A delicate balance

ND. Kali Simmonds
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Sodium to potassium ratios important to health

Question: I have major salt cravings, but I hear everywhere how bad it is for you. How should I handle my cravings and do they mean anything in your work?

Answer: I am so glad you asked this question, as it is a subject I frequently talk about with my patients.

Like many constituents of your body, you can have too much or too little sodium. The “too much” sodium is well-known, but “too little” is rarely discussed.

The sodium to potassium ratios is really what needs to be optimized not just avoiding sodium. An ideal diet provides a ratio of 2:5 or 2000 mg:5000 mg of sodium (Na):potassium (K). This intake ratio helps to maintain levels of Na and K inside and outside your cells. This controls fluid balance and electrical (nervous) activity in your body. Water follows Na, so too much Na in your blood attracts water which increases blood volume which can raise blood pressure.

However, optimal potassium found mostly in fruits and veggies is just as important to maintain ideal sodium levels, as potassium causes sodium to be excreted in your kidneys. So, someone who takes in less than 2000 mg of sodium, but too little potassium can still have issues related to too much sodium, such as tissue swelling and/or high blood pressure.

The best way to increase potassium (K) intake is fruits and vegetables. The best source of potassium is avocado at 1300 mg per avocado, baked potato skin on or 1/4 cup dried apricots is 800 mg, a large tomato at about 500 mg and the ever popular banana, great but only in the 400 mg range. A  standard potassium supplement has 99 mg per tablet, which is not very much. Higher potassium supplementation should be under medical supervision.

Many people have such low blood pressure that it can make them feel lightheaded and even faint at times. For these people, believe it or not, 1/4 tsp of sea salt each morning can help blood pressure increase more towards normal. Those who are worried about salt sometimes are too concerned, and in knowing that 75 per cent of sodium comes from processed foods, eating a meal of vegetables, potatoes and chicken with a light sprinkle of salt (i.e. 1/8 tsp) to add flavour is only adding 250 mg.

As far as why people crave salt, one mechanism is low adrenal function, not necessarily Addison’s disease, but sub-optimal or very low normal.

Symptoms include low blood pressure, fatigue, sensitivity to light, chronic inflammation and hypothyroidism. The adrenal glands make adrenaline and steroid hormones. Aldosterone is one of these steroid hormones and it controls Na retention, so if aldosterone is a bit low your body may try to compensate by urging you to eat more salty foods.

Having your serum cortisol checked at 8 a.m. and then 3 p.m. and/or a 24-hour urinary cortisol test is a good indicator of overall adrenal output.

We live in a go-go society that rewards type A behaviour and pushing yourself past healthy limits with the help of stimulants such as caffeine. However, the harder you go or the more adrenaline you pump out, then the more you will need to support your adrenal glands.

The key nutrients used by the adrenals are vitamins C, B5 (pantothenic acid), B6, magnesium and zinc. Many medications can deplete these nutrients adding insult to injury if your nutrient intake is low and your stress is high.


Kali Simmonds, ND is a doctor of naturopathic medicine who practises in Charlottetown. The information provided is not intended to diagnose or substitute the advice of your healthcare professional. Please consult with your health-care provider before making any changes. She welcomes questions for this column, which is published the first Tuesday of the month in The Guardian. She can be reached by mail at 34 Queen St., Charlottetown, C1A 4A3 or by email at kali@drkalisimmonds.com.

Geographic location: Charlottetown, The Guardian

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