Since graduating from medical school in 1989, I have come to the conclusion that much of what I was taught was wrong. In fact, at my medical school graduation, the dean said, “Fifty percent of what we just taught you was wrong, your job is to figure out which part was correct and which was incorrect.” When medical students come to my office, I always encourage them to question everything I tell them and, furthermore, to question what they have been taught.
I was taught in medical school that a lowered salt diet was a healthy diet—for everyone. Furthermore, it was drilled into my head that anyone with heart disease, particularly heart failure, should limit salt in his/her diet. In fact, it is still standard-of-care for a cardiologist to tell his/her heart patient to limit salt in their diet. This is especially true when the patient is suffering from heart failure.
So, does limiting salt in the diet of a patient with heart failure result in a better outcome?
A recent study (Journal of the American College of Cardiology: Heart Failure. Vol. 4, No. 1, January, 2016) sought to evaluate the impact of sodium restriction on heart failure outcomes. The authors enrolled 902 patients with heart failure and followed them for 36 months. Based on the sodium intake, the subjects were classified into sodium restricted (<2,500 mg/d) and unrestricted (>2,500 mg/d) groups. The primary outcome was death or hospitalization from heart failure.
Most Americans consume about 3,300 mg/day of sodium.
Results: Sodium restriction was associated with a significantly higher risk of death or heart failure hospitalization of 85%. According to this study, as compared to those who do not restrict their salt intake, for every six subjects that restrict their salt intake, there will be one increased death or hospitalization for heart failure. The authors concluded, “In symptomatic patients with chronic heart failure, sodium restriction may have a detrimental impact on outcome.”
Comment: Salt is the second major constituent in the human body, next to water. If doctors are going to suggest limiting the second major constituent in the body they should have good, solid data available to back up that recommendation. I have tested thousands of patients for their salt levels and I have found that the vast majority–over 90%–are salt deficient.
Folks, there has never been good, solid data that limiting salt in the diet of heart patients is beneficial. Yes, there have been some studies showing a benefit. However, there have been many other studies that have found the opposite conclusion.
Salt is a vital nutrient in the body. Most people who limit salt in their diet become miserable as they develop many adverse effects including high blood pressure (you read that correctly), brain dysfunction, fatigue, weakness, as well as muscle and leg cramps. Now we can add a significantly increased death rate and hospitalization for heart failure in those that limit salt in their diet.
My book, Salt Your Way To Health, was written to dispel many of the myths of salt. Salt is a vital nutrient; we cannot live without it. It is as vital as oxygen or water to our body. For the vast majority of us, limiting salt is a ridiculous idea. Yes, there are few salt-sensitive patients out there—but they are few and far between.
I encourage you to read about salt and learn about the benefits of ingesting healthy salt products in your diet. It is important to eat the right kind of salt—unrefined salt—and avoiding refined salt.
Remember, you must educate yourself as you are ultimately responsible for all your health care decisions.
Happy New Year and To All Our Health!!
DrB
Hi Dr. B., I just recently purchased your book ‘Salt Your Way to Heath’ (excellent book BTW!), and have started to add unrefined salt to the water I drink throughout the day. I am seeing good results so far regarding BP lowering and overall feeling better. I knew there had to be some sort of deficiency/in-balance going on inside me and hope I am on the way to curing that. All my doc wanted to do is put me on a high BP med, but thank God I refused! At 54, I am on zero pharma meds and my goal is to stay that way!
Have you had any experience or have you heard of the Hyland’s brand Bioplasma Mineral Cell Salts (the one with the combination of 12 mineral cell salts in one)? My wife is having a hard time drinking her water that has the unrefined salt mixed in so was wondering if these mineral cell salts would do the same thing that unrefined salt does? Also, any opinion on if I should also take these as well as the unrefined salt at the same time?
Thanks!
Steve,
I have not used that product. Unrefined salt is the cheapest way to replace minerals.
For those that do not like the taste, buy empty capsules, large size, and fill with salt. It has worked well with my patients.
DrB
What has disturbed me all my life about blood pressure medication is that we have a situation where the body is raising blood pressure and it is doing that to achieve homeostasis, as is generally the case with such changes. So there are consequences of this of course but it’s not just a one sided affair, there’s more stress on the cardiovascular system but the body has decided that this is preferable to just keeping BP normal. In other words, better blood flow may be preferable to greater CV stress. Blood flow is very important of course.
So what do we do? We seek to remove this adjustment, always focusing on symptoms and not underlying causes, that’s the creed of allopathic medicine. So then we see increased deaths due to strokes with these patients, which can be expected when you look to reduce blood flow in cases where more is needed, in addition to other negative effects of this, plus the side effects of the medications themselves.
As it turns out, the real culprit here isn’t even being addressed, which is hyperinsulinemia, which is behind just about all chronic diseases, including high blood pressure, cardiovascular disease, obesity, hyperlipidemia, the list goes on. Of course type 2 diabetes is included here, and hyperinsulinemia is the hallmark of this disease, and it’s what causes the insulin resistance that is behind the blood sugar dysregulation we call T2DM. Conventional medicine by the way looks to worsen excess insulin levels intentionally rather than to look to normalize the hormone and actually treat the condition.
So we’re told to cut down on fat and salt, that forms the basis of the dietary recommendations really, they aren’t really that concerned with the high blood sugar itself and the foods that increase it. It’s all about treating a symptom, high blood sugar in the moment, with not a care in the world about longer term outcomes, just like the idea that you can cut a few points off your BP with salt restriction, you don’t have to look further and we don’t want you to either.
What this does to our adrenal hormones is well known, and the story isn’t pretty, and it’s the same thing that high insulin does, disrupting hormones to produce further illness is the goal here though. To fix things we need to be willing to ask questions, and some have asked what happens if we restrict salt, and the answers have been rather disturbing.
So few people know about this, I did feature a blog post on my diabetes site some time ago, and was delighted to read this and this inspired me to do another post on this topic today, this time mentioning the significant contributions of Dr. Brownstein. In addition to being Dr. Iodine, he is now Dr. Salt as well. We have a long way to go to even begin to dispel the myths with this one, conventional medicine is all myth based though, an evil fairly tale. Keep up the great work Dr. Brownstein, on this and other matters important to maintaining and achieving health, every one you help is one more person that has a chance to save themselves.
I have always loved salt. I use it liberally. My spouse was told to reduce his salt intake. Another doctor did a blood test and found he was deficient. He is using it again.
We have pet birds. They have a Himalayan salt block in their cage. They peck it. They also get sea kelp for the iodine. Occasionally they get coconut sugar. Variety is the spice of life.
Thanks for replying Doctor. But I don’t know. Sure the heavy carnivores would get larger amounts of sodium from blood and flesh but primates like us in nature are not big carnivores. Only about 1 to 3% of their annual diet. It would seem to suggest that eating a lot of greens and just a little meat would provide enough sodium.
Personally, I figured this out about 40 years ago, despite the similar nonsense promoted in medical school (when “professors” were challenged by the rebel-rousers in my medical school class during the 4 years, the same answer was given, at least 50% of what we are teaching you is likely wrong; yet that does not mean that you do not have to memorize it all and repeat back our dogma on the test).
The far more important issue is body water balance, not dehydrated & not edematous, especially important for (a) CHF (brain adjusts water intake, retention & losses to adjust heart output over an ~12 hr period of integrated feedback to decide changes), (b) liver failure (albumin is what pulls water bulk-flow-spill along the arteriolar end of every body capillary back into the blood stream along the venous end over the same capillaries) and (b) renal failure (in which the healthy ability to adjust output to up to 50 fold changes of intake becomes more compromised, thus can lead to edema/internal drowning).
But since most humans ignore health, health is fantastically complex (thus poorly understood; evident only via the sad state of advanced symptomatic disease), humans have so many ways of compensating for disease (until eventually beyond their ability to compensate & avoid more obvious symptoms), choose to believe freedom-from-symptoms = health and people (public & physicians) are lazy/greedy wanting quick “fixes”, the medical industry is overwhelmingly a disease/failure focused industry (in which payment for labels being placed on their failures, after finally more obvious) and expensive treatments for symptoms (which routinely further complicate the disease state, yet may ease symptoms briefly) and in which most of the customers choose not to pay directly (instead indirectly; a lot more via expensive money accumulators), most are easily deluded into expensive, poor quality services which are promoted as Hi-Tech.
What a deal.
Thank you for your wise comments, Dr. Alvis. I especially enjoyed the part about medical school–you are totally correct.
DrB
The problem is not too much sodium, although it can play a part in high blood pressure, it is too low amounts of potassium. Doctors only focus on one half of the equation! Processed foods are the ones that have the hlghest amounts of sodium, and if someone is eating a lot of this type of food they are causing problems. Fruits and veggies ALL contain large amounts of potassium and low sodium, indicating that is the way we should be eating, low sodium, high potassium. It’s the necessary ratio to keep out cells healthy.
The patron who calculated the fluoride (critical) and bromide content of Himalayan salt is off by a decimal point. (too high)
My aunt had the habit of, almost daily, eating a water glass filled with ice to the brim and liberally shaking the table salt shaker into the ice. The practice finally got her as she died last year at the young age of 94. She did this all her life.
As dr. D. Brownstein said and I totally agree, salt it is life ! Ocean life exist in a very salty solution. The life solution of the Oceans for terrestrial life it is inside of us: blood + lymphatic liquids of our body.
When I was student I’ve build up a theory( studying the patho -physiology ) about the salt “never salt restriction “, which I’ve used n my practice …..and in very large numbers I’ve made “wonders “. I’ve saved the life of many patients as long my dogmatic and orthodox colleges fully failed and sent the patients to die at home. Not any chance whatsoever accordingly the official medical science .
Never be treated by a doctor who tells you everything like: “one measure fits all” or such common mantra’s as you hear everyday !
Good luck and I wish you a salty day !
dr. Alex. Semenciuc
Dr Brownstein, are you an original Star Trek fan? If you are, then I’m certain you know what episode I’m referring to. If not, well well, in the episode, crewmen were dying from salt depletion. To quote Mr. Spock, “he would die almost instantly”. As an old nerd, I just had to comment. Keep up the good work! Happy 2016!
I was brought up with a no salt diet as my father had high blood pressure and heart concerns. It had been drilled into my head that salt was bad for us. I didn’t eat salt and three years ago became very ill. My blood pressure was 85/56, and I was very fatigued and in a lot of pain with symptoms of heart attack and stroke. They did lots of tests on my heart, but I was fine and the cardiologist to this day can not figure out why my blood pressure is so low. I was told to increase my salt to 3 grams a day. I find that this is too much for me and my body retains water instead and I feel worse. I do add pink Himalayan salt to my cooking, and eat seaweed snacks with sea salt on it once a week. What is your recommended dose I should try to have? I eat a very strict organic diet free of dairy, gluten and refined sugar. I eat a paloe diet with almost everything homemade.
Anne,
Most of my patients do well with 1-2 tsp/day of unrefined salt.
DrB
I do know how bad low salt can be. I would go to may sisters and she would not have salt anywhere, and she wanted to cut her salt intake so she ate frozen vegetables and everything with no salt. When invited for dinner I would bring my pink sea salt. One day she said she had no energy , what could it be ? I told her at this point take any salt, and instantly she felt better. I even gave her a bag of pink sea salt. She learned her lesson. By the way I do have all your books and pass then out to others to get the information and truth out there.
Denise,
I love that story!! I get the most joy when another doc or person tells me they passed my info on to someone else and it helped them.
DrB
Just a couple ideas on this thread…
1) it was my recollectioon that the Concerned Scientists back in the 90s said the villain was not the sodium but the sodium-IMBALANCE, so that if you were getting your sodium from cheese then the sodium was balanced by the calcium and all was well….. so now what’s wrong with that expectation that lots of salty foods in a balanced mix is healthy?
2) I saw a confirmed report that baking soda (with its sodium) was good for people with kidney disease — counter to the expected idea that sodium/salt was no-no for kidney disease… in fact the research said a small amt (fraction of a tsp) per day could save the patient from dialysis and/or kidney replacement…… pennies a day…. doesn’t this make your blood boil?
thanks for this latest revelatory insight in the sodium picture for heart patients like brother-mine…. ttyl
Aside from the studies, what about the common sense observation that, say, primates in nature don’t have salt shakers, but merely eat plants and meats whole without additives of any kind including salt? How is it that they can satisfy sodium and other needs without adding anything?
Carl,
There is a lot of salt in blood and other tissues. We could satisfy our salt requirements by drinking the blood of cows as the Maasai do. And, man used to eat a lot more salt as he/she used to preserve food with salt.
DrB
I would just like to note that according to the following website, Himalayan salt has 0.23% fluoride and 4% (!) bromide in it:
http://poisonfluoride.com/pfpc/fluoride_Aromalife.htm
Aren’t kelp granules or powder also good for sodium and iodine? kelp is also a very good source of sodium and chloride and at least 50 or 60 other trace minerals, and it is the highest food source of iodine in the world. One tablespoon has at least 2-5mg of iodine, maybe more, and the iodine in kelp is probably more bioavailable, so 1mg of iodine from kelp could equal around 3 or 4mg of iodine from Iodoral or Lugols, or maybe better. And you’re getting sodium and the other minerals at the sme time. There are some organic brands that test their kelp and other sea vegetables for heavy metals and contaminants, so that takes care of that issue. I have also never had any signs of bromide toxicity when having kelp, so that’s also probably not an issue.
Hi Dr. Brownstein!
I was not contradicting you whatsoever! I agree that salt limitations are not good! I was merely stating that table salt was not a good thing and that use of “good” salt was even better! Good health and best wishes for a wonderful 2016!
Great article Dr B, I have your book, but wonder if I drink a lot of water, 100 Ozs if I need more salt as I lose minerals when I go to the bathroom. I use Himalayan salt but I think I need iodine. How do I get iodine in my salt?
I wanted to add to Helens friends with meniere’s problem. I too have menieres and was told to limit salt. I was also given a tiny dose of valium to help calm the inner ear. It caused me to develope a high pulse rate when standing up and the only thing that helped it was more fluid and more salt. After going back on salt my Meniere’s calmed down again and my pulse is going back to normal..
For clarification, you say that 90% of your patients had abnormally low sodium in blood? What group of patients do you see and how come they became like that? They were not even practicing sodium restriction, I assume. A conventional medical friend told me that abnormally low serum sodium is pretty uncommon and Sodium restriction is widely used in hypertensives along with sodium expelling diuretics…a one two punch. Why is Mayo Clinic still advising such sodium restriction practice for everyone given the serious negative effects in the article you cited ?
Mohammed,
I see normal people in my practice. The reason is simple: We are not ingesting enough salt to maintain optimal levels. As I said previously, salt deficiency is not uncommon.
DrB
My father-in-law has congestive heart failure. When he eats too much salt, his lung fill up and he has trouble breathing. He also has kidney problems from the medication he has been on for his heart.
We have assumed that it is the heart failure causing the breathing issue from the salt but could it be the kidney issue?
Deborah,
There are some people who cannot handle certain amounts of salt in their diet. They need to limit salt. This is particularly true with kidney failure patients.
DrB
I ate no salt for many years and my blood tests said I was ok. I now use Sea salt on poached eggs and now the blood test is alittle higher. Sea salt has 84 minerals. When adrenals are low people may crave salt which helps raise blood pressure alitte. Adrenals/asldosterone affect Na/K levels. I was very dehydrated…didn’t realize ticks were hurting me and affecting my adrenals. Water would go right through me…could not hold it into my body. I then got Lyme/C-diff etc and bad diarrhea so the hospital could not put an IV into my arm. Minerals are important. Celiac people’s intestines may not absorb minerals well. Salt before a women’s period can make her swell up. Heart failure maybe due to gluten/Lyme/clots due to low thyroid due to gluten/burned out adrenals and much more.
I too strive to consume low temperature dried mineral containing salt, but have concerns about impurities introduced into land mined salt through the collection and grinding process. Anyone know how purity can be assured?
Thank you, Dr. B., for offering invaluable health information, for thinking beyond traditional medicine approaches and for respecting the intelligence and intuition of your patients. I do so appreciate your genuine care of heart and brilliance of mind.
~~~Mary from Chicago
Hi Mary,
Thank you for the nice comments.
DrB
Gratefully we switched to Real Salt (brand)/Himalayian pink salt years ago. It tastes better than the bad for you stuff. We even get unsalted butter and salt it with the good salt so we can reduce the bad salt as much as possible.
Yes, low sodium *does* cause high blood pressure! Once my mom had almost washed out her electrolytes and ended up in the ER. Her blood pressure was outrageously high and she had dangerously low levels of salt. It was a real life happening that absolutely proved the medical mafia wrong… yet they would have kept her on a salt restricted diet! It really boggled my mind.
Can you list a few of your favorite unrefined salt brands? Thank you!
Elaina,
I have tested Selena’s Celtic Brand Sea Salt, Redmond’s Real Salt, and Himalayan Sea Salt. All three brands tested well and free of metal toxins. All four tested well for their mineral content. I primarily recommend Selena’s Celtic Brand Sea Salt and Redmond’s Real Salt as they are cheaper than Himalayan brands and there is no real difference in the mineral content.
DrB
The REAL culprit is table salt! I use primarily Himalayan and Slaea (Pink Hawaiian) salt combined. Full of great minerals. Unfortunately the processed foods that many cardiac patients use has a sodium content that is very high, however the “sodium” comes from horrific “sodium” containing products like monosodium glutamate (MSG), sodium nitrite, sodium saccharin and sodium benzoate, to name a few.
If cardiac patients use healthy “salt” with whole, organic foods, they would benefit greatly! As a nurse of 36 years, I know CHF and have seen all of the travestys that allopathic medicine has done that negatively impacts cardiac patients!
Terri,
I agree that unrefined salt is a better choice. BUT, limiting salt, even refined salt is not good as there are over a hundred grams of sodium and chloride in the human body at saturation. We need adequate amounts of sodium, chloride and other minerals as well. Limiting refined salt leads to poor outcomes as well.
DrB
Limiting salt reduces iodine intake and leads to iodine deficiencies. This may be a factor behind the increased morbidity.
Mary said: “I do use only Himalayan salt myself”
This cuts off a major source of iodine.
Dean,
Himalayan salt (and all other unrefined salts) do not contain appreciable amounts of iodine. OVer 97% of our population is deficient in iodine and it is not because they are not eating enough unrefined salt. It is because our food supply (including food with unrefined salt) is deficient and our exposure to toxic halides has increased.
DrB
We use only Himalayan salt as well, but I find that any amount of salt interferes with my blood sugar levels and gives me edema. Would love to be getting the minerals from 1/4 tsp Himalayan salt daily, but haven’t figured out how.
Juddee,
You might want to investigate NAET as you may have an allergy to salt. Go to: http://www.naet.com.
DrB
I do use only Himalayan salt myself. Commercial stuff is not so swift.
I don’t trust sea salt because of ocean pollution.
I have a friend who has Menieres. She limits her salt intake to almost nothing. Are there other ways to help her besides limiting her salt intake? Her life is really limited by this. Especially when she eats out and food has become a big issue now.
Helene,
I have written about this in my book. There is no reason that a patient with Meniere’s disease needs to limit salt–the research has shown that. In fact, in my experience, they do better with more salt.
DrB
I was just told that I am at the beginning of stage 3 kidney disease. My kidneys are functioning at 59%. So should I limit sodium intake since my kidneys are compromised? Thank you for your response.
Debra
Debra,
This is one situation where you may have to limit your salt intake. You will have to follow your kidney function along with your salt levels.
DrB