Description

Hyponatremia occurs when the concentration of sodium in the blood is abnormally low. Sodium is an electrolyte, and it helps regulate the amount of water that is found in and around the cells.

In hyponatremia, one or more factors, ranging from an underlying medical condition to drinking too much water-cause the sodium in your body to become diluted. When this happens, your body water levels rise, and your cells begin to swell. This swelling can cause many health problems, from mild to life-threatening.

Hyponatremia treatment is aimed at resolving the underlying condition. Depending on the cause of hyponatremia, you may simply need to reduce the amount you drink. In other cases of hyponatremia, you may need intravenous electrolyte solutions and medications.

Symptoms

Hyponatremia signs and symptoms may include:

  • Nausea and vomiting
  • Headache
  • The confusion
  • The loss of energy, sleepiness, and fatigue
  • Restlessness and irritability
  • Muscle weakness, spasms or cramps
  • Seizures
  • Comma

When to see a doctor

Seek emergency care for anyone who develops severe signs and symptoms of hyponatremia, such as nausea and vomiting, confusion, seizures or loss of consciousness.

Call your doctor if you know you're at risk of hyponatremia and are experiencing nausea, headaches, cramping or weakness. Depending on the extent and duration of these signs and symptoms, your doctor may recommend seeking immediate medical attention.

Causes

Sodium plays a key role in your body. This helps to maintain the normal blood pressure, supports the work of the nerves and muscles, and regulates your body's fluid balance.

A normal sodium level in the blood is between 135 and 145 milliequivalents per liter (mEq/L). Hyponatremia occurs when the sodium in your blood falls below 135 mEq/L.

Many of the possible conditions and lifestyle factors can lead to hyponatremia, including:

  • Certain medications. Some medications, such as water pills (diuretics (water pills), antidepressants and pain medications, can interfere with the normal hormonal and kidney processes that maintain concentrations of sodium in the normal range healthy.
  • Heart, kidney, and liver problems. Congestive heart failure and certain diseases affecting the kidneys or liver can cause fluids to accumulate in your body, which dilutes the sodium in your body, lowering the overall level.
  • The syndrome of inappropriate antidiuretic hormone (SIADH). In this condition, the high levels of antidiuretic hormone (ADH) occurs, causing your body to retain water instead of defecating normally in the urine.
  • Chronic, severe vomiting or diarrhea and other causes of dehydration. This causes your body to lose electrolytes, such as sodium, and also increases the levels of ADH.
  • Drinking too much water. Drinking excessive amounts of water can cause low sodium levels by overwhelming the capacity of the kidneys to excrete water. Because you lose sodium through sweat, drinking too much water during endurance activities, such as marathons and triathlons, you can also dilute the sodium content in the blood.
  • The hormonal changes. Adrenal gland insufficiency (Addison's disease) affects your adrenal glands and the ability to produce hormones that help to maintain your body balance of sodium, potassium and water. Low levels of thyroid hormone also can cause a low blood-sodium level.
  • The recreational drug Ecstasy. This amphetamine increases the risk of severe and even fatal cases of hyponatremia.

Risk factors

The following factors may increase the risk of hyponatremia:

  • Age. Older adults may have more of the factors that contribute to hyponatremia, including age-related changes, the taking of certain medications, and an increased likelihood of developing a chronic disease that disrupts the body's balance of sodium.
  • Certain medications. Medications that increase the risk of hyponatremia include thiazide diuretics, as well as certain antidepressants and medications for pain. In addition, the recreational drug Ecstasy has been linked to fatal cases of hyponatremia.
  • Conditions that decrease your body of water excretion. Medical conditions that may increase your risk of hyponatremia include kidney disease, syndrome of inappropriate antidiuretic hormone (SIADH) and heart failure, among others.
  • Intensive physical activities. People who drink a lot of water while you are taking part in marathons, ultramarathons, triathlons and other long-distance, high-intensity activities that are at an increased risk of hyponatremia.

Complications

In chronic hyponatremia, sodium levels drop gradually over 48 hours or more, and the symptoms and complications tend to be more moderate.

In acute hyponatremia, sodium levels drop rapidly, resulting in potentially dangerous effects, such as rapid brain swelling, which can result in a state of coma, and death.

The women appear to be at greater risk of hyponatremia-related brain damage. This may be related to the effect of the woman, the sex hormones in the body's ability to balance the levels of sodium.

Prevention

The following measures can help prevent hyponatremia:

  • The treatment of associated conditions. Treatment of conditions that contribute to hyponatremia, such as the insufficiency of the adrenal gland, can help prevent low sodium in the blood.
  • Educate yourself. If you have a medical condition that increases the risk of hyponatremia or taking diuretic medications, be aware of the signs and symptoms of low sodium levels in the blood. Always talk with your doctor about the risks of a new medicine.
  • Take precautions during high-intensity activities. Athletes should drink only the amount of fluid lost due to sweating during a race. The thirst is usually a good guide to the amount of water or other liquids you need.
  • Consider the possibility of drinking sports drinks during the most demanding activities. Ask your doctor about the replacement of water with sports drinks that contain electrolytes to participate in endurance events such as marathons, triathlons, and other demanding activities.
  • Drink water in moderation. The drinking water is vital for your health, so make sure to drink sufficient amount of liquid. But don't overdo it. The thirst and the color of your urine are usually the best indications of the amount of water that you need. If you're not thirsty and your urine is pale yellow in colour, it is likely that you're getting enough water.

Diagnosis

Your doctor will start by asking about your medical history and perform a physical exam.

However, because the signs and symptoms of hyponatremia occur in many conditions, it is impossible to diagnose the condition based on a physical exam alone. To confirm low blood sodium, your doctor will order blood tests and urine analysis.

Treatment

Hyponatremia treatment is aimed at treating the underlying cause, if possible.

If you have moderate, chronic hyponatremia due to your diet, diuretics or drinking too much water, your doctor may recommend temporarily cuts in fluids. He or she also may suggest the fit of your use of diuretics to increase the level of sodium in your blood.

If you have severe, acute hyponatremia, you will need more aggressive treatment. The options include:

  • Intravenous fluids. Your doctor may recommend IV sodium solution to slowly raise the sodium levels in your blood. This requires a stay in the hospital for frequent monitoring of sodium levels as too rapid a correction is dangerous.
  • Drugs. You can take medication to treat the signs and symptoms of hyponatremia, such as headaches, nausea and seizures.

Preparing for your appointment

Seek emergency care for anyone who develops severe signs and symptoms of hyponatremia, such as nausea and vomiting, confusion, seizures or loss of consciousness.

Call your doctor if you know you're at risk of hyponatremia and are experiencing nausea, headaches, cramping or weakness. Depending on the extent and duration of these signs and symptoms, your doctor may recommend seeking immediate medical attention.

If you have time to prepare, here's some information to help you prepare for your appointment, and what to expect from your doctor.

What you can do

  • List any symptoms you or your loved one has been experiencing and for how long.
  • Make a note of the key medical information, including other medical problems for which you are being treated, and the names of all the medications, vitamins, supplements or other natural remedies that you are taking.
  • Have a friend or family member, whether you are the person with symptoms of low sodium levels in the blood. Someone who accompanies you can help remember all the information and provide the technical support if you need immediate medical attention.
  • Write questions to ask their doctor.

For hyponatremia, some basic questions to ask your doctor include:

  • What is the most likely cause of my symptoms?
  • What is the cause of the hyponatremia?
  • How serious is the problem?
  • What treatment do you recommend it?
  • How soon do you expect that my symptoms will begin to improve?
  • Am I at risk of long-term problems?
  • How can I prevent a recurrence of this condition?
  • What do I need to make any change in the amount of liquid that I usually drink?

What to expect from your doctor

Be prepared to answer the questions your doctor may reserve time to go over any points you want to talk in-depth. Your doctor may ask:

  • What are the symptoms and when do they start?
  • Have to start taking any new medicine?
  • The symptoms been better or worse, as first developed?
  • Symptoms include all of the mental changes, such as the feeling of confusion, agitation, or depression?
  • You've had nausea, vomiting, or diarrhea?
  • She felt faint, had seizures or loss of consciousness?
  • Have you had a headache? If yes, it has become increasingly worse?
  • Symptoms include weakness, fatigue, or lethargy?
  • Do you use recreational drugs? If yes, what drugs?
Symptoms and treatment of Hyponatremia