Sodium on Keto: How Much Salt and Why
Summary: Keto lowers insulin and cuts out most packaged food, so you pass more sodium and eat less of it; official limits sit at 1,500–2,300 mg a day, a large observational study points higher, and your blood pressure and medicines decide which applies to you.
On this page
- Why sodium drops on keto
- What the official bodies say
- The PURE J-curve
- What salt cuts do to blood pressure
- Signs your sodium may be low
- Food sources and the bouillon routine
- Who should ask a doctor first
Why sodium drops on keto
Two things happen at once when you start keto.
- You eat less salt. Bread, crackers, chips, sauces and packaged meals carried most of the salt in a typical diet. On keto they leave the plate.
- You pass more salt. Insulin signals the kidneys to keep sodium. In healthy men, raising insulin while holding blood sugar steady cut how much sodium the kidneys released (DeFronzo et al., 1975). Very low carb eating lowers insulin, which runs that effect the other way.
No highly cited trial has measured this salt loss directly in adults on a ketogenic diet. The mechanism comes from insulin and fasting studies and reviews.
The early drop on the scale is partly this water and salt leaving. See water weight.
KetoDick on this: He gives the same two reasons: salt mostly disappears with processed food and starches, and in ketosis you retain less salt while more water flushes more out (video -dHjt_Bpruk).
What the official bodies say
| Body | Daily sodium for adults | Note |
|---|---|---|
| WHO (2012) | Under 2,000 mg (under 5 g salt) | Global average adult intake in 2021: 4,278 mg |
| NASEM (2019) | Adequate intake 1,500 mg | Cut back if above 2,300 mg |
| American Heart Association | No more than 2,300 mg; ideal 1,500 mg | Says 1,500 may not apply to people who lose a lot of sodium in sweat |
None of these bodies writes a separate number for people on keto. They are written for the general population, most of whom eat well above them.
One mg of sodium is not one mg of salt. Table salt is part sodium, part chloride, which is why WHO gives both "under 2,000 mg sodium" and "under 5 g salt".
The PURE J-curve
The PURE study followed 101,945 people in 17 countries (O'Donnell et al., 2014). People who passed 3–6 g of sodium a day had fewer deaths and heart events than people above or below that range. Plotted, the risk line looks like a "J".
What to know before you lean on it:
- It is observational. It shows a link, not cause. See observational studies vs trials.
- Sodium was estimated from one morning urine sample, not measured over 24 hours.
- Blood pressure still tracked sodium. In the same cohort, the link between sodium and blood pressure was steeper at higher intakes, in people with high blood pressure and in older people (Mente et al., 2014).
A plain-language walkthrough is in the PURE sodium study explained.
What salt cuts do to blood pressure
Trials, not just cohorts, show that lower sodium lowers blood pressure. The size depends on who you are.
| Group (Cochrane review) | Systolic change | Diastolic change |
|---|---|---|
| White adults, normal blood pressure | −1.09 mmHg | +0.03 mmHg |
| White adults, high blood pressure | −5.51 mmHg | −2.88 mmHg |
Source: Graudal et al., 2017. The same review reported that sodium cuts raised renin by 55%, aldosterone by 127%, cholesterol by 2.9% and triglycerides by 6.3%.
Other trials agree on the direction. Modest salt reduction for four weeks or more lowered blood pressure in people with and without hypertension, more in those with it (He, Li & MacGregor, 2013). In the DASH-Sodium feeding trial (n = 412), lower sodium lowered blood pressure on both diets tested (Sacks et al., 2001).
The practical reading: if your blood pressure is normal, the blood-pressure effect of salt is small. If it is high, it matters more, and your doctor should set your target.
Signs your sodium may be low
Low sodium is one common reason for the early-keto symptoms people call keto flu. The signs KetoDick lists for low electrolytes (video lbRPlGZ3Rvw; video -dHjt_Bpruk):
- Headache
- Low energy, including tiredness during ordinary chores or walking
- Muscle cramps
- Irritability
- Heart palpitations
These signs have other causes too. See keto flu and keto headache.
KetoDick on this: He says tiredness from walking or chores in the first weeks is probably electrolytes, not keto itself, and that an electrolyte drink in the morning should help before lunch if that is the cause (video -dHjt_Bpruk).
Food sources and the bouillon routine
Ways people add sodium on keto:
- Salt your food to taste.
- Drink broth or bouillon once or twice a day.
- Eat naturally salty foods: pickles, olives, cured meats, cheese.
On salt types: Pink Himalayan salt is still mostly sodium chloride. More on this in is pink Himalayan salt better? Sports drinks and flavour drops carry less sodium than many people expect; see sports drinks and electrolytes.
KetoDick on this: These are his figures, from his videos, not from the evidence review:
| His routine (video -dHjt_Bpruk) | Amount he gives |
|---|---|
| Daily sodium target | About 5,000 mg |
| Chicken bouillon cups | 3 a day |
| Potassium-chloride salt per cup | 1/4 teaspoon (about 640 mg potassium) |
| Total from the three cups | About 3,300 mg sodium, 1,800 mg potassium |
He bases his 5,000 mg target on a retrospective mortality study he describes in the video. His number sits inside the PURE 3–6 g range and well above the WHO, NASEM and AHA limits. Both positions are stated here; neither is adjusted to fit the other.
He also does not recommend pink Himalayan salt, saying it takes the biggest pile for the same sodium, and moved to kosher or sea salt over concern about overshooting iodine with iodised or light salt in large amounts (video -dHjt_Bpruk). In his 2018 beginners' video the simpler version is salted broth once or twice a day (video UygKGoP_BtA). He also warns that swelling in the hands or feet can mean too much salt (video lbRPlGZ3Rvw).
Broth ideas are in broth for keto flu.
Who should ask a doctor first
Adding salt is a real change for some people. Talk to your doctor before you raise sodium if you:
- Have high blood pressure or take medicine for it. The Cochrane numbers above show salt matters more for you.
- Take water pills (diuretics). They change how your body handles sodium.
- Have kidney disease or heart failure.
- Have type 2 diabetes or pre-diabetes. KetoDick notes many people with these have some kidney impairment and should bring salt changes to their doctor (video lbRPlGZ3Rvw).
- Are pregnant.
More: medications and who should talk to a doctor.
Related
- Guide: Chapter 7: Electrolytes · Potassium and magnesium · Keto flu · Hydration · Observational vs RCT
- Blog: PURE sodium study explained · Is pink Himalayan salt better? · Broth for keto flu · Relative vs absolute risk
- Videos: Electrolytes are absolutely critical · Making sense of electrolytes · Keto basics for beginners
Last verified: 2026-10-31