Why Salt Isn’t the Enemy: The Real Story Behind Sodium, Hypertension, and Whole-Body Health
Salt has been villainized for decades, often blamed for hypertension, swelling, and heart problems. Yet emerging research and clinical experience tell a much more nuanced story. While some individuals are salt-sensitive, many others are unknowingly harmed by not getting enough sodium, especially when paired with chronic stress, medications, or restrictive diets.
At Internal Healing and Wellness MD, we help patients understand how essential minerals support circulation, energy, fluid balance, and healthy blood pressure. This blog explores the evidence behind salt, how it works in the body, why mineral balance matters, and how functional medicine uses a whole-system approach to support long-term cardiovascular and metabolic health.
Disclaimer: This article is for educational purposes only and should not be considered medical advice; always consult qualified healthcare professionals regarding diagnosis or treatment.
Rethinking Salt: New Perspectives on an Essential Mineral
For nearly 50 years, public health messaging has pushed the belief that “salt is bad,” urging strict sodium restriction for nearly everyone. However, much of this thinking originated from early dietary guidelines that did not align with the scientific evidence available at the time.
Today, research increasingly shows:
- Sodium intake has a U-shaped relationship with health, meaning too little is just as harmful as too much.
- Low sodium intake dramatically increases the risk of fatigue, confusion, falls, arrhythmias, and hospitalization.
- For most people, salt has little effect on blood pressure, and some individuals actually feel worse when restricting it.
Functional medicine reframes salt not as a threat, but as an essential nutrient that must be used correctly and balanced with other electrolytes.
When Salt Becomes a Problem: Understanding Individual Sensitivity
Salt can cause issues, but usually in specific contexts, not for the majority of the general population.
Salt may contribute to symptoms when:
- A person has advanced heart failure, where excess fluid can worsen edema or lung congestion
- An individual is salt-sensitive, a trait influenced by genetics and metabolic pattern
- Diets are high in processed foods, which often combine refined salt with unhealthy fats, preservatives, and additives
- Potassium intake is low, disrupting the sodium-potassium balance essential for heart function
In these cases, the issue may not be salt itself, but a combination of fluid retention, impaired circulation, mineral imbalance, or the additives in refined foods.
When Salt Is Good: Why Many People Need More Sodium Than They Realize
Many people assume reducing salt will automatically improve their health, but for a large portion of the population, the opposite is true. When sodium levels drop too low, the body struggles to maintain stable blood pressure, energy, and hydration.
Restricting salt too aggressively can cause:
- Lightheadedness, dizziness, or fainting
- Chronic fatigue or low energy
- Headaches
- Rapid heart rate (tachycardia)
- Elevated stress hormones
- Poor concentration or brain fog
- Increased risk of falls, especially in older adults
Low sodium (hyponatremia) is one of the most common electrolyte abnormalities in hospitalized patients, and it dramatically increases the risk of serious complications. Studies also show countries with lower average sodium intake have shorter life expectancy.
Why Your Body Needs Salt: Foundational Roles in Health and Physiology
Salt is essential for nearly every function in the human body, playing a critical role in maintaining balance, energy, and overall physiological stability. Sodium, the active component of salt, supports several key processes that keep your cells, nerves, and circulation functioning optimally. This includes:
- Cellular Hydration: Salt helps maintain fluid balance inside and outside cells, preventing dehydration at the cellular level even when water intake is adequate.
- Nerve Signaling and Brain Function: Sodium drives electrical impulses. Low sodium can cause confusion, cognitive fog, irritability, or difficulty concentrating.
- Blood Pressure Stability: Salt helps support healthy blood volume and circulation. Too little sodium can result in dangerously low blood pressure and poor organ perfusion.
- Hormone and Mineral Balance: Salt interacts with potassium, magnesium, and the renin-angiotensin-aldosterone system (RAAS), all of which regulate stress response, kidney health, and vascular tone.
- Digestive Health: Chloride (the “other half” of sodium chloride) is required to produce stomach acid that is essential for nutrient absorption and proper digestion.
When we restrict salt, we restrict the very system that maintains hydration, energy, metabolism, and circulation.
The Hidden Power of Minerals: Why Natural Salts Work Better
Not all salts are created equal, and the type you consume can greatly influence how your body responds. Many people feel unwell not because of sodium itself, but because of:
- Refined table salt, stripped of minerals
- Anti-caking agents
- Bleaching agents or chemical processing residues
Natural salts , such as sea salt, Himalayan salt, and mineral-rich unrefined salts — contain trace minerals that support hydration, circulation, nerve conduction, and zeta potential, the electrical charge in fluids that keeps blood flowing smoothly.
Functional medicine emphasizes a personalized, whole-body approach that considers how minerals, hydration, diet, stress, and metabolic health work together to support optimal physiology.
- Choosing mineral-rich salts
- Pairing sodium with adequate potassium and magnesium
- Ensuring hydration with clean, mineral-balanced water
- Avoiding processed foods that distort electrolyte metabolism
The Ever-Changing Blood Pressure Guidelines: A Moving Target That Affects Care
Hypertension guidelines have changed repeatedly over the years. This involves lowering the “acceptable” blood pressure range and dramatically increasing the number of people diagnosed with hypertension.
This creates several challenges:
- More people are prescribed medications even when they have no symptoms
- Many individuals are treated to blood pressures too low for healthy organ perfusion
- Low blood pressure increases fall risk, dizziness, kidney strain, and cognitive decline
- The focus becomes the “number,” not the patient
In functional medicine, we prioritize:
- Circulation and perfusion
- Patient symptoms
- Individual variability
- Root causes such as stress, mineral deficiencies, inflammation, and autonomic regulation
Salt restriction paired with overtreatment can push patients into chronically low blood pressure which is a state that often feels far worse than mild hypertension.
Functional Medicine’s Perspective: Salt as Part of Whole-System Health
From a functional medicine viewpoint, mineral balance is inseparable from the interconnected systems that keep the body stable, energized, and adaptable.Because these systems work in constant collaboration, even small mineral imbalances can create ripple effects throughout the body. This interconnected framework includes:
- Adrenal function PSodium helps regulate aldosterone and cortisol balance, supporting energy, stress tolerance, and electrolyte stability.
- Hydration: Proper sodium levels ensure water moves efficiently into and out of cells, preventing dehydration even when fluid intake is sufficient.
- Kidney regulation: The kidneys rely on sodium signals to manage blood volume, filter waste, and maintain electrolyte equilibrium.
- Autonomic nervous system stability: Sodium influences nerve transmission and helps stabilize blood pressure responses, especially in conditions like POTS.
- Metabolic resilience: Minerals play crucial roles in mitochondrial function, glucose regulation, and sustained energy production.
- Inflammatory load: Sodium and other electrolytes interact with immune pathways that influence inflammation, tissue repair, and long-term cardiovascular health.
Internal Healing and Wellness approaches these situations comprehensively by:
- Reviewing dietary patterns
- Assessing sodium, potassium, and magnesium levels
- Evaluating stress hormones and autonomic nervous system function
- Identifying medications that impact sodium balance (e.g., SSRIs, diuretics, BP meds)
- Reintroducing salt safely when needed
- Supporting overall cardiovascular health
Salt is not a standalone villain or cure, but a part of a complex, interconnected system that supports healing and long-term vitality.
Frequently Asked Questions
Common signs of low sodium include dizziness, fatigue, brain fog, headaches, and low blood pressure. Functional medicine testing can determine whether sodium imbalance is contributing to symptoms.
Yes. Natural salts contain trace minerals and lack additives found in refined salt. Many patients tolerate natural salts better and experience improved hydration and energy.
In some individuals, especially those with low blood pressure or autonomic dysfunction, appropriate sodium intake supports more stable circulation.
Start slowly with natural salts, pair with adequate hydration, and ensure sufficient potassium and magnesium from diet or supplementation — ideally under professional guidance.
Get Evidence-Based Guidance on Mineral Balance, Circulation, and Long-Term Cardiovascular Health
If you’re concerned about blood pressure, hydration, fatigue, or mineral imbalances, our team provides personalized, evidence-based functional medicine consultations designed to support your whole-body health. At Internal Healing and Wellness MD, we combine advanced diagnostics with integrative strategies to help you understand your biology and feel your best.
Start a clear, supportive path toward balanced energy, circulation, and long-term well-being. Schedule your appointment today.
Relevant Studies and References
De Keyzer, W., Tilleman, K., Ampe, J., De Henauw, S., & Huybrechts, I. (2015). Effect of sodium restriction on blood pressure of unstable or uncontrolled hypertensive patients in primary care. Nutrition Research and Practice, 9(2), 180 https://doi.org/10.4162/nrp.2015.9.2.180
Jaques, D. A., & Ponte, B. (2023). Dietary sodium and human health. Nutrients, 15(17), 3696. https://doi.org/10.3390/nu15173696
Lee, B., Yang, A., Kim, M. Y., McCurdy, S., & Boisvert, W. A. (2016). Natural sea salt consumption confers protection against hypertension and kidney damage in Dahl salt-sensitive rats. Food & Nutrition Research, 61(1), 1264713. https://doi.org/10.1080/16546628.2017.1264713
Palsdottir, H., (2025, May 12). 5 Little-Known Dangers of restricting sodium too much. Healthline. https://www.healthline.com/nutrition/6-dangers-of-sodium-restriction
Rondon, H., & Badireddy, M. (2023, June 14). Hyponatremia. StatPearls - NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK470386/
