Salt has been vilified as a leading cause of high blood pressure, so many doctors prescribe a low sodium lifestyle, but since salt is an essential nutrient that cannot be produced by the body, going too low can create its own set of problems.

There exists a correlation between salt consumption and stress (contrary to popular belief – especially among doctors). While the hazards of a high-sodium diet are well-documented (and most Americans eat too much), insufficient sodium intake can pose its own health risks, particularly concerning stress. Salt plays a pivotal role in expelling cortisol from the body, a hormone associated with stress.

A study unveiled that higher salt consumption corresponds to increased levels of cortisol in urine and reduced levels of cortisol in the bloodstream, showing a mechanism to assist the body in purging cortisol. Consequently, restricting sodium intake could potentially elevate circulating cortisol levels.

Many healthcare practitioners advocate for low-sodium diets for health purposes. However, inadequate salt consumption may impede cortisol elimination from the bloodstream. Sodium aids in eliminating the stress hormone from the body, and its avoidance could result in consistently heightened blood cortisol levels. If left unaddressed, elevated cortisol levels can trigger a range of distressing symptoms and potentially severe complications. Many individuals experience symptoms of heightened or dysregulated cortisol due to life stressors, and abstaining from salt could exacerbate the situation.

Cortisol, an essential steroid hormone produced by the adrenal gland in response to stress, is often dubbed the stress hormone. It is released in larger quantities during the fight-or-flight response to stressors, aiding in the release of stored glucose for energy during perceived threats. Despite its role in stress response, cortisol serves various vital functions, including blood sugar regulation, metabolism management, inflammation control, and regulation of the sleep-wake cycle. While crucial, prolonged high cortisol levels can negatively impact health, leading to weight gain, high blood pressure, and weakened immune function.

Salt and sodium are often used interchangeably, yet they differ significantly. Sodium, a mineral found in various foods, is crucial for proper bodily function. Salt, on the other hand, is a compound comprising sodium and chloride. Sodium, an essential mineral, helps regulate fluid balance in the body, maintain normal nerve and muscle function, and facilitate nutrient absorption and transportation. Since the body cannot produce sodium independently, it must be obtained from dietary sources, with salt being the primary source.

The above 2020 study’s findings are not novel. An earlier study from the same year found that a high-salt diet led to decreased urinary aldosterone excretion and increased urinary cortisol and cortisone excretion compared to a low-salt diet. In 2013, research published in Cell Metabolism concluded that a high-salt diet increased cortisol excretion in humans. Moreover, a study from 2003 in The Journal of Clinical Endocrinology and Metabolism demonstrated that dietary salt loading increased urinary free cortisol excretion in healthy subjects, while sodium restriction decreased it. Prior to that, a 1998 study reached a similar conclusion.

While further research is warranted to fully comprehend the relationship between salt intake and cortisol excretion, the 2020 study raises pertinent considerations. Elevated dietary sodium intake may yield false positives in urinary-free cortisol excretion tests, and low-sodium diets may yield inaccurate cortisol blood test results. Additionally, low-sodium diets may elevate cortisol levels, whereas integrating high-quality sodium sources into one’s diet may offer benefits in cortisol regulation.

So what is the range to shoot for? Well, everyone is different, so you should talk to a medical professional who knows your particular situation and is well-versed in sodium as a nutrient. Most MDs won’t be able to help you because they have had little to no training in nutrition, but a functional medicine practitioner and most naturopaths should have a good idea of what to recommend.

The recommended intake is 2,300 mg/day, but again, the real number varies between people based on size, gender, activity level, metabolism, and many other factors. Most Americans get 3,500-4200 mg/day if they are eating the Standard American Diet (SAD). The problem with this isn’t necessarily the amount of sodium, but more the source of sodium because most of that is from table salt.

The best source of salt is “Real Salt” from Utah, due to its high concentration of minerals and low processing. The second best is pink Himalayan salt, and third place is sea salt. A distant last place is table salt, so that is to be avoided whenever possible. I bring a small salt shaker with me every time I know I’m eating away from home so I can use my own salt.

In addition to consuming high-quality salt, certain foods can help lower cortisol levels by reducing inflammation. Dark chocolate, berries, fatty fish, nuts, leafy greens, fermented foods, herbal teas, and ashwagandha are among the foods known for their anti-inflammatory properties and cortisol-lowering effects. However, individuals should exercise caution with ashwagandha, as it may be (rarely) unsuitable for certain individuals and any changes in diet or supplementation should always be discussed with a qualified healthcare professional.