s4 e4: sodium deep dive

Sodium Deep Dive

In this episode, I am breaking down what exactly we need sodium for, debunking a lot of myths around salt intake, and as usual will go through how sodium impacts areas like our thyroid, digestion, and blood sugar since they all have a huge impact on hormone health. I also answer listener questions at the end and have a bonus episode for patreon members. In this bonus episode, I go through HTMA case studies with high and low sodium, share a chart comparison of all the popular electrolyte powders with the pros and cons, and so much more. You can join patreon at patreon.com/hormonehealingrd

Quick reminder, this podcast is for informational purposes only. Please talk with your healthcare provider before making any nutrition or lifestyle changes. 

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Episodes mentioned:
Calcium deep dive
Magnesium deep dive

Aldosterone production

Sodium restriction/needs in pregnancy: 

Sodium restrictions and babies
Stress and aldosterone

Sodium & Salt intake studies:

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Welcome to the Are You Menstrual podcast where we dive deep into all things women’s health to support you on your healing journey. I’m Amanda Montalvo functional and integrative dietitian also known as the hormone healing rd. If you enjoy this podcast and you want to keep learning, check out the podcast Patreon where I share a bonus episode with additional downloadable resources each week, you can go to patreon.com forward slash hormone healing rd, or check out the link in the show notes.

All right, we have our sodium deep dive episode, we have covered calcium and magnesium so far, this week we’re doing sodium potassium is next week. And just like all the other mineral deep dives, I’m going to cover the different functions of sodium. So like all the different things it does in the body, I’m gonna go into how it impacts areas like digestion, thyroid health, blood sugar, balance, all things that impact our hormones, I will be going deep into a lot of myths around sodium and salt in general. And then also how it impacts blood pressure and heart health. Because when I did a question box on Instagram, I cannot believe me people ask questions about that. I guess with my population, I thought it would be more related to hormones. But don’t worry, we’re going to talk about it a lot of questions about preeclampsia, too, which is high blood pressure in pregnancy or you know borderline. So we’ll talk about that. And yeah, a lot of a lot to cover how we regulate sodium in the body, which is I think, very important to grasp. And then finally sodium and its relationship to potassium. Because if there’s one thing I want you to get from this episode, it’s that we can’t just look at sodium and we can’t just focus on sodium in the diet, we have to pay attention to the sodium potassium ratio. So we’ll talk a lot about that I do have a bonus episode for aren’t my Patreon patrons today. And that goes into two case studies, a high sodium and a low sodium on a hair test. And you know, their specific health histories, what it means signs of stress, all that kind of stuff. And like the major takeaways, I’ve also put the kind of big parts of this episode like sodium regulation, the different relationships with sodium. And then the sodium potassium ratio, like the big areas, I made notes with like visuals for the download because I did a survey and a lot of my Patreon members really like PDF visuals. So there’s that as well. And then finally, I put together a handout that has different electrolyte powders, like all like the really popular ones, both like in mainstream and in the holistic world that I am in, and I went through and put sodium potassium, the sodium potassium ratio, other possible ingredients to consider. And then like if they have a sweetener, or not. So if you want access to the bonus episode and all those resources, you can go to patreon.com/hormone Healing rd. And then finally, before I dig into the different functions of sodium, please remember that this episode is for informational purposes only just like every episode I share. And you have to keep it in context with yourself. That’s impossible for me to do. I’m talking about like generalizations here. So if you have a concern or if you’re like, hey, this, I think this makes sense for me. Talk with your provider, because they can help you make sense of it all in decide if something like a nutrition supplement or lifestyle change is a good fit for you. So just be smart there. Okay, sodium basics. Sodium is a mineral, right, obviously we’re doing mineral deep dives this season. It’s also an electrolyte though since it does carry a positive electrical charge in the fluids in the body. It works very closely with potassium, which is another electrolyte. Sodium is primarily outside the cell. So it’s typically in like extracellular fluid, whereas potassium is an intracellular mineral and it’s mostly inside the cell. So they work very closely, there’s a sodium potassium ratio we’re going to talk about and when I talk about the RDA, like the recommendations for sodium, we’re also going to talk about potassium. Because while this is a sodium deep dive, I’m going to cover potassium in detail next week. It’s just like the calcium magnesium. There’s such a close relationship in the body and how they’re regulated that it’s pretty much impossible to only talk about sodium without mentioning potassium. And I was very pleasantly surprised that when I was getting into the research to prep for this episode, there was a lot more discussion about potassium, especially when it comes to like blood pressure and heart health and how important potassium is and how we love to have to look beyond sodium. So I have a lot of those articles in the show notes made me really happy. But essentially it’s like yes, this is about sodium, but we can’t talk about sodium or especially within our diet if we don’t talk about potassium too, so they work very closely together. Most people only associate sodium with blood pressure in the body. They think Oh, heart health, and that’s really what I saw. When I posted that question box story on Instagram, but sodium is very important for many other things, it’s actually essential for nourishing ourselves. So sodium impacts our cell marine permeability. So like how things can pass through our cell. If we don’t have adequate sodium, our cells cannot be nourished. And that’s just so important. It’s one of the major takeaways. And I just hope that everyone listening like leaves this episode, learning, like a couple of things, that sodium potassium ratio is more important than just sodium intake. And then that sodium is so much more than blood pressure, because it does a lot of important things. And if we don’t get enough of it in our diet, we can have issues if we get too much we can have issues. So very important for cell nourishment, it also helps maintain water and electrolyte balance, it helps you hydrate us, we will not be hydrated if we don’t have adequate sodium intake and potassium intake. And it’s important for our nervous system, it’s we need it for nerve functioning and signaling. So it both sodium and chloride. So if we think of salt, sodium chloride, they change concentrations. And based on that change in concentration, this allows our nerves to send signals to each other and communicate and to other cells. So if we don’t have proper nerve transmission between the cells, we’re not going to have proper like mechanical movement, nervous system function, those types of things. So it is important for our nervous system, it’s also really important for muscle functioning contraction, I have seen a lot of muscle weakness with very low sodium and potassium levels on hair mineral tests. So that is one where I’m like this, I see this a lot actually in practice. And I feel like it doesn’t get talked about a ton when it comes to sodium. But too little sodium can be a huge issue for muscle weakness, contraction, that sort of thing. We also need it for stomach acid production for that hydrochloric acid, specifically sodium chloride, so chloride helps us produce stomach acid. And if we don’t have enough stomach acid, then that is a huge, huge starting point for digestive issues and gut health problems. Because stomach acid is really like that first line of defense that protects us against pathogens, pathogenic bacteria, parasites, and it helps us break down our food properly. So one, we could get things getting into the gut that we don’t want to get in, they’re not ideal. Once those get in, then they create inflammation, they get our immune system going, and they can impact the balance of good and bad bacteria in our gut. And then too, if we aren’t breaking down our food properly, then that can lead to eventually over time, our immune system being overactive. And we can start reacting to foods that are really healthy for us. And then eventually, usually histamine issues. And many other things. I do have a histamine intolerance, one on one episode that if you’re like, that is me, like listen to that episode. It’s in season three. So it’s important for stomach acid production. And then it’s also important for absorbing and absorbing nutrients and water in the gut, especially like the large intestine, so that’s a big one. And finally, it does affect our blood pressure, it can increase our heart rate, and blood pressure, it can also lower it. And we’re going to go more in depth on this when I cover exactly how sodium is regulated. Next, but those are the main functions of sodium, it’s more than blood pressure, it’s very important for cell health, it’s important for our muscles, hydration, stomach, acid production, all things that are going to impact our overall health and hormones. Now it’s time to cover how we regulate sodium in the body. I think if when we understand this, it helps you grasp, like why someone may need more or less all or why levels may differ per person, when you understand like how exactly is my body regulating this. So just like most levels of minerals in the body, our bodies regulate the amount of sodium in our blood very closely, we can have changes in our sodium intake. So maybe you’re having less processed foods or you’re utilizing less sea salt, or stress or fluid loss that are both that you know, those are all going to impact sodium levels. But we have systems in place that are going to help keep that blood level within a very tight range. So if you start to see that coming out of balance, that’s typically a lot of times the high levels are due to dehydration, but it can be a sign of like kidney function and stuff. But it takes a lot for those to come out of balance because as you know, levels increase or decrease our body’s going to help either get rid of more or conserve more sodium just like it does with calcium. And we went through that very deeply in the calcium episode. So our kidneys are the main regulator of sodium and potassium. When our sodium levels decrease, say like say like I mentioned like stress, excessive sweating, maybe like athlete or some thing or if you’re just having a lower intake of it, or all three, then our kidneys are going to respond by trying to conserve sodium because they need to make sure that those blood levels stay within that range. And the way that they do this is our kidneys have these small blood vessels that release a hormone called renin. Once renin is released into our bloodstream, it’s going to act upon different enzymes that eventually make something called angiotensin. And this angiotensin then acts on our adrenal cortex. So that adrenal gland that stress impact here, we’re gonna talk about this more in a second, but just like plant that seed, adrenal cortex adrenals stress that is going to cause it to then make aldosterone. I talked about all dosterone in the magnesium episode because magnesium supplementation intake levels, they can actually impact aldosterone, so they can lower it. So that’s why you don’t want to do take too much magnesium if you already have low sodium, because aldosterone is the hormone that helps you preserve or retain more sodium. So and I actually have a good visual for this, let me

share my screen, okay. So we can see that if say, sodium decreases or blood pressure lowers or blood flow goes lower, you know, different things. But primarily, if sodium levels drop, kidneys are alerted, run in is released, and then it does go through angiotensinogen angiotensin one, two, we don’t have to go into all that. But eventually, that angiotensin causes our adrenal cortex to release aldosterone and that aldosterone causes sodium absorption to increase retention to increase so we retain more sodium in that extracellular fluid, blood volume increases, potassium excretion increases, so we lose potassium, thirst goes up, vasoconstriction goes up. And these are all things that we would want to happen to help regulate that sodium level. Once those sodium levels are normal again, or if they become high, then we will see the opposite happen. So low sodium eventually leads to an aldosterone release, which is I feel like the most important thing to understand aldosterone equals sodium retention. When we think about magnesium, it lowers aldosterone, so that’s less sodium retention. So that’s why sometimes people feel worse when they take magnesium and can have a hard time increasing sodium levels. But sodium levels very tightly regulated, when we think about stress. And sodium, this is a big one, because our sympathetic nervous system impacts sodium. But then low sodium can also impact our nervous system and our adrenals. So when we’re experiencing a stressor, and we’re stimulating that sympathetic nervous system, or a lot of people refer to it as fight or flight response, this causes more sodium retention, right, your adrenals are activated, they will release aldosterone as part of the stress response, which retains sodium. So then from there, that will increase the body’s sodium levels, thirst goes up all that stuff. Eventually, over time, your adrenals can become exhausted. And this is where low sodium levels come in. So if we do not have, if we’re having a hard time retaining sodium, say, we’ve used up a lot of our reserves, maybe it’s stress, we’d be at sweating, maybe it’s lower intake, or all the above, it’s usually not just one thing, then those low sodium levels will actually act as a stressor on the body because our we have to release that aldosterone in order to retain them. So over time, if we have chronically stressed adrenals. And technically, if you are thinking of this from like Western medicine, type of eye like viewpoint, then Addison’s disease where we have very high levels of cortisol, eventually, that could lead to low sodium levels, because over time, your adrenals get exhausted. But I have also seen this just day to day people that are in that more exhaustive stage of stress. And that’s when on a hair mineral test, which is typically what I’m looking at, we’re gonna see much lower sodium levels, minerals in general, but you know, when we’re thinking of like stress, and adrenal health, low sodium is a stressor on the body. So eventually, we want to increase it, but we have to be really smart. Because when the adrenals are tired, and sodium levels are very low, we don’t always respond well to more sodium. And a lot of it is with how our body has to compensate and regulate it. So I know in the like holistic health space, it’s very like don’t be afraid to salt and I don’t think people should be afraid of salt, especially like a high quality sea salt, but sometimes people are so compromised, that they add it in and they don’t feel better and they just retain fluid and it doesn’t lead to like positive changes. Sometimes people add it in and they feel amazing, but not always. And the other thing with the low sodium and stress, so like over time, like say your body is getting very exhausted, your adrenals are tired, and they’re having a hard time retaining sodium. That’s obviously stressful. But it’s also stressful on ourselves. Because remember, sodium helps the like different nutrients pass through and get inside the cell. And so if we don’t have adequate levels, we’re going to have less nutrients inside the cell. And that can have an effect in many areas of our health. Insulin resistance being a huge one, because low sodium restriction restrictive diets, we have seen in the research lead to more insulin resistance, even in Healthy People. So that’s like a kind of like stress and sodium in a nutshell, you know, stress leads to more sodium retention, because you know, we’re using up that sodium, and then eventually, it can lead to adrenal exhaustion and low sodium and then low sodium levels can be a stressor on the adrenals, because they have to get activated in order to retain it. So it’s kind of like a feedback loop there. And then potassium and sodium, when it comes to how we regulate sodium, I was like, I can’t not mention potassium, because this is really one of the big takeaways of this episode is that the focus is on sodium, especially when it comes to like broad blood pressure and things like that. But we I think a lot of people don’t realize that if we increase our intake of potassium, that can actually lead to an excretion of sodium. So instead of just restricting sodium intake for different health concerns, rather focusing on increasing potassium is typically a much more balanced and helpful approach because it can help balance the sodium. So if we’re someone say you’re taking in a lot of sodium and not enough potassium, then you can deal with things like fluid retention, because that water is going to get pulled from our cells, because it’s going to try to get remember sodium outside the cell. So it’s going to try to get to where that higher concentration of sodium is. And that’s going to get pushed into the blood. And just to compensate and our bodies have it’s, our bodies do this, because they’re always going to try to compensate and keep us safe, and keep the sodium levels regulated very in the blood very tightly regulated. So that’s going to lead to dehydration of ourselves and fluid retention. And this is a big one where I see a lot of people, especially if they are have very low sodium levels and exhausted adrenals, they try to up their salt intake, and they are like I have so much fluid retention, this isn’t going well. So we have to lower their salt intake and focus more on potassium. Because the more potassium you eat, the more sodium that’s gonna get excreted in the urine. And then those cells can be hydrated, versus all that fluid leaving the cell and leading to more fluid retention. And adequate potassium is also just essential for keeping sodium in balance. In general, if it’s too high or too low, then water is going to build up in the blood create more pressure on the blood vessel walls, and then that can cause high blood pressure. So both for fluid retention and for blood pressure. Potassium is key for balancing out sodium. And just in general, I mean, potassium will go through that next week. But it does a lot of important things in the body, very similar to sodium. So we need enough of it. It’s I think it’s probably one of the most under utilized minerals when it comes to like supporting blood sugar thyroid and like hormone health in general. And it doesn’t even have like an RDA, like there’s not even a specific recommended amount. There’s just like an adequate intake for potassium, which we’ll talk about what that means when I talk about sodium and babies because that was a big question. And something I obviously went through recently with my daughter. So I’ll share my thoughts on that. But potassium is so so important that we don’t even have a recommended amount for it. They’re just kind of like a you should take in about this much. In general. They actually lowered it recently. Then they increase sodium, which I’m like, this is the opposite of what we should be doing. But overall sodium, you know, I think the recommendation was a bit low anyway. But it really depends on the person. So if we’re thinking of like, how are we regulating sodium in the body? Yes, if levels get too low or kidneys are going to kick in nervous system turns on, we’re going to have that aldosterone release and retain sodium. And then if we can balance that out by having adequate potassium intake, where that can lead to more sodium loss in the urine. So potassium is essential for sodium balance, and it gets rid of a lot of issues of fluid retention and high blood pressure that can be caused by an imbalance of sodium. So let’s talk about pregnancy and sodium because this was another really big one, when it comes to pregnancy there is an increased need for sodium. It is so so important during pregnancy remember one it helps nourish ourselves to our blood volume is increase received during pregnancy. And this increases our sodium requirement. If we don’t get enough sodium when pregnant, it can restrict blood volume and then that can negatively impact the growth and function of the placenta. And the placenta is what is sustaining and allowing your baby to grow and develop. So that can lead to low birth weight development issues. There’s a 2007 study that I was looking at, where it showed that babies with low sodium in their blood due to low salt intakes by the mom, their moms during pregnancy, were more likely to be underweight at birth. And then that low birth weight, of course, is going to lead to higher risks for of health problems later in life. And then another study I was looking at found infants with low sodium intake, can experience poor neurological function in early adolescence, which I thought was very interesting. We also need sodium for the development of glial cells, which are immune cells in the brain. For babies, I mean, it’s so important in so many levels for the health of the growing baby, but because of how it helps with the increase in blood volume in the of the placenta, all that stuff, but it’s also really important for mom and her health as well, because a lot of the times if we’re dealing with like swelling, a lot of people will blame it on sodium. Yes, we need enough potassium, especially in pregnancy, but sometimes it’s too little sodium that moms are getting, and that water is leaking into the extracellular fluid and leading to Florida attention. A lot of times I will tell you, it’s Protein Protein is so important. And I think it’s one of the harder foods for women to eat while they’re pregnant. For many reasons, there can be like food aversions, stomach acid levels are also altered because of the hormonal fluctuations in pregnancy. And we need enough stomach acid to break down protein properly. So like if you can’t break down a food properly, you you probably have a food version. So I think like understanding what can be helpful for digestive support and what’s safe during pregnancy is important. But a lot of times it’s it can be like mineral deficiencies. In general lack of protein intake, you might need some lymphatic system support. And if you don’t follow limp love club on Instagram. It’s my friend Leah. And she’s just amazing. I mean, she is hilarious. If you’d like to learn through humor, and just someone that has so much knowledge and teaches so generously, you can learn everything you need from her Instagram. I mean, it’s it’s absolutely ridiculous how much amazing free content she puts out there. I think every every pregnant woman should do I did limb support my entire pregnancy. And I learned it all from Leah. And it really, really helped me. I had very little Florida attention, maybe at the very end, but even then it like wasn’t bad. And then like, you know, your adrenals are going to have a big impact on that as well. So if someone’s already exhausted, adrenal wise and mineral depleted going into pregnancy, they’re much more likely to have fluid retention as well. So I think it’s a lot of times fluid retention in pregnancy is blamed on like salt regulation or too much salt. But I think a lot of it is related to other things potassium, protein limb support, what your adrenal and hormonal state was going into pregnancy. And yeah, I think like working on your fascia and stuff, too. If you can learn anything about that, that’s like probably one of my biggest regrets. I didn’t get into that. And so I was postpartum. And I think I could have avoided a lot of pain during labor. But that really goes hand in hand with the limb support. And that’s something Leah talks a lot about. So if you want to learn about fashion live, check out Leah she’s great, limp love club on Instagram. But that’s that’s like my my take on pregnancy and sodium and how important it is there and how we do have an increased need for sure during that time. Okay, let’s talk about the RDA for sodium, the recommended daily allowance. This is where a lot of the concern and confusion comes in of like how much salt should I be eating every day? Because this is what’s recommended. And you know, this focus on low salt diets for heart health is just very false. But we’ll get into that. So when I think about the RDA for sodium, I think it’s really cool to think about our history with salt and sodium intake in general and Chris kresser has a really good blog about the history and I’m gonna I have that linked in the show notes. So if you want it he has like a whole series but the first one is like the history of Sol and how much it’s very there are a few studies on this as well. And I feel like that it’s just good to know because you know, there’s so many people in the space that are like more salt more salt any more salt and then if you look at like conventional medicine, it’s like less salt. But if we look at historically, our or even like ancestrally our ancestors ate like 700 milligrams, sometimes as low as 500 milligrams of sodium per day if we’re estimating based off of what they had access to. So some some studies I like that said 800 milligrams of sodium. So that It you know, there’s not a one teaspoon of salt has 2300 milligrams for reference. So not, you know, very, very small amounts, salt did come become much more popular obviously, when we started farming and needing a way to preserve food and sell it like when we were not Hunter hunting and gathering anymore, salt was huge and the whole cities and populations have been developed around salt, so definitely don’t need to demonize it, I also don’t think we need to keep it as low as our ancestors like 700 milligrams is pretty low. It’s estimated that 500 milligrams is what’s physiologically required as the bare minimum. So like 700 is not much above that. And then you have to remember, work depending on like, if you’re dealing with stress, how much potassium you’re taking in different things about what’s going to affect the regulation of sodium, we have to keep all those in mind with what’s appropriate for someone. So the RDA is, I think it’s important to note that there are generalized recommendations. So we don’t, they may not be appropriate for everyone, right. And so the current RDA is less than 2300 milligrams per day. And again, that one teaspoon of sea salt is 23, or of salt is 2300 milligrams of sodium. See salts gonna vary depending on the brand, the type, all that kind of stuff. But generally, one teaspoon of sea salt is about 2000 milligrams of sodium. So a little bit less because it has other minerals as well. In I would say in the last I guess it’s recently it was in like 2019. somewhat recently, they changed the recommendation for the RDS for potassium and sodium. And they just increased the sodium one a little bit before it was like 1500 milligrams per day with the upper limit of 2300 milligrams. Now it’s like less than 2300 milligrams is a recommendation unless someone has like a heart health history or blood pressure concerns. And they typically recommend lower. But it’s interesting because it’s their main concern around sodium is they want to reduce chronic disease risk. And I’m like, there’s so much more to chronic disease and sodium intake, let me tell you, and again, with the potassium because they they slightly increased, they didn’t necessarily increase it, but they just said instead of having 2300 be the upper limit, it’s like less than 2300 milligrams is the goal for sodium. But with potassium, they actually decreased it from 4700 milligrams to 3400 milligrams a day for men and 2600 milligrams a day for women. So this is like pretty close to a one to one ratio of sodium to potassium, which is not ideal, especially if we’re trying to reduce chronic disease risks. So I think the main reason when I was reading more into it was like they wanted it to be more realistic for people. And again, like it’s not like an RDA for potassium. It’s just an adequate intake. Because there’s adequate intake is when there’s not enough research around a nutrient to give an exact RDA, an exact recommended amount. There’s just not enough research for them to say, hey, because of xy and z, we recommend this much. So they say, Hey, an adequate intake of potassium is most likely around this guesstimate, which 2600 milligrams a day for women 3400 milligrams a day. For men, I recommend closer to 4700 milligrams per day, the World Health Organization recommends at least 3500 milligrams per day. So it’s going to be different all over Institute of Medicine recommends 4700 milligrams per day. So an interesting thing about if we look at pre agricultural humans, they’re estimated to have consumed 10,500 milligrams of potassium each day. And I was reading in another one of my mineral books about how it’s can go up to like 18,000 milligrams a day was assumed that they consumed of potassium. So that’s a lot of potassium, not a lot of sodium. If we’re in now it’s a kind of like flip flops, where it’s like sodium and potassium are almost like a one to one ratio when it comes to like the RDA recommendations and adequate intakes. And I mean, this is where my concern comes in. I don’t I think yes, we talk about like, yes, people need more salt. We’re all stressed, we’re using up a lot of salt. A lot of people are have adrenal dysfunction. But most people are probably not getting enough potassium. And that’s another thing that research says is like the majority of Americans especially, are not getting enough potassium every single day. It’s like way less. I think it was like closer to like less than 2000 milligrams a day. So that’s significant. And I think that has to be brought up when we’re thinking of the RDA for sodium. It’s like well, let’s compare that to potassium because they these minerals seem to be imbalanced and we need more potassium and sodium in order to regulate and have healthy sodium levels and avoid things like high blood pressure, fluid retention, all all that. So that’s like the RDA stuff for adults. Let’s talk babies. Because that was a very common question that I got. And I know like when you start giving your baby food, it’s I feel like they just terrify you with and that could be like pureed food. Or if you’re doing baby led weaning, every I did a lot of research, we did baby led weaning. And even with that more holistic approach, there’s a lot of fear on assault. And Lily Nichols has a really good blog that I’m linking in the show notes. I’m going to cover part of it. But please, if you’re interested in this topic, like go read her blog post, it’s really good. She did a ton of research, if you follow the lead Nichols she has really great books on nutrition for pregnancy, she does a ton of continuing ed webinars for dietitians, and she’s very, very research base. And if if Lily Nichols can’t find the research on salt, and babies, I’m gonna go with no one can find it. She said that she consulted a bunch of pediatric dieticians, she could not find anything. And it turns out that salt intake recommendations for babies are an adequate intake recommendation, which if you remember when I was talking about potassium, that means that we don’t have enough research or data showing us of what a healthy amount of sodium is for babies. So it’s just a guesstimate. And I would say like an even, I think it’s probably one of the least adequate adequate intake recommendations out there. A lot of it is because there’s just pretty much no research. So there’s one aspect that Lily goes through in her article, where she talks about how like the whole aspect of the adequate intake for sodium for babies is based on breast milk since of course, you know, for babies younger than six months, that’s primarily what they’re taking in. So it makes sense that they would go with the amount of sodium that’s in breast milk. The issue is that sodium and breast milk varies a ton on the mom, the race, the culture, so many things are going to impact that sodium level, mom’s health status prior to pregnancy, her recommendations for nutrition during pregnancy, those are all going to impact her sodium levels. And so that will impact the sodium levels in breast milk. And the basically how the researchers explain it is that for the first six months of age, they took the average daily volume of breast milk, 780 milliliters, and they times that by the concentration of the nutrient in the breast milk, the issue is just that you can’t assume that there’s the same amount of sodium in every woman’s breast milk, they vary a lot. So that’s a really big one. There was other issues with like, smaller aspects of the study, like changes in composition over the course of feeding because breast milk does change a lot as the baby grows, it changes with your baby. And that was not accounted for not sampling it properly. If a mom is using supplements, or like some sort of fortification with the milk composition, there’s so many aspects that were not covered with this. So that’s pretty concerning. And then for babies that are six months and older, they’re assumed to be having breast milk and solid food they took they made the adequate intake on that based on adding the estimated mean intake of the nutrient from solid food to sodium to the amount of the sodium provided by 600 milligrams of breast milk, which I also think is interesting. Because not I mean, my daughter definitely has she does she did not eat that much less like a nurse that much less when she started eating food. So I don’t know, there’s a lot of aspects of this, we just know that it’s not super accurate. So as far as like, what is the recommendation for sodium and babies it is an adequate intake. It’s not an RDA, we don’t have enough research to support it. It’s based on averages. And the research is very, very poor and has a lot of, you know, technical errors that are going to impact that result. So just keep that in mind. There’s also no research that supports that babies have babies kidneys cannot process the sodium. And so this is where the concern comes from. And if even when I was reading one of my baby led weaning books when before my daughter started eating solids, it talks about how until a baby is one year one year old, one years old. They can’t process their kidneys cannot process a certain amount of sodium, but there’s no research to support this. And Lily went through this a lot in the article and how she actually found that there is research that shows kidney development of a one year old is similar to an adult, and even at four months old babies our babies kidneys are able to excrete higher amounts of sodium probably preparing them to start eating foods soon, which is likely going to Have more sodium than breast milk. So I just thought this was really interesting. I think that ultimately, like you have to do your own research, when you start to look up research on this, it’s really hard to find anything like Lilly mentioned in her article. She does link to everything in there, though. So I would definitely go check that out. I linked her article in the shownotes. When I did look for research, a lot of the stuff I found was how important sodium is for premature babies and the development of babies in the first few months of their life. So that’s something important to take in. I was like, okay, so we know that it’s really important. And there was a study in 2002 of like, premature babies. And they found that babies that supplemented with sodium or salt during their first few weeks of life, all experience greater memory, learning language and coordination, and IQ and behavioral skills and behavioral skills as children. So I like that study in the show notes as well. So this highlights just the importance of salt and sodium and brain development. So it’s important for mom when she’s pregnant, it’s important for a baby, as they’re developing. Do we want to overdo it? No. But if you’re mostly giving her baby unprocessed Whole Foods, I just would not be incredibly concerned. Like everything where you give my daughter Eliana is something that we’ve made. So for the most part, she does go out to eat with us, which is fun. It’s like, really, there’s not a ton of salt other than like, what we’re adding to the food, but I do not restrict her salt. Like I wouldn’t give her like a ton of processed foods. But it’s just interesting how, like, there’s concern around salt, but not as much concern around like giving babies more processed foods. So you know, do what you want with that information. But yeah, so that is RDA is for adults, the adequate intake recommendation for sodium for babies because there’s no RDA. And then I do get questions around like, Are there any populations that might need more sodium? I don’t, again, I don’t like looking just at sodium. So I had a hard time making these lists. But I would say pregnancy for sure I went through those reasons. People that have migraines, if you’re a chronic migraine sufferer, I did a newsletter on migraines. And when I was doing a ton of research on it, one of the things I found is that migraine sufferers actually excrete more sodium in their urine. And if you use like a small amount of salt in water, when you feel a migraine coming, you can actually help it go away. And I have used this with clients as well. But we always balance their sodium with their potassium and make sure it’s appropriate for them because we do hair testing. So again, you know, it can vary per person. But pregnancy migraines is someone has low blood pressure, but I would also look at other minerals as well like potassium and magnesium. If someone has low sodium on their hair test, they probably need more salt, but they they need more potassium first. And they need to look at other you know, are they taking other supplements like magnesium, so many different things, but they could be someone that eventually would need more salt, or sodium. And then if someone is having a lot of cravings, I mean, I think our bodies are very intelligent, and they’re going to tell us what they need. So if you’re having a lot of cravings for salty foods, then I would say like that’s something to listen to just be mindful of like, you know, are you getting potassium rich foods with it as well, athletes, for sure anyone that’s like sweating a lot more, you’re gonna have more sodium loss as well as potassium and magnesium. So you want to pay attention to those elderly, that population tends to actually have low sodium or hyponatremia is a much bigger concern and dehydration. So that is I actually used to work in long term care when I first became a dietician. So that’s definitely a population that likely needs more. And then type two diabetes, they’re a population that they have, there’s actually studies and I have some I’m gonna go through that actually can do better and see more insulin regulation improvements with more salt or sodium and again, like not from processed food sources from like, a sea salt, or even subsidies just use table salt. So that’s something to keep in mind. But with blood sugar issues, potassium is huge for this because it can help get glucose inside the cell. We’ll talk about this more next episode on potassium, but those are populations, I think, would probably need more, or I would at least like that’s what I would expect if I were exploring that with those clients. And then populations, it might need less. If someone has like severely high blood pressure, and like they’re salt sensitive, they might need less. But the caveat with that is that typically that salt sensitivity mechanism can be reversed if they add in more potassium rich foods. So I think it really kind of depends on the person. If someone has really depleted adrenal glands like their sodium is incredibly low on their hair mineral tests, then that is someone that I typically go very slow with salt and sodium with because they will typically have fluid retention and maybe even some blood pressure changes with an increase. So that’s a population I’d be i I wouldn’t necessarily restrict, but I would like be very mindful. If someone has impaired kidney function, I mean, I, they also would probably have some restrictions with potassium, kidney stones is one population where the evidence is definitely mixed. It’s not perfect. But excess sodium intake is associated with more excretion of urinary calcium. And subjects that on this one study that I’m going to link in the show notes, they consumed higher levels of sodium, they tended to have the greatest urinary excretion of calcium, which lead to more kidney stone formation. The issue with that is that there are also studies that have shown that there wasn’t as big of an increase in calcium or even if there was that some populations don’t have an increase in kidney stones. So I would say, like, take that one with a grain of salt. But that is technically what some of the research shows and then osteoporosis, because you can have more calcium loss in the urine, if again, if you have a lot of sodium intake, but the calcium absorption has also been shown to increase in the gut when that calcium loss is happening from an excess of sodium intake. So I don’t know that one I find hard to believe, but there’s a ton of research on potassium, and how potassium is actually really, really important for osteoporosis, which we’ll talk about in the next deep dive episode on potassium. But those are populations that I would consider and maybe like it not have a forever restriction, depending on you know, if there’s kidney issues you might have to but it’s just so important to keep in mind that like, we don’t just want to look at sodium for people, we want to also look at their potassium levels. And where are they at right now you have to meet people where they’re at. If someone’s really depleted right now, and sodium and their their adrenals are exhausted, maybe we keep it low for now. But it doesn’t mean it’s low forever. So that, you know, just things to keep in mind. All right, let’s get into a little bit more on blood pressure, and then how we could actually have negative consequences with blood pressure. If we don’t get enough sodium intake.

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So yes, you know, we talked about sodium regulation we can an excessive amount of salt, and sodium intake via usually like if that’s like salt, or maybe it’s processed foods. Either way, when we have that increase of sodium intake, that can increase our blood pressure, because of how it’s going to affect the water. You know, it’s an extracellular fluid. So the water wants to leave ourselves and go into the extracellular fluid to balance out the sodium because our bodies are super smart, and they tightly regulate everything. So because this is happening, it can raise our blood pressure. We also can see times where people if they have too low of salt intake or sodium intake, then they can also have high blood pressure. And they can do really well with more. There’s almost always another mineral involved though with those people. And honestly, high blood pressure in general. I feel like we never look at magnesium or calcium or potassium. And those are definitely the three top minerals where if we have imbalances in those it’s going to affect how our heart is functioning our heart health like in the calcium episode, I talked about how calcification is such an issue for increasing the risk of stroke and heart attacks that doesn’t get talked about enough. And we’re always just focusing on sodium for this population. And it’s like, Listen, this is not helping them avoid chronic disease and improve their long term health. We have to talk about their calcium intake via supplementation because that’s so common. Are they getting enough in their diet, if they’re not that can also cause calcification. Other supplements are taking our vitamin D or if they’re deficient in vitamin D that can cause calcification, and then magnesium, of course, magnesium deficiencies can cause calcification can raise our blood pressure. And that’s why a lot of times people do really well if they have high blood pressure and they prioritize some magnesium supplementation. So there’s just so much more high blood pressure then you have to lower your salt intake and a lot of the research shows that that can actually have negative side effects on heart health, as well. And there’s a 2011 study in the Journal of American metal Association, medical association that I’ll link in the show notes. And it goes through different low salt zones, you know, populations that have like very low salt intake, that are typically used to talk about, like how healthy you know, low salt intake is for different chronic diseases, but stroke, heart attack and death are much more likely in these populations, despite the fact that they have a very low sodium intake. So it’s not low sodium alone, that’s gonna protect someone from heart health or blood pressure problems. And in fact, it could make it worse. And if we compare these with moderate sodium excretion, there was actually an association between low sodium excretion and cardiovascular death, or hospitalization for coronary heart failure. So like really serious end stage heart disease issues, despite having a low sodium intake. So that’s really important. And somebody considered there’s another 2011 study that confirmed this. And not only was lower sodium excretion in the urine associated with higher cardiovascular mortality, so death, but baseline sodium excretion did not predict the incidence of hypertension. So that’s high blood pressure, and any associations between systolic blood pressure and sodium, sodium excretion did not translate into less morbidity or improved survival. So I think a lot of it is like Yes, can lowering your sodium intake, lower your blood pressure in the short term, possibly, adding more potassium could also do that fixing a magnesium deficiency that’s causing calcification could also do that. So is it like it’s kind of like, it’s like diets like a short term solution for a long term issue that doesn’t actually improve your long term health or health outcomes in the long run. So that’s like a really big one. The other thing I think of for someone that is concerned with high blood pressure, heart attack stroke, typically that’s paired with high cholesterol as a concern, right, I did a whole cholesterol deep dive in season three, if you want to nerd out about that. But low salt diets, they can contribute to an increase in lipids, so cholesterol levels and triglycerides, because of how they impact insulin resistance. So there’s in healthy in both diabetic patients and then in people that were healthy, restricting sodium intake to a very low level, increase insulin resistance. So like, Just let that sink in. Because I think sometimes we don’t realize that lowering sodium to improve blood pressure, but keeping that so isolated, and not thinking about how it’s going to impact another system of your body, like your hormones, your insulin regulation, blood sugar, cholesterol levels, that also has an impact. And this is what happens when we like compartmentalize the body into different systems. And you know, only endocrinologist are going to talk about any like hormonal or thyroid, or insulin things. And then like only cardiologists are going to talk about stroke and heart attacks and calcification and that sort of thing. But it’s like we can’t keep them separate, because that’s not how our body works. So that this is just, you know, something that I feel very passionate about, because I think that is what we’re missing. Even sometimes in the functional health space. We’re still looking at things separately, we’re not preparing them together and connecting the dots for people and showing them how how their thyroid health or their blood sugar balance or lack thereof is impacting their cholesterol levels. You know, I’ll get clients all the time. They’re like, Oh, my gosh, my cholesterol is this, I can’t believe it. You know, I’ve been working on XYZ. And they’re, they feel they should have like healthy cholesterol levels. But then we go through and we’re like, well, actually, it looks like your thyroid is not functioning as optimally. Maybe they went through a big period of stress. Maybe they had a really legal life or nutrition change recently, so many different things are going to impact that. And that will definitely impact cholesterol level. So like even I think it’s so associated with food and diet. They’re like I haven’t changed my diet. So like why did my cholesterol levels change? It’s like, well, other organ systems in the body are going to impact how we regulate that cholesterol, especially insulin. Insulin impacts that LDL receptor that regulates the uptake of cholesterol, so you might just not be taking it up in your blood. It’s not even that you’re necessarily making too much. So low sodium has poor outcomes for type two diabetics, it also can cause insulin resistance issues in Healthy People. And then of course, in athletes in the elderly. It’s a very big issue. We need to have enough sodium intake for this these two populations. Otherwise it can lead to You, especially the athletes like injury, I mean, obviously, they’re working really hard towards something like you want them to be able to, like carry out all those goals, and not even being able to perform or like trying to perform and getting injured because they can, you know, you they can be dealing with like confusion and lethargy and muscle weakness. And then for the elderly, they’re much more likely to have those same issues of like muscle weakness, confusion, and they’re falling more than they’re getting injured. So you got to be careful with what recommendations you’re following, especially if it’s a generalized, like reduce sodium intake for high blood pressure, you have to look so much further. And then same thing for preeclampsia. There is the preeclampsia is probably one of the more confusing ones for people. And I got quite a few questions on this of like, How can I reduce my salt and connect should I reduce my salt intake if I’m pregnant, and I have a history of preeclampsia or if I currently have it and where that’s like when you’re kind of like on the cusp of high blood pressure during pregnancy. And there’s the thing that kills me about this is that for pregnancy, it is different, like I said, we need our blood volumes increasing, our sodium needs are increasing. If we do not have enough sodium, then we can have issues not only for the baby, but for mom as well. And when we think about this, it like say for example, a mom is restricting her sodium intake because she thinks that that’s what she’s supposed to do, because she’s worried about high blood pressure and pregnancy. If it’s below her body’s requirements, then we’re going to have that aldosterone release that I went through earlier. But this actually causes our arterioles to constrict, and that can raise your blood pressure. So if you know a mom’s trying to do the right thing, lower her sodium, but it’s actually making her preeclampsia worse, if we put a pregnant woman on a low salt or no salt diet, that will definitely lead to high blood pressure. And whether that’s like, if she already has it, or if she didn’t have it, yet, it can lead to high blood pressure. That’s what the research shows us. There’s a really amazing OBGYN Margaret Robinson, who’s very famous for all of her work on salt tablets, and utilizing those in different studies in pregnancy. And what she found was, and I’ll link the article and stuff in the show notes that salt tablets usually relieve Restless Leg cramps during pregnancy. If we deprive pregnant women of salt, it increases the infant death rate twice as high as women that were encouraged to eat salt. This, it’s there’s a lot of ethical issues with the studies. Trust me, I know. We definitely could not replicate these today. So is essential for the health of the placenta, which I went through before. Women deprived of salt had two and a half times more preeclampsia. So that blood pressure woman who had higher levels of salt had lower incidences, or have preeclampsia. So if they had more salt, they have less high blood pressure. Women who added salt were also able to reduce their blood pressure and swelling. So that think that fluid retention, like I talked about before. And what did they recommend for these women that saw such a drastic change in lowering blood pressure, improvement in placenta growth, not having any fluid retention, that sort of thing. They recommended four teaspoons of salt per day. And this helped women recover from preeclampsia as long as they were consistent up until delivery. So what we think is the opposite actually helps the in they were like giving them salt tablets. And there’s the brewer pregnancy diet, which I don’t agree with everything there. But Dr. Brewer has this article on his website. And it goes through the different types of things that they tried to have happen for the study, which is why like it’s not super ethical. But basically she with what Margaret was doing in her work was she was trying to induce all overload in pregnant women. And she failed, she couldn’t do it because they needed more salt and their bodies would compensate when she continued to add more 28 pregnant women were divided into two groups and they were followed for one month, even with urging from the doctor to increase salt intake by the means of salt tablets, capsules and syrups. The high salt mothers retained no excess sodium in their bodies, nor did any of them develop toxemia which is usually what happens. What what were taught happens if too much salt gets into the diet. So in pregnant women, no matter how much salt they got, they took in they could not have any they didn’t have any issues or fluid retention, which I thought was really good to know. And then there’s there’s a few other examples with high blood pressure and kidney issues. But the biggest takeaway is that assault on pregnancy should not necessarily be feared, especially if you have preeclampsia. I would work with your provider. Maybe you can find a functional practitioner to help you focus on your minerals especially like sodium and potassium in order to optimize that preeclampsia, but I tend to see it in I definitely Like there’s like a genetic component because if you have it with your baby, then your baby’s more likely to have it. And a lot of that can come back to mineral status. So hair mineral testing can be really helpful in working with a more functional base provider that has like an understanding of how all that works. But you know, salt and preeclampsia. Pretty amazing how that’s how they actually, we used to fix it. Alright, let’s get into thyroid health. And then we’ll talk about digestion a little bit, and then I’ll go through other minerals and how they impact sodium levels and how sort of impacts them. So number one, sodium and thyroid health because thyroid health is essential for optimal hormone health, which is if you’ve been following me for any time, you know, I talked about that all the time, when it comes to sodium is actually impacts how we’re using iodine. So I did a whole episode on iodine. It’s actually my most popular podcast episode. But I talk a lot about the sodium iodide symporter. It’s this specific, basically, it helps get iodine inside the cells and helps make thyroid hormone. So if we don’t have enough sodium, then we can really struggle with getting adequate iodine into the thyroid gland, also into the breast tissue, and into breast milk. Soy, so not only is it important for iodine levels, but it’s also for mom, but it’s also important for iodine levels for baby. So sodium is huge for that. And those if we think about so that’s like, low sodium can equal low thyroid hormone levels because of not being able to transport iodine. But thyroid health can also impact sodium levels, especially with severe hypothyroidism. But honestly, I see this a lot in hair mineral testing, where, because on hair testing, you’re gonna see a mineral imbalance way sooner than you would on bloodwork. I talked about this in episode one. But even with my hypothyroid clients, they have a harder time retaining that sodium and potassium and it can take longer to increase. And there’s one study that actually goes through the mechanism, it talks about the mechanism. And they say the main mechanism for the development of hyponatremia, or low sodium in patients with chronic hypothyroidism is the decreased capacity of free water excretion due to elevated antidiuretic hormone levels, which are mainly attributed to the hypothyroidism induced decrease in cardiac output. So typically, you’re going to see low sodium levels, if someone has had hypothyroidism to for a long time often, because they’re not excreting that they’re not excreting as much water because of lower cardiac output, lower antidiuretic hormones. I also think this would pair up well with like, they probably also have lower aldosterone levels, because thyroid health is very tied to your adrenal health, and vice versa. So like if your adrenals aren’t functioning optimally, then typically your thyroid is going to have a harder time as well. And I’ll probably go through that more when I do the potassium episode, because potassium helps us get thyroid hormone inside the cell. But stress hormones like cortisol can inhibit that. So stress can make it much harder to utilize thyroid hormone properly, which will trickle down impact thyroid function, which can trickle down and impact sodium retention. The other thing to think about is that sodium and potassium they are solvent minerals. So when one of them is lower, it’s a lot harder to keep other minerals like calcium magnesium inside the cell. And in the calcium episode, I talked a lot about how can impact thyroid function and our ability to use thyroid hormone because if we have really high calcium leaving the cell, then that can make it harder for one to get thyroid hormone inside the cell. But it also can make it harder to utilize iodine. So sodium will, it has it it’ll impact thyroid because of how it transports iodine, it’ll also low thyroid function can lead to lower sodium. And then low sodium potassium can lead to excesses of other minerals that will slow down thyroid function. So there’s kind of like three different areas at play there. I already talked about how low salt diets can lead to an increase in insulin resistance. This is a big one. But I have some studies that I’m going to link in the show notes. But if we have that increase increase in insulin resistance, this can trickle down and impact many different areas. I mentioned cholesterol before that’s a big one or lipids. It can increase triglyceride levels, but it can also have a really big impact on thyroid function because we have a harder time storing glucose energy managing our blood sugar balance, which that leads to a lot more ups and downs in our blood sugar, which leads to more stress. Because our bodies are smart, they’re going to release more stress hormones if we’re experiencing those lows, because they need sugar. They need glucose at energy. And they’re always going to try to keep that stable. So just like we keep our mineral levels very stable, tightly regulated in our blood. We do the same thing with our blood sugar levels. Alright, we’re gonna we’re gonna wrap up the info about sodium with how other minerals impacts sodium levels, I’m going to stick with potassium, magnesium. There’s things like heavy metals, other things that can impact sodium levels. But if we’re going to keep it simple and think about like, what’s the most important in our day to day food, supplement wise, potassium and magnesium are definitely going to be the two biggest ones. Remember, we need potassium to keep sodium in balance, you know, not enough potassium is going to lead to too much sodium retention, too much potassium is going to can lead to more sodium excretion. But ideally, you want to balance of the two. And this is where the ratio comes in. So a lot of people were like, what is the optimal sodium potassium ratio, it’s gonna dip, it’s gonna vary based on who you ask. But I would say like in the more like functional health space, even some Western medicine based doctors that are just very biochemistry based, I guess you would say like, if they’re very into like, nutrients, micronutrients, like vitamins and minerals, you’re often going to get a one to four ratio of sodium to potassium. So that means you would have four times the amount of potassium that you have sodium. And I mean, I, there’s a lot of caveats to this, because I think what’s most important is where someone is right now. So if someone is at a one to one ratio, which is, if we look at the standard American diet, that’s you’re lucky, if you get a one to one ratio, often you have even more sodium than potassium, unfortunately, I think it’s not so much about like exactly hitting that one to four ratio, having four times as much potassium, but looking at where someone is, and just Oh, I know, I say this a lot. But like meeting them where they are, if someone is eating a one to one ratio, sodium, potassium, they don’t have to automatically eat four times as much potassium, they’ll see an improvement in how they’re feeling. And things like sodium retention, fatigue, maybe adrenal fatigue, if that’s what they’re dealing with, if they even just increase, usually digestive issues, I see a lot of constipation with low potassium. But even just that, they’ll see an improvement if they increase, they’re having like 2000 milligrams a day if they go up to 3000 or 4000 milligrams a day. So someone if they’re moving from a one to one ratio to a one to two, while it may not be optimal, it’s still an improvement for them. And they’re going to see progress, I think in this is where I understand with the RDA is in the adequate intake, how they lowered the recommendation for potassium because they’re trying to make it more realistic for people. And I do get that to an extent because sometimes it’s overwhelming being like I need 4700 milligrams of potassium a day, I’m only getting like 1500 Right now, obviously, that’s going to feel overwhelming. But I think just understanding that, hey, you know, if you are adding salt to your food, and you maybe you don’t even have a ton of processed food, but you’re definitely getting a decent amount of sodium. Maybe you really like things like I think of like even like canned oysters or sardines, very healthy, nourishing. Same thing with like sauerkraut fermented foods nourishing, but they do have a good amount of sodium. So it’s like, how can you balance that out with your potassium intake as well. So I honestly even see a lot of success with a one to three ratio with clients. But technically one to four is optimal. I think what matters is what you’re currently doing and making changes from there after you talk with your provider. But that’s technically the optimal ratio. So that’s like kind of what I went by when I made that electrolyte handout for the bonus for Patreon. But it was interesting to see that a lot of them were like a one to one ratio, or had like a really high sodium and a low potassium are really high potassium, low sodium. So it’s interesting, they can all be used for different things. But you know, I think it’s your electrolyte powder doesn’t have to be a one to four. But looking at your overall intake, what, what is your total at the end of the day. And if you’re like if you haven’t tracked your food intake, I really like the app chronometer, because it gives you a very detailed micronutrient breakdown of vitamins and minerals that you it’s hard to find another app. So chronometer is the best. And the sodium potassium pump, I got a few questions on this of like, what is the sodium potassium pump? What does it do? It was discovered in 1957. And it’s it’s called the sodium potassium pump. Because on the outer side of the cell, the outer plasma membrane of the cell, you’re going to have sodium and have the sodium potassium pump but like because we want to keep sodium on the outside and potassium on the inside. Remember, sodium is extracellular potassium is intracellular. And so this cell this pump is powered by ATP. And ATP is the body’s main energy source. Remember, I talked about this a lot in the first mineral testing episode because minerals are essential for making ATP or energy. And these pumps helped maintain a higher concentration of sodium outside and a higher concentration of potassium inside the cell. And if these are not functioning properly, then we would die so it just shows you how important it is to keep that sodium outside the potassium inside. And yeah, we have to have that high concentration gradient. So that’s really what the sodium potassium pump does. We need enough to make sodium potassium make sure that pump is working. But we also need enough energy in general. So things like your thyroid metabolism, mineral status in general, like do you have an adequate levels of minerals, especially like calcium, magnesium are really important for ATP production, or energy production deficiencies. And those could lead to issues with these pumps, or hypothyroidism, too, because again, like their hypothyroidism can lead to issues with like the excretion of water and minerals. And then that could also affect how efficient these pumps are working. So that’s our sodium potassium pump, the other mineral magnesium, like I talked about the magnesium episode, I’m going to keep this short because I did go into it there. But too much magnesium supplementation can inhibit aldosterone. Remember, aldosterone helps retain sodium. So if we’re supplementing with a lot of magnesium, it can be harder to keep sodium inside the cell and retain it. Now, if someone has high like high blood pressure, and they have high sodium retention, magnesium can be magical. But if someone has very low sodium and stress adrenals, magnesium usually does not go well because you don’t ever get to increase your sodium. And that can make you feel very tired. And like you don’t handle stress well. So that’s potassium, magnesium. Let’s do rapid fire of these Instagram questions. Okay. Is there any instance you would recommend reducing sodium, like if someone had high blood pressure, I would say first assess your potassium intake. If someone has really stressed adrenals, I would, I would, I don’t know if I would reduce sodium to depends on the person. But I would make sure they’re getting enough potassium and going very slow. With sodium. A lot of times that we think like, Oh, I’m so stressed and fatigued, I’m gonna add more salt, but it might not actually be helpful. If someone is salt sensitive. I don’t know that I would reduce their sodium, I might, but I would add more potassium to see if it helps them tolerate more sodium. And then chronic kidney issues for sure, you’d probably have to reduce it depending on the person in the stage of the disease. Okay, why do I always feel like I need salt, I would say possibly a deficiency. But remember, you can if your body’s super stressed, that can increase a certain hormone called ACTH. That can also increase the cravings for salt. So it could be that your body is super stressed could be that you’re deficient. But you could do a hair mineral test to see if there’s any issues or if you were, like confused or just experiment with slowly adding it in just make sure you’re adding potassium to is elementi. Bad to take if you have high blood pressure.

I think it depends. It’s so elementi is an electrolyte powder, it’s very high in sodium. Let me find the ratio quick. Of course, it’s not like out. Okay, so elementi has 1000 milligrams of sodium, and 200 milligrams of potassium. So it’s a five to one ratio of sodium versus potassium, I would say for heart health and high blood pressure. It depends on like that person, like, you know, do they are they pregnant, they probably do great with it. But if they’re not getting enough potassium, I would say it would probably it could definitely increase I have actually seen that increase someone’s blood pressure. It was one of my friend’s parents, because, you know, she thought she was doing a great thing with getting him more minerals in but turns out that that’s super high in sodium, and then he didn’t have enough potassium, it did cause high blood pressure. So I would say probably not the best option. You could do like one like Bumble ru or Ray the powder that’s like way higher and potassium, that would probably be a better fit. Okay, so I got a question about sodium being inflammatory, because it can it’s proposed that it can activate the th 17 TNF alpha, which is a genetic issue. And it’s like an immune thing with someone that has inflammatory bowel disease. And I did put some studies in here about that, like I did a little bit of a research deep dive on this, but I couldn’t find it’s mostly if things were in mice. First of all, they did not talk about potassium at all, which I just really wonder but basically what they found the anti inflammatory effect of the P 38. inhibitor was not lost in mice receiving a high salt diet, thus arguing against the hypothesis that sodium chloride is acting through the P 38 pathway. But since high sodium chloride or salt did increase the severity of colitis, and since the P 30 inhibitors suppressed even this later effect, this supports the hypothesis that p 30. Control Yeah, so it’s like technically there are aspects where it shows that like the sodium and the people that had a sodium or a salt will increase physically assault, the high salt diet, they did have more severity of their colitis. I mean, I don’t know, I don’t think there’s enough human data to really know. And it really the study that they concluded by saying that excessive salt consumption can increase the risk of inflammatory pathology in the gut. But there’s no direct causal relationship between salt and IBD. So I would be very curious to know, if balancing it with potassium kind of affected these people like it did salt sensitive people, and if it mitigated some of that effect. And then like, if anything else impacts, it’s really hard with these kinds of studies, because it’s like, well, what other foods are they eating? What kind of stress? Are they under? When they increase that salt? Do they increase their fluid intake with the salt? That sort of thing? Do they have an I’d also be curious that they excrete more salt and or sodium in their urine? With the increase? Is there an issue with the mechanism? You know, so I think there’s a lot more to be desired, but it does not look like it’s like there’s a causal relationship. And then there was a lot of questions about salt and heavy metals, like does pink Himalayan sea salt have heavy metals, I think, typically, that one, pink Himalayan sea salt is higher and heavy metals and like a white sea salt. But honestly, if you’re worried, just reach out to the company, if they will, especially if it’s like a good company, they usually will provide their testing, some of them have it right there on their website, like third party testing of their salt. So you can see how many heavy metals are in it. I think that people are very scared of heavy metals. And I understand like, I mean, I just think about like with mineral status, they can deplete your minerals, because certain minerals can help bind to heavy metals or remove them from the body. But if we have a deficiency of those minerals, certain heavy metals can actually take their place in the body, which is obviously not good. So I understand the concern. But I think that it’s important to recognize that we’re never going to avoid all heavy metals, they are a part of the Earth’s crust. They’re in ocean water, which is why you find them in sea salt. I think it’s more about like the processing of that sea salt, is there anything added in the processing, that sort of thing is a much that’s something that I care more about. And again, you can reach out to companies and ask them for that third party testing. Someone asked about, let’s say, if mom was researching the heavy metals and mineral salts, like Redmond’s, Himalayan Celtic, that sort of thing. She’s got a blog on her website where it breaks down like parts per billion and like which sea salts have like low, moderate or high levels? The thing is, like, there’s just so much controversy, there’s even lawsuits, so I’m not getting involved. But there’s a lot of controversy around this was like there’s not enough third, there’s not third party testing done. You know, how is she getting these levels? That sort of thing? I don’t know her I don’t know, I have truly have no opinion. I think if someone cares about the heavy metals and their salt, you should reach out to the company. And if they don’t share that information with you, then you probably don’t want to give them your money. But like someone asked about Redmond’s Real Salt, I mean, they have it on their website, you can go find it. And it has the report and it’s very low levels of lead. So I don’t know where her levels are coming from. But there’s a lot of drama here. So we’re not getting involved but reach out to companies if you care people ask like what are my favorite brands assault, I like salt work. These are mostly like for flavor obviously quality too, but I love salt work. I like the mineral salt from Andes Mountain salt. It’s very tasty the crucial for us like Icelandic sea salts, like out of control, probably the vessel I’ve ever had. But the way I go through solids, like very pricey, so I don’t I get it, I use it only for certain things. And then I do like molten sea salt. This is high levels on the lead mamas website. But when I reached out to them, I did not get that same information. So I’m not you know, don’t know where all the data is coming from, but just do your own research. Okay, does the body’s wisdom keep sodium low for a reason? Does it regulate blood pressure, I have low sodium despite always eating salt. This is probably more related to chronic stress, because over time when your adrenals are exhausted, you’re gonna make less aldosterone. And then that means you retain less sodium. So I don’t think that low sodium in the blood or on a hair test would be a sign of your body, trying to preserve or regulate blood pressure. I think it’s a sign of dysfunction and depletion and that there’s other things going on, like your adrenals are probably really tired. Maybe there’s other mineral imbalances. Maybe there’s stuff and like your nutrition lifestyle, day to day that you need to address, but I don’t think it’s like a, like a safety thing that your body’s doing. Why do I get swarmed when I eat too much salt because it’s probably not balanced with potassium, like I went through for the Florida attention piece. And then again, like if your adrenals are very stressed, then you’re not going to regulate that fluid in that sodium as well. So that’s why like I go very slow with salt and very fatigued people. So it’s probably a mix of both. How much is safe for sodium per day for pots? Uh, So I found some research, then I will put this in the show notes. But what I found in the research is that typically higher dietary sodium intake compared to low sodium intake for someone with pots will actually increase plasma volume, it lowers the plasma app, but norepinephrine and it decreases heart rate. So higher dietary sodium is often better for this population. But there’s always caveat to this, like you, I would go based on your labs, and like, are you taking magnesium? Could that be impacting how you’re retaining that sodium, or your adrenals super stressed and already depleted in sodium, because then like, you might not do super well with increasing the only the sodium really quickly. And I would always still keep it imbalanced with potassium. But in general, it looks like it is helpful for pots, especially if someone’s dealing with like, low blood pressure, low blood volume, that sort of thing. And then last one, if sodium is high on an on htma, and potassium is low, should we reduce salt? I don’t know, because I don’t know how much salt you’re taking in. But instead of reducing salt, I would increase your potassium. And then you have to remember like a high sodium on a hair test is showing that you’re really stressed. So it makes me think like it’s not so much about like lowering your salt but looking at where the heck is this dress stress coming from in the first place. So that’s how I would frame it of like, what’s causing the stress is it like related to nutrition is related to maybe supplementation, other mental emotional stressors, physical stressors in your day to day all those things are going to impact that sodium level. But remember, minerals are looking at your stress response and all the things we do every day impact our stress so usually it’s taking a look at your day to day habits. All right, that is our sodium episode another patch one if you want to get access to the bonus episode, the electrolyte handout and the case studies that I’m going to go through you can go to patreon.com/hormone Healing rd. Other than that I will see you in the next episode where we do our deep dive into potassium.

Thank you for listening to this episode of the Are You Menstrual podcast. If you want to support my work please leave a review and let me know how you liked the episode. This lets me know like what you guys want more of less of I read every single one. And I appreciate them more than you know. If you want to keep learning you can get access to the bonus episode and additional resources on patreon.com forward slash hormone healing rd I’d love to have you in there. Thanks again and I will see you in the next episode.

Amanda Montalvo

Amanda Montalvo is a women's health dietitian who helps women find the root cause of hormone imbalances and regain healthy menstrual cycles.

Master Your Minerals

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