Sodium: The Good and the Bad

The Importance of Sodium

A baby learned to walk at six months. It could climb chairs and pull itself up onto the table. It loved salt — whenever its parents held it, the child would grab for the saltshaker and fuss until they let it have some.

The parents mentioned it to their doctor. Eventually the child was admitted to a pediatric unit for workup. Blood tests were ordered. And because something metabolic was clearly going on, the team put the child on a no-salt diet while the investigation continued.

Six days later, the child died in the hospital.

The doctors realized too late what they were dealing with. The child's adrenal glands couldn't hold on to sodium — a condition we now recognize as congenital adrenal hyperplasia. That fierce, instinctive craving wasn't a quirk. It was a child keeping itself alive.

Pediatrician Lawson Wilkins reported that medical misadventure in 1940. How dramatically that experience illustrates something we easily forget: sodium is not optional. The body runs on it. The question isn't whether we need sodium, but how much.

Note

The first time I heard this story, I felt disdain for the doctors involved. Later I learned that the condition the child suffered from was rare, poorly understood, and the medical specialty needed to diagnose it was still only a dream in the mind of Dr. Lawson Wilkins, the doctor who reported the tragedy. The condition was not treatable until the mid 1950s.

Sodium is Vital to Life.

• Athletes and laborers in hot environments face serious risks from loss of sodium in sweat.

• Aging brings increased risk of sodium loss as the various physiologic systems grow weaker. Some common medications cause sodium loss. Annual check-ups for older adults can prevent low-sodium-related conditions such as cognitive loss, falls and fractures.

Why You May Be Advised to Use a Low Sodium Diet

Humans evolved in an environment with very low sodium. The amount we get today is about 30 times too high for us. Many of us get away with it, and many others develop

• high blood pressure
• heart disease
• stroke
• kidney disease
• stomach cancer
• dementia

Only about a third of our sodium comes from our saltshaker, with the rest from packaged and restaurant food.

If your provider has advised you to reduce your sodium intake, check out this solution that works for most of us.