Sodium, Blood Pressure, and the Russian Nephrologist
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wabmester
Posts: 2,748 Member
By way of background, I established my goal of losing weight about 10 months ago in order to rid myself of "metabolic syndrome," which was elevating my risk of heart disease and other problems.
I had 4 of the markers of MetS:
Weight loss and low-carb eliminated the first 3. My blood pressure dropped a bit, but it was still elevated. In the past, my doc had ignored it and chalked it up to "white coat syndrome."
I decided to measure it at home, and with weight loss, it normalized in the morning, but it fluctuated a lot, and was high at night. My doc was reluctant to prescribe anything because of my kidney stone risk, so he referred me to a Russian nephrologist who specializes in diagnosing the cause and treating it directly.
I met him today. Wow.
It was like meeting a comrade in the low-carb revolution. We were completing each other's sentences. He was lamenting how hard it was to get good lard because they don't fatten lard hogs like they used to -- too skinny!
Not only is he an iconoclast when it comes to carbs and fat, but he thinks the current advice about reducing sodium is nuts!
He basically says the correlation with high sodium and poor health outcomes is due to the mix of cultures in the US. Europeans, he says, basically evolved in a high-sodium environment. Early Romans: 30g of sodium per day (salty fish). Later Europeans: 70g of sodium per day! (Due to preservation techniques.)
So, he suggests that my mildly high blood pressure may be nothing to worry about, but he ordered some diagnostic tests (more about those when I get results).
And he recommended an experiment to see if we can reduce my BP fluctuations. Ready?
20 grams of sodium per day. With lots of water to keep urine dilute and reduce kidney stone risk.
Crazy, eh?
I had 4 of the markers of MetS:
- high triglycerides
- low HDL
- high fasting glucose
- high blood pressure
Weight loss and low-carb eliminated the first 3. My blood pressure dropped a bit, but it was still elevated. In the past, my doc had ignored it and chalked it up to "white coat syndrome."
I decided to measure it at home, and with weight loss, it normalized in the morning, but it fluctuated a lot, and was high at night. My doc was reluctant to prescribe anything because of my kidney stone risk, so he referred me to a Russian nephrologist who specializes in diagnosing the cause and treating it directly.
I met him today. Wow.
It was like meeting a comrade in the low-carb revolution. We were completing each other's sentences. He was lamenting how hard it was to get good lard because they don't fatten lard hogs like they used to -- too skinny!
Not only is he an iconoclast when it comes to carbs and fat, but he thinks the current advice about reducing sodium is nuts!
He basically says the correlation with high sodium and poor health outcomes is due to the mix of cultures in the US. Europeans, he says, basically evolved in a high-sodium environment. Early Romans: 30g of sodium per day (salty fish). Later Europeans: 70g of sodium per day! (Due to preservation techniques.)
So, he suggests that my mildly high blood pressure may be nothing to worry about, but he ordered some diagnostic tests (more about those when I get results).
And he recommended an experiment to see if we can reduce my BP fluctuations. Ready?
20 grams of sodium per day. With lots of water to keep urine dilute and reduce kidney stone risk.
Crazy, eh?
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sounds legit.
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Yeah, my wife's response was "if you die, at least I'll know who to sue." 4
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Wait, you must be typo-ing...I've done like 10g (grams) sodium for a while, which is in itself just difficult to digest on daily basis. You could have atypical HTN if you do ambulatory blood pressure monitoring; most have high AM BP. Seems "crazy" to up fluid intake if your Na+ is within normal limits [135-145]Keq/L or mmol/L because expanding blood volume would increase blood pressure; seems plausible to increase Na+ to decrease serum calcium to counter Nephrolithiasis (IV normal saline plus loop diuretics are standard).
That's why lab tests are so useful.0 -
He saw my jaw drop when he was giving me the little evolutionary history, so he spelled it out for me. 70 grams. 7-0.
He also says that's why some Asian cultures have such good health: Kimchi.
I'm not doing anything crazy yet. Still waiting for the diagnostics. Also waiting for a post-op stone analysis and metabolic work-up. Now it's time to do some research to see if his story holds up. 0 -
Well, you are using the best preservative at least! The hyperosmolarity & water fluctuations would be too much to handle for many...I got quite sick of it.0
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Wow! That is pretty cool. I'm not sure how I would even get that much sodium a day, unless I ate salt from the salt shaker directly. How did he advise getting all the sodium? I had 5g of Lo-Salt (one of those sodium and potassium mix thingies) yesterday in a glass of water and it was hard to swallow!0
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I asked him that, and he basically recommended lots of preserved products, like sauerkraut, kimchi, pickles, etc. Even with those, you'd need to eat a bunch I think. He recommended gradually ramping up. To, what, 40 pickles a day!?
I'm still recovering from shock. 1 -
It is an interesting train of thought. I know my grandmother takes some sort of anti-sodium medication for high blood pressure, it doesn't seem to do her any good/difference at all. She tried keto recently, went from a regular amount of carbs to 20 per day overnight (bad idea!), combined with these tablets and not eating much salt, she felt like crap and gave up. I told her 20g is very extreme and unnecessary.
I've never heard of those foods - well I have heard of pickles - myself, I prefer olives in brine. Yum!0 -
I use to eat like half a jar of sauerkraut/day. No digestion issues whatsoever but it was just too hard eating that much volume of food each day to stay consistent. Loads of tyramine, precursor to neurotransmitters...why not to combine with mono amine oxidase inhibitors...MAOIs. Also in Cod Liver Oil0
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Lots of great recipes to make your own kimchi online - I have some in my fridge and while I don't love it, both the salt and all those gut healthy probiotics can't be beat!!0
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Holy wow!!!0
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Interesting! And thanks for sharing. The past few weeks, since stopping lisinopril, I've noticed that both my BP and water retention fluctuate with salt intake, and it's been the opposite of what you'd expect with conventional medical advice. I haven't been able to explain it at all.
When I'm at home, adding 1-2 tsp of truffle salt (delicious, I'd highly recommend it btw) to my food over the course of the day, I diurese. A lot.
When I'm eating commercial beef jerky on the road for work, I diurese. A lot.
When I'm eating comparatively low sodium foods and not conciously salting at meal times, I've been retaining. To a point that they were checking me for blood clots again. My feet couldn't fit in my slip-on shoes.
At home, afew tastes of truffle salt later, my shoes were falling off again.1 -
Interesting....
I always wondered what people did when they used salt to preserve their meats (and other things), prior to refrigeration. Then I thought, maybe prior to eating the meat, they would rinse it off??? But still, I imagine the salt would penetrate deep into the meat and wouldn't rinse off too well. But if they were eating a lot of "keto" meals, then that wouldn't be a problem. For example if they didn't have access to flour or other carbs, the "keto" way of eating would flush the salt out.
I love salt, but I don't think I would like 20 grams a day. I'd have to drink too much water and would pee too much to get any work done....
I'm glad you found a doc that understands LC. Has he done the 20 gram a day thing with anybody else? (I hope so)
Dan the Man from Michigan
Keto / Water Fasting / E.A.S.Y. Exercise Program
110 pounds down, 24 to go. 12 months 3 weeks on diet
It's Ketogenic or Bariatric Surgery! How I Found the Ketogenic Diet
Previous Discussions on the LCD & Keto Groups
Blog #10 Keto: Abbreviations, Acronyms & Terminology Used on the LCD & Keto Discussion Groups Updated
DittoDan's Keto Sub Groups Blog
Blog #13 DittoDan's Milestone's, First's And Good Changes Since Starting the Ketogenic Diet Updated
DittoDan's Keto Blogs
How I got Off of Diabetic Prescriptions Drugs Since I Started Keto Updated
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Lol now I'm more confused. If I have low normal blood pressure will lc make it lower? Do I need more sodium to bring it higher or less sodium?0
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It is confusing. I was not only confused. I was flustered. I kept looking at his nurse for a reaction, but she had a face of stone. She reminded me of Nurse Ratched.
He expects that the high salt diet might raise my blood pressure a bit, but he says it will reduce variability.
And that's apparently key. He says there is a significant risk associated with high variability (like a standard deviation of something like 10 points -- mine's not that variable).
And he says that there's not much of a causal link for high blood pressure itself -- it's mostly a correlate with other health issues.
Still digesting. Starting to research....1 -
Funny that his example of evolutionary biology only went as far back as the Romans... That's post agriculture. How much salt did early humans eat?0
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I asked him about earlier periods. Salt intake was probably lower. But his point was that there were intense selective pressures in later periods, and that they were regional. The European techniques for food preservation weren't world wide, but Europeans needed them to survive. If you couldn't tolerate the high-salt food, your genes didn't get passed on.0
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Consider researching Apple Cider Vinegar and Blood Pressure. It has lowered mine by 20 points. Also, consider researching distilled water. After you have your information, share it with your doctor and see if he would recommend this for you.0
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Consider researching Apple Cider Vinegar and Blood Pressure. It has lowered mine by 20 points. Also, consider researching distilled water. After you have your information, share it with your doctor and see if he would recommend this for you.
I was curious about your research on vinegar. Does it have to be Apple Cider vinegar, or can it be Wine Vinegar? Chemically, I can't see that much difference. Yes, the apple variety probably has "probiotics" in it, but is that the good stuff or is the acidic nature of vinegar the key?
I try to drink 1 tablespoon a day in my tea.
This was the link I looked at a few months ago posted by @wabmester:
Vinegar and Insulin Resistance
Thank you,
Dan the Man from Michigan
Keto / Water Fasting / E.A.S.Y. Exercise Program
110 pounds down, 24 to go. 12 months 3 weeks on diet0
