pile of salt next to a salt shaker low sodium diet, high sodium

Q. I was rushed to the emergency department a few weeks ago because of low sodium. I have always been careful to eat a healthy diet low in salt. I’ve also made it a habit to drink a lot of water to stay well hydrated.

As a consequence of my fluid intake and low-sodium diet, I actually ended up with hyponatremia. The doctor advised me not to drink too much water because it can lead to an imbalance of electrolytes. I’d like to warn others of this danger.

A. Hyponatremia is a life-threatening shortage of sodium in the blood stream. Elite athletes sometimes end up with this condition if they drink too much water and don’t replace electrolytes.

A low-salt diet rarely results in hyponatremia by itself, but some people may not do well on a strict regimen. One reader shared this story:

“My uncle Jim followed a low salt diet and suffered from dizziness to the point of vertigo. To keep his balance while walking, he had to hold onto the walls or furniture. He suffered with this for many months and consulted several physicians. Finally one suggested that he increase his sodium intake. This immediately cured his problem.”

Medications such as hydrochlorothiazide for high blood pressure can exacerbate the problem of hyponatremia by making the body throw off sodium (American Journal of Medicine, Aug., 2012). In an older person, the combination of exercise and a diuretic can lead to sodium depletion that causes delirium (Wilderness and Environmental Medicine, June, 2012).

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  1. Tyne

    I have cut my water intake for the last two days and my fog head and dizziness are gone, I am eating more salt and I feel like my self again. now I have to get in shape, for three years the doctor had no idea what was wrong with me, I was admitted to the ER and stayed there 5 days until my BP and sodium were back to normal. I used to drink 3 gallons of water a day, now I am sipping 12 oz. every 3 hours.

  2. Polyven
    San Antonio, TX

    My high-starch diet is opposite some of you who have been extolling the virtues of low-carb eating. I’ve had lifelong low blood pressure. I’ve made sure I remain on no medications by doing the online research whenever needed to find natural means to solve health issues. I’m at age 84 on my way to 120, and my sodium has been on the low side for years. Because it seems to affect my once-strong sense of secure balance when I walk, I’ve become concerned enough to try to do something about it.

    Because of my desire to live an extra-long healthy life, four months ago I chose to begin Dr. John McDougall’s totally enjoyable online organic diet derived from his long and intensively researched study of the diets of those cultures living the very longest lives at our time in history. (I guess our more ancient ancestors may not have survived long with hungry animals around in that high-stressed “kill or be killed” age of Man.) It turns out that in modern cultures, the major life-sustaining 20th Century diets were vegetarian: high on fiber and vegetables, low on meat, cheese and eggs (with the exception of Eskimos).

    So my foods are now all fibrous: rice, beans, corn (incl. popcorn) and potatoes are 60% of diet, and other veggies, cooked or raw, form 30%, with no more than 5mg oil MAX daily, no dairy, fish or eggs, and no sugar, and my weight has nicely gone down by 15 lbs. But recent tests showed me I’m still low on sodium even though I do not ever skimp on consuming salt!

    The answer, apparently, is in drinking more water, but not more than one liter in one hour, which I admit I was exceeding every morning until a couple of weeks ago when I intuitively began to cut back to only one liter upon awakening & to drink another liter and a half more evenly through the day. I’ve also added easy-to-do lying-down isometric exercises of my core muscles 20 reps, repeated 5 times daily, which in one week have really helped loosen tight and cramping muscles elsewhere in my limbs. I hope I remember to check back in a few months with my updated sodium blood work results. It’s hopeful to think that just drinking more water could help, and if so, that this might help others to find their balance of both water and body!!

  3. Valetie
    Severna Park, MD

    HYPONATREMIA killed my 62-yr-old husband. Paramedics had never heard of it, ER docs ignored it and he was found with no heartbeat on an ER bathroom floor. ER had no idea how long he had no heartbeat and shocked him back to “life.” Life in an eyes-awake coma for 9 hideous weeks. The medical world needs to know more about this disease/condition/inherited disorder. No children should lose their father to ignorance.

  4. Hong
    Houston, TX

    I have been searching the cause of my dizziness online for awhile but this is my first time reading your post. After taking more salt yesterday afternoon my dizziness immediately subsided and gradually improved, today I can walk fast comfortably. Thank you for posting

  5. starpainter

    I have venous reflux disease and was advised months ago to cut back salt and drink about 120 oz. of fluid or more daily. Finally after many problems in between–pulmonary bleed, swelling, gone up three pants sizes, exploding veins–I was craving salt so I dosed myself with 800 mg.(approx.). Within minutes my pain lessoned, my veins and swelling starting to receed. I fought with docs for months concerned about the fluid retention. They did nothing. I almost killed myself with too much fluid and too little sodium. When are they going to take our symptoms seriously?

  6. DM

    Could there possibly be a connection between the apparent increase in HPB cases and the health care profession’s promotion of a low fat diet? This resulted in most people eating lots of carbs. Humans are carnivores! Our ancestors ate meat, nuts and berries, not processed grains, HFC and sugar! Could be that the modern diseases of HBP and diabetes (and maybe others) are a result of this dietary change.

  7. Gwen F.

    Extremely helpful because I suffer with high blood pressure also. I’ve never thought about how many carbs I consume. I too, try to watch my salt intake. I don’t eat a lot of processed foods. So I am going to start monitoring my carb and salt consumption. Thanks for sharing.

  8. PBL

    A number of years ago, my blood pressure was 210/100. I took the prescribed medication but started reading about things that controlled high blood pressure naturally since I tend to forget to take pills if I have no symptoms. Over & over I read that low carbohydrate diets lower your blood pressure, blood sugar, etc. so I cut down on bread to about one slice per week, rarely eat pasta or other grains, cut down on fruit but eat lots of non-starchy vegetables, eliminated sugar and in the next few months my blood pressure dropped to about 120/80 without meds.
    I never cut back on salt and my blood tests show sodium right where it should be. My blood pressure is now regularly 110/68 at home and sometimes lower but still pops up to 140/80 at the doctor’s office. I carry my cuff with me there so that she can check my recent readings and test it against her meter. So try cutting the carbs, not the salt. For more information, see Atkins or Protein Power books.
    Also, be sure to check your blood pressure after sitting quietly for 5 minutes. I got these instructions while a member of a 10 year Women’s Health Initiative study. At the doctor’s office they tend to take your blood pressure after you have marched down the hall and you are answering questions.

  9. JFR

    My lab work showed low sodium. One doctor told me to eat more salt.
    This simply made my ankles swell and did nothing to bring my sodium level up. Another doctor, whom I have switched to, told me to balance my sodium with electrolytes. This worked. I buy my electrolytes in powder form from an online health food store and put it in my morning lemon water. It tastes like lemonade. It contains what, in my opinion, is the only artificial sweetener that is not harmful, stevia. I also use sea salt or Himalayan salt, both of which have the trace minerals that naturally occur before salt is refined. Your body appreciates this natural form. And, yes, it tastes like real salt–because it is.

  10. M. K.

    My mother was on a salt free diet too long, due to high blood pressure. She ended up in ER with sodium depletion complications, a very serious condition. She recovered after having sodium by IV, but for some anxious hours, we weren’t sure she was going to make it.

  11. Lou G

    I’ve all but cut out salt since diagnosed with high blood pressure, in the 120’s to 130’s at home, 140 – 150 in doctor’s offices. The Hematologist that monitors my blood labs, for taking Humira for Arthritis, says I’m low on sodium, but he said not to increase salt. Now I’m confused.

  12. abigail

    This article rates 6 stars!
    On my computer, at last, the set of stars below the various articles does not register.

  13. A Davis

    I am so happy that I read this as now my dizziness makes so much sense. Thank you for this tip. You are great. I was on the way to my doctor to complain, now I know what to complain about.

  14. DS

    I have read that some doctors recommend adding 1/4 tsp. of salt to every fourth glass of water, or drinking broth for salt when on a low carb diet. For myself, I have increased my salt intake as well as the quality of the salt I use, and my blood pressure is better than ever.

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