When is a reduced sodium salt not right for me?

For some people, switching to a reduced sodium salt such as LoSalt is not appropriate due to their risk of having higher serum potassium levels.

If you are not sure this information is relevant to you, please check with your doctor.

Our in-house GP Dr Sarah Jarvis offers advice for:

People with Diabetes

People with both type 1 and type 2 diabetes are at risk of chronic kidney disease (CKD). If you are taking certain medications (such as 'ACE inhibitors' like ramipril or lisinopril, or 'sartans' such as candesartan or losartan) which may raise your potassium, you should avoid using reduced sodium alternatives which contain potassium. Likewise, if you have moderate to severe CKD, you should avoid using these alternatives. This caveat applies whether or not you have diabetes and is one which I make in all my recommendations on the website.

For other people with diabetes, there is no specific reason to avoid reduced sodium alternatives which contain potassium. Indeed, several studies have suggested that people with low potassium may be at increased risk of type 2 diabetes (refs 1,2). In addition, a study looking at potassium intake in people with type 2 diabetes and normal renal function showed that higher potassium intake (reflected by higher potassium excretion in the urine) was associated with slower decline in kidney function and lower levels of cardiovascular disease. A wealth of research literature suggests that people with diabetes should reduce their sodium intake because of a clear link to an increased risk of high blood pressure, stroke and heart disease. None of the literature suggests that in people with diabetes and normal kidney function, there is any such link associated with potassium intake.
Heart Disease

Overall, the evidence is that increasing our potassium intake as a population may reduce the number of people who develop heart disease (1), and that increasing the ratio of potassium to sodium is particularly important (2).

However, if you have already had a heart attack or stroke, or if you have high blood pressure, you may be taking a medicine called an ACE inhibitor (such as ramipril, lisinopril etc.) or a Sartan (candesartan, losartan etc.).

Because these medications can cause the potassium levels in your blood to rise, it's important to check with your doctor before you use a reduced sodium alternative such as LoSalt if you've been diagnosed with heart disease.

References
1) www.nih.gov
2) www.ncbi.nlm.nih.gov
Chronic Kidney Disease

Your kidneys play a hugely important role in keeping your body's levels of salts, like sodium and potassium, stable. As you get older your kidneys naturally become less efficient. As part of this, your kidneys filter less potassium, and this increases the risk of high potassium levels in your bloodstream (1). Medical conditions such as diabetes and kidney scarring can also reduce your ability to remove potassium from your system through the kidneys. This reduced function of the kidneys is known as Chronic Kidney Disease or CKD.

If you have kidney problems, you may be taking a medicine called an ACE inhibitor (such as ramipril, lisinopril etc.) or a Sartan (candesartan, losartan etc.). These can cause the potassium levels in your system to rise.

Very high levels of potassium in your blood can be dangerous. The World Health Organisation estimates that unless your kidney function is less than 40% of normal (Stage 4 or 5 CKD), you should not need to restrict your potassium intake (2). However, if you are taking an ACE inhibitor or a Sartan, you may be advised to avoid reduced sodium alternatives.

If you have CKD, consult your doctor before taking LoSalt.

References
1) Scientific Advisory Committee on Nurtrition
2) WHO (2009) Potassium in drinking water. Background document for development of WHO guideline for drinking water quality. WHO/HSE/WSH/09.01/7.

When is a reduced sodium salt not right for me?

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