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If you take a blood pressure pill or a water pill and you've started carnivore, the salt advice you keep seeing online wasn't written for you. So here's the straight answer to "how much salt." Most people on carnivore land around 3-5 g of sodium a day, about 1.5-2 teaspoons of salt, spread through the day. This is not for everyone. Talk to your doctor first if you have high blood pressure, kidney or heart problems, diabetes, are pregnant, or take medicine. For you, the right number is the one your doctor or pharmacist agrees to, because the medicine changes it.
It's the actual answer, and I'll explain why. If you want a starting point for your protein and fat numbers while you sort out the salt, the free calculator gives you those.
Why the usual salt advice feels different on these pills
Here's the normal carnivore story. When carbs go away, insulin falls, and lower insulin tells your kidneys to let go of sodium and water. That's the 3-7 lb water drop in week one, and it's why most people need more salt than they're used to early on.
Now add a water pill. A diuretic's whole job is to make your kidneys dump sodium and water. So you've got two things pulling in the same direction at once, the diet and the pill. A few pounds of water coming off can lower your blood pressure more than your doctor planned for when the dose was set.
Other blood pressure medicines pull a different lever. ACE inhibitors (the ones ending in -pril), ARBs (ending in -sartan) and some water pills make your body hang on to potassium.
Dizzy, headachy and cramping in week two: what it usually means
A lot of you on these medicines describe the same week two. A head rush when you stand up, a dull headache by afternoon, and calves that seize at night. Half the internet says add salt, your doctor said cut salt, and you're standing in the kitchen with the shaker not knowing which way to go.
Dizziness on standing is your blood pressure dipping for a moment when you rise. On carnivore plus a blood pressure medicine, that often means the combination is now pulling your pressure lower than it was when the dose was chosen. Headaches and calf cramps are classic low sodium and low fluid signs, and healthy people get them in the first weeks too.
The reason the first call goes to your prescriber or pharmacist, and not to a bigger scoop of salt, is that the salt and the pill act on the same system. If the pill is what's pushing you too low, more salt is fighting the medicine rather than fixing the problem. I wrote about that pattern in when carnivore drops your blood pressure too low. Any change to your medicine is your prescriber's decision, and they can only make a good one if they know what's happening.
What to bring to that phone call
Doctors and pharmacists make better decisions with numbers. If you have a home cuff, take readings for a week:
- Seated, after five quiet minutes, morning and evening.
- Standing, one minute after you get up. The gap between the two is what they want to see.
- The time you took your pill, your symptoms, and roughly how much salt you're using.
The pharmacist is often the quicker call. They know which of your medicines move sodium and potassium, and whether a salt range is reasonable with your list. Then your doctor decides what, if anything, changes. How long carnivore takes to lower blood pressure covers the usual timeline.
Potassium and magnesium when you're on these pills
This is where I give you less than other sites do, on purpose.
Potassium comes from food on carnivore. Beef carries about 300-400 mg per 4 oz, and bone broth adds more. I don't publish a potassium target or a supplement amount, because too much potassium is dangerous, and ACE inhibitors, ARBs and some water pills change how much your body holds on to. One thing to watch: potassium-based salt substitutes. On those medicines they can push potassium up fast. Ask your pharmacist before one goes in your cart.
Magnesium is the one supplement I'll name. Glycinate, in the evening, and skip oxide since it's poorly absorbed. I don't give a milligram amount, because your kidneys clear magnesium, and blood pressure medicine, water pills and reduced kidney function all change the safe amount. Ask your pharmacist what fits your list. If you're eating keto rather than carnivore, the KetoDial electrolyte guide covers the same three minerals.
Four or five months in: do you still need the packets?
Some of you are 19 or 20 weeks in, feeling good, and quietly afraid to stop the electrolyte packets. Has your body adapted? Does anyone just drink plain water all day and feel fine?
Yes, plenty of people do. Most people feel adapted by weeks 4-6, and full fat adaptation settles in around 8-12 weeks. By month four or five the big sodium dump is long over and your kidneys have found a new normal. The packets were scaffolding, not the building. I drink plain water most of the day here in Whistler and salt my food well.
Here's how I'd test it if you're not on a water pill. Keep salting your food, spread through the day, and drop the packets for a week. Watch for the three signals: standing dizziness, afternoon headache, night cramps. If none show up, you have your answer. If one does, a pinch of salt in water before bed, which I covered in leg cramps at night on carnivore, often handles it. For reference, one LMNT packet carries 1,000 mg of sodium, less than half a teaspoon of salt.
If you are on a water pill, the pill keeps pulling sodium whether or not you've adapted, so "I feel fine without packets" is a data point to bring to the person who prescribed it, not a decision to make alone.
See a doctor now if
- You faint or nearly faint, not just a brief head rush.
- Your heart is racing or beating irregularly along with the dizziness.
- You're confused, very weak, or your home readings are far below your usual.
- Cramps come with muscle weakness that doesn't pass.
Those aren't week two settling in. They're a same-day call.
I'm not a doctor. I've researched this deeply and worked with many people, but I'm not your doctor. Everything I write is educational based on research and what I've seen work. Your situation might be different.