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Originally published Sunday, August 31, 2014 at 6:18 AM

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Doctor prescribes more salt in patient’s diet

Public-health organizations have all recommended limiting salt intake in order to reduce high blood pressure, but sometimes these cuts can be too much.

Syndicated columnists


Q. I cut my salt intake many years ago, just for good health. Now I have low sodium in my blood and suffer from low blood pressure and fainting spells.

When I needed surgery, the surgeon was concerned about my low sodium level and its effect on healing. I have had three doctors advise me to eat more salt! How can this be?

A. Public-health organizations like the Centers for Disease Control and Prevention, the American Heart Association and the Food and Drug Administration all have recommended that people limit salt intake to reduce the risk of high blood pressure, heart and kidney disease and stroke. Guidelines suggest that most middle-aged people should not exceed 1,500 mg of sodium daily. That’s less than a teaspoon of salt daily.

A recent study in The New England Journal of Medicine (Aug. 14, 2014) involving 17 countries and more than 100,000 participants determined that fewer than 4 percent achieved a sodium intake in that range.

A daily intake of 3,000 to 6,000 mg of sodium a day “was associated with a lower risk of death and cardiovascular events (heart attacks, strokes) than was either a higher or lower estimated level of intake.”

When sodium levels are too low, stress hormones kick in to conserve this vital mineral. That can have negative health consequences. You should follow your doctor’s advice to get a bit more salt in your diet.

Q. My vitamin D level was low, so my doctor prescribed vitamin D-2 in a dose of 50,000 IU once a week. Within a day, I was experiencing terrible nausea and heartburn.

It took a couple of weeks for me to figure out the pill was causing my reflux. I never suffered from it before. Is there a good way to get enough vitamin D without causing such misery?

A. Although doctors frequently prescribe a once-weekly dose of 50,000 IU of vitamin D-2, some readers report side effects from this formulation. Don’t ignore low levels of this nutrient, though, because deficiency is associated with arthritis, asthma, cancer, infections, depression, diabetes and dementia.

Sharing this information with your doctor should help the two of you reach a decision about the best way for you to replenish this essential vitamin.

Q. I am utterly confused about aspirin. I read recently that the FDA discouraged the use of aspirin to prevent heart attacks. Now I read that regular aspirin use lowers the risk of cancer. So, should people take aspirin or not?

A. This spring the FDA determined that aspirin should not be used to prevent a first heart attack. According to the agency, the benefit is too low and the risk of internal bleeding is too high.

More recently, an analysis of 200 aspirin studies found that a daily dose of this old drug can significantly lower the risk of several common cancers (Annals of Oncology online, Aug. 5, 2014). The researchers concluded that the benefits outweigh the harms when it comes to cancer prevention, especially in high-risk individuals. Please discuss your individual risks with your primary-care provider.

In their column, Joe and Teresa Graedon answer letters from readers. Write to them in care of Features Syndicate, 300 W. 57th St., 15th floor, New York, NY 10019 or via their website:

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