This is a condition which is happening when the level of sodium in the blood is abnormally low. We know that the sodium is electrolyte which can help to regulate the amount of water which is in and around the cells. When someone suffer from this condition, then one or more factors (which can range from underlying medical condition to drinking too much water during endurance sports) are causing the sodium in the body to become diluted. When this is happening, then the water levels of our bodies rise and our cells begin to swell. This swelling can cause many health problems which can range from mild to life – threatening. In general, the treatment of hyponatremia is aimed at resolving the underlying condition. It depends on the cause of hyponatremia, you may simply need to cut back on how much you drink. When there are other cases of hyponatremia, then the affected person may need medications and intravenous fluids. [1]
Signs and symptoms of hyponatremia
Here are the most common signs and symptoms of hyponatremia:
- Coma
- Seizures
- Muscle weakness, spasms or cramps
- Restlessness and irritability
- Loss of energy and fatigue
- Confusion
- Headache
- Nausea and vomiting
Hyponatremia causes
We know that the sodium is playing an important role in the body. Sodium can help to maintain the normal blood pressure, regulates your body’s fluid balance and supports the work of your nerves and muscles. It is known that the normal sodium level is between 135 and 145 mEq/L (miliequivalents per liter) of sodium [2]. When the sodium in our blood fall below 135 mEq/L then the hyponatremia is happening. There are many possible conditions and lifestyle factors which could lead to hyponatremia such as
- The recreational drug Ecstasy: It is known fact that this amphetamine is increasing the risk of severe and even fatal cases of hyponatremia. [3]
- Hormonal changes: Addison’s disease (adrenal gland insufficiency) can affect the ability of our gland to produce hormones which can help to maintain our body’s balance of sodium and water. Also if you have low levels of thyroid hormone, then this can lead to a low blood – sodium level. [4]
- Dehydration: When you are taking in too little fluids, then this can be a problem. When someone gets dehydrated, then his or her body loses fluids and electrolytes. [5]
- Drinking too much water: When we sweat, then our body lose sodium and if we drink too much water during endurance activities, such as triathlons and marathons, then this can dilute the sodium content of the blood. Also when you are drinking too much water at other times, then it can also cause low sodium. [6]
- Chronic and severe vomiting or diarrhea: We know that these conditions are causing are bodies to lose fluids and electrolytes, such as sodium. [7]
- SIADH (syndrome of inappropriate anti – diuretic hormone): When someone has this condition, then high levels of ADH (anti – diuretic hormone) are produces which are causing your body to retain water instead of excreting it normally in the urine. [4]
- Heart, kidney and liver problems: Certain diseases that are affecting the kidneys or liver and congestive heart failure can cause fluids to accumulate in the body which can dilute the sodium in the body, lowering the overall level.
- Certain medications: There are some medications, such as pain medications, antidepressants and water pills (diuretics) which can cause you to urinate or perspire more than normal. [8]
Risk factors: There are some factors which can increase your risk of hyponatremia such as
- Intensive physical activities: Those people who drink too much water while they are taking part in marathons, ultra marathons and triathlons and other high – intensity and long – distance activities are having increased risk of getting hyponatremia. [9]
- Conditions that decrease your body’s water excretion: There are some medical conditions which can increase your risk of hyponatremia, such as heart failure, SIADH (syndrome of inappropriate anti – diuretic hormone) and kidney disease. [4]
- Certain drugs: There are some medications which can increase your risk of hyponatremia such as pain medications and antidepressants. Also the recreational drug Ecstasy has been linked to fatal cases of hyponatremia. [3]
References:
[1] Braun MM, Barstow CH, Pyzocha NJ. Diagnosis and management of sodium disorders: Hyponatremia and hypernatremia. American Family Physician. 2015;91(5):299-307.
[2] UCSF Health. Sodium blood test. Retrieved from www.ucsfhealth.org/medical-tests/003481
[3] Moritz ML, Kalantar-Zadeh K, Ayus JC. Ecstacy-associated hyponatremia: why are women at risk? Nephrology Dialysis Transplantation. 2013;28(9):2206-9.
[4] Goh KP. Management of hyponatremia. American Family Physician. 2004;69(10):2387-94.
[5] Powers KS. Dehydration: Isonatremic, hyponatremic, and hypernatremic recognition and management. Pediatrics in Review. 2015;36(7):274-85.
[6] Yamashiro M, Hasegawa H, Matsuda A, et al. A case of water intoxication with prolonged hyponatremia caused by excessive water drinking and secondary SIADH. Case Reports in Nephrology and Urology. 2013;3:147-52.
[7] Soleimani A, Foroozanfard F, Tamadon MR. Evaluation of water and electrolytes disorders in severe acute diarrhea patients treated by WHO protocol in eight large hospitals in Tehran; a nephrology viewpoint. Journal of Renal Injury Prevention. 2017;6(2):109–12.
[8] Ruzicka M, McCormick B, Magner P, et al. Thiazide diuretic-caused hyponatremia in the elderly hypertensive: will a bottle of Nepro a day keep hyponatremia and the doctor away? Study protocol for a proof-of-concept feasibility trial. Pilot and Feasibility Studies. 2018;4.
[9] Hew-Butler T, Loi V, Pani A, Rosner MH. Exercise-associated hyponatremia: 2017 update. Frontiers in Medicine (Lausanne). 2017;4:21.
