Salt - Good, Bad or What?

SALT - GOOD, BAD OR WHAT? One of my first forays into the world of alternative medicine took place soon after my arrival in Japan when I was in my early 20’s. Not feeling particularly energetic and without any helpful feedback from conventional sources, I sought the advice of elderly Japanese man who placed me on a diet. The diet basically consisted of brown rice, beans, vegetables, fermented soybean products like soy sauce and miso, sesame oil and a few, mostly salty condiments.

Some people might recognize this as basic “Macrobiotic” fare. Macrobiotics was a diet and philosphy based on an idealized concept of the traditional Japanese food before the widespread use of milled white rice and foreign dietary influences. I was excited by the idea of feeling better and took up the challenge of changing the way I ate immediately. I remember standing on the train platform waiting to catch the train home after my first meeting with “my advisor”. I pulled out a cheese sandwich I had packed for the ride home and most ceremoniously dumped it in the garbage.

Looking back after over a quarter century of experience, I marvel at the consequences of my enthusiastic embrace of this idea. Admittedly, I will give myself a A for effort, but more importantly, I’d get a D- for common sense and an F for results.

The first 2 weeks were great. My energy increased, I felt light, I slept well... But after that initial honeymoon period of clean eating, the metabolic imbalances of insufficient protein, too many carbohydrates and especially too much salt gradually led to an ever decreasing level of health. My energy started to slide downward, my muscles felt tight and stiff, my emotional and mental outlook became increasingly narrow. Within six months I was a wreck and worst of all I had no understanding of how bad things were. I just wasn’t well enough in any sense of the word to see or evaluate my own condition.

Fortunately, a somewhat crazed American Zen devotee snapped me out of it. I hardly knew him, but through a mutual friend, it was arranged that he be put up at my house for a few days. At one point during his stay, he said to me, “The problem with you is that you aren’t eating any food at all, you are just eating theoretical concepts!” That comment, which I still remember with great clarity and appreciation, was like a lightening bolt, cutting through my dazed state and awakening in me a sense of perspective about my condition.

In retrospect it was a very destructive - and instructive episode in my life. Even after returning to an appropriate balanced diet, some of the symptoms that developed during that half year took years to disappear. Unfortunately, some of them still linger on in a ghost-like fashion, reappearing now and again.

The lessons I did learn have also stayed with me and I have had many occasion to share them with clients over the years. First and foremost, never delegate total responsibility for one’s own health to anyone else, even an “authority”. This is especially so in regard to dietary regimens. There are many ideas and theories, most of which worked for someone at some time, none of which work for everyone. It is important to keep an open mind, a sense of perspective and trust one’s common sense while trying out any diet. It might work marvelously for your best friend and be a disaster for you; and your mother might say you look too thin and pale, but you might feel absolutely fantastic.

Secondly, I experienced firsthand how diet is an extremely powerful tool, for better or for worse, to change one’s state of health and wellbeing. While I have studied and employed many different healing modalities over the years, there is no other tool as fundamental as considering the food a patient eats. It isn’t simply a matter of what is eaten, but also the amount that is eaten, the way it is eaten and, most importantly, the attitude with which it is eaten.

Third on the list is the necessity to consume adequate amounts of appropriate forms of protein. With all the publicity concerning the Atkins, Zone and other low carb diets, this certainly is a secret no longer. (When bakeries around the country are reporting that bread sales are off as much as 40% around the country and RJ’s Diner in downtown Bellows Falls advertises LOW CARB MEALS on the sign in front, you know the idea has taken hold...) Actually, it took me a long time to fully appreciate this particular lesson, but I firmly embrace it and written about it frequently over the years.

Lastly, it is important to respect the effect of salt on one’s health. Either too much or too little can make a critical difference in how one feels. The single most destructive aspect of my dietary adventure back in Japan was the over-consumption of salt. That is why I became so stiff and rigid - both physically and mentally. I was so dried out that it was nearly impossible to muster the energy to bend my legs to climb a flight of stairs.

My youthful “joie do vivre” was replaced by a rigid, narrow mindedness that I could no longer even see what was taking place. True excess salt intake and the fluid imbalances that it causes can also disturb the circulatory system and the function of the heart, resulting in elevated blood pressure, palpitations, headaches and a generalized anxiety.

Over the last 30 or more years, salt intake has become one of the standard tools of conventional medicine to regulate blood pressure. Next time we will explore this issue in greater detail.

PART II

Baseball is by far the most popular spectator sport in Japan - and nothing is followed with greater interest than the national high school tournament played every summer in one the most historical professional league ballparks. During the week or two (I can’t remember clearly how long it goes on anymore) that the teams representing each of the provinces fight it out in the single elimination tournament, the country’s attention is firmly fixed on these adolescent athletes.

Each day promises 3 or 4 consecutive games beginning around 9 am. Just about every office and public place has a TV or radio tuned in to the action. For the Japanese, this tournament is the embodiment of “ganbaru ki” or “fighting spirit”: true amateur athletics played with the intensity of samurai warriors. One might compare it with the Little League world series held every year in Pennsylvania or college basketball’s March Madness tournament, but the high school tournament has much higher skill levels than the former, the absence of the masqueraded professionals of the latter, as well as an intensity and a nearly universal popularity that is unequaled by both of them put together.

For all its appeal, I didn’t find high school baseball the most intriguing spectator sport during my time in Japan. For me, it didn’t have the same allure as the primeval, ritualized sport of Sumo wrestling. These modern day athletes still live by social and athletic traditions that originated several thousand years ago. They are descendants of ancient warriors who, it is said, fought until death.

At the professional level, the 6 major tournaments consist of two weeks of matches, every day beginning with the lowest ranked wrestlers in the morning and ending with the highest around 6 pm. Each wrestler has a precise rank based on his performance history, and that rank is re-evaluated after each tournament. The matches themselves are quite brief, lasting anywhere from a few seconds to two or three minutes - until the opponent is forced outside of a ring or is made to fall on his knee or back.

What takes just as much, or perhaps, even more time are the stylized rituals that the fighters perform. Some take place as a joint presentation when a group or class of wrestles is introduced, others as the two wrestles prepare to face off against each other. To my foreign eyes, they always had an almost mesmerizing effect. Naked except for special silk loin clothes with detachable aprons that display their place of origin and rank, these behemoths slowly perform a series of arm motions and various types of stomps with their legs, all the while maintaining the same expressionless demeanor which is there code of honor.

Compared to the self-aggrandizing, demonstrative athletes of contemporary american sport, Sumo wrestlers are trained to never show a hint of emotion. This is especially so after a match. Whether they have been humiliated by a lower ranked opponent or have won the tournament championship, these fellows never betray any feeling whatsoever.

An integral part of the Sumo ritual is the use of salt. This, no doubt, is due to the fact that one of the four basic principals of Japan’s native Shinto religion is that before praying or approaching a religious shrine, a person must be cleansed through the sprinkling salt and then washing.

Likewise, the Sumo ring, known as a Dohyo, which is a clay platform with a straw circle, is purified with salt and sake each day before each tournament by a tournament referee and a Shinto priest. And before each match, the ring is again ritually cleansed with salt to ward off evil spirits. As the wrestles warm up, stretch and go thru their stylized motions before they face off, they once more grab handfuls of salt, sprinkle it on various body parts to ensure their personal protection and then toss the remainder into the ring .

A similar ritual was performed in Japanese theaters, where salt was sprinkled on the stage before each performance to prevent evil spirits from casting a spell on the actors and ruining the play.

The central role of salt in these rituals is not unique to Sumo or Japan. A fascinating article about salt by Dr. Paul Rosch, many similar examples are given .1

Many people are familiar with the superstition of throwing three pinches of salt over your left shoulder. This was because it was considered so valuable a substance that spilling any was thought to bring on bad luck. The idea was that some evil spirit was behind you causing the accident, and thus throwing salt in its direction would blind it and send it away.

The Biblical covenant of salt gave the rule over Israel to David and his descendants forever, while the Law of Moses required that all offerings contain salt.

Leonardo da Vinci painted an overturned salt dish in in front of Judas which represented an ill omen for the traitorous act. Another example are the ancient Druid rituals performed at Stonehenge that incorporated salt because it was “a symbol of the life-giving fruits of the earth”.

The importance of salt originated not only from its nutritional value as a mineral source, but also from its usefulness in preserving foods for seasons when people would otherwise have starved.

It became so valuable that many societies used salt as a form of currency. The expression "not worth his salt" comes from the practice of trading slaves for salt in Greece. The word “salary” comes from “salis”, the Latin word for salt, with which Roman soldiers were sometimes paid. "Soldier" is a derivative of “sal dare”, meaning “to give salt”. .

Salt was used to seal an agreement or contract, in the way a signature is used today, in many cultures. In Arabic countries, it also signified safety and friendship.

Participants at medieval feasts were seated in order of importance based on the location of the salt dishes. Distinguished guests dined at an elegant elevated banquet table "above the salt." Lesser lights sat "below" in the boondocks in progressively lower trestle type tables.

Indeed, as Rosch points out with the Latin saying “Nil sole et sale utilius”, there is nothing more useful than the sun and the salt.

PART III

For thousands of years, salt has been considered an irreplaceable component of the human diet. Without adequate amounts of salt, people suffered from mineral deficiencies and metabolic disorders. Yet, for the last several decades, instead of being celebrated as the essential, life-giving food that it is, salt has been gained notoriety as a cause for high blood pressure.

Dr Paul J. Rosch, a professor of Medicine and Psychiatry at the New York Medical College has written a fascinating overview of both the history of and our contemporary attitudes towards salt in an article entitled, “Take the Latest Low Sodium Advice With a Grain of Salt”.1

Millions of dollars have been spent on government sponsored salt related research. This generally negative attitude toward salt has been most famously codified by the 1979 "Surgeon General's Report on Health Promotion and Disease Prevention" which identified salt as a major factor in hypertensive conditions. Five years later, a huge government sponsored study concluded that in general societies with higher salt intake would also have higher average blood pressure.

Even more damning was a 1999 study that followed over 20,000 Americans for more than a quarter century. The results were that people who ate more salt “had 32 percent more strokes, a whopping 89 percent more deaths from stroke, 44 percent more heart-attack deaths, and 39 percent more deaths from all causes.”

What is most interesting about this research is that although the statistics were technically correct, the conclusion was actually false. It is a classic example how numbers can be manipulated to prove just about any preconceived opinion.

What an independent review of the data showed was that the correlation of high salt intake and cardiovascular disease was only true for persons who were overweight. If overweight persons were removed from the study, the correlation disappeared. In fact, Michael Alderman, an epidemiologist and past president of the American Society of Hypertension, concluded quite the opposite and wrote that for persons who were not overweight, "the more salt you eat, the less likely you are to die."

While it is undoubtedly true that certain hypertensive persons are sensitive to salt intake, it is simply impossible to conclude that high salt intake is a cause of high blood pressure. For instance, in one of the salt studies, one group of Chinese all from a particular province had the highest salt intake of any group in the study - and very low rate of hypertension. Conversely, another group from Chicago with low salt intake had above average incidences of high blood pressure. Another group, a Brazilian rain forest tribe had low salt levels also had mean blood pressures that ran 20 to 30 points lower than what is considered normal.

The fact of the matter is that while it is possible to manipulate or cherry pick the data to “prove” any number of theories that may contradict each other, restricting salt can also have negative health consequences. For instance, after reviewing data in a study of 3,000 people with relatively moderate hypertension, Dr. Alderman concluded that, “those who consumed the least sodium had the most myocardial infarctions and other cardiovascular complications.”

An article published in the Lancet, a prestigious British medical journal, in 1998 similarly concluded that people “who eat lots of salt live longer than those who avoid it.” The 25% of people who consumed the lowest amounts of salt had a higher risk of death compared with the 25% who consumed the highest amounts of salt (23 deaths per 1,000 compared to 19 per 1000 person-years). Likewise, in an eight-year study of hypertensives in New York, those on low-salt diets had more than four times as many heart attacks as people with normal sodium intake.

Rosch states that reduced salt intake actually has a number negative consequences including: increased levels of renin (an enzyme that is associated with hypertension), increased levels of LDL (Low density lipids - the “bad” type of cholesterol), insulin resistance (the cause of adult onset or “type II) diabetes), reduced sexual activity in men and cause cognitive difficulties and anorexia in the elderly.

Reductionist thinking, that is an attempt to reduce complex phenomena to a single simple factor, is always tempting because it makes things simple. But the human metabolism is too complicated to reduce the cause of cardiovascular disease to a single culprit, be it salt or anything else.

There are many factors that influence blood pressure. For instance, it is known that deficiencies of other minerals such as calcium, potassium, and magnesium, correlate with hypertension. Excessive dietary intake of carbohydrates can also have a similar influence.

Balancing the amounts of sodium, magnesium and potassium can reestablish a healthy blood pressure when it is raised. Sodium, potassium and magnesium also act to regulate fluid balance in the body, allowing nutrients and oxygen to reach necessary destinations within the body.

That is why for anyone concerned about blood pressure, it is important to use a high quality of salt such as Celtic Sea Salt from France or Real Salt from Utah, both of which contain not only sodium chloride, but a plethora of other minerals essential for maintaining a healthy metabolism. Unfortunately, most of the commercial salts commonly available, even those labeled as sea salt or kosher salt, are heated and bleached. This results in a chemically altered, mineral deficient product which, though inexpensive and easy to pour from a shaker, is best avoided.

1 Rosch, Paul J., M.D. “Take the Latest Low Sodium Advice With a Grain of Salt”, Health and Stress newsletter of The American Institute of Stress

Placebo Talk

A while back I received an email from a patient, a conventionally trained medical doctor, telling me that he was feeling a lot better and wondering whether it was necessary to take the remedy I had prescribed. It turns out that a sense of well-being — what the patient referred to as ‘OK-ness’ — had come over him in the midst of our consultation and had not dissipated weeks afterward. He also tacked on the following PS: “This whole experience makes me believe that a placebo-controlled homeopathy study is not possible.” This was a significant realization for him because he has an interest in investigating the outcomes of alternative treatments using standard double-blind experimental methods.

It is not unusual to get similar feedback about the effects of a homeopathic consultation. Sometimes people will make intellectual discoveries about themselves, have little epiphanies about how they experience their illness and their lives, or, as in this particular case, just have a shift in the way they feel. In one case, a young woman whose chief complaint was the absence of her menstrual period, began a period two days after the appointment, before she took the remedy.

This phenomena raises some interesting questions. What was the nature of the ‘healing’ that these patients experienced? Could it be deemed a placebo effect? And, along the lines of the patient’s post script, what is the relationship between homeopathy - or any energy based healing system, for that matter - and placebo controlled studies?

When first learning homeopathy, I was taught that there were certain questions one needed to ask about the patient’s complaints and about their general state of health in order to get the appropriate information that would then be analyzed to find the remedy that ‘fit’ that person. It was a pretty straight forward, linear process of data collection and data processing. The only problem was that for many cases — way too many cases — it didn’t really seem to work.

The problem was that homeopathy is not linear in this way at all. What one is really after is not just a collection of data that can be gathered on a questionnaire or through a set battery of questions. In a sense, it is exactly the opposite type of information — if one wants to call it ‘information’ at all — which is most significant for selecting a remedy.

The most appropriate homeopathic remedy is always found by perceiving what is unique about the patient physically, mentally and emotionally. Homeopaths have given this uniqueness many names over the years: “rare, strange and peculiar”, ‘characteristic nature’, ‘individualized constitutional state’, etc. All of these are terms that point to the fact that fundamentally in homeopathy, what is unique is helpful and what is common is not.

Eventually, what I understood was that by asking a standard set of questions I was in effect limiting my perspective on the type of information that would be gathered — and thereby limit my perspective on the nature of the patient. The more directive and well defined the questions, the narrower the scope of my understanding.

So, I learned to do the opposite — to try to elicit information in a non-directive, open ended manner. This was not something that I thought up or invented, but a number of techniques other homeopaths were already exploring, implementing and disseminating. ‘Non-directive’ means to ask for information in a way that the patient takes the lead and the homeopath follows. It is not being totally passive — with each answer, there is a need to prompt the patient to explore and elaborate on the significant aspects of what was just said.

The prompts are straightforward, often repetitive: “Tell me more.” “Describe it further.” “Tell me about the word ‘X’ ”. And the results can be very effective, often startlingly so. Step by step, the patient follows his or her own expressions in a spiral that penetrates through to the core of their state, revealing that characteristic nature needed to select the appropriate remedy.

As an example, I spoke with a patient this morning who was being seen for a respiratory condition. Something showed up on a test, but there were no symptoms - and no diagnosis. “So, what is the worst thing about it?” “It’s a puzzle”. “A puzzle?” “Everything in my life is joined. Things aren’t separate.” “What do you mean?” “Things fit together, they mesh”. “Tell me more.” “Pulled together, whole & comfortable.” “What is together?” “Not fragmented, not crashing around, in place.” “Describe fragmented.” “Fractious, broken up, not smooth, broken.” “Broken?” “Like broken glass, hard edges, like it was thrown on the floor.”

Odd as it may seem, that sensation of things fitting perfectly together versus fragmentation is the characteristic nature of this person — what is called the ‘vital sensation’. The same sensation can be seen in all aspects of life; it is the lens through which life is perceived. Asking for a dream I was told one from the night before about a party, of friends gathering socially - and the feeling was of connecting with everyone, of everyone being together. Asking for a favorite thing to do, I was told of going out at night, lying down and looking at the stars - and the feeling was of complete oneness with the sky and world, of the absolute absence of fragmentation.

A comprehensive homeopathic consultation can last upwards of 2 hours. As the give and take of the conversation hones in on the vital sensation, the patient often will not only intellectually understand what it is, but also can experience it in a very direct, physical level. This phenomenon is quite similar to that of the most fundamental Buddhist meditation technique, in which the meditator is trained to focus on body sensations.

For the homeopath, bringing the conscious mind of the patient to the vital sensation makes it possible to choose the most appropriate remedy. For the patient, like the meditator, it creates a form of experiential awareness beyond the intellect, that resonates energetically throughout the body.

Experiencing the vital sensation directly can elicit strong emotional reactions, positive, negative, or a combination of both. For some it is akin to an act of purification. For others, it can actually be curative to a greater or lesser degree. Whatever the reaction, it is most definitely not a placebo in the common sense of the word and that is why it is correct to question the value of double-blind studies in homeopathy.

The consultation itself has therapeutic value and, as the patient this morning succinctly put it afterward: “I want to let you know that these conversations with you make me goes places I never otherwise go.”

Inner Logic

Recently, the documentary “Grizzly Man” made it to the top of my movie rental queue (which usually is over 80 flicks long) and into my DVD player. Having read a few reviews beforehand, I was expecting a very different type of film – and I wasn’t expecting it to be such a vivid example of what might be called ‘homeopathic living material medica’. For those of you who haven’t had the opportunity to watch it, “Grizzly Man” chronicles the exploits of Timothy Treadwell who spent parts of 13 years in the Alaskan wilderness communing with grizzly bears. Much of the footage was shot by Treadwell himself featuring numerous encounters he had with a variety of bears (all of whom he had named and with whom he had seemingly developed individualized relationships), along with several solo scenes where he sermonizes on various aspects of his life with the bears and the need to protect them.

Werner Herzog, the German director renowned for his death defying filmmaking adventures, has found a perfect subject for himself: someone whose taste for living on the edge matched his own. He intersperses Treadwell’s videos with his own footage, mostly interviews with Treadwell, people who knew him or various experts who comment on his grizzly exploits.

What is most remarkable is that the man Timothy Treadwell is not at all what one might expect. With the looks of a California surfer and a slightly effeminate and loquacious manner, he is definitely not a classic adventurer or mountain man, not a grizzled reticent recluse living a simple existence close to the land. Nor is he a stereotypical tree-hugging environmentalist dedicated to the cause, an academic immersed in field research or even a backwoods spiritualist seeking to be one with nature. This man appears less a hero and more a fool, a tragic fool.

Or, is he? Treadwell simply is obsessed with grizzly bears. His obsession is founded on an identification with them. Although he certainly admires them and wishes to protect them from the dangers of encroaching civilization, those endeavors are secondary to what really drives him: to be one with the bears, or, even more precisely, to be a bear. Homeopathically speaking, it is clear that he IS one – that is his inner nature. Somewhere residing in his deepest being is this quality of ‘bearness’ presiding over his life.

Now, this might sound like so much new age hokum, but in reality it is a clinically verifiable fact. Time after time I have witnessed in consultation with patients this inner nature – what homeopaths call ‘the source’ – manifest itself. More importantly, this is not an idle philosophical pursuit. I have witnessed homeopathic preparations of made from a person’s source material acting curatively for any number of symptoms and conditions, be they physical, mental or emotional.

All of us have a source. It may be something sexy like an exotic animal or mundane like an obscure mineral, but very very few of us are consciously aware of it. The source is something we live, not think.

What was remarkable about Treadwell was the extent to which he lived his source. In most cases, people have either a powerful attraction or aversion to their source material. That is, the little boy in need of a spider venom spontaneously draws big black tarantulas when I give him crayons and paper during a consultation; a woman in need of snake venom has horrifying dreams of them crawling in her bed; a person who benefited immensely from a homeopathic preparation of diamond has a tremendous fascination with crystals; a young woman who was helped by a remedy made from a type of fungus has a strong craving for mushrooms. This phenomenon is commonly witnessed in homeopathic practice.

It is important to note that strong interest or distaste in something does not necessarily mean this is the source for a particular person. Someone who is fascinated by or dreams of, say, eagles will not necessarily benefit from a remedy made from a drop of eagle’s blood. In fact, being misled by these correspondences is a very common mistake that homeopaths themselves make. To identify a person’s remedy, that is their source, it is essential to understand that the person not only wants or hates or dreams about a particular thing, but that on some level he or she experiences the world as that thing.

Once one perceives the source in individuals, their motivations and fears, the way they live their lives and the way they relate to others around them, and even the types of illness they have begins to all make sense. This is the inner logic of their existence.

Treadwell was exceptional because in the end he was not content to just be proximal to grizzly bears, to witness or document them. He constantly pushed the boundaries separating man and bear. A bear trapped in human form, yearning to be recognized for what he truly was had a compulsion to establish an intimacy with and gain an acceptance by them that transcended the divide between two very different species of mammals.

The tragedy was that this was not possible except by one course of action. While his discourses could spiral off into nearly incoherent rants, danger was the one consistent theme that he came back to over and over again. He appeared to revel in the peril that he was placing himself in by getting ever closer to these animals. On some level, he must have known what was to come.

There was a scene in which Treadwell finds a huge mound of bear feces. He experiences a thrill that goes beyond discovery and curiosity. Appearing nearly ecstatic, he exclaims, “Just think, this came from inside the bear!” It is as close as he can come to them – at least until he pushes the limits one step too far and becomes bear feces himself. And with that final sacrifice, he at last becomes one with the bears.