For half a century, medicine has waged a relentless campaign against salt, warning that it raises blood pressure, damages hearts, and shortens lives. Yet, as with so many dietary dogmas, the evidence behind this crusade is shakier than a table with uneven legs. The war on salt began in 1977, when a U.S. Senate committee published dietary guidelines urging reduced sodium intake, despite scant scientific support. Since then, the anti-salt narrative has gained unstoppable momentum, fuelled by institutional inertia and profit-driven medicine rather than robust science.

The core argument? Salt raises blood pressure, and high blood pressure is deadly. But here's the catch: the link between salt and blood pressure is tenuous at best. The most detailed reviews show that drastic salt reduction typically lowers blood pressure by less than 1%, a negligible effect. Meanwhile, hospitals routinely administer IV saline (10 times the recommended daily sodium intake) without sending patients' blood pressure through the roof. The logic simply doesn't hold.

While the medical establishment fixates on the perils of excess salt, it ignores a far more common and dangerous problem: hyponatremia, or dangerously low sodium levels. Hyponatremia is one of the most frequent conditions seen in hospitalised patients, affecting 15–20% of admissions. Chronically low sodium greatly increases the risk of death, cognitive impairment, falls, and even heart failure. Yet, patients are still aggressively pushed to restrict salt, often to their detriment.

Key risks of salt restriction:

Increased mortality: Countries with lower salt consumption have shorter life expectancies. A study found that following the recommended low-sodium diet increases the risk of dying by 25%.

Cardiovascular harm: Low sodium intake is linked to a 34% increase in heart disease and death. Rapid sodium drops can trigger arrhythmias and shock-like states, as the heart struggles to pump thickened, sluggish blood.

Neurological and physical decline: Fatigue, confusion, insomnia, and light-headedness are common symptoms of hyponatremia. Many patients report dramatic improvements in energy, cognition, and even erectile dysfunction after increasing their salt intake.

Worsening chronic illness: Salt restriction can exacerbate conditions like POTS (Postural Orthostatic Tachycardia Syndrome) and chronic fatigue syndrome, which are often linked to poor circulation and low blood volume.

The obsession with lowering blood pressure, often to levels that are dangerously low for older adults, is another example of medicine's profit-driven approach. Pharmaceutical companies benefit from lifelong prescriptions, and the definition of "healthy" blood pressure has been repeatedly narrowed to expand the pool of patients needing medication. The result? Elderly patients medicated into fatigue, dizziness, and falls, all while their quality of life plummets.

The truth about blood pressure:

High blood pressure is often a symptom of poor circulation, not the cause. Reducing it further can starve organs of oxygen, leading to kidney damage, cognitive decline, and macular degeneration.

Many blood pressure medications (and antidepressants like SSRIs) increase the risk of hyponatremia, creating a vicious cycle of harm.

As with many physiological factors, sodium intake follows a U-shaped curve: both too much and too little are harmful. Studies show that moderate salt consumption is associated with the lowest risk of death, while both extreme restriction and excess increase mortality. This nuance is lost in the one-size-fits-all advice to "eat less salt".

Key considerations for healthy salt consumption:

1.Natural vs. refined salt: Processed table salt is stripped of minerals and often contains anti-caking agents that may disrupt physiological balance. Natural salts (like Himalayan or sea salt), rich in trace minerals, are a healthier choice.

2.Potassium balance: Modern diets are low in potassium (found in vegetables) and high in refined sodium, disrupting the critical sodium-potassium ratio needed for heart and nerve function. Restoring this balance is vital for health.

3.Hydration matters: Consuming salt with adequate water helps maintain zeta potential, the electrical charge that keeps blood cells dispersed and circulation smooth. Poor zeta potential (from imbalanced electrolytes) can lead to clotting, edema, and heart strain.

The fixation on salt (like the demonisation of sunlight or saturated fat) is a distraction from the real drivers of chronic disease: processed foods, environmental toxins, stress, and sedentary lifestyles. These factors are far more profitable to ignore, as they require systemic change rather than simple scapegoats.

What's needed now:

Evidence-based guidelines: Policies should reflect the U-shaped reality of salt intake, not blanket restrictions.

Patient-centered care: Individuals — especially the elderly, those with heart failure, or autonomic dysfunction — should be assessed for salt deficiency, not just excess.

Focus on real health: Instead of vilifying essential nutrients, medicine must address the toxic environments, poor diets, and stress that are truly making us sick.

Salt is not a villain. It's a vital nutrient that, like sunlight, has been unfairly maligned. The key is balance: enough to support life, not so much as to harm it. The medical establishment's refusal to acknowledge this, driven by profit, inertia, and oversimplification, has led to needless suffering.

It's time to end the salt wars. Let's focus on real health, not misguided crusades. Your body, and your blood pressure, will thank you. No medical advice; for information purposes only!

https://www.midwesterndoctor.com/p/what-they-never-tell-us-about-salt