Are there any salt substitutes to avoid?

December 12, 2025 •

3 min read

According to the Centers for Disease Control and Prevention, about 90 percent of Americans over the age of two consume too much salt, which can lead to chronic health issues. While salt substitutes offer a way to reduce sodium, it is crucial to know that not all are suitable for everyone and some should be approached with caution.

Quick Summary

Many salt substitutes, particularly those containing potassium chloride, can be risky for individuals with certain health conditions or on specific medications. Always consult a healthcare provider before using them.

Key Points

Potassium Chloride: Can be dangerous for people with kidney disease, heart conditions, or diabetes due to the risk of hyperkalemia (high blood potassium).
Certain Medications: Individuals taking medications like ACE inhibitors, ARBs, or potassium-sparing diuretics should avoid potassium-based substitutes unless cleared by a doctor.
Monosodium Glutamate (MSG): While generally recognized as safe, a small percentage of people may experience adverse reactions like headaches and chest pain.
Combining Substitutes: The use of both potassium chloride and MSG is not recommended and can place an undue burden on the body.
Read Labels: It's crucial to check ingredient labels, especially for 'lite' salt or other processed foods, to identify hidden potassium or sodium compounds.
Medical Consultation: Always consult a healthcare provider before incorporating salt substitutes into your diet, especially if you have chronic health conditions.
Natural Alternatives: Herbs, spices, citrus, and vinegars are safe and flavorful ways to reduce sodium intake without the risks associated with certain substitutes.

When to Be Wary of Potassium Chloride

Salt substitutes containing potassium chloride (KCl) require careful consideration. While potassium is essential and can help lower blood pressure for many, excessive intake can be dangerous for some. Products labeled 'lite salt,' 'low-sodium salt,' or 'no-salt' alternatives often contain potassium-based substitutes.

The Risk of Hyperkalemia

High blood potassium, known as hyperkalemia, is the main concern with excessive potassium intake. Symptoms vary from mild muscle weakness to severe issues like dangerous heart arrhythmias, paralysis, and even cardiac arrest. The kidneys are vital for removing excess potassium. People with impaired kidney function struggle with this, making them vulnerable to hyperkalemia from potassium-based salt substitutes.

Health Conditions and Medications that Increase Risk

Certain health issues and medications increase the risk of using potassium chloride salt substitutes:

Chronic Kidney Disease: This significantly raises the risk because the kidneys can't properly excrete excess potassium.
Diabetes: Especially with reduced kidney function, individuals with diabetes face higher risk.
Heart Failure: Patients may have reduced kidney function or take medications affecting potassium levels.
Blood Pressure Medications: ACE inhibitors (like lisinopril), ARBs, and potassium-sparing diuretics (like spironolactone) can increase blood potassium levels.
NSAIDs: These non-steroidal anti-inflammatory drugs can also contribute to higher potassium levels, posing a risk with potassium-based substitutes.

The Problem with Monosodium Glutamate (MSG)

Monosodium glutamate (MSG) is a flavor enhancer with a small amount of sodium, sometimes used for a savory taste. It is generally safe in moderation for most people. However, a small number report adverse effects, historically referred to as "Chinese Restaurant Syndrome".

Reported Side Effects of MSG

Sensitive individuals may experience symptoms such as:

Nausea
Chest pains
Headaches
Burning sensations

These reactions usually follow the consumption of large MSG amounts, often without other food. Most people tolerate small amounts well. Awareness of personal sensitivity and moderate consumption are key.

Combining Potassium Chloride and MSG

Using both potassium chloride and MSG is not advised. Nutritionists warn that combining these substitutes can overload the body with both sodium and chloride, and is not a safe alternative to reducing overall salt intake.

Natural Alternatives to Salt

For those needing to avoid potassium chloride or MSG, or simply seeking natural ways to lower sodium, many safe, flavorful options exist. These rely on herbs, spices, and acids to enhance taste without the risks of certain substitutes.

Safer Seasoning Alternatives

Here are some generally safe, healthy salt alternatives:

Herbs and Spices: Flavorful options include basil, oregano, thyme, rosemary, cilantro, dill, cumin, paprika, garlic powder, onion powder, and black pepper.
Citrus: Lemon or lime juice and zest can brighten dishes.
Vinegars: Balsamic, apple cider, and red wine vinegars add a tangy element.
Nutritional Yeast: This offers a nutty, cheesy, savory flavor and B12.
Garlic and Onions: Fresh or powdered, they provide a savory base.

Comparison of Salt Substitutes


Substitute Type	Primary Ingredient	Sodium Content	Potassium Content	Who Should Avoid	Potential Side Effects
Potassium Chloride (KCl)	Potassium Chloride	Low to None	High	Individuals with kidney disease, heart failure, diabetes, or those on specific medications (ACE inhibitors, diuretics).	Hyperkalemia (high blood potassium), cardiac arrhythmias, muscle weakness.
MSG (Monosodium Glutamate)	Monosodium Glutamate	Low	None	Individuals with MSG sensitivity or allergy.	Headaches, chest pains, flushing, nausea.
Natural Herbs/Spices	Various Herbs & Spices	None	None	Anyone with specific allergies to individual ingredients.	Generally none, unless consumed in excessive amounts.
Citrus/Vinegar	Citric/Acetic Acid	None	Low	Individuals with acid sensitivities or reflux issues.	Digestive irritation in some cases.

Conclusion: Prioritize Safety and Medical Advice

Reducing sodium is beneficial, but understanding your tools is key. Potassium chloride substitutes, effective for many in reducing sodium and blood pressure, pose serious risks for those with impaired kidney function, heart failure, diabetes, or on specific medications. MSG also carries risks for a small group. If you have pre-existing conditions, consult your doctor or a dietitian before using salt substitutes. They can guide you on the best approach. Using herbs, spices, and citrus is a naturally safe and tasty alternative.

For more information on salt substitutes and patient safety, review health organization recommendations.

Frequently Asked Questions

Potassium-based salt substitutes, like potassium chloride, can be dangerous for individuals with impaired kidney function, as their bodies cannot properly excrete excess potassium. This can lead to a dangerous condition called hyperkalemia, which can cause life-threatening heart arrhythmias.

No, people with chronic kidney disease should avoid salt substitutes, especially those containing potassium chloride. Their kidneys cannot effectively filter potassium, and the added potassium from substitutes can cause dangerously high levels in the blood.

Yes. Individuals taking ACE inhibitors (like lisinopril), ARBs, or potassium-sparing diuretics (like spironolactone) should not use potassium-based substitutes. These medications already increase potassium levels, and additional potassium can be harmful.

MSG is generally considered safe for most people. However, a small percentage of individuals report adverse reactions like headaches or flushing after consuming large amounts. It should be used in moderation, and individuals with a known sensitivity should avoid it.

Safe, natural alternatives include herbs and spices (like basil, oregano, cumin), citrus juices and zests (lemon, lime), vinegars (balsamic, apple cider), garlic, and onion. These options add flavor without increasing sodium or potassium levels.

It is essential to read the ingredient label. Many products are clearly labeled with potassium chloride as a primary ingredient, especially 'low-sodium' or 'no-salt' alternatives. If you are unsure, avoid the product or consult a healthcare provider.

Symptoms of high potassium can include muscle weakness, tingling sensations, chest pain, and heart palpitations. In severe cases, it can lead to dangerous heart rhythms. Anyone with these symptoms after using a potassium-based substitute should seek immediate medical attention.