Hyponatremia: are you at risk?

Hyponatremia means low levels of sodium in our blood.

It’s the opposite of  hypernatremia, when sodium levels are very high. Both conditions can occur when patients are in hospital – especially true if they are receiving fluid intravenously, have an existing condition like kidney or heart disease, or are in critical care.

So you may think – that gets me into the clear, right? Wait up.

It has now been ascertained that hyponatremia develops in 15-30 percent of all patients during hospital stays, (1) but…

Hyponatremia and related electrolyte imbalances can sneak up on us during exercise or on a hot day, when dehydration symptoms are more common.
Mild hyponatremia, or sometimes, even moderate,  may not even have any symptoms.  When it’s more severe, hyponatremia symptoms typically include headaches, nausea and in some cases even seizures or a coma.

What is Hyponatremia?

A type of electrolyte imbalance: abnormally low sodium levels in the blood.
Sodium (salt) often gets a bad rap because too much of it affects blood pressure and contributes to fluid retention/swelling. We forget that it’s actually an essential electrolyte. All electrolytes have important jobs throughout the body. This is because of how they carry an electric charge when dissolved in bodily fluids, including blood. (2)

Some of sodium’s jobs include:

  • Helping to regulate the amount of water that’s in and around your cells.
  • Controlling blood volume.
  • Regulating blood pressure.
  • Allowing your muscles and nerves to work properly.

Treatment for Hyponatremia

Treatment usually comes down to being careful about regulating fluid levels in our body.  Basically, intake and excretion of salt versus water must be balanced. Ways you can prevent hyponatremia from developing, or reverse the condition once it’s already occurred, include:

  • drinking the right amount of water in proportion to how much sodium you’re losing, or drinking water that is not devoid of mineral salts.
  • eating a balanced diet
  • taking care of your adrenal glands
  • making an effort to balance hormone levels

What is considered low sodium, versus normal sodium? (3)

  • Normal sodium levels are: 135-145 mEq/L.
  • Hyponatremia is defined as a serum sodium level of less than 135 mEq/L.
  • Mild hyponatremia is between: 130-134 mmol/L.
  • Moderate is between: 125-129 mmol/L.
  • And severe is: anything less than 125 mmol/L.

A  good doctor will encourage you to adjust fluids to correct the imbalance. To prevent electrolyte imbalances, you can monitor your water intake and quality, diet and medications. Normally your body obtains sodium through your diet and loses the right amount through your urine or sweat. So, as long as you don’t have kidney problems, you should be able to naturally balance sodium and water levels by making a few healthy changes.

Common Signs and Symptoms of Hyponatremia

The problem with having too little sodium, and, at the same time, too much water, is that it causes your cells to swell. Depending on how much swelling and fluid retention occurs, hyponatremia can be very serious — even deadly in severe cases.

The most common hyponatremia symptoms include: (4)

  • Digestive issues like nausea, diarrhea and vomiting
  • Headaches
  • Dizziness and instability
  • Muscle weakness
  • Trouble concentrating and confusion
  • Low energy, lethargy, even if you’ve slept enough, and fatigue
  • Mood changes and increased irritability
  • Muscle pains, spasms or cramps
  • In severe cases when the condition isn’t treated, brain swelling, seizures and possibly coma or death can occur
  • In the elderly, hyponatremia can also cause falls, injuries and gait disturbances due to instability and weakness


Causes of hyponatremia:

  • An existing/underlying medical condition that affects sodium levels, your thirst sensation, the role of the kidneys (such as kidney disease which alters urine production), heart or liver problems. Kidney disease and heart disease are common conditions that both contribute to hyponatremia.
  • Being a premenopausal woman. Premenopausal women appear to be at the greatest risk of hyponatremia. This is due to how women’s sex hormones affect fluid and sodium levels. (6)
  • Hormonal imbalances or changes that affect the adrenal glands. The adrenals normally produce hormones that help maintain your body’s balance of electrolytes (including sodium, potassium and water). Reasons that hormone production can change include adrenal gland insufficiency (Addison’s disease) and thyroid disorders/damage.
  • Chronic, severe vomiting or diarrhea due to an illness. This can cause dehydration (taking in too little electrolytes through foods and fluids).
  • Drinking too much water. This can happen in very hot temperatures, when someone is fasting, or during exercise and endurance sports. Studies show people who partake in marathons, ultra-marathons, triathlons and other long-distance, high-intensity activities are at an increased risk of hyponatremia.
  • People following restrictive diets that are very high in water and hydrating foods, but low in sodium (like raw food diets or fruit-only diets).
  • Older age. The elderly and older adults develop symptoms of hyponatremia more often than younger people. This is especially true if they take medications that impact fluid levels, have been staying in the hospital, or are sick.
  • Taking medications that alter sodium/water levels. Drugs that can cause or contribute to hyponatremia include thiazide diuretics, antidepressants and pain medications.
  • Producing high levels of the anti-diuretic hormone (ADH). This causes your body to retain water instead of excreting it normally in your urine.
  • Using recreational drugs, including ecstasy.Ian’ comment:
    All of the above info is important, and as an alkaline specialist I relate to the need to balance all electrolytes – not just salt.
    I was amazed at a scientific report that recently described increased mortality among older Israelis, pinpointing the reason as the sue national seawater desalination project that supplied ‘clean’ water devoid of minerals. Suddenly older Israelis began dying prematurely because they had insufficient electrolyte balance.
    Reverse Osmosis is the system used to desalinate seawater, and it’s also a common domestic system all over the world. But the WHO has already released a report that suggests strongly that mineralised water, particularly  water higher in calcium and magnesium, is the best choice for healthy water.
    And that’s why we insisted on these elements being a part of our UltraStream design brief.

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