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Pass The Bananas With The Salt: How The Sodium-Potassium Ratio Affects Your Adrenal Glands, Thyroid And Heart

mother feeding baby girlMany disorders, autoimmune and otherwise, are thought to be caused, at least in part, by an imbalance of vitamins, minerals and/or biochemicals within the body.  While such an imbalance rarely tells the entire story, in many cases it can be implicated as part of the problem.  Below we examine the issue of whether a disproportionate sodium-potassium ratio may be responsible for certain aspects of autoimmune disease.

What is the sodium-potassium ratio and why is it important to monitor intake of these two minerals?

The sodium-potassium ratio is a measure comparing the levels of sodium and potassium in the body.  It is most often considered in terms of daily dietary intake, although it may also be measured in urine, blood and hair, and may be expressed in relation to the amounts in one’s cells rather than in one’s diet.

Because both of these minerals play very important and prominent roles in many aspects of normal functioning (including being essential to the cardiac and nervous systems), the amounts taken in and retained by the body must be maintained within limits in order to promote healthy living.  Furthermore, a sodium-potassium ratio that is too large or too small may produce certain pathological conditions that can lead to health concerns, such as problems with the cardiovascular system and adrenal glands.

An article on the MSN healthy living website, while off on some of the recommended levels, provides a good overview on the importance of balanced consumption, and offers a table with relevant information for a wide variety of foods.  The hope is that Americans will learn to gradually correct their diets, reducing sodium intake while increasing dietary potassium, thus restoring their bodies to more natural levels compatible with healthy living.

How does a high or low sodium-potassium ratio impact autoimmune conditions?

While it does not appear that much has been studied regarding a low sodium-potassium ratio, it seems clear that there is definitely a negative effect on heart health and an increased risk for cardiovascular disease (and overall mortality) in those with a sodium-potassium ratio that is too high, as detailed in this Rotterdam study write-up from NIH.  Other research has suggested a connection between these levels and certain types of cancer.

As for autoimmune disease in particular, there is not much official information, though both adrenal disease and thyroid disease were cited by sources as likely being the result, at least partially, of an unbalanced ratio.  Such suggestions do make sense clinically, as the adrenal glands are directly involved in sodium and potassium regulation, and an imbalance of the two is thought to indirectly contribute to some arthritic conditions.  And if not direct contributors to disease itself, sodium and potassium levels are still important indicators used in the diagnosis of adrenal conditions such as Addison’s disease.

There is one site, operated by a single clinician, that goes into great detail about both high and low ratios, though these are largely professional opinions rather than evidence-based findings, and the reader is cautioned that many statements are beyond those accepted by the medical community.  Still, for those looking for a comprehensive (if somewhat dubious) source of information, this seems a good place to start.

Interestingly, there seems to be significant information on sodium-potassium ratio disruptions in canines, indicating that this is likely recognized by veterinarians as a more common problem in dogs.  Of course, such findings go beyond the scope or concern of this article.

What is the ideal level and what is an easy way to monitor the ratio? Should the ratio be estimated from diet over a day’s time or from diet over the course of a week?

According to dietary guidelines, the ideal sodium intake is 1,500 – 2,300 mg/day, depending on current disorders such as diabetes or heart disease, while 4,700 mg/day is the recommended amount of potassium.

This results in an ideal sodium-potassium ratio of between approximately 1:2 and 1:3, meaning that one’s sodium intake, even under healthy conditions, should never be more than two thirds that of potassium.  It should be cautioned that several online sources confuse and reverse the ratio, stating that it should be between 2:1 and 3:1(or other figures), rather than the opposite.  This is obviously crucial to understanding and implementing the correct diet, and should be examined carefully before any action is taken.

Unfortunately, owing to a lack of fruits and vegetables in the average diet, combined with high levels of consumption of processed foods (containing tons of sodium), these target levels are met by very few people in the U.S.  For this reason, correcting the imbalance has become a major focus for some researchers and clinicians.

As to how best to measure these levels, it is important to understand that dietary recollection is merely an estimate of one’s intake, and not a good way of getting precise data.  For this reason, it is important to record such intake for more than just one day, so that a sense of the average daily consumption can be appreciated.  The more days such information is recorded, the more helpful the data may be in narrowing the probable sodium-potassium ratio range.

Having said this, it is probably not necessary to do this for more than a couple of weeks, assuming diet does not change radically from week to week.  However, your doctor or nutritionist should be consulted for more information on how best to accomplish accurate reporting.

Questions for your doctor:

  • Do you believe that the sodium-potassium ratio could be having a negative impact on my autoimmune conditions?
  • Where can I find more legitimate information on this topic?
  • Should I see a nutritionist to get a sense of the types and amounts of foods I should be eating in order to correct any imbalance?
  • Should I consider using salt substitutes (such as potassium chloride) to lower my sodium intake and possibly raise my potassium intake?
  • What is the best way to measure sodium-potassium ratio – diet, urine, blood, hair or another way?


About the Author
Dr. Rothbard is a professional medical writer and consultant based in New York City, specializing in medical education articles targeted at a variety of audiences, from children through clinicians.  After leaving medicine, he worked as a biology and medical science educator for several years, before deciding to pursue writing full-time.  He may be reached at

This blog post was originally published by, written by Dr. Rothbard, and first published on Aug 5, 2013.

This post contains the opinions of the author. Autoimmune Association is not a medical practice and does not provide medical advice, diagnosis, or treatment. It is your responsibility to seek diagnosis, treatment, and advice from qualified providers based on your condition and particular circumstances. Autoimmune Association does not endorse nor recommend any products, practices, treatment methods, tests, physicians, service providers, procedures, clinical trials, opinions or information available on this website. Your use of the website is subject to our Privacy Policy.

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