Keto made easy

Tired on Keto? Sodium, Potassium and the Bouillon Routine, With the Salt Measured Out

2018-05-02

In this video

A 21-minute Facebook broadcast from January 2018, uploaded in May. People were worn out after the holidays, and my answer was electrolytes.

Watching this in 2026

The demo is still the best thing in it. Putting 3,000 mg of each salt in a dish shows in two seconds why "I salt my food" isn't a plan. I would keep that, and the bouillon routine, which is cheap and easy.

The sodium target is where I'd slow down. I gave 5,000 mg as if it were settled. It isn't, and the reasons matter if you have high blood pressure.

The claim worth unpacking: is 5,000 mg of sodium optimal?

The study I described sounds most like PURE (O'Donnell et al., 2014). It followed 101,945 people in 17 countries and found 3–6 g of sodium a day associated with lower death and cardiovascular events than intakes above or below. My 5,000 mg sits inside that range.

Two things about PURE. It's observational, so it shows an association, not cause. And it estimated each person's sodium from a single morning spot urine, which is a rough measure.

The reference bodies land much lower:

The trial data on blood pressure sit between the two camps. In the Cochrane review by Graudal et al., 2017, cutting sodium lowered systolic pressure by 1.09 mmHg in white people with normal blood pressure, and by 5.51 mmHg in white people with hypertension. It also raised renin by 55% and aldosterone by 127%. So salt reduction matters far more if you have high blood pressure, which is roughly the line I drew in the video.

My "ketosis makes you hold less salt" point has partial support. Insulin reduces how much sodium your kidneys excrete (DeFronzo et al., 1975), so lower insulin plausibly means more goes out. No highly cited trial has measured it directly on a ketogenic diet.

Potassium: my number vs the current one

I called 4,700 mg the potassium RDA. The 2019 National Academies figures are an adequate intake of 2,600 mg a day for women and 3,400 mg for men, with no upper limit set (NASEM, 2019). For most women watching, my target was well above the current reference.

Potassium salt substitutes have good trial data. In SSaSS (Neal et al., 2021), 20,995 people in rural China who used a potassium-enriched salt substitute had fewer strokes, fewer major cardiovascular events and lower death rates, with no significant difference in serious high-potassium events. WHO now suggests these substitutes, except for people at risk of high potassium (WHO).

Who should talk to their doctor before copying this routine

I said the old 3,500 mg limit doesn't apply to you if you're not on blood pressure medication and your doctor hasn't warned you about sodium (video -dHjt_Bpruk). Keep that condition attached. Specifically:

Then vs now

Key points