Why Salt Is Essential for Health — And Why Quality Matters More Than Quantity
Debunking the salt and blood pressure myth, understanding why quality matters, and how to choose clean, mineral-rich salts free of toxins.
For decades, salt has been framed as a dietary villain—blamed for high blood pressure, heart disease, and poor cardiovascular health. Public health messaging has reinforced the idea that less salt is always better, while “low-sodium” labels have become synonymous with healthy choices.
But this narrative is built on outdated assumptions and oversimplified interpretations of early research.
Salt is not a toxin. It is a foundational mineral—essential for hydration, nerve signaling, muscle contraction, digestion, hormone regulation, and cardiovascular balance. Your body is equipped with sophisticated regulatory systems, particularly the kidneys, that tightly control sodium levels under normal physiological conditions.
The real issue is not salt itself—but context.
Modern diets combine refined, mineral-stripped salt with ultra-processed foods, excess sugar, chronic stress, and widespread nutrient deficiencies. At the same time, many people are unknowingly under-consuming sodium while sweating more, restricting carbohydrates, or living in a state of chronic physiological stress—conditions that increase mineral demand.
To further complicate matters, modern environmental pollution has introduced a new variable: even “natural” salts can contain heavy metals and microplastics, making salt quality just as important as quantity.
This article breaks down:
Why salt was incorrectly blamed for hypertension
Who is actually salt-sensitive—and who is not
The real drivers of high blood pressure and cardiovascular strain
Why low sodium intake can backfire metabolically
How refined salt differs from unrefined, mineral-rich salt
What to look for to avoid contaminated salts
Understanding salt through a regulatory, systems-based lens allows us to move beyond fear and restriction—and toward informed, individualized choices that support long-term health.
Debunking the Myth: Salt and High Blood Pressure
The belief that salt is a primary driver of high blood pressure has been repeated for decades, yet it rests on a narrow interpretation of early population studies and public health campaigns that failed to account for physiological regulation and individual variability (1,2).
Blood pressure is not governed by sodium intake alone. In healthy individuals, sodium levels are tightly regulated by the kidneys through hormonal feedback and renal excretion. When sodium intake increases, excess sodium is excreted in the urine. When intake drops, sodium is conserved to maintain circulation, nerve signaling, and cellular hydration (2,6).
Large reviews of the literature show that only a subset of the population—roughly 20 to 25 percent—is truly salt-sensitive, meaning blood pressure rises meaningfully with higher sodium intake (2,3). Salt sensitivity is more common in individuals with metabolic dysfunction, insulin resistance, chronic inflammation, kidney disease, or advanced age (6,15).
For most people with intact kidney function and metabolic health, sodium intake does not produce sustained elevations in blood pressure (3,6). In these individuals, blood pressure is far more strongly influenced by blood sugar instability, chronic stress, sleep disruption, inflammation, and micronutrient imbalance (13,15).
Importantly, aggressive sodium restriction can backfire. Very low sodium intake has been associated with increased insulin resistance, unfavorable lipid changes, activation of stress hormones, higher heart rate, and increased cardiovascular events (4,5,6,7).
Salt, therefore, is not inherently dangerous. The clinically relevant questions are who is salt-sensitive, what the broader metabolic context is, and whether sodium intake is supported by adequate mineral balance.
When these factors are examined, it becomes clear that blood pressure regulation depends far more on metabolic, hormonal, neurological, and environmental inputs than on sodium intake alone.
The Dangers of Low Sodium Intake
Salt restriction is often presented as harmless or protective, yet inadequate sodium intake disrupts multiple regulatory systems that are foundational to metabolic stability, cardiovascular function, and neurological health (4,11). Rather than producing balance, chronic sodium insufficiency pushes the body into a compensatory stress state that prioritizes short-term survival over long-term regulation.
Sodium is the primary extracellular electrolyte. It governs fluid balance between cells and blood vessels, supports nerve impulse transmission, and enables normal muscle contraction. Adequate sodium is also required to maintain plasma volume and effective circulation. When sodium intake drops too low, blood volume contracts, perfusion becomes less efficient, and the body responds by activating stress-based hormonal pathways to preserve blood pressure and circulation (4,7).
How Low Sodium Disrupts Regulation
When sodium intake is insufficient, the body initiates survival-driven adaptations rather than achieving balance. These responses are not benign—they represent physiological strain.
These include:
Increased aldosterone and renin signaling to conserve sodium and maintain circulating volume (4)
Elevated stress hormones, including cortisol and catecholamines, to sustain blood pressure and cardiac output (7)
Reduced insulin sensitivity, as stress signaling interferes with normal glucose uptake and metabolic flexibility (4)
Over time, this stress physiology shifts the body toward insulin resistance, impaired energy regulation, and greater cardiovascular load rather than protection.
Metabolic and Cardiovascular Consequences
Low sodium intake has been associated with several downstream effects that directly contradict the assumption that restriction is cardioprotective.
These include:
Increased insulin resistance due to chronic activation of stress pathways (4)
Elevations in LDL cholesterol and triglycerides as lipid metabolism becomes dysregulated (5)
Increased inflammatory signaling, which further impairs vascular function (5)
Higher resting heart rate and cardiovascular strain as the body compensates for reduced plasma volume (7)
Rather than lowering cardiovascular risk, aggressive sodium restriction can amplify it when underlying metabolic and hormonal drivers are left unaddressed (6,11).
Neurological and Physical Symptoms
Because sodium is essential for nerve conduction and cerebral perfusion, deficiency commonly affects neurological and musculoskeletal function.
Early symptoms often reflect impaired circulation and nervous system signaling, including:
Dizziness or lightheadedness, especially when standing, due to reduced blood volume and orthostatic intolerance (9)
Headaches and fatigue as cerebral perfusion becomes less stable (10)
Cognitive fog and poor concentration related to impaired neuronal signaling (9)
Muscle weakness or reduced exercise tolerance due to altered neuromuscular function
With prolonged or more severe depletion, additional risks emerge. Chronic low sodium has been associated with impaired balance, increased fall risk, fractures, sleep disruption, and increased mortality—particularly in older adults and individuals with chronic illness (9,10,12).
Who Is Most Vulnerable to Sodium Depletion
Sodium deficiency is most likely to occur in individuals whose lifestyle or physiology increases mineral loss or demand, including:
Heavy sweaters and endurance athletes who lose large amounts of sodium through perspiration (10)
Individuals exercising intensely or using saunas regularly without adequate mineral replacement (10)
Those following low-carbohydrate or ketogenic diets, which reduce insulin-mediated sodium retention (4)
People under chronic psychological or physiological stress, where adrenal and electrolyte demands are higher (7)
In these populations, sodium needs are often higher—not lower—and restriction can worsen fatigue, dizziness, and poor recovery.
Why Blanket Sodium Restriction Backfires
Reducing sodium without evaluating potassium balance, blood sugar regulation, stress load, kidney function, and overall mineral status frequently leads to worsening symptoms rather than improvement (4,6). Symptoms are then misattributed to aging, overtraining, or unrelated conditions rather than recognized as signs of electrolyte imbalance.
This is why sodium intake cannot be assessed in isolation. It must be evaluated within the broader context of electrolyte balance, metabolic health, nervous system regulation, and individual physiology.
What Really Causes High Blood Pressure
Salt is frequently blamed for high blood pressure, but for most individuals it is not the primary driver. Hypertension develops when multiple regulatory systems are stressed simultaneously, overwhelming the body’s ability to maintain vascular balance (2).
Rather than a single cause, elevated blood pressure is most often the result of interacting metabolic, nutritional, neurological, and environmental factors.
Ultra-Processed Foods and Refined Carbohydrates
Diets high in refined carbohydrates, added sugars, and industrial seed oils promote chronic inflammation and blood sugar instability. These metabolic disturbances damage the vascular endothelium and increase sympathetic nervous system activation, both of which contribute to rising blood pressure (13).
Ultra-processed foods are also the dominant source of refined table salt, which lacks buffering minerals and worsens electrolyte imbalance. In this context, sodium is consumed without the mineral cofactors needed for proper regulation (18).
Potassium Deficiency and Electrolyte Imbalance
Sodium does not act alone. It functions in balance with potassium to regulate fluid distribution, vascular tone, and nerve signaling.
When potassium intake is insufficient, sodium regulation becomes impaired. This imbalance promotes fluid retention, increased vascular resistance, and higher blood pressure even when total sodium intake is moderate (14).
Modern diets are typically high in sodium from processed foods and low in potassium from whole plant foods, creating a regulatory mismatch that drives hypertension.
Chronic Stress, Poor Sleep, and Sedentary Lifestyle
Psychological stress and sleep disruption activate the sympathetic nervous system and increase cortisol and adrenaline signaling. These hormones constrict blood vessels, raise heart rate, and elevate blood pressure independent of sodium intake (16).
A sedentary lifestyle further compounds this effect by reducing insulin sensitivity and impairing vascular flexibility. Over time, this creates a persistent state of cardiovascular strain.
Metabolic Dysfunction and Insulin Resistance
Insulin resistance is one of the strongest predictors of hypertension. When insulin signaling is impaired, sodium retention increases, blood vessels stiffen, and inflammatory pathways remain chronically activated (15).
This metabolic environment promotes weight gain, endothelial dysfunction, and progressive elevation of blood pressure, regardless of dietary sodium restriction.
Environmental and Chemical Burden
Environmental toxins add an often-overlooked layer to blood pressure dysregulation. Heavy metals, endocrine disruptors, and industrial pollutants can impair kidney function, disrupt hormonal signaling, and increase oxidative stress within the vascular system (17).
Mercury, lead, and arsenic are particularly harmful, as they interfere with nitric oxide signaling and promote vascular inflammation. Over time, toxin burden increases cardiovascular risk even in individuals following “healthy” diets.
Key Takeaway
High blood pressure is rarely caused by salt alone. It develops when metabolic dysfunction, electrolyte imbalance, chronic stress, poor sleep, inactivity, and environmental exposure converge.
Focusing solely on sodium restriction ignores the broader regulatory context and often delays meaningful improvement.
Why Your Body Needs Salt
Salt isn’t just a seasoning—it’s a vital nutrient. It provides sodium and chloride, two essential electrolytes your body must have to function optimally (2,11).
These minerals play critical roles in:
Maintaining hydration and fluid balance
Sodium regulates water movement inside and outside cells, preserving circulation and cellular function.Powering nerve conduction and muscle contraction
Essential for movement, reflexes, and brain signaling.Supporting healthy blood pressure regulation
In balance with potassium, sodium helps stabilize vascular tone rather than elevate it.Producing stomach acid (HCl)
Required for protein digestion and absorption of minerals such as iron and vitamin B12.Fueling adrenal health and energy production
Sodium supports stress resilience, cortisol regulation, and sustained energy output.
If you eat a clean, whole-food diet, sweat regularly, exercise intensely, or follow a low-carbohydrate lifestyle, your sodium needs are often higher—not lower.
Why Salt Quality Matters
Not all salt is the same. Understanding the difference between unrefined salt and table salt is crucial for both health and taste.
Refined Table Salt: A Modern Mistake
Most conventional table salt—the kind found in processed foods and restaurant shakers—has been heavily processed and altered in ways that strip it of its natural benefits (19).
Stripped of trace minerals
Natural salts contain over 80 essential minerals such as magnesium, potassium, and calcium. Refining removes these, leaving behind only sodium and chloride.Loaded with chemicals
Anti-caking agents and bleaching agents are added to keep salt bright white and free-flowing. These synthetic additives can stress the liver and disrupt the gut microbiome.Contains synthetic iodine
While iodine is crucial for thyroid health, the form added to table salt is poorly absorbed without cofactors such as selenium and zinc. This imbalance can create more problems than it solves.Contributes to an acidic environment
Stripped of its buffering minerals, refined salt tends to shift the body toward acidity, creating a breeding ground for inflammation and chronic disease.
A consistently acidic internal environment can (20):
Weaken the immune system
Increase inflammation, paving the way for conditions such as arthritis or cardiovascular disease
Make it harder for the body to detoxify heavy metals and environmental toxins
Promote fatigue and hormonal imbalance
By contrast, unrefined, mineral-rich salt supports the body’s natural buffering systems, helping maintain a healthier, more alkaline internal environment.
Unrefined, Mineral-Rich Salts: The Natural Choice
Unprocessed salts contain dozens of essential trace minerals that work synergistically with sodium to support full-body health. These minerals help regulate hydration, nerve function, detoxification pathways, and hormone balance.
However, natural does not automatically mean risk-free.
Because unrefined salts are harvested directly from the earth or ocean, they can naturally contain small amounts of heavy metals such as lead, arsenic, or cadmium. While these levels are often low, consistent exposure over time can accumulate—particularly in vulnerable populations such as children, pregnant women, or individuals with chronic illness.
While unrefined salts are far superior to refined table salt, modern environmental pollution has introduced an additional concern: even high-quality salts may contain invisible contaminants, including heavy metals and microplastics (19).
Microplastics and Heavy Metals in Salt
Unrefined salt is often assumed to be inherently clean. However, modern environmental pollution has altered the safety profile of many natural salts, introducing contaminants that were not historically present.
Studies have shown that microplastics are now detectable in the majority of commercial sea salts, reflecting widespread plastic contamination of marine environments (19). These particles are small enough to evade basic filtration and accumulate through repeated, low-level dietary exposure.
In addition to microplastics, heavy metals such as lead, arsenic, and mercury have been identified in some salts, depending on geographic source, harvesting method, and processing controls (17). Because salt is consumed daily and consistently, even low concentrations of these contaminants can contribute to cumulative toxic burden over time.
These exposures matter physiologically.
Microplastics have been shown to interfere with endocrine signaling, promote inflammation, and burden detoxification pathways. Heavy metals can impair kidney function, disrupt nitric oxide signaling, and increase oxidative stress within the vascular system—mechanisms that directly intersect with blood pressure regulation and cardiovascular risk (17).
Importantly, contamination risk is not evenly distributed across all salts. Variability in sourcing, environmental conditions, and post-harvest handling means that two visually similar salts can differ substantially in purity.
This is why third-party testing is essential. Without independent verification, there is no reliable way to assess microplastic load or heavy metal content, regardless of whether a salt is marketed as “natural,” “artisan,” or “unrefined.”
Modern salt quality, therefore, must be evaluated on two levels simultaneously:
Mineral integrity
Contaminant exposure
Mineral richness alone is no longer sufficient. Purity now matters just as much.
Choosing Clean, Mineral-Rich Salt
Once the role of salt quality is understood, the next question becomes how to choose a salt that supports physiology rather than introducing new stressors.
Not all unrefined salts are equal. In a polluted environment, mineral content alone is not sufficient—purity and sourcing now matter just as much.
A clean, health-supportive salt must meet three non-negotiable criteria.
1. Mineral Integrity
A high-quality salt should retain its naturally occurring trace minerals, including magnesium, potassium, and calcium. These minerals influence how sodium is absorbed, distributed, and regulated within the body.
When sodium is consumed in isolation, it is more likely to trigger compensatory hormonal responses. When consumed with its mineral cofactors, it is more likely to support steady hydration, nerve signaling, and vascular regulation (18).
This is especially important for individuals with metabolic stress, adrenal strain, or high mineral turnover from exercise or sweating.
2. Absence of Additives and Processing Chemicals
Clean salt should be free of anti-caking agents, bleaching compounds, flow conditioners, and synthetic additives.
These substances are not inert. They can irritate the gut lining, burden detoxification pathways, and disrupt mineral absorption—undermining the very reason for choosing a higher-quality salt in the first place (18).
Ingredient lists matter. A quality salt should contain one ingredient only: salt.
3. Verified Purity Through Third-Party Testing
Because salt is consumed daily and consistently, even small amounts of contamination can accumulate over time.
Independent testing for heavy metals and microplastics is now essential. Without third-party verification, there is no reliable way to assess purity, regardless of marketing language or geographic origin (17,19).
Clean sourcing, protected harvesting areas, and post-harvest quality control all influence final contaminant load.
Practical Guidance
When selecting a salt for daily use:
Choose unrefined sea salt or mineral salt with documented mineral content
Avoid salts that list additives, whitening agents, or flow aids
Look for third-party testing or published purity analyses
Be cautious of vague claims such as “natural,” “artisan,” or “hand-harvested” without verification
For individuals with higher mineral needs—such as athletes, sauna users, those on low-carbohydrate diets, or people under chronic stress—salt choice can meaningfully influence energy, hydration, and symptom burden.
Selecting a clean, mineral-rich salt is not about culinary preference. It is about reducing avoidable toxin exposure while supporting the body’s regulatory systems.
Don’t Forget Iodine — But Skip the “Iodized Salt”
Iodine is an essential mineral for thyroid health, hormone balance, and metabolic regulation. However, refined table salt is a poor and unreliable way to obtain iodine.
The synthetic iodine added to iodized salt presents several problems:
It is chemically unstable and inconsistently absorbed
It lacks the necessary cofactors—such as selenium, zinc, and vitamin A—required for proper thyroid utilization
Refined salt itself contributes to inflammation and mineral imbalance, undermining thyroid and metabolic health
Rather than relying on iodized salt, iodine is best obtained from whole-food sources, including:
Sea vegetables such as dulse, nori, and kelp
Pasture-raised eggs
Wild-caught seafood such as cod, shrimp, and scallops
When iodine supplementation is needed, it should be guided by clinical context and laboratory assessment, not added indiscriminately.
Signs You May Need More Salt
If you experience any of the following symptoms, it may indicate that you are under-consuming quality salt or lacking the electrolytes your body needs to function properly:
Headaches, especially after sweating or sauna use
Muscle cramps or twitching, particularly at night or post-workout
Dizziness upon standing, including low blood pressure or orthostatic symptoms
Fatigue, especially in the morning or during periods of stress
Intense salt cravings
Insomnia or difficulty staying asleep
Poor recovery after workouts or illness
These symptoms are especially common in:
Athletes and individuals who sweat heavily (10)
People following low-carbohydrate or ketogenic diets, where sodium needs are higher due to reduced insulin-mediated water retention (4)
Individuals under chronic psychological or physiological stress, where mineral depletion is more pronounced (7)
Why These Symptoms Happen
When sodium intake is insufficient, the body struggles to:
Maintain proper hydration and fluid balance
Conduct nerve impulses and support normal muscle contraction
Regulate blood pressure, circulation, and energy production
In response, stress hormone and aldosterone signaling increase in an effort to preserve blood volume and blood pressure. Over time, this compensatory state contributes to fatigue, dizziness, impaired exercise tolerance, disrupted sleep, and increased fall risk rather than improved health (9,10,12).
These symptoms are not random—they are physiological signals of electrolyte imbalance and regulatory strain.
How to Use Salt the Smart Way
Supporting sodium balance is not about indiscriminately adding salt. It is about quality, timing, and physiological context.
Practical strategies include:
Salting food to taste using unrefined, mineral-rich salt (18)
Adding a pinch of quality salt to filtered water, especially around workouts, sauna use, or periods of heavy sweating (10)
Using Quinton Isotonic or Hypertonic for targeted mineral replenishment when clinically appropriate
Considering functional lab testing to evaluate mineral balance, electrolyte status, and iodine needs
Ensuring adequate intake of potassium-rich foods to maintain proper sodium–potassium balance (14)
Used thoughtfully, salt becomes a supportive regulatory input, not a stressor.
Final Thoughts: Salt Is Not the Enemy
Salt is not dangerous—it is foundational for life.
The real danger lies in:
Refined, chemical-laden table salt stripped of its natural mineral matrix
Chronic sodium restriction applied without metabolic or electrolyte context
Poor education around mineral balance, stress physiology, and modern toxin exposure
When you choose the right type of salt—unrefined, mineral-rich, and third-party tested—you support hydration, nervous system regulation, cardiovascular balance, and detoxification while minimizing exposure to hidden contaminants such as microplastics and heavy metals.
At Denver Sports & Holistic Medicine, we help patients restore physiological balance through a comprehensive, root-cause approach that includes:
Functional lab testing to identify mineral and electrolyte imbalances
Nutrient-dense, personalized nutrition strategies to support metabolic health
Targeted mineral therapy for adrenal and cardiovascular regulation
Whole-body detoxification to reduce environmental toxin burden
Nervous system and energy system support to restore resilience
Whether you are optimizing athletic performance, recovering from illness, or supporting long-term metabolic health, upgrading your salt quality may be one of the simplest—and most impactful—changes you can make.
Next Step
If you’re experiencing fatigue, dizziness, muscle cramping, poor exercise recovery, blood pressure fluctuations, or persistent salt cravings, your body may be signaling an underlying electrolyte, metabolic, or adrenal imbalance.
At Denver Sports & Holistic Medicine, we take a functional and integrative approach to assess mineral status, metabolic health, toxin burden, and hormone balance—so symptoms are addressed at the root, not masked.
→ Functional & Integrative Medicine
→ Advanced Functional Lab Testing
You may request a free 15-minute consultation with Dr. Martina Sturm to review your health concerns and outline appropriate next steps within a root-cause, systems-based framework.
Frequently Asked Questions About Salt, Blood Pressure, and Salt Quality
Is salt bad for blood pressure?
Not necessarily. Only a subset of people are salt-sensitive, meaning their blood pressure rises more noticeably with higher sodium intake. For many individuals with healthy kidney function, sodium is tightly regulated, and blood pressure is more strongly influenced by ultra-processed food intake, low potassium levels, chronic stress, poor sleep, and insulin resistance.
What is the difference between table salt and unrefined salt?
Table salt is heavily processed, stripped of naturally occurring trace minerals, and often contains anti-caking agents or other additives. Unrefined salts retain trace minerals that support electrolyte balance and hydration when they are responsibly sourced.
Why does salt quality matter?
Salt is consumed daily and consistently. When it lacks minerals or contains contaminants, it can contribute to electrolyte imbalance and cumulative toxin exposure. Both mineral integrity and purity influence how sodium behaves in the body.
What are microplastics, and why are they a concern in salt?
Microplastics are tiny plastic particles created as plastics break down in the environment. They have been detected in many commercial sea salts and may contribute to inflammation, hormone disruption, and increased detoxification burden over time.
Do I need iodized salt to get enough iodine?
No. The synthetic iodine added to table salt is poorly absorbed and lacks the cofactors needed for proper thyroid utilization. Iodine is better obtained from whole foods or supplementation when clinically appropriate.
What type of salt is best for everyday use?
A high-quality, unrefined salt that retains trace minerals and is free from additives is generally preferred. Purity, sourcing, and testing matter more than marketing claims.
How do I know if I need more salt?
Symptoms such as dizziness, muscle cramping, fatigue, poor exercise recovery, low blood pressure, or salt cravings may indicate inadequate sodium or electrolyte intake, particularly in people who sweat heavily, exercise intensely, or follow low-carbohydrate diets.
Resources
ScienceDirect – The History of the Salt Wars
The American Journal of Medicine – Is Salt a Culprit or an Innocent Bystander in Hypertension? A Hypothesis Challenging the Ancient Paradigm
Cochrane Database of Systematic Reviews – Reduced dietary salt for the prevention of cardiovascular disease: a meta-analysis of randomized controlled trials
PubMed – Low-salt diet increases insulin resistance in healthy subjects
PubMed – Dietary salt restriction increases plasma lipoprotein and inflammatory marker concentrations in hypertensive patients
The Lancet – Associations of urinary sodium excretion with cardiovascular events in individuals with and without hypertension
PMC – Reduced Dietary Sodium Intake Increases Heart Rate: A Meta-Analysis of Randomized Controlled Trials
PMC – Estimated salt intake and risk of atrial fibrillation in a prospective community-based cohort
PubMed – Mild chronic hyponatremia is associated with falls, unsteadiness, and attention deficits
ScienceDirect – Total body sodium depletion without hyponatremia triggers overtraining-like symptoms and sleep disorders
JAMA Cardiology – Reducing Dietary Sodium: The Case for Caution
PubMed – Mild hyponatremia is associated with an increased risk of death in ambulatory adults
Open Heart – The wrong white crystals: not salt but sugar as an aetiological factor in hypertension
PMC – Why Potassium Intake Reduces Blood Pressure
ScienceDirect – Insulin resistance and hypertension: new insights
ScienceDirect – Physical activity, sleep duration, sedentary behavior, and hypertension: a Mendelian randomisation study
Circulation Research – Heavy Metal Exposure and Cardiovascular Disease
PMC – Gourmet Table Salts: The Mineral Composition Showdown
ScienceDirect – Microplastics in European sea salts and exposure through consumer choice
PMC – High dietary salt intake activates inflammatory cascades via Th17 immune cells