Q: I was feeling awful for several weeks and went to see my doctor. He had no idea why I felt so terrible.
Eventually, I couldn’t take it anymore and went to the ER. There I was put through a lot of tests. The doctor found I was low in sodium and said I should add salt to my diet. I was surprised and said my primary-care doctor had told me to restrict my salt intake to help control my high blood pressure.
I followed the ER doctor’s advice and started putting salt in my food. Before long, I felt better. Am I making my hypertension worse?
A. Most doctors suggest cutting salt to reduce blood pressure and the risk of stroke or heart attack. The American Heart Association recommends that people should “reduce the amount of sodium in their diet to less than 1,500 mg a day.”
That target is challenging and would require eliminating prepared foods as well as the saltshaker. But it may be extreme. An analysis of research in the American Journal of Hypertension (September 2014) found very low salt consumption and very high sodium intake associated with an increased mortality risk.
When sodium levels fall too low, the condition is called hyponatremia. Symptoms may include fatigue, lethargy, confusion, nausea, headache and memory problems, as well as muscle cramps, weakness or spasms.
Diuretics, certain blood-pressure medications, acid-suppressing drugs, some antidepressants and seizure medications may increase the risk for this serious problem, so sodium levels should be measured periodically. You will need to monitor your blood pressure to tell whether adding salt to food has a negative impact.
Gin-soaked raisins aid arthritis
Q: I am taking gin-soaked raisins for arthritis in my right hand, and it is working really well. Is there any interaction with my meds: hydrochlorothiazide, simvastatin, terazosin and finasteride?
I have been doing the gin/raisins for a month or two, and the relief has been fabulous.
A. We doubt there is an interaction between your medications and the gin-soaked raisins you are using. As long as you stick to the recommended dose of nine raisins a day, you are getting about one drop of alcohol.
On the other hand, there has been no research on this topic, so you may have to be vigilant on how your body is responding.
Monitor low blood pressure
Q: I read a lot about the dangers of high blood pressure, but mine is abnormally low. Is that a problem?
A. If your blood pressure is naturally low, there may be no problem, especially if you don’t have symptoms like dizziness or lightheadedness.
People with cognitive dysfunction who take blood-pressure medicine are at higher risk for dementia if their treated blood pressure goes too low, with systolic pressure under 128 (JAMA Internal Medicine online, March 2, 2015).
In a related commentary, Dutch gerontologists suggest the idea that lower is always better needs to be re-examined. Optimal blood pressure in older people may be a bit higher than the usual target of 120/80.
Reach Joe and Terry Graedon at PeoplesPharmacy.com.