The Truth About Salt - by A Midwestern Doctor

The Forgotten Side of Medicine

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The Truth About Salt<br>What they don't tell us about salt and how to select the healthiest options

A Midwestern Doctor<br>Jun 08, 2025<br>∙ Paid

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This newsletter exists to help others, and as a result, I frequently receive correspondences from individuals with pressing questions I want to answer. Unfortunately, due to how long each article takes to write (e.g., I’ve spent the last month putting together the last major part of the DMSO series and it’s still not quite done) I don’t have the time respond to all of those correspondences.<br>I wish that I did, so the best solution I’ve been able to come up with is to have monthly open threads where anyone can ask whatever is needed (e.g., any lingering questions from the previous month) and I would make a point to always reply to them (as having them all in a single place makes it easier to get to them and also possible for others with the same question to see that answer).<br>Each time I do a monthly thread, I try to tag it to a topic I’ve wanted to write about but I do not quite feel is enough for its own article. In this article, I will focus on one my major frustrations with the medical system—the war against salt.<br>Note: the war against salt began in 1977 when a Senate Committee published dietary guidelines arguing for reduced sodium consumption despite the existing evidence not supporting this. Since then, like many other bad policies, it has developed an nearly unstoppable inertia of its own.<br>Is Salt Bad For You?

Many people you ask, particularly those in the medical field will tell you salt is bad, and one of the most common pieces of health advice given both inside and outside of medicine is to eat less salt.<br>Over the years, I’ve heard two main arguments for why salt is bad for you.<br>First, salt raises blood pressure, and high blood pressure is deadly, so salt is too and should be avoided.<br>Second, with individuals who have heart failure, eating too many salty foods will create exacerbations of their condition, and as a result, after holidays where people eat those foods (e.g., the 4th of July) more heart failure patients will be admitted to hospitals for heart failure exacerbations.<br>Note: excessive sodium causes these exacerbations because an excess amount of fluid accumulates in the body (e.g., because the weakened heart can’t move enough blood to the kidneys to eliminate it), which then overloads other parts of the body (e.g., causing swelling and edema, which, if in the lungs, can be life threatening).<br>Because of these two things, many in the medical field assume that salt must be bad for you and hence strongly urge patients to avoid it (to the point you often see an elderly patient who loves her salt be aggressively pushed into abandoning it). Unfortunately, the logic behind those two arguments logic is less solid than it appears.<br>Blood Pressure

Many things in medicine resulted from what approach to patient care was the most profitable, not the most helpful. In turn, since recurring revenue is a foundational principle of successful businesses, a key goal in medicine often ends up being to have as many patients as possible be on lifelong prescriptions.<br>In most cases, the drugs that are developed and approved have real value for specific situations, but those situations are not enough to cover the exorbitant cost it requires to get a drug to market. As a result, once drugs are approved, the industry will gradually come up with reasons to give them to more and more people and in turn quickly arrive at the point where many of their customers have greater harm than benefit from the pharmaceutical.<br>One classic way this is done is by creating a drug that treats a number, asserting that the number has to be within a certain range for someone to be healthy, and then once that is enshrined, narrow and narrow the acceptable range so less and less people are “healthy” and hence need the drug (e.g., this happened with cholesterol once statins were invested). Likewise, this characterizes the history of blood pressure management:

Because of this, many people (particularly the elderly) are frequently pushed to excessively low blood pressures which reduces critical blood perfusion for the organs . This then makes them significantly more likely to get a variety of significant issues (e.g., kidney injuries, cognitive impairment, macular degeneration), the most studied of which is lightheadedness or fainting leading to (often devastating) falls. Additionally, blood pressure medications also often greatly reduce one’s quality of life (e.g., by causing fatigue or erectile dysfunction).<br>Note: for those interested in learning more about the great blood pressure scam (a lot of what we’re taught about blood pressure is less than accurate), it can be read here.

Low Sodium

A corner stone of cementing the blood pressure market has been to make everyone terrified of...