Low sodium levels are uncommon. That’s because sodium is a mineral we consume in salt — the vast majority of people consume far more sodium than they need. Even though your sodium intake fluctuates from day to day, your body does a good job of maintaining the correct concentration of sodium in your body.
However, sodium levels can sometimes be lowered by disease or dietary habits, resulting in a condition called hyponatremia (low blood sodium). Symptoms can range from mild to severe depending on low levels of sodium.
This article looks at the symptoms and causes of hyponatremia. It also explains how to define, diagnose and treat the condition.
Symptoms of hyponatremia
Sodium is an essential mineral, which means your body can’t make it. The only way to get it is through food. Hyponatremia can occur if you don’t get enough and levels start to drop.
Many people with mild hyponatremia may be asymptomatic (asymptomatic). However, as sodium levels continue to decline, the incidence and severity of symptoms may increase.
Symptoms of hyponatremia may include:
- lost balance
- loss of appetite
- inability to concentrate
- profuse or sudden sweating
- nausea and vomiting
- loss of consciousness
Hyponatremia can affect the function of the thyroid. The thyroid works by producing hormones that regulate metabolism, heart rate, digestion, and other bodily functions.
Our bodies need dietary iodine to make thyroid hormones, most of which comes from the iodized salt we eat. If you have chronic hyponatremia, you may also experience symptoms of hypothyroidism, including:
- always feel cold
- weight gain
- puffy face
- muscle weakness
- dry skin
Symptoms of hyponatremia can range from mild to severe, depending on how low your sodium levels are. Mild cases can cause headaches and fatigue, while severe hyponatremia can cause seizures and coma. Hypothyroidism (underactive thyroid) may also occur.
Low sodium can be caused by lifestyle factors and medical conditions that affect water and/or sodium balance in the body.
Diet and lifestyle issues rarely affect sodium levels. Even so, rapid loss of fluids and/or excess intake of fluids can lead to a dramatic drop in sodium concentrations.
Excessive sweating can lead to a rapid loss of sodium. Sweat and other body fluids are high in sodium. If you are unable to properly replenish your sodium supply after sweating a lot, your sodium levels can drop dramatically.
If you drink too much water after sweating without replenishing electrolytes (essential minerals like sodium, calcium, and potassium), your sodium levels may drop further. This is because you are diluting the amount of sodium per volume of water in your body.
Hyponatremia can also be caused by an extreme sodium-free diet. Drinking too much water (overhydration) only increases the risk.
There are medical conditions that can cause hyponatremia. Some develop slowly over time, with symptoms developing gradually. Others develop rapidly, with symptoms developing suddenly.
Medical causes of hyponatremia include:
- Adrenal insufficiency: Adrenal gland production Aldosterone Balances sodium and potassium in the body. Adrenal insufficiency, also known as Addison’s disease, can disrupt this balance.
- Brain Salt Wasting Syndrome (CSWS): This rare disorder caused by brain damage changes the function of the kidneys, causing them to remove excess sodium from the body.
- Congestive heart failure: The inability of the heart to pump blood efficiently into the body causes fluid to build up, leading to hyponatremia.
- Diarrhea: Severe diarrhea can cause a hypovolemia In this condition, extreme fluid loss can lead to hyponatremia, low blood pressure, and in severe cases, shock.
- Diuretics: “Water pills” used to lower blood pressure can affect the balance of water and sodium in the body. Diuretics can cause hyponatremia if electrolytes are not replenished.
- Cirrhosis: Scarring of the liver can cause fluid retention. The retention level increased with the severity of liver injury.
- Syndrome of Hypersecretion of Antidiuretic Hormone (SIADH): Antidiuretic hormone (ADH) prevents the body from losing too much water in the urine. SIADH can cause the body to retain too much water, which can lead to hyponatremia.
Hyponatremia occurs when the water and sodium levels in the body are out of balance. Causes include severe diarrhea, an extremely sodium-free diet, overhydration, diuretics, congestive heart failure, cirrhosis, and hormonal dysfunction.
Hyponatremia is diagnosed by physical examination, laboratory tests, and reviewing your medical history. At the heart of the diagnosis are blood tests that measure the concentration of sodium in the blood.
Levels are measured in milliequivalents per liter (mEq/L) and are classified as follows:
- Normal: 135 to 145 mEq/L
- Hyponatremia: less than 135 mEq/L
- Severe hyponatremia: less than 120 mEq/L
Physical examination and medical history provide clues to the underlying cause. The test will check your blood pressure, urine output, and urine concentration for abnormalities. Other blood tests may check for abnormalities in your adrenal hormone levels or liver function.
Doctors will also check for neurological (central nervous system-related) problems, such as loss of alertness, concentration, or orientation.
Hyponatremia is diagnosed by physical examination, review of medical history, and laboratory tests. Hyponatremia was defined as blood sodium levels below 135 mEq/L.
Sodium Test Uses, Side Effects, Procedures, and Results
Treatment of hyponatremia is sometimes simple and sometimes difficult. Treatment is usually based on slow and careful replacement of body sodium and management of the underlying cause of hyponatremia.
If a low-salt diet is the cause of your low sodium, your healthcare provider will recommend slowly increasing your salt intake. The recommended sodium intake is about one teaspoon of salt per day for adults and about 1/2 teaspoon of salt per day for children.
Remember that salt in processed foods, breads, pastas, sauces, and even desserts count toward your daily recommended intake.
You’ll also be advised to drink enough water—about 12 glasses a day for women and 16 glasses a day for men—but don’t over-hydrate.
If you have severe hyponatremia, you may need to replace sodium with intravenous (IV) fluids. Intravenous fluids will contain water, sodium, and other key electrolytes.
The medical team will restore sodium levels within a few hours or days, depending on the severity of your condition. Infusing sodium too quickly can lead to osmotic demyelination syndrome (ODS), a type of brain damage.
Few medications are consistently effective in treating hyponatremia.known as drugs Vasopressin receptor antagonists It is sometimes used for people with fluid retention and avoided by those with low fluid volumes. These drugs are most effective in people with congestive heart failure, cirrhosis, and SIADH.
Dechloramphenicol (norcycline) are antibiotics sometimes used to treat SIADH. Results may vary, and some people have overcorrected sodium levels. This drug may also cause kidney problems and sensitivity to sunlight in some people.
Mild cases of hyponatremia can be treated by increasing dietary salt intake. Severe cases may require hours or days of intravenous (IV) sodium replacement therapy.
Hyponatremia is an abnormally low level of sodium in the blood. People with hyponatremia usually experience no symptoms if their sodium levels are mildly reduced. When sodium levels drop significantly, hyponatremia can cause headaches, fatigue, nausea, vomiting, muscle cramps, and poor concentration. Severe cases can lead to seizures or coma.
Hyponatremia is caused by an imbalance of sodium and water in the body. Causes include severe diarrhea, a salt-free diet, excessive water intake, diuretics, congestive heart failure, and cirrhosis. Hormonal dysfunction, such as adrenal insufficiency and syndrome of hypersecretion of antidiuretic hormone (SIADH), are also common causes.
Hyponatremia can be diagnosed with a blood test. A physical exam and reviewing your medical history can help uncover the underlying cause. Treatment of hyponatremia may involve increased dietary salt intake in mild cases and intravenous sodium replacement in severe cases.
There are many causes of hyponatremia, some more severe than others. Be sure to see your doctor if you have symptoms of hyponatremia. The reason may be that dietary problems are easily resolved, but symptoms can also be the first signs of serious illness.