Chloride undersupply and oversupply
What you eat has a big impact on your well-being. Old habits and a careless diet are usually only noticed when physical problems become apparent. The mineral chloride plays a vital role in the proper functioning of our body. Among other things, it influences water balance, nerve conduction, blood pressure and the formation of stomach acid. The minimum requirement for an adult is about 830 mg; according to the German Nutrition Society, 2,300 mg a day is optimal. An oversupply or undersupply can be dangerous for our body. But how does this happen and what are the consequences for my health?
Elevated chloride levels in the body
Possible causes for increased chloride levels are kidney diseases, autoimmune diseases, excessive breathing (hyperventilation), diabetes and chronic diarrhoea. The latter sounds illogical at first, because the body excretes something. But prolonged diarrhoea leads to a loss of hydrogen carbonate (salt of carbonic acid), which is needed to maintain the pH value in the organism. When the pH value in the blood drops below 7.35, this is called hyperacidity (acidosis). The body tries to compensate for the imminent imbalance by reducing chloride excretion. The chloride concentration increases.
The main cause of increased chloride levels, however, is too much salt consumption. A healthy person needs about 2 - 3 grams a day. The World Health Organisation (WHO) recommends a maximum of 5 grams of salt, which corresponds to about one level teaspoon. But if you add salt to your food a lot and often use convenience foods such as packet soups, salad dressings and canned foods, you will quickly exceed this value by twice as much. Even everyday foods contain a lot of salt: two slices of bread for breakfast, each containing 35 g, contain an average of 1 g of salt. According to the consumer advice centre, about 80 per cent of the daily dose comes from processed foods. It is hidden in bread and rolls (27 to 28 percent of salt intake), meat and sausage (15 to 21 percent), dairy products and cheese (10 to 11 percent). (You will find a link to the consumer advice centre at the bottom of the sources).
How does a chloride deficiency occur?
Causes of chloride deficiency include vomiting (loss of chloride in stomach acid), taking dehydration tablets (increased excretion via the urinary tract), kidney weakness or heavy sweating. Athletes in particular lose water and salt through their sweat glands during training. A chloride deficiency can also result from malnutrition, which is especially the case in old people's homes and nursing homes, in eating disorders or in people who are under great pressure of deadlines and time. Deficiencies are rare because of the high salt concentration in our food, but this is precisely why they are often associated with symptoms only at a late stage. A typical symptom is low blood pressure. You can recognise this, among other things, when you feel dizzy or black before your eyes during certain movements.
The consequences of over- or under-supply
A mild chloride deficiency shows hardly any symptoms and leads mainly to thirst. A long-term low chloride level can result in dry skin, muscle cramps, nausea, headaches, dizziness and fatigue. Water retention in the tissues is also possible, because an essential task of sodium chloride is to bind water in the blood. Even brain function can be affected: Supposed "states of confusion" in old age can be indicative of a salt deficiency. To digest protein in food, the body needs a lot of stomach acid. However, with a sodium chloride deficiency, stomach acid production is reduced. If we eat foods containing protein, such as meat, fish, pulses, nuts, eggs and dairy products, we experience digestive problems. The undigested protein rots in the intestine, causing flatulence and diarrhoea. As a result of the putrefaction, intestinal flora disorders or fungal diseases also occur.
A slightly elevated chloride level often resembles the symptoms of a deficiency, such as the existence of an increased feeling of thirst. Chronic over-supply can lead to circulatory problems and increased blood pressure (hypertension), which increases the risk of stroke or heart attack. It is therefore particularly important to adhere to the recommended maximum values for people who are prone to high blood pressure or suffer from kidney and heart diseases.
Examples of alternative foods for elevated salt levels:
| Product | Salt in g (per 100 g) | Alternative | Salt in g (per 100 g) |
|---|---|---|---|
| Salami | 5,4 | Turkey salami | 3,2 |
| Smoked ham | 5,3 | Cooked ham | 2,5 |
| Salmon ham | 6,1 | Turkey breast | 3,1 |
| Gouda (40 % fat) | 2,8 | Fresh cheese (double cream) | 1,0 |
| Gorgonzola (55 % fat) | 3,6 | Camembert (45 % Fett) | 1,7 |
| Feta | 2,4 | Mozarella | 0,5 |
| Salzstangen | 4,5 | Sesamstangen | 0,9 |
In healthy people, excess chloride is excreted via the urinary tract and the sweat glands. Thus, side effects due to an excess supply are rare. However, complaints should not be taken lightly. Nutritional counselling can be helpful. In case of strong deviations of the chloride level, a medical examination is necessary.
The right choice of food
The daily requirement of chloride can easily be met with a balanced mixed diet. Doctors and the media advise you to eat a balanced and varied diet - but what does that actually mean? Balanced means giving preference to foods that are important for the body. In other words, eating more products from this category and eating foods that have no health benefits sparingly. Varied means eating many different foods, i.e. from different categories. Out of habit, we usually fall back on the same foods over and over again. So feel free to try foods from other product groups and try new recipes. Maybe you will even follow in the footsteps of another food culture and experience taste surprises? But take your likes and dislikes seriously, otherwise the fun of eating will quickly fall by the wayside.
Caution during preparation! All minerals, including chloride, are water-soluble. This means that they are partially lost during cooking. With a gentle preparation, for example by steaming, you preserve the valuable ingredients and avoid that later there are more minerals in the cooking water than in the food. Excessive heating can also impair the composition of certain foods and thus their health-promoting effect.
Examination methods at the doctor's
If a chloride deficiency is suspected, a urine test is useful. The chloride value in the urine can be used to determine whether the patient is excreting too much chloride through the kidneys. The amount excreted within 24 hours is measured. The normal value in spontaneous urine is 46 - 168 mmol/l, in 24-hour urine it is 110 - 250 mmol/l. A slight deficiency can be well compensated by an increased salt intake with the diet. Good sources of chloride are also rye, tomatoes, lettuce and celery. In severe cases, an infusion may be necessary.
Your doctor can also check your chloride levels with a blood test. The normal value in the blood serum for adults is approx. 98 - 110 mmol/l. The value is usually measured together with other electrolytes, such as sodium, potassium, calcium and magnesium in the blood serum. Because of diurnal and seasonal fluctuations , the tests are often repeated after a reasonable time. If the values are chronically elevated, increased fluid intake and a low-salt diet are advisable to avoid health consequences. If this is not enough, your doctor can prescribe medication to increase excretion in the urine.
Which salt is good for me?
Many more expensive salts on the market contain additional minerals and trace elements. This is of no advantage to a healthy person without a mineral deficiency. Sea salt differs little in composition from regular table salt. For health reasons, it is recommended to use iodised salt in the kitchen. The mineral iodine is important for the proper functioning of our thyroid gland. If there is an undersupply, too few thyroid hormones are produced and a so-called "goitre" can develop. In 1989, the World Health Organisation (WHO) classified Germany as an iodine deficiency area, whereupon iodisation of table salt was introduced (15 to 25 mg iodine per kilogram salt). As a result, the iodine supply of the population has improved significantly over the last three decades. Not only consumers cook with iodised salt and eat more sea fish, but also the food industry uses it in food preparation (for example bakeries and butcheries).
Unfortunately, flavour enhancers are often added to industrial salts. But you can easily make your own herbal salt! First dry fresh herbs and then grind them. Which you use is up to your personal taste. Then mix in a 3:1 ratio, i.e. three parts salt and one part herbs.
Conclusion
You probably know the saying: The right dose makes the poison. Both low and high chloride levels pose health risks. However, your body can easily compensate for temporary deficiencies or excesses. Before you reduce or increase your salt intake on your own, go to the doctor and have your blood levels checked.
