Salt Intake And Water Retention

(John Dulleck) #1

About 10 years ago I was diagnosed with BPPV (Benign paroxysmal positional vertigo), a condition that can trigger attacks of extreme vertigo, often without warning.

One of the main triggers of these attacks is retention of excess water in the body. This can affect the fluid balance and pressure in the body. It can also interfere with your internal equilibrium and balance mechanisms in the inner ear.

Since being diagnosed I have been taking a daily water pill and a mild blood pressure medicine. In addition, I was advised to keep my sodium intake no higher than 1.5- 2 grams per day. These measures have kept my BPPV mostly in check and I only rarely have a any kind of attack, and then, it is only minor and short lived.

I have been doing carnivore for a little over a week and already I have a sense that I might be close to a BPPV event, in fact, I had a very minor event, one that was almost unnoticed, just yesterday. I have been adding small amounts of salt to my meat, eating a fair amount of bacon and then reusing the bacon fat for cooking.

I recently saw a YouTube video for making a homemade keto/carnivore electrolyte that was a mixture that was about 90% salt, 7% potassium, and 3% magnesium. If I were to use the recommended ½ teaspoon in a quart of water, I would have about 80% of my salt allowance without eating a bite of food. And I see in articles and YouTube videos a strong advocacy for using 5 of more grams of salt per day, “to keep blood pressure in check”. That’s a new one for me, I have always heard that increased salt would increase bllod pressure.

What should I do?

(Bacon is a many-splendoured thing) #3

This is a difficult call.

One thing to bear in mind is that elevated insulin, such as from a high-carb diet, slows the excretion of sodium by the kidneys. With insulin back down on a keto or carnivore diet, they return to the normal, faster rate of excreting sodium. So we recommend that people make a bit of extra effort to keep their salt intake up, to avoid symptoms of the keto “flu.” What this means is that you can probably tolerate a bit more salt than before you went carnivore.

Another thing is that long-term carnivores often find over time that they want/need less added salt in their diet. They advise not forcing that, but letting the body guide us, however in your case, you might be okay with less salt right from the beginning.

The advice regarding sodium intake comes from a couple of studies released a few years ago, in which daily sodium intake (from all sources, including added salt and salt already present in food) in the range of 4-6 g associated with the best health outcomes. Risk of bad outcomes drops steeply as sodium intake drops below 4 g/day; it rises more slowly (what they call a J-shaped curve). For more information on this, go to YouTube, find the Low Carb Down Under (LCDU) channel, and search for a couple of presentations by Dr. Andrew Mente, on of the lead investigators on the PURE study.

Yours is a special case, however, so perhaps you should ignore all the advice and do what works best for your body.

Lastly, the matter of vertigo came up recently on this site, and there is a postural manipulation one can do to get the stones that cause this problem back into their proper place in the inner ear. If you do a search on “vertigo,” you should be able to find the reference. If you don’t find anything, look in the main list of categories for our health forum. If you don’t see it, send me a private message and I’ll see about getting you access to it. (You are still fairly new, and the Health forum is locked, to protect sensitive information from Internet searches.)

(KM) #4

The exercise is called the Epley Maneuver.


I eat 2, sometimes a bit more sodium a day myself as far as I know. That’s 5g salt or a bit more. It’s my ideal amount, I feel horrible when it’s much higher.

Whatever is our reason to have this level of sodium intake, obviously that salty electrolyte drink isn’t for us! I never supplement sodium and when I use more processed stuff (sausage and the like but even cheese counts here as it’s salty), my salt intake already moves up. I don’t worry about it going too high as I automatically stop salting my food if I get too much of it and develop a salt aversion, it’s not nice but I immediately drop the problematic items and all is well and at 2g sodium again. Or a bit higher but definitely way below 4-5.

Of course, it not only depends on person but other things, water intake, sweating, temperature…?

Our sodium need on keto may be different from ours on a carbier diet. So many things may change on a woe change. My sodium need did nothing for some reason but it’s atypical as far as I know.
By the way, some carnivores use zero extra salt, I just don’t know if those always eat a huge amount of food that they get my level of sodium from their food… I couldn’t do that, about 20% of my current sodium intake comes from my meat and eggs, the rest is added salt. But some carnivores need to add a lot of extra salt. So it’s quite varied and you should find your sweet spot.

(Robin) #6

I do that! Works!

(KM) #7

I’ve done it too, I was amazed.


Most people aren’t sodium hypersensitive as far as BP goes, but many still notice it when salt is up, I’m one of them. I absolutely hold more water when I use a lot of salt, depending on what diuretic you’re on, you’re in a weird spot. Cranking up salt may just undo the diuretic, OR the diuretic may be completely unnecessary eating near carnivore. If you’re on something mild like HCTZ than it’ll just dump small amounts of water, dose depending. If you’re on something way stronger like a loop diuretic like Lasix, keep an eye on electroyltes since that one will dehydrate people even on high carb diets, let alone keto/carni which has a diuretic effect on it’s own.

On the daily, you don’t need to have 5g or more a day unless your body is telling you that you need that. Everybody holds/releases water differently. Given that your vertigo is apparently tied to sodium retention, I definitely wouldn’t start slamming salt for no reason at all.

(John Dulleck) #9

Thank you all for your answers, they have given me a lot of new information that I was unaware of. I feel much more confident now of finding a sodium balance that will work for me.

Also, I just found a video discussing the importance of potassium and the sodium/potassium balance. This is not exclusively a Keto/Carnivore-focused video, but much of the information applies no matter what WOE a person is practicing.

POTASSIUM: The Most Important Electrolyte Yet an Ignored Epidemic - Dr. Berg

(Bacon is a many-splendoured thing) #10

Just be careful with potassium, since too much can be as much of a problem as too little. Both hyper- and hypokalemia have been known to be fatal, in fact.

(John Dulleck) #11

I tried using electrolytes to stabilize my blood pressure but it really wasn’t working. I tried increasing salt to help me retain water because I was always thirsty, but when I did my BP rose in response.

I felt like I was getting dehydrated because I was always thirsty, and I couldn’t drink enough to be satisfied.

Eating only beef, chicken, a cube of butter a day (average), as much salt as I dared, and lots and lots of water, I was always thirsty and developing constipation that only got worse and worse.

So, I put an end to my carnivore experiment before I needed medical attention to correct things.

I was carnivore for just under a month so transitioning back to the way I was before was no real problem. I am looking now for an eating plan that, given my restrictions, I can stick to.

I want to thank everyone here and especially those who tried to help me get started. I appreciate it very much.

(Bacon is a many-splendoured thing) #12

Do you have any idea of your total salt consumption? Constipation is generally a symptom of low sodium, which a couple of studies have shown is anything below 4 g/day. The healthiest range of sodium intake is 4-6 g/day, which translates to 10-15 g/day of sodium chloride. Lightheadedness, headaches, and dizziness are also symptoms of lack of sodium. If you get your sodium intake into the right range and drink to thirst, you should be fine.

As long as you keep your intake of carbohydrate below 20 g/day, you are likely to be in ketosis. That has some implications, however. The lowered insulin from not eating glucose (carbohydrate) allows the kidneys to return to the normal, faster rate of sodium excretion, so you might need to work a bit harder to keep your sodium intake up (this would be true of a carnivore diet, also). Also, without all that glucose coming in, you are going to be retaining less water (it’s 3 or 4 molecules of water per molecule of glucose) as your glycogen store drops to a more normal level. If you feel you need fibre, you can increase your carbohydrate to 20 g/day of digestible carbs (net carbs), exclusive of fibre.

Lastly, a lot of people feel that a month is not really long enough to fully adapt to a carnivore diet. You might consider whether three months would be a worthwhile commitment. Of course, you can still get a great deal of benefit from a ketogenic diet, as opposed to carb-free/carnivore, so it’s really more about what you feel most comfortable doing.


I got constipated too. That was hard ! I had to stop too. Since then I’ve given up salt, coffee and tea and although I’m not fully Carnivorous I’m close.

Both cramps and constipation are no longer a problem and I feel really well hydrated


Ooh I have a Berroca a day too.


The problem is you’re trying to play by two different sets of rules.

Your doc has you on a diuretic because under normal circumstance that would help, but that advice is wrong in the context of eating keto or especially carnivore because both WOE’s are diuretic by nature, which is why you’re dehydrating yourself. While eating keto or Carni you can’t take diuretics, because your WOE is already doing that for you. You can’t expect a mainstream doctor in most cases to understand that. You also need to throw that salt limitation out the window because again, you’re not going to hold onto them. Doesn’t mean overdo it, but you’re being prescribed stuff based on rules you’re not playing by.

Whether you’re on a weak one like HCTZ or a violent loop diuretic like Lasix, you’re going to electrolyte deplete on them if you’re eating Keto or Carni. Broscience figured out that one a long time ago with bodybuilders in cut cycles with the carbs pulled out.

What kind of diuretc are you taking? You shouldn’t need either, but if a weak one like HCTZ if you feel like you’re retaining, I’d half dose it. If a loop diuretc, you’re simply not going to keep up with how fast that’s dumping your water (and electroytes).