Ninety percent of people in the United States eat too much salt, the body’s main source of sodium. Although many people don’t experience notable symptoms, eating too much salt can still cause long-term harm in the form of hypertension (high blood pressure), a condition that affects five of every 10 adults in the United States.
You can watch out for certain telltale signs of high sodium, including persistent thirst, fatigue, headaches, heart palpitations, and puffiness. By cutting back on salt, including processed foods high in sodium, you may be better able to manage your blood pressure and reduce your risk of heart disease and other health complications.
1. Thirst and Dehydration
Sodium is an essential nutrient that helps the body maintain a balance of fluids inside and outside cells, known as cellular homeostasis. To achieve this, you need to obtain the right amount of sodium from the foods you eat.
If you eat too much salt without increasing your fluid intake, the body will draw water from cells to compensate, leading to dehydration. Increased thirst is one of the key symptoms of dehydration. Others include dry mouth, dry skin, and sunken eyes due to water depletion in tissues.
2. Headaches
Headaches are another possible symptom of chronically high sodium levels. The cause of the pain is not always entirely clear, but dehydration is thought to play a part. The headache itself is commonly described as dull and “squeezing.” There may also be neurological symptoms such as dizziness, irritability, and brain fog (feeling mentally drained and unable to concentrate).
High blood pressure itself doesn’t usually cause headaches unless it is related to a medical emergency known as a hypertensive crisis. At such times, a severe headache accompanied by vomiting, chest pain, and seizures can develop when the blood pressure is over 180/120.
With that being said, some studies suggest that cutting back on salt may help people with hypertension who experience chronic headache pain. According to 2016 research published in the American Journal of Public Health, a low-sodium diet helped reduce the risk of headaches by 41% in a group of older adults with poorly controlled high blood pressure.
3. Fatigue
Fatigue and weakness are common signs of abnormally high blood sodium levels, known as hypernatremia. This can alter the balance of fluids inside and outside of the brain.
When sodium levels are excessively high, fluid levels in the brain can increase dramatically, leading to a condition called cerebral edema. The swelling of the brain, in turn, can contribute to early signs of hypernatremia, typically headache, fatigue, and muscle weakness.
Dehydration is one of the primary causes of hypernatremia. However, high sodium intake alone is unlikely to cause hypernatremia.
4. Heart Palpitations
Sodium is an electrolyte, meaning an electrically charged mineral that contributes to essential body functions like digestion, muscle contractions, and heartbeats. When you have too much sodium in the blood, it can cause an imbalance of the two electrolytes—sodium and calcium—that facilitate heartbeats.
This can lead to a skipped heartbeat, known as a palpitations. While most palpitations are relatively harmless, frequent or severe ones can lead to symptoms such as dizziness, light-headedness, chest pains, cold sweats, and fainting.
5. Bloating and Swelling
One of the key symptoms of excessively high salt intake is bloating and swelling. This is due to fluid retention, in which tissues retain more fluid than is excreted by urination (“peeing”).
Fluid retention can cause facial puffiness, especially around the eyes. In people with severe heart, liver, or kidney disease, it can lead to an overload of fluid in the lower legs, ankles, and feet. This is referred to as peripheral edema.
For reasons that are not entirely clear, a high-sodium diet can also cause gastrointestinal (GI) bloating and gas. According to a 2019 study in the American Journal of Gastroenterology, a high-sodium diet independently increases the risk of GI bloating by more than 1.2 times compared to a sodium-controlled diet. Females are more affected than males.
6. Weight Gain
Fluid retention is a key factor for transient weight gain in people on a high-sodium diet. However, fluid retention appears to account for only part of the problem.
A 2015 study in the journal Hypertension found that, among a group of about 1,240 adults and children, a sodium increase of 1 gram per day increased the risk of obesity by 26% and 28%, respectively. What makes the research notable is that the gain was not attributed to fluid retention but rather to an overall increase in body fat mass.
The cause of this gain in fat is not understood. More research is needed.
7. High Blood Pressure
Dietary sodium causes your body to retain fluid, which can increase fluid volumes in your blood, causing blood pressure to increase. This can contribute to the onset of hypertension.
The World Health Organization (WHO) reports that consuming over 5 grams of sodium per day is strongly linked to hypertension as well as an increased risk of cardiovascular illness and death. Even modest reductions in sodium can significantly lower blood pressure in as few as four weeks, along with the risk of these complications.
For most people, hypertension does not cause any symptoms. For this reason, have your blood pressure checked annually by a healthcare provider if you are age 40 and over, even if you are otherwise in excellent health.
8. Digestive Problems
In addition to weight gain and bloating, high sodium intake can lead to symptoms such as nausea, stomach upset, and diarrhea. This is caused by the overload of fluid, referred to as hypervolemia, in the gastrointestinal tract
High sodium can also alter the normal balance of bacteria and yeast in the stomach and intestine, known as the gut microbiome. The imbalance can impede the normal absorption of fluids in the gut, leading to watery diarrhea. The trouble absorbing nutrients (malabsorption) can also cause fermentation of food retained in the gut, resulting in bloating, cramping, and gas.
9. Sleep Disturbances
Fluid retention and high blood pressure caused by a high-sodium meal can disrupt sleep in different ways. Fluid retention can increase the risk of obstructive sleep apnea (pauses in breathing during sleep due to airway factors) as fluids from the legs are transferred to the upper airways as you lie down. Hypertension may promote symptoms like chest pain and headaches that can interfere with your sleep.
Some evidence also indicates that high sodium intake interferes with the production of the hormone norepinephrine, which helps regulate your circadian rhythm (sleep-wake cycle). Even excessive salt consumption on a single occasion can cause fragmented sleep patterns in some people.
Long-Term Complications
The main concern about eating too much salt is its impact on your blood pressure and heart. This is because high blood pressure forces your heart to work harder to pump blood to the rest of your body.
Over time, this can cause the lower left chamber of the heart, called the left ventricle, to become thicker and stiffer, leading to a condition called left ventricular hypertrophy (LVH). It also leads to the enlargement of the heart itself, known as cardiomegaly.
High blood pressure also causes tiny tears in the walls of blood vessels, which the body tries to patch with additional endothelial cells. This causes arteries to become thicker and stiffer and allows fatty deposits to build up on arterial walls, leading to a condition known as atherosclerosis.
LVH, cardiomegaly, and atherosclerosis are also associated with an increased risk of:
The heart is not the only organ affected by high sodium. Other possible long-term complications include:
- Osteoporosis (caused when high sodium promotes the excess excretion of calcium in urine)
- Kidney stones (caused by the accumulation of calcium in the kidneys)
- Chronic kidney disease (caused by increased blood pressure that can scar the kidneys)
- Cirrhosis (caused by excessive fluid accumulation, which contributes to liver scarring)
How Much Is Too Much?
The daily value (DV) is a reference established by the Food and Drug Administration (FDA) to describe the recommended daily intake of different nutrients. The DV is used on Nutrition Facts labels to indicate the percentage of the recommended daily intake is found in one serving of a food.
By way of example, 50% DV of sodium means you are consuming 50% of your recommended daily intake of sodium in just one serving.
The Dietary Guidelines for Americans published by the Department of Health and Human Services (DHHS) advises adults to limit their sodium intake to less than 2,300 milligrams (mg) per day, or roughly 1 teaspoon of table salt daily, from all sources.
Even so, people in the United States consume far greater quantities than this, averaging around 3,400 mg per day. This is a problem given the high rate of high rate of hypertension in the United States.
For people diagnosed with hypertension, a further reduction in sodium would be needed. The same applies to children in the United States, who also tend to eat far too much salt, a habit that can follow them into adulthood.
To this end, you need to ensure an adequate intake (AI) of sodium to allow your body to function normally each day while limiting your intake based on your age and hypertension status.
| Group | Adequate intake (daily) |
Maximum intake (daily) |
|---|---|---|
| 0 to 6 months | 110 mg | Speak with a pediatrician |
| 7 to 12 months | 370 mg | Speak with a pediatrician |
| 1 to 3 years | 800 mg | 1,200 mg |
| 4 to 8 years | 1,000 mg | 1,500 mg |
| 0 to 13 years | 1,200 mg | 1,800 mg |
| 14 years and over | 1,500 mg | 2,300 mg |
| Adults with hypertension | Speak with your provider | 1,500 mg |
Can You Flush Salt From Your System?
When you drink plenty of water (generally around eight 8-ounce glasses per day) your body can flush out much of the excess sodium. You can also do this by exercising to the point of sweating.
However, ample hydration and exercise alone cannot compensate for excessive sodium intake. What is arguably more important is that you cut back on your salt intake.
According to the FDA, this can be accomplished by avoiding restaurant foods and processed (packaged) foods, which account for roughly 70% of sodium in the standard American diet.
This can be accomplished by:
- Targeting high-sodium foods: Start by cutting back on foods like deli meats, pizzas, burgers, burritos, potato chips, crackers, and cured meats that are invariably high in sodium.
- Comparison shopping: Choose foods that are lower in sodium by reading the Nutrition Facts label and knowing what terms like “sodium-free” and “reduced sodium” mean (see below).
- Eating fresh foods: Processed foods are almost invariably high in salt. This includes packaged sauces, marinades, salad dressings, and condiments that contain lots of hidden sodium.
- Rinsing canned foods: Rinsing canned beans, vegetables, or sardines can help remove some of the excess salt. There are also reduced-salt versions of these foods to choose from.
- Using salt alternatives: Replace table salt with no-salt seasoning blends and other flavorings like lemon and fresh herbs.
- Tracking your sodium intake: Start by determining your recommended DV based on your age and hypertension status. Then, keep a journal or use an online app to monitor your intake.
| What the Label Says | What It Means |
|---|---|
| Sodium-free or salt-free | Less than 5 mg of sodium per serving |
| Very low sodium | 35 mg of sodium or less per serving |
| Low sodium | 140 mg of sodium or less per serving |
| Reduced sodium | At least 25% less sodium than the regular product |
| Light in sodium or lightly salted | At least 50% less sodium than the regular product |
| Unsalted or no salt added | No salt is added during processing, although they may not be strictly salt- or sodium-free |
Although it may take time for your taste buds to adapt to a reduced salt diet, by cutting back gradually, a little every week, most people are surprised at how little they miss the extra salt.
Do I Have Salt Sensitivity?
Salt sensitivity is defined as a greater than 10% increase in your blood pressure after eating a high-sodium diet. Some studies suggest that up to 30% of healthy people are salt-sensitive and therefore more vulnerable to hypertension than someone who may consume the same amount of salt daily.
If you are unable to control your blood pressure despite cutting back on salt, ask your healthcare provider about a urine-based renin test which can help diagnose salt sensitivity. This can help determine if more aggressive reductions in sodium are needed to control or prevent hypertension.
Medical Treatment Options
Sometimes, a change in diet and interventions like weight loss and routine exercise are not enough to bring your blood pressure under control. In such cases, drugs known as antihypertensive medications can be prescribed to help lower your blood pressure, each of which works in different ways.
These include:
- Diuretics (“water pills”): These work by promoting urination and removing excess water from the bloodstream. Options include Thalitone (chlorthalidone) and Microzide (hydrochlorothiazide).
- Angiotensin converting enzyme (ACE) inhibitors: These drugs relax blood vessels by blocking chemicals that induce vasoconstriction (the narrowing of blood vessels). Options include Prinivil (lisinopril), Lotensin (benazepril), and Capoten (captopril).
- Angiotensin 2 receptor blockers (ARBs): These relax blood vessels by acting on receptors in the walls of the vessels. Options include Atacand (candesartan) and Cozaar (losartan).
- Calcium channel blockers: These also help relax blood vessels and are often combined with ACE inhibitors in older adults. Options include Norvasc (amlodipine) and Cardizem (diltiazem).
If these drugs fail to get your blood pressure under control, others may be added, including:
- Alpha-blockers like Minipress (prazosin)
- Alpha-beta blockers like Coreg (carvedilol)
- Central alpha agonists like Catapres (clonidine)
- Beta-blockers like Lopressor (metoprolol)
- Renin inhibitors like Tekturna (aliskiren)
Summary
Eating too much sodium in the form of salt can cause fluid retention and an increase in blood pressure. These can give rise to symptoms like extreme thirst, fatigue, bloating, diarrhea, puffiness, weight gain, heart palpitations, headaches, and sleep difficulties.
By limiting your intake to no more than 2,300 mg of sodium per day (or 1,500 mg if you have hypertension), you can help ease these symptoms and avoid long-term complications like heart attack, stroke, chronic kidney disease, and liver disease.
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