loren Cordain (considered to be the founder of the paleo diet) continue to recommend lower salt intake. Still, there have been an increasing number of scientists and physicians coming out in favor of the benefits of salt: Dr Barbara Hendel, Dr. F. Batmanghelidj, Dr. Esteban Genoa, Dr. Eric Westman, Dr. Jeff S Volek, Dr. Stephen D. Phinney, and Dr. James DiNicolantonio. Many of these experts argue that increased amounts of salt is particularly important for a low-carb diet and that is even more true with high-protein. This relates to issues transitioning into ketosis, what is referred to as keto flu. Basically, the electrolytes temporarily get out of balance while one is adapting to ketosis. Yet Sally Fallon Morell states that it is a plant-based diet that requires more salt to increase HCL in the stomach for digestion.

All of this was brought to my attention because of Dr. DiNcolantonio’s book The Salt Fix that came out recently. His simplest advice is to salt to taste since your body (presumably under normal conditions) should know how much salt it needs. He argues that salt isn’t addictive like sugar. So, according to this view, salt cravings can be safely treated as a genuine need for salt. I haven’t read The Salt Fix, but I have skimmed a bit of one of his other books, Superfuel. In that book, he states that salt, besides maintaining healthy blood pressure, helps maintain insulin sensitivity. Also, salt goes back to the fat issue — more from the book:

“Diets very low in sodium (salt) increase adrenaline and aldosterone, and these hormones reduce activity of D6D and D5D. For this reason, low-salt diets increase the need for EPA and DHA due to the reduced desaturase enzyme activities. Another extremely common hormonal issue these days, one that interferes with conversion of the parent omega-6 and omega-3 fats into their derivatives, is hypothyroidism. Thyroid hormone is required for proper activity of D6D and D5D, so individuals with suboptimal thyroid hormone levels may benefit from consuming more EPA and DHA or taking good-quality supplements.”

There is a number of issues with sodium, potassium, and magnesium in relation to insulin, adrenaline, and aldosterone. Shifting the diet can affect any or all of these. The problem is most research has been limited to people on the standard American diet. We know very little, if anything at all, about salt intake or electrolyte supplementation with other diets. That forces people into experimentation. Anything true of high-carb diets may or may not apply to low-carb diets. Nor do we know that the same will be true between moderately low-carb diets, extremely low-carb diets, zero-carb diets, etc. Then there are other factors such as fasting, ketosis, autophagy, etc that alters the body’s functioning. It’s possible that, on low enough carb restriction, the need for electrolytes and trace minerals decreases, as is the case with vitamin C. Sounds like a great hypothesis to be tested.

Then there is the issue of what actually helps vs what might harm you. What are the potential risks and benefits of getting too few electrolytes and trace minerals vs higher levels? I’m not sure self-experimentation can exactly figure this out, although maybe some have strong enough responses to salt or its lack that they can figure out what works for them. My own experimentation hasn’t indicated anything particular, either positive or negative.

Like anyone else, I enjoy the taste of salt. But unlike sugar, I’ve never craved salt in the addictive sense (and I know what addiction feels like). According to some of what I read, the danger seems to be specifically with refined salt, as is the case with so much else that is refined. Refined salt doesn’t give your body what it needs and so throws off the balance, disallowing healthy processsing of glucose, and so according to this explanation this is why refined salt disposes you to sugar cravings. I remember reading about this sugar and salt craving cycle back in the 1990s, but apparently it only applies to refined salt, if I’m understanding the research correctly. It just so happens that processed food manufacturers love to combine refined carbs and sugar with refined salt, where taste has become disconnected from actual nutrient content because almost all nutrients have been stripped away. They also throw in addictive wheat and dairy for good measure.

I noticed that Dr. James DiNicolantonio says to worry less about sodium and instead focus on potassium. But he emphasizes natural sources of potassium. His point is that salt simply makes high-potassium foods more palatable, foods that otherwise would be more bitter. He points out that there are both animal and plant foods that have greater amounts of potassium: fish, shellfish, greens, beans, potatoes, and tomatoes. The significance of the salt is that once potassium hits a threshold the sodium supposedly will balance it out. Seafood is particularly high in these particular micronutrients, along with much else that is healthy (e.g., EPA and DHA). Many healthy populations have lived near the ocean, as observed by Weston A. Price and others. Some argue that seafood shaped human evolution, the aqauatic ape theory.

“Most animals with a sodium deficiency display an active craving for salt which, when satisfied, disappears. In humans, salt intake has little or no relation to the body’s needs. Some Inuit tribes avoid salt almost completely, while people in the Western world consume 1520 times the amount needed for health. In other works, a single African species (assuming humans have an African origin) possesses a wildly different scheme of salt management. Humans are also the only primates to regulate body temperature by sweat-cooling, a system profligate in the use of sodium. Proponents of the Aquatic Ape Hypothesis believe that sweat-cooling could not have developed anywhere except near the sea where diets contain considerable salt, in fact much more salt than the body requires.” (William R. Corliss, Our aquatic phase!)

An interesting theory to explain the unusual aspects of salt in the human species and why there is so many differences even across traditional societies. Whether or not the aquatic ape theory is correct, it’s for certain that the foods in the standard American diet are far different in numerous ways, likely including nutrient content of magnesium and potassium. It would be useful to measure the levels of micronutrients in a healthy hunter-gatherer diet, not only from salt but food sources as well. Besides seafood and certain plants, especially seaweed (Birgitte Svennevig, Did seaweed make us who we are today?), many have noted that it is a common practice among hunter-gatherers to consume blood along with organ meats and interstitial fluid, all of which are high in salt.

I wonder if this is something we overthink because dietary experts came to obsess over it, as a convenient scapegoat (as they scapegoated saturated fat). The whole debate has become polarized, those arguing for low-salt vs those for high-salt. But other factors might be more important. Besides the problems of a high-carb diet, maybe salt levels aren’t that big of an issue. Assuming there aren’t specific health conditions, most people might be perfectly safe to salt to taste or largely ignore salt if they prefer. Potassium and magnesium seem a bit different, though. Those mostly come from foods, not salt. I don’t know of research that compares people who eat foods high in these micronutrients and those who don’t. It’s another one of those confounders with the standard American diet. And even a zero-carb dieter can eat foods that are either high or low in these micronutrients. For those not using salt, it would be useful info to know which foods they eat and their micronutrient profile.

My conclusion is simply that salt tastes good and, until better science comes along to tell me otherwise, I’ll salt to taste. I’m definitely a fan of the philosophy of listening to one’s body. I self-experiment and find out what works. In my experience, there is a big difference between craving sugar and enjoying salt. One is clearly an addiction and the other not, at least in my case. I was reminded of this just moments ago. I got a glass of water. Since it was on my mind, I sprinkled some sea salt in it and a few drops of electrolytes, along with a capful of apple cider vinegar as I’m wont to do. I quickly downed it and realized how refreshing it was. Earlier this morning I had a glass of water without anything in it and it wasn’t nearly as thirst-quenching. I’m not sure why that is. Something about water with salt and trace minerals in it is so satisfying. I suppose that is why many people love Gatorade and similar drinks. They go down so easily, even though the other ingredients are horrible for your health.

My advice is this. Enjoy salt. It tastes good and makes food more satisfying. Certain trace minerals are necessary for life and health, although only small amounts are naturally found in salt. As for potential downsides, there is yet no clear evidence and no consensus. So, do as many others do, find out what works for you.

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There is a secondary issue or rather some related secondary issues. Angela A. Stanton advises against consuming rock salts that have to be mined, such as Himalayan pink salt and Real Salt (The Truth About Himalayan Salt). She gives two main reasons. First, there might be impurities, including radioactive elements and heavy metal toxins such as lead, although she mentions there are also impurities in sea salt as well. The other problem is that these natural sources of salt lack iodine, an important nutrient. So, for both reasons, she recommends a refined salt that has been purified and iodized.

Her second point is the strongest. Iodine is, without a doubt, an essential nutrient and a deficiency is serious. I’m not sure how likely deficiencies are these days for those eating an otherwise wholesome diet, but it is something to keep in mind. Of course, you could solve this problem by occasionally sprinkling on your food some seaweed, a great natural source of iodine. Her fear about impurities, though, is maybe less substantiated because the amount of impurities is so small as to be insignificant. If we are to be paranoid, impurities are almost everywhere and in almost everything — the air you breathe and the water you drink, the food you eat and supplements you take. The human body evolved to handle such miniscule exposures.

If you have health concerns with iodine deficiency, then go ahead with iodized salt. But otherwise, it probably doesn’t matter too much which kind of salt you use, as long as it comes from a high quality source. But if you want to learn more about the issue of contaminants, David Asprey has directly responded to Stanton (Is Pink Himalayan Salt Toxic?) and so has Jeremy Orozco (Is Pink Himalayan Salt Toxic? Radioactive?). There are others as well who respond to the issue more generally to the topic. There were some responses to a Quora inquiry: Is the amount of plutonium in pink Himalayan salt dangerous? (less than .001 ppm). Also, in the comments section of a piece by Harriet Hall (Pink Himalayan Sea Salt: An Update), there were useful responses:

Jeff Mink • 2 years ago
“In case it wasn’t clear from the article, Himalayan sea salt does not contain “84 trace elements”. If you follow the link to the spectral analysis, it simply lists all non-noble gas elements in the periodic table. If the concentration is “< X ppm”, that means that none of that element was detected. That leaves it with a total of 29 elements (NOT MINERALS!) detected, assuming I counted correctly. In fact, they didn’t even test for as technetium and promethium, since there’s no chance (according to our modern scientific theories) that those could be in there. None of the elements that are actually contained in the salt are radioactive (at least not that I saw), but thallium and lead are definitely not good for the human body. Of course, at the concentrations listed, you’d probably succumb to sodium poisoning long before you got a harmful dose of heavy metals.”

Mathew Taylor • 2 years ago
“There are two main parts to this article: 1) Pink Salt does not provide any health benefits, or they are overstated grossly. I concede this point.

“However, the 2nd part, that pink salt is HARMFUL appears to be wrong. You state that it is full of poisons / contaminants. Lets look at a few of them;

“Arsenic – <0.01 ppm – There is more arsenic in some foods than this. In fact, local authorities limit arsenic concentrations in some seafood to 2mg/kg, thats 2ppm, orders of magnitude more than in pink salt and in something you would consume an order of magnitude more of.

“Mercury – .03 ppm in pink salt. Contrast that with Tuna, where levels are at least TEN TIMES higher, and the volume you would consume in a serving is many orders of magnitude higher.

“Lead – .1 ppm – There is lead in a variety of foods, but usually lower concentrations than this. Remember that salt is not used in massive quantities, unlike vegetables. The target for blood lead levels is less than 10 mcg/dl, or approx 500 mcg total. To get that much lead from pink salt, you’d have to consume 5 kilograms of the stuff. Good luck with that.

“Uranium – <0.001 ppm – Lots of food has uranium in it. Mushrooms can have over 100 μg U/kg (Dry mass).

“So don’t use it if you don’t want to, but don’t make out like this stuff is bad for you, it is, after all, 97.3% table salt.”

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If you want further info about salt, here is a somewhat random collection of articles and videos, all of them bringing new perspectives based on the latest research:

The Salt of the Earth

Salt: friend or foe?

Why Salt Is Good For You, But Some Salt is Better Than Others

Dr. James DiNicolantonio On Sodium-Potassium Balance

The Potassium Myth

The Importance of Potassium and Sodium for Fertility Health

On Keto Flu and Electrolyte Imbalances

Leveraging basic physiology to prevent ‘keto-flu,’ ‘Atkins-flu,’ and ‘adrenal fatigue.’

How much sodium, potassium and magnesium should I have on a ketogenic diet?

Salt