Originally published 6/16/2011, Updated 9/9/2024

Watch the CarbSmart Podcast Episode 18 on YouTube

Listen to the CarbSmart Podcast Episode 18 Here

Show Notes for the Podcast

Serendipity: the faculty or phenomenon of finding valuable or agreeable things not sought for.

It’s funny how events sometimes just sort of compile themselves in a useful shape. A few days ago, I was annoyed when I opened the freezer on the top of my kitchen fridge, and a bag of steak bones, accumulated over many months, fell out at my feet. I figured that was the universe’s way of telling me it was time to make beef broth.

So I put the steak bones in my soup kettle, covered ’em with water, added a little salt and vinegar, and let them simmer for a couple of days. (Yes, a couple of days, on very low heat. A slow cooker would work, too, and wouldn’t heat up the kitchen as much.) But seeing as it’s in the 90s here in Southern Indiana, a nice pot of vegetable beef soup just didn’t sound appealing.

On an entirely different front, I’d had a cluster of annoying minor symptoms recently – tired with no reason, a little queasy, lightheaded when I stood up. When I pointed my toes to stretch, my calves would start to cramp. A little achy, a little headache-y. I’d been irritable, cross for no good reason. Most frightening, I’d made some odd, inexplicable errors in very basic arithmetic, and used the wrong word for simple things – saying “purple” when I meant “green,” that sort of thing – enough times to disturb me.

I wondered if I might be slipping hypothyroid again, and thought maybe bumping up my dose of Armour thyroid might help. I emailed my doctor to inquire.

Then I went outside to read The Art and Science of Low Carbohydrate Living, which had been sitting on my desk for a couple of weeks. It’s great, and I recommend it highly, though I’m only about 85 pages in.

Having seen both authors, Stephen Phinney and Jeff Volek, speak during the Q&A at the Nutrition and Metabolism Society symposium back in April, and having read New Atkins For a New You, I knew they put an emphasis on adding sodium to a low carbohydrate diet, because of the kidney’s increased excretion of sodium when insulin levels drop. (This is why you lose water weight the first few weeks, and why blood pressure drops so fast on a low carbohydrate diet.) Hadn’t really thought much about it, though. I’ve been low carb for so long, I figured my body had worked it out long since.

Sodium Deficiency – hyponatremia

Then I got to the piece in the beginning of The Art and Science of Low Carbohydrate Living about the symptoms of sodium deficiency, also known as hyponatremia. And guess what? It sounded very familiar. I looked up hyponatremia online and found this: Symptoms of hyponatremia include nausea and vomiting, headache, confusion, lethargy, fatigue, appetite loss, restlessness and irritability, muscle weakness, spasms, or cramps, seizures, and decreased consciousness or coma. Sounded all too familiar. (Except for the coma part, thank heaven.)

I got to thinking about it, and it seemed possible I’d been eating less salt than I used to. I’ve been eating less in general since I went on the blood sugar medication Victoza. Too, I haven’t been eating a lot of dishes that have much salt mixed in, soups and stews and the like, because of the hot weather. There’s a limit to how much salt you can shake on your eggs or steak, you know? More than once I’ve substituted Greek yogurt with strawberries and nuts – very little sodium there – for supper. And of course, like everyone else, I sweat more in hot weather, losing sodium that way. Been eating a lot of veggies, so my potassium intake has been up, and potassium and sodium need to balance. All told, it seemed very possible that I had become hyponatremic.

Well, I knew that Volek and Phinney recommended bouillon or broth as a source of sodium, and there I was with a big pot of beef broth – beef broth with considerably less sodium than the commercial variety, I might add. Still, there had to be some way to use the broth.

I flashed on church coffee hours back at dear old Christ Church, in Ridgewood, New Jersey, in my childhood. Along with coffee, tea, and juice, they served a popular light soup, just a 50-50 mixture of beef broth and tomato juice. Indeed, I included it in one of my cookbooks. And tomato juice is fairly high in sodium. So, for that matter, is V-8 Original 100% Vegetable Juice, which I prefer to tomato juice. And I had some in the basement.

So I poured a 4 ounce can of V-8 and a half-cup of my nice beef broth in my little saucepan, and added a teaspoon of Beef Better Than Bouillon. Heated it up, stirred till the bouillon paste dissolved, poured it into a mug, and tried it.

It was lovely. Very tasty, and light enough that it didn’t seem overwhelming in the heat. By my calculations it had more than a gram of sodium, putting it in the range recommended by Volek and Phinney. (1-2 grams of additional sodium per day.) Seven grams of usable carb.

The next day, I found a version I like even better, especially for summer:

4 ounces of chilled V-8
4 ounces of chilled beef broth
1/2 teaspoon of good, mined, ancient sea bed sea salt stirred in.

Added a few dashes of Louisiana hot sauce, too. This is really refreshing – and has over a gram of sodium per serving. I’ve been drinking this once a day. Leaving out the bouillon concentrate drops another gram of carb off of this, by the way – 6 grams usable carb, total.

My whooshy head, queasy stomach, and general bad disposition have cleared up. My energy level is back where it belongs. And – so far – I haven’t had another disconcerting moment of hearing the wrong word come out of my mouth, or messing up embarrassingly easy arithmetic.

So now I know what I’m going to do with all that beef broth.

It seemed very possible that some of you might have the same problem, especially if it’s as warm there as it’s been here. Again, Volek and Phinney consider this sodium supplementation important, and they’re smart and very knowledgeable guys. If the symptoms above ring a bell, you might want to add some salt to your diet daily and see how you feel.

One caution: A poster at my Facebook fan page took me to task for using bouillon concentrate and canned juice. (I am not a purist, and I make no apologies for that.) She said I should just stir a teaspoon of salt into a glass of water and drink it.

Do not do this.

The “salt flush” is a well-known colon-cleansing technique

Why? Because it makes for a terrific intestinal purge, that’s why. The “salt flush” is a well-known colon-cleansing technique. Which is fine, if that’s what you want, but stick close to the bathroom if you do. And you’ll still need to get your sodium somewhere else, ’cause most of it will be running straight through you if you do this. Indeed, it may take some other nutrients with it.

Salt is an essential nutrient – our body needs sodium

The take-home message here is that despite the demonizing of sodium, it is an essential nutrient; without it we die. Low carbohydrate diets both normalize the body’s ability to excrete excess sodium and dramatically reduce our intake of processed foods, baked goods, chips, and other “snack foods,” the biggest sources of sodium in the modern American diet. So pay attention.

Be aware, too, that having elevated blood pressure does not necessarily mean you need a low sodium diet. Clinical studies show that salt restriction raises blood pressure as often as it lowers it. It is possible to be hyponatremic and hypertensive at the same time. If you have high blood pressure, be sure you’re in the minority who are sodium reactive before you decide to restrict your salt.

Anyway, it seemed important to let you all know.

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