Health

Sodium on Keto: Benefits, Importance, and How Much Do You Need?

Published on: August 28, 2019

Sodium on Keto: Benefits, Importance, and How Much Do You Need?

Like most people, you’ve probably heard the news:

Too much sodium is bad.

Excess sodium in the diet can be a factor in the development of heart disease, tax the kidneys, and also lead to fluid retention, among other things.

The American Heart Association (AHA) recommends the consumption of no more than 2,300 milligrams (mg) of sodium daily [1].

If that is the case, then why do you need more sodium on a keto diet?

Is reducing salt always the best advice?

In today’s guide, we’re going to paint an accurate picture of sodium in terms of the ketogenic diet. Before you try going keto, read this so you can understand:

  • The functions of sodium in your body
  • Health conditions that benefit from a low-sodium intake
  • The relationship between keto and sodium
  • Ways to replenish sodium on keto

Let’s dive right in.


what-is-sodium

What's the Definition of Sodium?

Sodium is an electrolyte. We consume sodium in its dietary form, primarily from sodium chloride. People refer to sodium chloride as “table salt.”

It’s no secret that salt acts as a flavor enhancer for most of our foods, which is why its prevalent in prepared foods, soups, and dressings, to name a few.

Take note that the average blood sodium level is between 135 and 145 mEq/L [2].


What Is the Role of Sodium in the Human Body?

As an essential electrolyte, sodium supports many essential body functions. Without it, your body would be out of balance, causing major health consequences, even death.

Here are the different roles of sodium:


role-of-sodium-in-the-human-body

1. Regulates your blood pressure

Sodium and other minerals like potassium, calcium, and magnesium help to regulate blood pressure. Sodium attracts water, so remember, “Where sodium goes, water follows.”

Because water follows sodium, too much salt can raise the volume of water in the blood. The increased volume in your circulation puts pressure on the walls of arteries. As a result, blood pressure rises [3].

Meanwhile, lowering sodium can decrease blood pressure.

You might also be wondering:

Why is it that some people can overeat salt without seeing an increase in their blood pressure?

A 2015 study suggests that some people are more sensitive to salt than others [4]. Salt-sensitive individuals who eat more salt experience an increase in blood pressure.

In another study, it was found out that people with a variation in their GNAI2 gene are likely to be salt-sensitive. However, this topic needs more research [5].


2. Maintains muscle and nerve function

Your body needs sodium to help your nerve cells maintain communication. The electrical signals sent by your nerve cells enable your muscles to contract [6]. Muscular contraction maintains posture and joint stability, and also allows your body to produce heat [7].

This explains why low sodium serum levels lead to consequences such as [8, 9]:

  • Muscle weakness
  • Muscle cramps
  • Confusion
  • Headache
  • Convulsions
  • Coma

3. Helps with fetal development

Some pregnant women experience hyperemesis gravidarum, which is an extreme form of morning sickness resulting in nausea and vomiting [10].

pregnancy-and-morning-sickness

Severe vomiting puts a person at risk for electrolyte imbalances through the loss of bodily fluids, including sodium, due to dehydration [11].

A study suggested that the loss of salt from vomiting could cause low birth weight. Not just that, mothers who take less salt may affect their babies’ blood sodium concentrations, and these babies are more likely to be underweight at birth [12].


4. Prevents insulin resistance

This might surprise you:

Salt restriction intake increases your risk of insulin resistance. But how so?

Sodium restriction activates your renin-angiotensin-aldosterone system or RAAS [13].

In case you don’t know, the RAAS is a crucial physiologic system that regulates your blood pressure. It also regulates your body’s fluid and electrolyte balance [14].

Studies suggest that activating the RAAS could predispose a person to insulin resistance and type 2 diabetes [15].

Bottom line?

Sodium is important for our body’s functioning.


sodium-and-medical-conditions

When Can Sodium Be an Issue?

You already know how sodium helps with normal body functions, but that doesn’t mean that everyone can eat as much salt as they want.

There are specific medical conditions that require a lower sodium intake. If you have the following health issues below, your doctor may recommend a low-sodium diet.


1. Kidney disease

People with kidney problems cannot remove excess sodium and fluids from their bodies, causing excess sodium and fluid to accumulate within the tissues.

As a result, some areas of the body swell, such as hands, feet, ankles, and abdomen. This swelling is also called “edema” [16].


2. Heart failure

When your heart is weak, it cannot efficiently pump enough blood throughout your body, and blood circulation becomes sluggish [17].

The kidneys sense this reduced flow and compensate for the lack of blood volume by retaining sodium and fluid instead. This is why people with heart disease often have edema [17].

Limiting one’s sodium intake helps manage heart failure by reducing fluid buildup around the heart, which helps the heart to not work so hard.


3. Hypertension (high blood pressure)

Hypertensive patients can benefit by reducing salt in their diet, which reduces blood volume and therefore helps keep blood pressure under control.


sodium-on-keto

Why Is Sodium Important on a Keto Diet?

Do you need more sodium when going keto?

Hint: At the start of your keto diet, your body loses more water. It also flushes out more sodium along with water.

Unless you have a health issue that needs medical supervision, you’re encouraged to increase your salt intake.

Fact: Sodium intake on keto is crucial.

When you reduce your dietary carbs on a keto diet, your body starts losing electrolytes too.

Here’s why it happens:

Cutting back on carbohydrate-rich foods lowers your blood glucose levels, as well as decreases the amount of the hormone insulin. Your body senses the low blood sugar and responds by releasing glycogen, a form of stored sugar from your liver [18].

Next, glycogen gets converted back into glucose and enters your bloodstream.

The interesting part:

In your liver and muscle cells, glycogen binds to water molecules; each gram of glycogen is associated with at least 3 grams of water [19].

So, as your glycogen stores diminish through a low-carb diet, your body excretes more water, which can cause more urination and fluid loss.

In addition, insulin is associated with sodium retention; therefore, lower insulin levels equals less sodium retention [20].

In fact, many people starting on keto will lose a lot of water weight initially.

Sounds exciting, right?

sodium-is-important-in-keto-diet

But here’s the thing: You’ll also be losing electrolytes through your urine, one of which is sodium.

Another way that your sodium levels decrease is this:

A well-formulated keto diet cuts out a lot of processed foods [21]. Processed or commercially-prepared foods have high sodium content [22].

What happens when your sodium levels are disrupted?

You experience a variety of unpleasant symptoms. Some people refer to these symptoms as the keto flu, and they are so nasty that they become a reason why people quit keto.


Benefits of sodium on a keto diet

Many people who follow a keto diet often neglect their sodium intake. The reason? They’ve focused on the stigma that more sodium is bad - which isn’t always the case, as you now likely have realized.

Here are the ways sodium helps you in your keto journey:


benefits-of-sodium-on-a-keto-diet

1. Helps prevent muscle cramps.

One of the common effects of low sodium is muscle cramps, which are when muscles tighten and contract. Muscle cramps are painful and can last up to several minutes.

Muscle cramps often occur during exercise, as the body is also losing fluid during a workout.


2. Keeps potassium in balance.

On a low-sodium diet, the kidneys tend to eliminate potassium as well [23].

Like sodium, potassium performs many essential functions, such as helping to control your blood pressure, aiding in muscle contractions and helping to regulate fluid balance.


sodium helps with fatigue

3. Fights low energy or fatigue.

People who are new to keto will agree with this: they often feel tired and fatigued during the first week of keto.

Being fatigued on keto decreases your physical performance, and also negatively impacts your ability to focus.

While fatigue can be caused by insomnia, another common keto flu symptom, it can also be caused by sodium deficiency.


4. Relieves headaches.

Throbbing headaches make it hard for you to adjust to a keto diet. Headaches can be caused by dehydration and low sodium levels [24].

You need to start worrying about your headaches if they get worse despite electrolyte supplementation, which prompts urgent medical attention [25].


Electrolytes and Sodium Imbalance on the Ketogenic Diet?

A diet that is low in carbohydrates, such as a keto diet, leads to electrolyte loss.

Burning through your glycogen stores leads to increased water loss. Again, glycogen is bound to water molecules. Your kidneys excrete excess water. Sodium goes with water. You lose sodium together with other electrolytes.


keto-sodium-per-day

How Much Sodium Do You Need on a Keto Diet?

How do you avoid annoying keto flu symptoms and the consequences of low sodium? Easy - bump up your salt consumption.

Now, we ask the most awaited question:

How much sodium per day on keto do you need?

A well-formulated keto diet requires a daily sodium intake of 3,000 to 5,000 mg [26], or about 1-2 teaspoons of table salt.

Of course, the exact amount you should take depends on various factors.

For instance, your physical activity level affects your sodium intake.


exercising-increase-the-required-sodium-quantity

Are you an athlete, training and competing for hours a day? Do you sweat profusely? Is your exercise intense? If you answer yes, 3,000 mg of sodium could be too low for your activity.

Studies also show that higher rates of sweating increases an athlete’s likelihood to experience cramps [27].

Wondering how you can increase your keto salt intake? Check out these helpful tips:


1. Salt to your taste.

We recommend adding salt in your meal preparation. A total of 1-2 teaspoons of salt per day will meet your increased sodium needs, which are around 3,000-5,000 mg. Note that many foods already contain some sodium, so you may not need 1-2 teaspoons of salt on top of your normal sodium intake.

Instead of regular table salt, feel free to use Himalayan pink salt and sea salt, which tend to contain more minerals and electrolytes such as calcium, magnesium, potassium, iron, manganese and zinc [28, 29].


2. Drink bone broth.

Have you considered bone broth?

Bone broth is a soup that you make by boiling the bones, tendons, and ligaments of an animal. This healthy soup provides various micronutrients that can help prevent electrolyte imbalances on keto.

Bone broth is also a source of sodium; 100 grams (100 ml) of bone broth made from beef bones, chicken liver, and spices contain 116 mg of sodium.

What about other minerals? 100 ml of bone broth also provides [30]:

  • 1 mg calcium
  • 3 mg iron
  • 1 mg magnesium
  • 156 mg potassium
  • 3 mg zinc

sodium-keto

3. Snack on something salty.

There are tons of snack foods to enjoy that help you avoid or minimize keto flu symptoms. Try one or more of these salty keto snacks:

  • Pork skins (100 grams) = 1, 838 mg sodium [31]
  • Dry roasted macadamia nuts with salt (1 cup) = 350 mg sodium [32]
  • Bacon bits, meatless (100 grams) =
  • 1, 770 mg sodium [33]
  • Beef jerky, chopped and formed (1 piece, large) = 443 mg sodium [34]
  • Salted Dry roasted almonds (1 cup) = 468 mg sodium [35]

4. Go for a sugar-free electrolyte drink.

A significant concern when it comes to sports drinks is that they tend to contain a lot of sugar.

Instead, consider making your own low-sugar electrolyte drink at home. You could mix the following:

  • Lemon or lime juice
  • Your tea of choice
  • Powdered stevia
  • Pink Himalayan salt (¼ teaspoon = 575 mg sodium)
ketone-salts-supplement

5. Take ketone salts.

Taking an exogenous ketone supplement can help boost your ketone levels, which encourages your body entering into ketosis.

If you take a ketone salt, a ketone body bound to minerals such as salt, you’ll be able to increase your sodium intake as well.

6. Take ½ teaspoon of salt before a workout.

We can overlook sodium replacement when it comes to working in hot environments. Studies show that a person can sweat as much as 10-12 liters per day, and sweat contains sodium [36].

Here’s a useful tip to mitigate sodium loss:

Take ½ teaspoon of salt 30 minutes before you exercise. If you’re going to do an intense workout in a hot environment, take an additional ½ teaspoon of salt each hour [37].

sodium-and-intense-workout

Conclusion

A ketogenic diet affects electrolyte levels. This happens as you reduce carbs and your body utilizes its stored glycogen which is a large part water. This explains why you lose water when you deplete glycogen stores on a low-carb diet.

Sodium is an essential electrolyte. It controls your blood pressure, preserves muscle and nerve function, maintains body fluid volume, and more.

Low sodium levels cause those unpleasant symptoms at the start of your keto diet. Cramps, headaches, fatigue - you name it. To prevent or mitigate them, be sure to bump up your sodium intake.

If you have a medical condition, consult a physician before you start keto. Certain conditions require a low sodium intake.

We hope you learned from today’s guide!


Takeaways

  • On keto, you need to consume around 3,000 to 5,000 mg of sodium, which is equal to about 1-2 teaspoons of salt.
  • The more active you are, the higher your salt intake should be. This is especially true if you work or exercise intensely in a warm environment.
  • There are many ways to take more sodium. Options include but are not limited to taking bone broth, salty snacks, ketone salts, and
  • sugar-free electrolyte drinks.

References

  1. American Heart Association. Why Should I Limit Sodium? 2017 - https://www.heart.org/-/media/data-import/downloadables/pe-abh-why-should-i-limit-sodium-ucm_300625.pdf
  2. Mayo Clinic. Hyponatremia. 2018 May 8 - https://www.mayoclinic.org/diseases-conditions/hyponatremia/symptoms-causes/syc-20373711
  3. Cloe A. The Actions of Sodium in the Human Body. 2018 December 7 - https://healthyeating.sfgate.com/actions-sodium-human-body-8362.html
  4. Choi HY, Park HC, Ha SK. Salt Sensitivity and Hypertension: A Paradigm Shift from Kidney Malfunction to Vascular Endothelial Dysfunction. 2015 June 30 - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4520886/
  5. Boston University School of Medicine. Biomarker for salt sensitivity of blood pressure discovered. 2018 July 5 - https://www.sciencedaily.com/releases/2018/07/180705115632.htm
  6. Tremblay S. What Minerals Contract a Muscle? 2018 December 6 - https://healthyeating.sfgate.com/minerals-contract-muscle-6293.html
  7. NIH. Introduction to the Muscular System - https://training.seer.cancer.gov/anatomy/muscular/
  8. Varghese J et al. Muscle cell membrane damage by very low serum sodium. 2009 November 12 - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2984287/
  9. Wedro B. Hyponatremia (Low Sodium) - https://www.emedicinehealth.com/hyponatremia_low_sodium/article_em.htm#what_is_hyponatremia_low_sodium
  10. Dulay AT. Hyperemesis Gravidarum - https://www.msdmanuals.com/professional/gynecology-and-obstetrics/abnormalities-of-pregnancy/hyperemesis-gravidarum
  11. Nierenberg C. Hyperemesis Gravidarum: Extreme Morning Sickness. 2017 November 1 - https://www.livescience.com/60831-hyperemesis-gravidarum.html
  12. Sakuyama H et al. Influence of gestational salt restriction in fetal growth and in development of diseases in adulthood. 2016 January 20 - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4719732/
  13. Garg R et al. Low-salt diet increases insulin resistance in healthy subjects. 2010 October 30 - https://www.sciencedirect.com/science/article/abs/pii/S002604951000329X
  14. Underwood PC, Adler GK. The Renin Angiotensin Aldosterone System and Insulin Resistance in Humans. 2013 February - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3551270/
  15. Das UN. Renin–angiotensin–aldosterone system in insulin resistance and metabolic syndrome. 2016 July 7 - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5290902/
  16. Mayo Clinic. Edema. 2017 October 26 - https://www.mayoclinic.org/diseases-conditions/edema/symptoms-causes/syc-20366493
  17. Harvard Health Publishing. Fluid retention: What it can mean for your heart. 2014 January - https://www.health.harvard.edu/heart-health/fluid-retention-what-it-can-mean-for-your-heart
  18. Diabetes.co.uk. Glycogen. https://www.diabetes.co.uk/body/glycogen.html
  19. Fernández-Elías VE et al. Relationship between muscle water and glycogen recovery after prolonged exercise in the heat in humans. 2015 April 25 - https://www.ncbi.nlm.nih.gov/pubmed/25911631
  20. Brands MW, Manhiani MM. Sodium-retaining effect of insulin in diabetes. 2012 October 3 - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3533616/
  21. Phinney S, Bailey B, Volek J. The Ten Defining Characteristics of a Well-Formulated Ketogenic Diet. 2018 August 13 - https://blog.virtahealth.com/well-formulated-ketogenic-diet/
  22. Nieto C et al. Sodium Content of Processed Foods Available in the Mexican Market. 2018 December 19 - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6316842/
  23. Phinney S, Virta Team. What causes muscle cramps on a ketogenic diet? - https://blog.virtahealth.com/muscle-cramps-ketogenic-diet/
  24. Leonard J. What are the symptoms of low sodium levels? 2018 November 28 - https://www.medicalnewstoday.com/articles/323831.php
  25. Harvard Health Publishing. Headache: When to worry, what to do - https://www.health.harvard.edu/pain/headache-when-to-worry-what-to-do
  26. Phinney S, Virta Team. How much sodium, potassium and magnesium should I have on a ketogenic diet? - https://blog.virtahealth.com/sodium-potassium-magnesium-ketogenic-diet/
  27. Verle V. The Importance of Salt in the Athlete's Diet. 2007 August - https://journals.lww.com/acsm-csmr/Fulltext/2007/08000/The_Importance_of_Salt_in_the_Athlete_s_Diet.9.aspx?trendmd_shared=0
  28. Lee B-H et al. Natural sea salt consumption confers protection against hypertension and kidney damage in Dahl salt-sensitive rats. 2016 December 20 - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5328355/
  29. Leonard J. Does pink Himalayan salt have any health benefits? 2018 July 30 - https://www.medicalnewstoday.com/articles/315081.php
  30. SELFNutritionData. Bone Broth - https://nutritiondata.self.com/facts/recipe/2768812/2
  31. SELFNutritionData. Snacks, pork skins, plain -https://nutritiondata.self.com/facts/snacks/5362/2
  32. SELFNutritionData. Nuts, macadamia nuts, dry roasted, with salt added. https://nutritiondata.self.com/facts/nut-and-seed-products/3175/2
  33. SELFNutritionData. Bacon bits, meatless. https://nutritiondata.self.com/facts/legumes-and-legume-products/7633/2
  34. SELFNutritionData. Snacks, beef jerky, chopped and formed. https://nutritiondata.self.com/facts/snacks/5332/2
  35. SELFNutritionData. Nuts, almonds, dry roasted, with salt added. https://nutritiondata.self.com/facts/nut-and-seed-products/3170/2
  36. Bates GP, Miller VS. Sweat rate and sodium loss during work in the heat. 2008 January 29 - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2267797/
  37. Phinney S, Bailey B, Volek J. The Importance of Managing Potassium and Sodium as Part of a Well-Formulated Ketogenic Diet. 2019 February 19 - https://blog.virtahealth.com/potassium-sodium-ketogenic-diet/

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