How to replace dietary sodium with alternative seasonings or supplements in patients with hypernatremia or those requiring a low-sodium diet?

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Last updated: April 13, 2025View editorial policy

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From the Guidelines

To replace dietary sodium, potassium-enriched salt substitutes with a composition of 75% sodium chloride and 25% potassium chloride should be recommended to all patients, unless they have advanced kidney disease, are using a potassium supplement, are using a potassium-sparing diuretic, or have another contraindication. This recommendation is based on the most recent and highest quality study, which suggests that potassium-enriched salt substitutes are an effective option for improving consumption levels and reducing blood pressure and the rates of cardiovascular events and deaths 1.

When replacing dietary sodium, it is essential to consider the following:

  • Gradually reduce salt in cooking while increasing alternative seasonings like garlic, onion powder, black pepper, oregano, basil, cumin, and lemon or lime juice
  • Use commercial salt substitutes containing potassium chloride, such as Morton Salt Substitute, Nu-Salt, or No Salt, with caution in patients with kidney problems or those taking certain medications due to their potassium content
  • Experiment with flavor-enhancing acids like vinegar or wine in cooking, and try salt-free seasoning blends like Mrs. Dash
  • Choose fresh or frozen vegetables over canned varieties, read nutrition labels carefully, and rinse canned foods to remove excess sodium

Reducing sodium intake helps lower blood pressure and decreases the risk of heart disease and stroke, as the average person consumes far more than the recommended 2,300mg daily limit 1. It is crucial to note that patients with advanced kidney disease, those using potassium supplements, or those using potassium-sparing diuretics may require alternative approaches to sodium reduction, and their healthcare provider should be consulted for personalized guidance 1.

From the Research

Replacing Dietary Sodium

To replace dietary sodium, several options can be considered:

  • Using salt-free seasonings, as discussed in the study 2, which highlights the availability of various salt-free seasoning mixtures that can add flavor to food without adding sodium.
  • Replacing garlic salt and onion salt with garlic powder and onion powder, as mentioned in the study 2, which can help reduce sodium intake.
  • Reading food labels carefully to identify hidden sources of sodium, as noted in the study 2, which emphasizes the importance of being a dedicated shopper to find low-sodium options.
  • Exploring alternative seasoning options, such as those offered by companies like Mrs. Dash, which is mentioned in the study 2 as a popular choice for salt-free seasonings.

Managing Sodium Intake

Managing sodium intake is crucial, especially for individuals with certain health conditions, such as chronic kidney disease. The studies 3, 4, 5, and 6 discuss the importance of managing sodium intake in the context of hypertension, heart failure, and chronic kidney disease, although they do not directly address replacing dietary sodium. However, they highlight the importance of careful management of sodium intake and the use of medications such as ACE inhibitors and ARBs to manage related health conditions.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Notes from the CKD kitchen: a variety of salt-free seasonings.

Journal of renal nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation, 2007

Research

ACE inhibitors and ARBs: Managing potassium and renal function.

Cleveland Clinic journal of medicine, 2019

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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