Sodium Deficiency

[WaiWay]

I was reading up on Sodium deficiency symptoms and ever since I started this diet, my mental symptoms have progressively gotten worse. The main ones I'm referring to are the cognitive impairment.

"Cognitive Impairment
Decreased sodium levels may cause altered mental status. Most of the tissues in the body can handle the expanding tissue cells caused by the hyponatremia, but the brain cannot compensate for the increased cell size. Brain dysfunction may occur because of the changes. Symptoms of this impairment include a headache, lethargy, fatigue and confusion. As the condition worsens, a person may experience irritability and hallucinations. A decreased level of consciousness, a coma and possibly death may also occur when blood sodium levels drop."

I consulted a nutritionist and these are her calculations of my vitamins and minerals intake:

Nutrient DRI Intake

energy
Kilocalories
3178 kcal
2730.73 kcal
86%

Carbohydrate
358 - 516 g
303.08 g

Fat, Total
71 - 124 g
164.83 g

Protein(g/kg/day)
57.83 g
52.11 g
90%

fat
Saturated Fat
< 10%
27.76 g

Monounsaturated Fat
no rec
107.68 g

Polyunsaturated Fat
no rec
20.59 g

Cholesterol
300 mg
901.11 mg
300%

efa
Omega-6 Linoleic
16 g
17.26 g
108%
Omega-3 Linolenic
1.6 g
1.46 g
92%

Dietary Fiber, Total
38 g
57.82 g

152%
Sugar, Total
no rec
180.77 g

vitamins
Thiamin
1.2 mg
1.24 mg
103%

Riboflavin
1.3 mg
1.69 mg
130%

Niacin
16 mg
17.43 mg
109%

Vitamin B6
1.3 mg
3.97 mg
306%

Vitamin B12
2.4 mcg
1.61 mcg
67%

Folate (DFE)
400 mcg
558.1 mcg
140%

Vitamin C
75 mg
330.42 mg
441%

Vitamin D (ug)
5 mcg
1.82 mcg
36%

Vitamin A (RAE)
900 mcg
496.42 mcg
55%

Vitamin A (IU)
3000 IU
5579.1 IU
186%

alpha-tocopherol (Vit E)
15 mg
23.69 mg
158%

minerals
Calcium
1300 mg
391.58 mg
30%

Iron
11 mg
8.3 mg
75%

Magnesium
410 mg
371.43 mg
91%

Potassium
4700 mg
5889.31 mg
125%

Zinc
11 mg
5.78 mg
53%

Sodium
1500 mg
124.96 mg
8%


I eat a variety of fruit and get the maximum in take of animal products your diet recommends. How do you justify this? My sodium intake is 8% of the DRI.

[RRM]

You were doing the acne sample diet.
Once your skin is clear, you are advised to experiment with animal food intake,
to get to know how much animal food your skin can cope with.
So, you could try to increase your intake of sea-fish.
Instead, you could also try to see how your skin reacts to adding a pinch of salt.

[WaiWay]

Well other than just me personally, don't you find that alarming that this diet doesn't properly address this issue, considering external sources of salt (i.e table salt) is not advocated by its personnel?

[dime]

What personnel are you talking about? Nobody is employed here and nobody is making any money out of it.
You're getting advice for free here, so take it with a pinch of salt (pun intended).

[RRM]

Im guessing its his way to show his gratitude for that we helped him to eliminate his acne.
Im sure its a cultural thing that we misinterpret his way of thanking us.
Where are you from, WaiWay?

The reason why table salt is not advocated,
is because its a major possible cause of acne.
When one is doing the acne sample diet, we need to be sure its working,
otherwise this person will get discouraged (and for a good reason).
So, once this person is 100% sure the diet is eliminating his/her acne,
then its time to start experimenting.
If we advise to include a small pinch of salt in the acne sample diet,
it may prevent a lot of people from eliminating their acne.

How much salt we actually need is also debatable.
Ive been not using salt since 1995, and im still doing perfectly fine.
Sure, it wouldnt hurt me to try taking some salt.

[Oscar]

The RDA/DRI is an arbitrary list of numbers, as what we need daily is individually different and changes all the time. Aside from that, the range of what people need isn't known in most cases. Also, when it IS known (vitamin C), the RDA/DRI can be several times higher than we actually need (around 10-15 mg/day vs. 75 mg/day for vit. C).

[WaiWay]

I understand you guys are motivated to help people, and I really appreciate it. I didn't mean to come across in a negative way. I was just a little alarmed that I was following the diet for a few months and my sodium was that low.

[RRM]

I understand you guys are motivated to help people, and I really appreciate it. I didn't mean to come across in a negative way.

Ok, apology accepted.

I was just a little alarmed that I was following the diet for a few months and my sodium was that low.

You dont know whether its low.
The nutritionist entered your dietary data in a nutrient calculator,
and she did not test your blood, did she?
You should test it as soon as possible, so that you really know.
Thats because if it is not too low, you need to look for an other explanation. (important)

[WaiWay]

Exactly my thoughts. I went for a blood test so we'll see the results soon.

[Kasper]

Uric acid is also interesting as it comes low dietary sodium.
"Fossil evidence suggests that hominids of the Miocene epoch (a period between 24 and 6 million years ago) inhabited sub-tropical forests and were woodland quadrupeds that had a diet based mainly on fruit.[37, 38] The salt content of the diet at the beginning of the Palaeolithic period, in the mid-Pleistocene (1–2 million years ago), was very low, ~690 mg/day (1.9 g NaCl) compared with a mean of 4000 mg/day (10 g NaCl) in the current American diet. Salt ingestion in hominids in the Miocene was probably even less, because they only ate fruit and leaves, estimating that with such a strict vegetarian diet salt ingestion could only be 225 mg (0.6 g NaCl). Watanabe et al. [17] demonstrated that the increase in UA can maintain blood pressure in conditions of low salt ingestion, both acutely (by stimulation of the renin–angiotensin system) as well as chronically (inducing sensitivity to salt by the development of microvascular and interstitial renal disease). The increase in blood UA could enable the hominids to maintain blood pressure in times of low salt ingestion and it has been suggested that this increase in blood pressure from the increase in UA could be essential for hominids to maintain their vertical position.[27]"

Serum uric acid increases in short-term dietary sodium restriction. http://www.ncbi.nlm.nih.gov/pubmed/1921253
If your body doesn't react with inflammation to uric acid, low dietary sodium may be able to improve neuroprotection.
But, I'm still not at all sure about if high uric acid could be desirable. It's quite complicated.

[djkvan]

Is it true that there is an important distinction between the sodium found in food and that which is found in table/sea salt? From what I've read sodium chloride has a biocidal effect and certainly hurts like hell when placed on open wounds/eyes (for the record I've never intentionally put salt in my eyes ). Would it not have the same irritant effect on the intestinal mucosa (esp. if already distressed)? I have also read (unfortunately unreferenced) that a K:Na ratio of 50:1 or even 100:1 is sufficient to sustain humans.

[Aytundra]

Is it true that there is an important distinction between the sodium found in food and that which is found in table/sea salt?

Table salt = NaCl, sodium chloride. Most of the time, something labeled as "table salt" is NaCl, because it is the most inexpensive kind to produce.
Iodized table salt = NaCl with iodine added. Iodized table salt helps people get some iodine in their system, people that consume less seafood, usually has less iodine in their dietary source, and with less iodine in their system, people can get thyroid problems. Hence, some salts are fortified with iodine. Iodized table salt is also quite common in supermarkets.
Sea salt = NaCl, KCl, MgCl... a number of salts minerals and possible contaminants...

From what I've read sodium chloride has a biocidal effect and certainly hurts like hell when placed on open wounds/eyes (for the record I've never intentionally put salt in my eyes )

Nerve cells run on sodium and potassium pumps. Release too much salt near a nerve cell, and the nerve will fire a signal, you feel a sensation, and if the sensation is too strong, we call that pain.
If you cry too much, and let the tears dry on your skin, the salt on the skin may sting the skin.
Same thing with a runny nose, that salty liquid can sting the skin around your nose and mouth.
-->But it all depends on how well your nerve cells are insulated with glial cells and fat, and how much salt makes it through the skin layers.
It you have a layer of fat on your skin, you can cry a lot and you will be less susceptible to the sting.

Biocidal, that is because too much salt on a cell's surface dehydrates the cells. Salt on the surface of cells, draws water from cells, osmosis. Dried cells cannot function, no water = no life = cells become dead. That is how you make/preserve ham and cheese. Add salt, dry it out, bacteria can't grow on your ham and cheese. Sugar does the same thing, with dehydrating water from cells in preservation of dried candied fruits, osmosis, again.

Alternate theory to crying and runny nose sting is, your skin cell surface becomes dried, pressure mounts on skin surface, causing pressure on nerve cells beneath skin cells to fire and you feel that tight skin feeling after crying or a runny nose.

Would it not have the same irritant effect on the intestinal mucosa (esp. if already distressed)?

I don't really know. I never self-studied anatomy. RRM/Oscar help?

But I will guess: I do not think that salt can irritate the intestinal mucosa much, because the salt would have been dissolved in saliva or water before it goes down to your intestines, the dissolved salt cannot act like a sand paper on the intestinal mucosa. I think things like solid food items, solid food particles, or food molecules, like fiber and acid, that will scratch or irritate the film of intestinal mucosa. Dissolved salt are ions, and ions are much smaller in size than solid food items, solid food particles, and food molecules. The mucous layer is probably composed of a matrix of proteins like your saliva except thicker, hence solid food items or particles or molecules,will scratch the film much more easily. Mucous layer breaks down, and expose more acid to intestinal skin or smooth muscle cells hence the cells react and create pain via unrhythmic muscle movements. Then these muscle contractions pressures the muscles together, pinching nerves within and adjacent to the muscles, causing pain sensations.(My educated guess, take it as a grain of salt. )

I have also read (unfortunately unreferenced) that a K:Na ratio of 50:1 or even 100:1 is sufficient to sustain humans.

But to sustain humans, in what way? Is it for heart ratios? blood ratios? or nerve ratios?

[djkvan]

Thanks, Aytundra. In terms of adequate sodium, I meant sustain as in "to not eventually incur symptoms of sodium deficiency due to insufficient intake". Since RRM's K:Na ratio has been around 50:1 for nearly 20 years, I'm guessing it works for him, but perhaps others may need to experiment with levels if they have adrenal/kidney issues.

[Novidez]

Luckily, our body is very capable in adjusting absorption rates (up to 10-fold!), so that non-extreme intakes have little influence.

So, for example, when I took almost 1 tsp. of Salt the other day, I immediately had water retention. That body adaption also works for NaCl? This is, if I had continued taking it 1 tsp. daily, would my water retention disappear and would my body adapt to the new salt intake? It was thinking on being brave and trying to do that experience, but then again I was not happy at all knowing that I gain 5 kg in two days...

With that being said, I would like to hear (read), if possible, why it is advised to not take any extra salt (specially regarding K:Na and also the stimulation of the renin-angiotensin-aldosterone hormonal system.).

If we do not consume sufficient sodium, our metabolism, driven by specific feedback mechanisms, goes into a sodium-sparing mode so that the circulatory system can maintain osmotic balance and adequate blood pressure. This has several important consequences for us. A reduced intake of sodium is characterized by the stimulation of the renin-angiotensin-aldosterone hormonal system (RAAS). Renin, the first enzyme taking part in the RAAS was clearly shown in a dose-response curve1 to increase as sodium intakes fell below 150 mmol sodium (or 1.5 teaspoons/8 grams of salt) per day. At a point of intake below 110 mmol (6 grams) sodium per day renin begins to rise rapidly. The RAAS feedback mechanism is the most transparent measure of our dose response to salt intake and is a fundamental indicator of sodium intake sufficiency.
Although this cascade of reactions is designed to sustain osmotic balance and blood pressure, chronically elevated levels of renin and aldosterone have significant negative effects on the condition of the circulatory system and may stimulate inflammatory agents within the body. Included among the negative outcomes of chronically elevated levels of renin and aldosterone are insulin resistance,2 metabolic syndrome,3 cardiovascular disease,4 cognition loss,5 and others.

I would like address also:
- Association of the Renin-Sodium Profile with the Risk of Myocardial Infarction in Patients with Hypertension
- Aldosterone-induced inflammation in the rat heart : role of oxidative stress.
- Low urinary sodium is associated with greater risk of myocardial infarction among treated hypertensive men.
- Fatal and Nonfatal Outcomes, Incidence of Hypertension, and Blood Pressure Changes in Relation to Urinary Sodium Excretion
- Urinary Sodium and Potassium Excretion and Risk of Cardiovascular Events
- Dietary patterns and cardiovascular disease mortality in Japan: a prospective cohort study

P.S.: I hate the fact that even though there may be evidences that low sodium intake increases CVD, I bet the diet itself, in most cases, must have a more important role...

[RRM]

when I took almost 1 tsp. of Salt the other day, I immediately had water retention.

It means that your body is not so much effective in adjusting the absorption and excretion rates.

if I had continued taking it 1 tsp. daily, would my water retention disappear and would my body adapt to the new salt intake?

Maybe, but you might be unlucky.

It was thinking on being brave and trying to do that experience

I dont think it is sensible to do such an experiment.
You may compare it to the insulin system; you dont want to imbalance it.

why it is advised to not take any extra salt (specially regarding K:Na and also the stimulation of the renin-angiotensin-aldosterone hormonal system.).

Because you may have issues adjusting properly.
You may opt to decrease K intake instead, if necessary for the K:Na ratio.

A reduced intake of sodium is characterized by the stimulation of the renin-angiotensin-aldosterone hormonal system

That very much depends on whether the actual Na uptake is suboptimal.

The RAAS feedback mechanism is the most transparent measure of our dose response to salt intake and is a fundamental indicator of sodium intake sufficiency.

Here you go.