I keep hearing how people consume way too much salt, how it contributes to all sorts of health problems, etc. I decided to lower my salt
intake. Soon after, I noticed I often got these horrible cramps -- usually in the middle of the night . . . as if I don't have enough
trouble sleeping! -- and frequent twitches, fasciculations, or whatever you call it. Is that a normal response to lower salt intake? (If it is, I'll pour on the salt, no matter what any doc tells me!!!!) I then decided to add some salt to my drinking water -- about 1 - 2 tsp/gallon -- and this seemed to eliminate the cramps. (And best of all, I didn't
have to pee almost every freakin' hour!) Despite adding the salt, my blood pressure is still a healthy 110/70. Is this "lower the salt" stuff for everyone, or are they just talking about sedentary people? (I'm a mailman, so I walk all day, plus I ride a bicycle 150 - 200 miles/week.) Also, I take magnesium and calcium. (It used to help me sleep better, and minimize the cramps and twitches, but it doesn't to be helping much lately.)
I asked my doctor about watching my intake of sodium and he said to try to eat a low salt diet. Eat more fruits, vegetables, grains, low fat dairy etc.. I have read conflicting reports regarding salt and hypertension. I have read that only a small percentage of hypertensives are "salt sensitive" and lowering their intake of sodium does not lower blood pressure very much. The nurse asked me if I put salt on my food and I told her no because so many processed foods are already loaded with sodium. She did not seem to concerned about it. I think it the balance of sodium and potasium you eat is more important. I have read that you should try to get as much potasium in your diet as you can so if you eat alot of fruit and vegetables you should be all set. I take DIOVAN also for my blood pressure and I have read that this medication also flushes out the salt in your system. I have also read that if you do not get enough sodium in your diet that this can raise your blood pressure. The bottom line for me is just to keep the salt in my diet at a moderate level..
Some people are salt-sensitive, some aren't. I've read figures all the way from only 10% to 60% are. Who knows? The fact is that the average person in many countries eats way too much salt. But that includes all the people who consume bags of potato chips and other salty snacks and those who regularly use packaged rice, pasta dishes, gravies, etc., which are loaded with salt. Those whose diet is centered on fresh fruits and vegetables and "prepared from scratch" foods are getting far less, and may not need to lower their sodium consumption much, if at all. People who exercise a lot, like your bike riding, lose salt in perspiration, so need more. With blood pressure like yours, I think you can just use your best judgment about how much salt you need.
I came across a couple of interesting articles this afternoon which pertain to this very question. Here is a quote from one:
Researchers determined that salt intake only adversely affected blood pressure when a person was deficient in calcium. When calcium intake was adequate, salt had no effect on blood pressure. As calcium intake increased, blood pressure decreased. The researchers concluded that salt sensitive hypertension is more likely to indicate a poor diet than a predisposition to hypertension.
It would be interesting to follow this up and see what results those who are salt-sensitive on this board got if they added more calcium to their diet. I personally don't think I'm particularly salt sensitive, but then I do try to get several servings of non-fat or low-fat dairy each day, and when I don't, I take a calcium supplement.
There is a feedback mechanism, the renin-angiotensin system (RAS), that our kidneys use to regulate BP. Without this system, a low-sodium diet would cause your BP to drop. However, in most people (non-salt sensitive folks), this system will raise your BP back to the level your kidneys would like. This is how everything is supposed to work. You can eat any level of sodium and our kidneys will make appropriate RAS adjustments to stabilize BP.
There are many folks who are salt-sensitive. For whatever reason, these individuals have a deficient RAS. It either doesn't completely compensate or only partially compensates. For these individuals, a low-sodium diet will lower BP.
And, there is also a population that has an overly active RAS. For these individuals, a low-sodium diet will RAISE BP.
The problem with many people is that the kidneys' preset level is just too high. There are two classes of drugs, ACE Inhibitors and ARBs, that will essentially deactivate this RAS system. For individuals on these medications, a low sodium diet will effectively lower BP.
Ultimately, what you want to do is to eat whatever level of sodium makes you feel the best and keeps your BP at a desirable level.
I find that I am very salt sensitive. I can just walk by a salt shaker and my blood pressure goes up. I hate it because I can hardly eat anything without a reaction. It is like you said every quick and easy meal is full of sodium and with having to work all day I hate to come home and have to cook "from scratch" meals.
Are you saying that if I take an ARB or ACI I wouldn't have to be so concerned about my salt intake? I am presently on Clonidine because it seems that it controls my bp with the least amount of side effects, although I still get spikes as it wears off. I take .1mg 5x's/day.
I have read that if you take for example DIOVAN ( ARB) it helps your kidneys get rid of salt in your body. I still try to watch my sodium intake but I have eaten high salt meals and have not noticed any difference in my blood pressure. I try to eat alot of fruits and vegetables because they are high in potasium which helps control blood pressure..
I think you may want to eat more high potassium foods like bananas to help with the night cramps. If you sweat a lot you will need to take in more salt. As has been said above, not everyone is salt sensitive. If your blood pressure stays nice and low dispite the amount of salt you use, then enjoy it.
For us salt-sensitives, it is probably even more important to watch our salt intake if taking an ARB or an ACEI. In fact I would venture to say that salt sensitives almost always need to take a diuretic if taking an ARB or and ACEI or go on a severe salt restriction.
Or, I'll go even further and say that ARBS and ACEIS are not good antihypertensives for us.
Another definition for "salt-sensitives" might be "low-renin-hypertensives." Using higher and higher levels of renin-angiotensin lowering medications is the wrong way to treat this. Unfortunately, few doctors are willing to differentiate and throw us all in the same pot with the same drugs.
What would be a good bp medication for us "salt sensitive" people to take? I have tried almost everything on the market but I am so sensitive to medications and their side effects. I am presently taking clonidine .01mg 5x's/day. This seems to be the only drug that works for me in keeping my bp down. The only thing is I have to take that many because it is not long lasting and I do get spikes. So I guess I am not really getting that good of control. It is all so frustrating.
Just thought I'd toss in my two cents. My Mom was given a beta blocker and a diuretic last week for her BP. After 4 days on the diuretic (coupled with a few warm days) we ended up in ER. Her sodium level was 116 (30 points low). Be VERY careful with diuretics the first few days, and monitor how you are feeling. This pill was a COSTLY mistake for her. BTW, while in the hospital the first night, she got up to use the bathroom and fell. But, she broke the fall--with her face. Broke her nose, etc....
Was that chlorthalidone she was taking? My one experience with it threw me into severe hyponatremia too...I have to stick with HCTZ, much weaker.
That beta-blocker might have been a BIG contributor to your mother's fall.
And in that vein, if taking diuretics NEVER restrict salt and be careful when sweating up a storm in hot humid weather.
The literature says that the next best drug class for salt-sensitive hypertensives are the calcium channel blockers. My only experience with them was a month of Norvasc which didn't do me any good, just torment. Maybe verapamil or diltiazem might be worth a try for the adventurous.
Also, it pays to consider what quality of salt the body is ingesting. The human body needs salt (a chief natural bodily component-- i.e. we are of the sea). Consider looking into "natural sea salt" (quite a different matter than commercial, land-based, heavily processed and often iodized varieties mostly on the market). You will have to go to a health food store for the best of the previous. And also, google on-line, "natural sea salt" and self-educate. Also, learn about natural body salts, the salt already available in foods (healthy in fruits, vegies-- not healthy in salami, fritos, et al). The "right" salts can correct a salt imbalance (and its deleterious health effects that follow) either way.