Sodium is one of the most studied nutrients in nutrition science — and also one of the most misunderstood. Recommendations vary, the evidence is nuanced, and the right answer genuinely depends on who you are.

The Current State of Evidence

The Dietary Guidelines for Americans recommend no more than 2,300 mg of sodium per day for most adults, while the American Heart Association (AHA) sets an optimal target of 1,500 mg/day for those at cardiovascular risk (AHA, 2023). The World Health Organization (WHO) similarly recommends less than 2,000 mg/day (WHO, 2023). A 2024 systematic review in Food and Nutrition Research concluded that limiting sodium to approximately 2,000 mg/day is appropriate for most adults, with an optimal intake closer to 1,500 mg/day (Birgisdottir et al., 2024).

As Dr. Norm Campbell, a leading hypertension researcher and former chair of the World Hypertension League, has stated: “The evidence that high sodium intake raises blood pressure and increases the risk of cardiovascular disease is overwhelming and consistent across populations.”

That said, sodium needs are not one-size-fits-all.

When You May Need More Sodium

Heavy Sweaters and Endurance Athletes

Sweat contains significant sodium — anywhere from 200–2,000 mg per liter depending on the individual (Baker et al., 2022). Athletes engaged in prolonged exercise (>60–90 minutes), especially in heat, may require 500–1,000 mg of additional sodium per hour of activity (Lara et al., 2025). A 2022 review in PMC found that sodium intake both before and during prolonged exercise supports hydration status and performance, particularly in heavy sweaters (Baker et al., 2022). For endurance athletes, daily sodium intake may appropriately range from 3,000–5,000 mg/day depending on training volume and sweat rate.

Low Blood Pressure (Hypotension) and Orthostatic Intolerance

For individuals with symptomatic orthostatic hypotension, clinical guidelines recommend increased salt intake as a first-line intervention (Lahrmann et al., 2020). Typical recommendations range from 6,000–10,000 mg of salt per day (approximately 2,300–4,000 mg of sodium), though this should always be supervised by a physician (Lahrmann et al., 2020).

Postural Orthostatic Tachycardia Syndrome (POTS)

POTS is a condition characterized by an abnormal increase in heart rate upon standing, often linked to low blood volume. A 2021 RCT published in the Journal of the American College of Cardiology found that a high sodium intake of approximately 6,900 mg/day over five days significantly improved POTS-associated parameters (Garland et al., 2021). Consensus guidelines recommend 10,000–12,000 mg of salt per day (approximately 4,000–4,700 mg sodium) for POTS patients, in conjunction with high fluid intake (Raj, 2021).

When You May Need Less Sodium

Hypertension

A landmark 2020 meta-analysis in the BMJ confirmed that sodium reduction significantly lowers systolic blood pressure in adults, with greater reductions seen in those with hypertension (Huang et al., 2020). For individuals with high blood pressure, the AHA recommends targeting 1,500 mg/day or less.

Heart Failure

The Heart Failure Society of America recommends 2,000–3,000 mg/day for most heart failure patients, and less than 2,000 mg/day for those with moderate to severe disease (Yancy et al., 2017).

Chronic Kidney Disease (CKD)

For CKD patients, most guidelines recommend 1,500–2,300 mg/day, as excess sodium accelerates kidney damage and worsens blood pressure control (Kalantar-Zadeh et al., 2017).

Why Too Much Sodium Is a Problem for Most People

Excess sodium intake raises blood pressure by increasing fluid retention, which places greater strain on the heart and blood vessels. A 2023 epidemiological and Mendelian randomization analysis in Frontiers in Nutrition found that higher sodium intake was significantly associated with increased risk of both heart failure and hypertension (Zhang et al., 2023). High sodium intake during exercise can also impair hydration by drawing fluid into the bloodstream and increasing thirst without adequately supporting cellular hydration.

It Is Surprisingly Easy to Eat Too Much Sodium

The average American consumes approximately 3,400 mg of sodium per day — nearly 50% above the recommended limit (CDC, 2023). More than 70% of this comes from packaged, processed, and restaurant foods — not the salt shaker (Harnack et al., 2017). The biggest contributors include:

• Restaurant meals (often 1,500–3,000+ mg per entrée)
• Processed meats (deli meats, sausage, bacon)
• Canned soups and vegetables
• Bread and rolls
• Frozen and ready-to-eat meals
• Snack foods (chips, crackers, pretzels)
• Condiments and sauces (soy sauce, ketchup, salad dressings)

Also, be wary of electrolyte supplements. While these are marketed as “improving” hydration, for many people they contain far too much sodium and can have the opposite effect. Do not let the marketing fool you – you may not actually need that amount of sodium.

A Good Range for Most People

For most healthy adults, targeting 1,500–2,300 mg of sodium per day is a reasonable and evidence-supported goal. Practical strategies include:

• Cooking at home more frequently using herbs and spices instead of salt
• Reading nutrition labels and choosing lower-sodium options
• Rinsing canned foods to reduce sodium content by up to 40% or choosing low-sodium options
• Requesting sauces and dressings on the side when dining out or reducing the frequency of restaurant eating - for a deeper look at how restaurant eating affects your nutrition, check out our article “How to Eat at Restaurants.”
• Limiting processed and packaged snack foods

Individualize Your Approach

Sodium needs are highly individual. If you are a competitive endurance athlete, a heavy sweater, or have a condition like POTS or orthostatic hypotension, your needs may be significantly higher than the general recommendation. Conversely, if you have hypertension, heart failure, or kidney disease, a more aggressive restriction is warranted. For most folks, aiming for 1500-2300mg/day is a safe bet.

All the best,

Kevin Rogers, RDN, LD

Founder | Redesign Nutrition

References

Baker, L. B., De Chavez, P. J. D., Ungaro, C. T., et al. (2022). Exercise intensity effects on total sweat electrolyte losses and regional vs. whole-body sweat [Na+], [Cl−], and [K+]. European Journal of Applied Physiology, 119(2), 361–375.

Birgisdottir, B. E., Andersen, R., Arnesen, E. K., et al. (2024). Sodium — a systematic review for Nordic Nutrition Recommendations 2023. Food & Nutrition Research, 68. https://doi.org/10.29219/fnr.v68.10319

Garland, E. M., Gamboa, A., Nwazue, V. C., et al. (2021). Effect of high dietary sodium intake in patients with postural tachycardia syndrome. Journal of the American College of Cardiology, 77(17), 2174–2184.

Harnack, L. J., Cogswell, M. E., Shikany, J. M., et al. (2017). Sources of sodium in US adults from 3 geographic regions. Circulation, 135(19), 1775–1783.

Huang, L., Trieu, K., Yoshimura, S., et al. (2020). Effect of dose and duration of reduction in dietary sodium on blood pressure levels: Systematic review and meta-analysis of randomised trials. BMJ, 368, m315.

Kalantar-Zadeh, K., Fouque, D., & Kopple, J. D. (2017). Dietary sodium in chronic kidney disease. PMC, 2921029.

Lahrmann, H., Cortelli, P., Hilz, M., et al. (2020). Increased salt intake for orthostatic intolerance syndromes. The American Journal of Medicine, 133(12), 1471–1478.

Raj, S. R. (2021). Postural tachycardia syndrome consensus statement. Journals of the American College of Cardiology.

World Health Organization. (2023). Sodium reduction. https://www.who.int/news-room/fact-sheets/detail/sodium-reduction

Yancy, C. W., Jessup, M., Bozkurt, B., et al. (2017). 2017 ACC/AHA/HFSA focused update of the 2013 ACCF/AHA guideline for the management of heart failure. Circulation, 136(6), e137–e161.

Zhang, Y., Li, S., Zheng, X., et al. (2023). Sodium intake and the risk of heart failure and hypertension: Epidemiological and Mendelian randomization analysis. Frontiers in Nutrition, 10, 1263554.