Doc: 74-year-old stroke victim confused about salt
Dear Dr. Roach: I’m 74 years old and have been very healthy. I take only Synthroid. My cholesterol and blood pressure were high, but I didn’t want to take medication for fear of side effects.
In July, I had a stroke, leaving me with mouth and leg numbness. My neurologist told me not to eat salt. I started having cramps in my fingers and toes, and my general doctor said I need 1,400 mg of sodium a day.
Some doctors tell you not to eat salt, but I understand that we need a certain amount. It’s very confusing.
Dear P.J.R.: We certainly do need a small amount of sodium for normal function. Back in the middle ages, “salt famines” were a serious problem. However, this has not been a significant public health issue for centuries — indeed, the converse is true.
In North America, most of us get far excessive amounts of salt, not only exceeding requirements (minimum requirement may be as little as 200 mg daily), but at a level where it raises blood pressure in a great proportion of people; I have seen people whose daily sodium intake is in excess of 25,000 mg. (Note that I am talking about sodium intake. To convert to how much table salt that is, multiply by 2.5.)
Different groups have different recommendations, but reducing salt intake is likely to reduce risk of high blood pressure and of stroke. The Centers for Disease Control and Prevention recommends a diet that has less than 2,300 mg of sodium daily — that is less than a teaspoon.
Most of the salt in our diet (75 percent) comes from processed and restaurant foods, not from adding salt at the table.
In my experience, cramping comes from low potassium, and not low sodium intake. Plenty of fruits will ensure good potassium intake, which is important, as it helps to minimize the effects of sodium (but people with kidney disease may need to watch potassium intake).
If you can get your blood pressure and cholesterol down with diet, that’s great. If not, medication can reduce the risk of a second stroke.
Email questions to ToYourGoodHealth@med.cornell.edu.