Why You Might Not Be Getting Enough Sodium

large grains of sea salt on shabby light blue table

Updated May 24, 2017 @ 10:03 am

By Isadora Baum

When it comes to dietary villains, salt is always on the Most Wanted list. It’s so ingrained (sorry) that salt is bad for us, that even reaching for the salt shaker can be guilt-inducing. But as with most things having to do with nutrition, the facts aren’t that simple. It turns out it’s possible to get too little salt. 


Sodium is an electrolyte, a mineral that keeps the body’s fluid level balanced and optimizes nerve and muscle function. Experts at the Mayo Clinic recommend eating about 1 teaspoon of salt per day. The American Heart Association prefers 3/4 teaspoon to keep levels close to 1,500 mg. But it’s very difficult to track sodium this way, since it doesn’t all come from the salt shaker; it’s both added to, and naturally occurring in, food and beverages.

Many Americans–especially those with high blood pressure–have excess sodium in their diet, but the solution isn’t as simple as telling people to cut as much salt as possible. Athletes and people with certain medical conditions or who take some medications are at risk for hyponatremia, “a condition that occurs when sodium in the body is depleted and not replaced, but water intake remains high, diluting sodium stores and leading to serious consequences,” Pam Nisevich Bede, MS, RD, sports dietitian with EAS Sport Nutrition, tells Clean Plates.

When there’s inadequate sodium in the blood, water pours into cells to compensate, adds Lauren Popeck, R.D. at Orlando Health. This excess fluid, if not treated, can lead to brain impairment, and even death, over time.


Dr. Partha Nandi, creator and host of Emmy-award winning talk show “Ask Dr. Nandi,” says symptoms of sodium deficiency include “nausea and vomiting, decreased appetite, headache, fatigue, confusion, and muscle cramps.”

You lose sodium when you sweat, though for most people, a healthy diet provides enough sodium to replace the amount lost, Popeck says. But people with the following conditions are at risk:

Certain illnesses: Heart, kidney, and liver disease can all lead to excess fluids that upset the body’s sodium balance.

Medications: Antidepressants, pain medications, and diuretics can cause frequent urination and perspiration.

Exercise: The old thought process was that you couldn’t drink enough water during workouts. Now we know that too much fluid and too few electrolytes during workouts can be dangerous.

If you have one of the above medical conditions or you’re on medications that can affect your sodium-fluid balance, talk to your doctor.

And if you think you might be at risk because of your gym habit, good news: You don’t have to ditch your favorite spin class. “We see hyponatremia (a low sodium level in the blood) rear its ugly head during endurance sports when athletes continuously drink loads of water without any electrolytes. Sip on a sports drink instead,” Bede recommends. “Unless you’re exercising longer than 90 minutes and need fuel. Then aim for one that contains around 25 calories per serving to avoid excess sugar.”

Here’s a simple way to determine whether you’re drinking too much while exercising: “If you finish a workout and gained weight, chances are you over-drank,” Bede notes. “Next time out, pay attention to thirst and weight and personalize your fluid intake to better meet your body’s needs.”


Refueling post exercise is also important, and there’s a reason runners receive bananas after races: Sodium’s partner in maintaining the body’s fluid balance is potassium. “Eating a high-quality diet that’s rich in potassium is helpful to achieve sodium balance,” Popeck says. “Top sources of potassium include avocado, lima beans, white beans, bananas, yogurt, sweet potatoes, spinach, and Portobello mushrooms. The goal is to get 4,700 mg potassium per day.” An avocado has about 1,067 mg, a large sweet potato has 855 mg, a cup of coconut water has about 600 mg and a banana has about 485 mg.

Unless your doctor advises against it, you can enjoy a few salty foods as well. These staples are rich in sodium and actually good for you, so add them in small portions:

Mixed nuts

Cottage cheese

Instant Oatmeal




Pasta sauce



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