Greetings, Dr. Roach According to a health publication I read, eating a lot of sodium is bad for your diet. A daily salt intake of no more than 2,300 mg is the federal standard. Some medical professionals advise against consuming more than 1,500 mg of sodium per day if a person’s health is poor. Everything you consume matters.
Why aren’t there restrictions on how much sodium a firm can include in its products if sodium consumption is so harmful to your health? Like alcohol and many other chemicals included in food and beverages that come in cans, boxes, and packaging, shouldn’t the federal government regulate this as well?
Why, for example, should diet soda contain sodium? — E.R.
ANSWER: I concur with public health experts that people should consume less sodium because it is true that too much of it poses health hazards. For most people, high salt raises blood pressure. A high-sodium diet raises the risk of stroke and kidney stones even in those without high blood pressure.
Even though sodium deficiency is unheard of today, a high-sodium diet is crucial in some situations since salt is an essential nutrient. Yesterday, I encountered a woman who developed POTS (postural orthostatic tachycardia syndrome) following COVID-19. She requires 8–12 grams of salt per day to maintain appropriate blood pressure.
My job as a doctor is to give advice. I don’t have the right to control public policy, and I’m concerned about the government enforcing laws that restrict personal freedom. A large bag of pretzels may contain 5 grams of sodium, which is equivalent to two days’ supply, as a 1-ounce serving of pretzels contains 250–300 mg of sodium. Even though it’s not a good idea for me to eat it all in one sitting, I find it unsettling that the government is restricting my access to purchase this.
However, I believe that the Food and Drug Administration made the right choice in 2015 when it decided to outlaw the use of trans fats. Because trans fats are so dangerous, manufacturers have swiftly shifted to healthier alternatives. Making the choice to restrict or outlaw a substance requires careful consideration.
The bitter taste that some artificial sweeteners can have is suppressed by salt in diet sodas. Typically, diet sodas aren’t the worst offenders because they only contain 20 mg of salt (0.02 grams). However, a big pizza may include 6–10 grams of salt.
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Greetings, Dr. Roach My prostate is very big, and I’m 73 years old. I had a PSA of more than 11 ng/mL. Finasteride was prescribed by my new urologist after I had negative biopsies. He assured me that he could reduce my cancer risk by 80% and that he had excellent results with it.
My most recent PSA was 4.4 ng/mL, and I had been taking it for more than six months. I don’t want to continue taking it. How do you feel about finasteride? — H.D.
ANSWER: I concur that finasteride lowers the risk of prostate cancer and prostate cancer-related mortality. Regretfully, the evidence indicates a risk reduction of 25% to 30% rather than 80%. We would advise all men to use it if it were 80% effective in preventing prostate cancer (assuming no negative side effects). However, when it comes to treating symptomatic prostate enlargement, a reduction in the risk of prostate cancer is worth taking into account.
Lastly, when interpreting the PSA level, it is important to consider that finasteride lowers PSA levels by almost half.
Although he regrets not being able to respond to each letter individually, Dr. Roach will try to include them in the column. Questions can be sent by mail to 628 Virginia Dr., Orlando, FL 32803 or by email to [email protected].
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