Sodium chloride

Related Terms

Atomic number 11, baking soda, elemental sodium, Na, Na+, NaCl, NaHCO3, natrium (Latin), Natrum muriaticum, normal saline, SaltSticks?, sea salt, sodium acetate, sodium ascorbate, sodium benzoate, sodium bicarbonate, sodium chloride, sodium citrate, sodium lactate, sodium phenylacetate, sodium phosphate, table salt, Thermotabs?.
Note: The information in this monograph is based on meta-analyses and systematic reviews of sodium. Various types of sodium are available (in the diet as well as in medications and industrial sources), but sodium chloride is the main salt used as a source of sodium ions. Other sodium salts are generally used for their ion partners. Thus, sodium benzoate, sodium phenylacetate, sodium ascorbate, sodium acetate, sodium bicarbonate, and other sodium salts are not specifically discussed. This monograph does not cover the use of sodium for nasal irrigation; there is a separate monograph available on this topic.

Background

Table salt (sodium chloride; NaCl) is the most common form of dietary sodium. Other sodium salts exist in the diet, including sodium bicarbonate (baking soda; NaHCO3) and sodium acetate. Sodium is necessary for the function of nerves and muscles, as well as for fluid and electrolyte balance.
In adults, the adequate intake (AI) of sodium is 1.5 grams daily, with a tolerable upper limit (UL) of 2.3 grams daily. Most individuals in North America consume sodium at levels much higher than recommended. Many experts believe that increased salt consumption is a risk factor for the development of high blood pressure. Too much sodium may also contribute to heart disease (stroke, heart failure), kidney disease, osteoporosis, and stomach cancer.
Sodium chloride and other sodium-containing salts may be taken by mouth or injected into the veins to correct electrolyte imbalance. Sodium chloride is also used to help some medicines dissolve in water and as a priming agent for hemodialysis. Baking soda may be used to evaluate parathyroid gland function in people with a specific chromosome disorder (22q11.2 deletion). Concentrated sodium chloride solutions may be inhaled by people with cystic fibrosis to reduce lung complications.
Sodium chloride may improve the taste of foods, and it is commonly added to many dishes. However, sodium may increase the risk of high blood pressure in individuals who are genetically susceptible to this condition. Therefore, the 2010 Dietary Guidelines for Americans recommend that people "reduce intake to 1,500mg" among persons at risk for high blood pressure, diabetes, or kidney disease.
Sodium bicarbonate has been used to treat bleeding gums, sore throats, cankers, mouth sores, and heartburn.
Sodium chloride is used to prevent or treat muscle cramps, fatigue, and other symptoms of perspiration caused by the loss of sodium from sweating.

Evidence Table

These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. GRADE *
These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. GRADE *


Evidence suggests that sodium chloride, sodium acetate, and sodium bicarbonate may be taken by mouth or injected into the veins to treat electrolyte imbalances caused by dehydration, excess sweating, or dangerously high sugar levels (in people with diabetes).

 A


Evidence suggests that sodium chloride, sodium acetate, and sodium bicarbonate may be taken by mouth or injected into the veins to treat electrolyte imbalances caused by dehydration, excess sweating, or dangerously high sugar levels (in people with diabetes).

 A


Evidence suggests that sodium bicarbonate may increase exercise performance. However, the positive benefits may be due to bicarbonate, not sodium. Further research is needed before a firm conclusion can be made.

 C


Evidence suggests that sodium bicarbonate may increase exercise performance. However, the positive benefits may be due to bicarbonate, not sodium. Further research is needed before a firm conclusion can be made.

 C


Preliminary evidence suggests that sodium may help treat exercise-induced encephalopathy (brain dysfunction). Marathon runners may have too low concentrations of sodium in their urine, which can lead to brain dysfunction due to excessive fluid intake and decreased urine production. Limited research suggests that 3% sodium chloride solutions may prevent this effect. Additional research is needed before a firm conclusion can be made.

 C


Preliminary evidence suggests that sodium may help treat exercise-induced encephalopathy (brain dysfunction). Marathon runners may have too low concentrations of sodium in their urine, which can lead to brain dysfunction due to excessive fluid intake and decreased urine production. Limited research suggests that 3% sodium chloride solutions may prevent this effect. Additional research is needed before a firm conclusion can be made.

 C
* Key to grades

A: Strong scientific evidence for this use
B: Good scientific evidence for this use
C: Unclear scientific evidence for this use
D: Fair scientific evidence for this use (it may not work)
F: Strong scientific evidence against this use (it likley does not work)
* Key to grades

A: Strong scientific evidence for this use
B: Good scientific evidence for this use
C: Unclear scientific evidence for this use
D: Fair scientific evidence for this use (it may not work)
F: Strong scientific evidence against this use (it likley does not work)

Tradition / Theory

The below uses are based on tradition, scientific theories, or limited research. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. There may be other proposed uses that are not listed below.

Dosing

Adults (18 years and older)
Based on the dietary reference intakes, the adequate intakes for sodium by mouth in adults are as follows: 1.5-2.3 grams daily for males and females aged 9-50 years, 1.3-2.3 grams daily for males and females aged 50-70 years, and 1.2-2.3 grams daily for males and females aged over 70 years.
1-2 liters of 0.45-0.9% sodium chloride has been injected into the vein daily. 3% or 5% sodium chloride injected into the veins at a rate of 100 milliliters per hour has been used, but further details regarding this method are not available at this time. Sodium injected into the veins should only be performed under the advice of a healthcare professional.
For sinus problems, sodium chloride may be added to warm water as part of nasal cleansing therapy or nasal irrigation. A separate Bottom Line monograph is available on this topic.
For sore throats, 0.25-0.5 teaspoons of salt has been dissolved in eight ounces of warm water and gargled.
For clearing lung mucus in people with cystic fibrosis, five milliliters of 7% sodium chloride solution has been inhaled four times daily for two weeks.

Safety

The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.

Interactions

Interactions with Drugs
Sodium may affect blood pressure. Caution is advised in people taking drugs that affect blood pressure.
Sodium may interfere with the way the body processes certain drugs using the liver's cytochrome P450 enzyme system. As a result, the levels of these drugs in the blood may be affected, and the intended effects may be altered. People taking any medications should check the package insert and speak with a qualified healthcare professional, including a pharmacist, about possible interactions.
Sodium may also interact with agents that treat heart conditions, corticosteroids, or diuretics.

Attribution

This information is based on a systematic review of scientific literature edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).

Bibliography

Costill, D. L., Verstappen, F., Kuipers, H., et al. Acid-base balance during repeated bouts of exercise: influence of HCO. Int.J.Sports Med. 1984;5(5):228-231.
Coton, T., Mallaret, C., Coilliot, C., et al. Severe acute ulcerated gastritis induced by salt. Presse Med. 2009;38(3):499-500.
Donaldson, S. H., Bennett, W. D., Zeman, K. L., et al. Mucus clearance and lung function in cystic fibrosis with hypertonic saline. N.Engl.J.Med. 1-19-2006;354(3):241-250.
Frings-Meuthen, P., Buehlmeier, J., Baecker, N., et al. High sodium chloride intake exacerbates immobilization-induced bone resorption and protein losses. J.Appl.Physiol 2011;111(2):537-542.
Horswill, C. A., Costill, D. L., Fink, W. J., et al. Influence of sodium bicarbonate on sprint performance: relationship to dosage. Med.Sci.Sports Exerc. 1988;20(6):566-569.
Lindh, A. M., Peyrebrune, M. C., Ingham, S. A., et al. Sodium bicarbonate improves swimming performance. Int.J.Sports Med. 2008;29(6):519-523.
Matson, L. G. and Tran, Z. V. Effects of sodium bicarbonate ingestion on anaerobic performance: a meta-analytic review. Int.J.Sport Nutr. 1993;3(1):2-28.
McCartney, N., Heigenhauser, G. J., and Jones, N. L. Effects of pH on maximal power output and fatigue during short-term dynamic exercise. J.Appl.Physiol 1983;55(1 Pt 1):225-229.
McNaughton, L. R. Sodium bicarbonate ingestion and its effects on anaerobic exercise of various durations. J.Sports Sci. 1992;10(5):425-435.
McNaughton, L., Dalton, B., and Palmer, G. Sodium bicarbonate can be used as an ergogenic aid in high-intensity, competitive cycle ergometry of 1 h duration. Eur.J.Appl.Physiol Occup.Physiol 1999;80(1):64-69.
Meinders, A. E., Cejka, V., and Robertson, G. L. The antidiuretic action of carbamazepine in man. Clin.Sci.Mol.Med. 1974;47(4):289-299.
Merten, G. J., Burgess, W. P., Gray, L. V., et al. Prevention of contrast-induced nephropathy with sodium bicarbonate: a randomized controlled trial. JAMA 5-19-2004;291(19):2328-2334.
Nagasaki, K., Iwasaki, Y., Ogawa, Y., et al. Evaluation of parathyroid gland function using sodium bicarbonate infusion test for 22q11.2 deletion syndrome. Horm.Res.Paediatr. 2011;75(1):14-18.
Zabala, M., Requena, B., Sanchez-Munoz, C., et al. Effects of sodium bicarbonate ingestion on performance and perceptual responses in a laboratory-simulated BMX cycling qualification series. J.Strength.Cond.Res. 2008;22(5):1645-1653.
Zoungas, S., Ninomiya, T., Huxley, R., et al. Systematic review: sodium bicarbonate treatment regimens for the prevention of contrast-induced nephropathy. Ann.Intern.Med. 11-3-2009;151(9):631-638.