Can low sodium cause dizziness. Low Sodium and Dizziness: Surprising Findings from the DASH-Sodium Trial
Can low sodium intake cause dizziness. How does sodium affect postural lightheadedness. What are the effects of sodium intake on blood pressure and lightheadedness. Is higher sodium intake recommended for preventing dizziness.
The DASH-Sodium Trial: Challenging Traditional Sodium Recommendations
The Dietary Approaches to Stop Hypertension (DASH)-Sodium trial, conducted from 1998 to 1999, has produced intriguing results that challenge conventional wisdom regarding sodium intake and postural lightheadedness. This randomized controlled trial examined the effects of the DASH diet and varying levels of sodium intake on blood pressure and lightheadedness symptoms.
Traditionally, higher sodium intake has been recommended to prevent lightheadedness, especially in older adults. However, the findings from this study suggest that this approach may not be universally beneficial and could potentially be counterproductive in certain dietary contexts.
Study Design and Methodology
The DASH-Sodium trial involved 412 participants with a mean age of 48 years. The study population was diverse, with 57% women and 57% Black participants. At baseline, the average systolic/diastolic blood pressure was 135/86 mm Hg, and 9.5% of participants reported experiencing lightheadedness.
Participants were randomly assigned to one of two dietary patterns:
- The DASH diet
- A typical Western diet (control)
Within each dietary group, participants consumed three different levels of sodium for 30-day periods, separated by 5-day breaks:
- Low sodium: 50 meq/d
- Medium sodium: 100 meq/d
- High sodium: 150 meq/d
These sodium levels were calibrated for a 2100 kcal diet. Participants reported the presence and severity of postural lightheadedness at baseline and after each feeding period.
Surprising Results: Higher Sodium and Increased Lightheadedness
The study’s findings were unexpected and challenge traditional recommendations for sodium intake to prevent lightheadedness. Among participants following the DASH diet, higher sodium intake was associated with an increased likelihood and severity of lightheadedness:
- High vs. low sodium intake increased the odds of experiencing lightheadedness (OR 1.71; 95% CI: 1.01, 2.90; P = 0.047)
- The severity of lightheadedness also increased with higher sodium intake (P = 0.02)
Interestingly, this effect was not observed in participants following the control diet (OR 0.77; 95% CI: 0.46, 1.29; P = 0.32). This suggests that the relationship between sodium intake and lightheadedness may be influenced by overall dietary patterns.
Age and Body Composition: Important Factors in Sodium Sensitivity
The study revealed significant interactions between sodium intake, age, and body composition in relation to lightheadedness symptoms. When consuming high vs. low sodium in the context of the DASH diet:
- Adults under 60 years old experienced more lightheadedness compared to those 60 and older (P-interaction = 0.04)
- Obese adults reported more frequent lightheadedness than non-obese adults (P-interaction = 0.01)
These findings highlight the complexity of sodium’s effects on the body and suggest that age and body composition may play crucial roles in determining an individual’s sensitivity to sodium intake.
Implications for Clinical Practice and Dietary Recommendations
The results of the DASH-Sodium trial have significant implications for clinical practice and dietary recommendations. Healthcare providers and nutritionists may need to reconsider the conventional advice of increasing sodium intake to prevent lightheadedness, especially for patients following a DASH-style diet.
Instead, a more nuanced approach may be necessary, taking into account factors such as:
- Overall dietary pattern
- Age
- Body composition
- Individual health status
It’s important to note that these findings do not negate the potential benefits of sodium restriction for blood pressure control. Rather, they emphasize the need for a balanced approach that considers multiple health outcomes.
The DASH Diet: A Key Factor in Sodium Sensitivity
The differential effects of sodium intake observed between the DASH and control diets raise intriguing questions about the role of overall dietary patterns in modulating sodium sensitivity. The DASH diet, which is rich in fruits, vegetables, whole grains, and lean proteins, may alter the body’s response to sodium in ways that are not yet fully understood.
Possible mechanisms by which the DASH diet might influence sodium sensitivity include:
- Alterations in the renin-angiotensin-aldosterone system
- Changes in vascular function and reactivity
- Modifications to the gut microbiome
- Interactions with other nutrients, such as potassium and magnesium
Further research is needed to elucidate the precise mechanisms underlying these observations and to determine whether similar effects would be seen with other heart-healthy dietary patterns.
Limitations and Future Directions
While the DASH-Sodium trial provides valuable insights, it’s important to consider its limitations and areas for future research:
- The study duration was relatively short (30 days per sodium level), and long-term effects may differ
- The sample size, while substantial, may not have been large enough to detect all relevant subgroup differences
- The study did not include individuals with severe hypertension or other cardiovascular conditions, limiting generalizability to these populations
Future studies should aim to address these limitations and explore additional questions, such as:
- The effects of sodium intake on lightheadedness in different populations, including those with autonomic disorders or orthostatic hypotension
- The potential role of other electrolytes and nutrients in modulating the relationship between sodium and lightheadedness
- The long-term health outcomes associated with different sodium intake levels in the context of various dietary patterns
Practical Advice for Managing Lightheadedness
Given the complex relationship between sodium intake, diet, and lightheadedness revealed by this study, what practical advice can be offered to individuals experiencing postural lightheadedness? Here are some evidence-based strategies:
- Consult with a healthcare provider: Lightheadedness can have various causes, and it’s important to rule out underlying medical conditions.
- Stay hydrated: Adequate fluid intake is crucial for maintaining blood volume and preventing lightheadedness.
- Rise slowly: When getting up from a lying or sitting position, do so gradually to allow your body time to adjust.
- Consider your overall diet: If following a DASH-style diet, be aware that higher sodium intake may not necessarily prevent lightheadedness and could potentially exacerbate it.
- Monitor your blood pressure: Regular blood pressure checks can help you and your healthcare provider make informed decisions about sodium intake.
- Engage in regular physical activity: Exercise can improve cardiovascular function and may help reduce the frequency of lightheadedness episodes.
- Explore non-dietary interventions: Compression stockings, medication adjustments, or other strategies may be recommended by your healthcare provider.
Remember that individual responses to sodium intake can vary, and what works for one person may not be appropriate for another. Always consult with a healthcare professional before making significant changes to your diet or sodium intake.
The Role of Sodium in Body Function
To better understand the complex relationship between sodium intake and lightheadedness, it’s helpful to review the role of sodium in the body:
- Fluid balance: Sodium helps regulate the distribution of fluids inside and outside of cells.
- Nerve and muscle function: Sodium is essential for transmitting nerve impulses and facilitating muscle contractions.
- Blood pressure regulation: Sodium levels influence blood volume and, consequently, blood pressure.
- Nutrient absorption: Sodium is involved in the absorption of certain nutrients in the small intestine.
The body tightly regulates sodium levels through various mechanisms, including hormonal control and kidney function. However, excessive or insufficient sodium intake can disrupt this delicate balance, potentially leading to adverse effects such as lightheadedness.
Potential Mechanisms Linking Sodium and Lightheadedness
The unexpected finding that higher sodium intake increased lightheadedness in the context of the DASH diet raises questions about the underlying mechanisms. Several potential explanations warrant further investigation:
- Rapid fluid shifts: High sodium intake may cause rapid shifts in fluid distribution, temporarily affecting blood volume and cerebral perfusion.
- Vascular reactivity: Sodium may influence the responsiveness of blood vessels, particularly in the context of the DASH diet’s other components.
- Autonomic nervous system effects: Changes in sodium intake could modulate autonomic function, affecting blood pressure regulation upon standing.
- Hormonal responses: Alterations in sodium levels may trigger hormonal changes that influence blood pressure and fluid balance.
- Interaction with other nutrients: The DASH diet’s rich nutrient profile may interact with sodium in ways that affect cardiovascular function.
Understanding these mechanisms could lead to more targeted approaches for managing lightheadedness and optimizing sodium intake for individual patients.
Sodium Intake and Cardiovascular Health: A Balancing Act
While the DASH-Sodium trial focuses on lightheadedness, it’s important to consider the broader context of sodium intake and cardiovascular health. Numerous studies have established a link between high sodium intake and increased risk of hypertension, cardiovascular disease, and stroke.
The challenge for healthcare providers and individuals is to balance the potential risks and benefits of sodium intake. This study underscores the complexity of this balance, particularly when considering symptoms like lightheadedness alongside long-term cardiovascular outcomes.
Key considerations in this balancing act include:
- Individual sodium sensitivity: Some people are more sensitive to the blood pressure-raising effects of sodium than others.
- Overall dietary pattern: As demonstrated by the DASH-Sodium trial, the impact of sodium intake may depend on the broader nutritional context.
- Presence of existing health conditions: Individuals with hypertension, heart failure, or kidney disease may have different sodium needs and tolerances.
- Activity level and climate: Those who engage in intense physical activity or live in hot climates may have higher sodium requirements due to increased losses through sweat.
Given these complexities, personalized approaches to sodium intake, guided by healthcare professionals, may be more appropriate than universal recommendations.
The Importance of Comprehensive Symptom Evaluation
The findings of the DASH-Sodium trial highlight the importance of comprehensive symptom evaluation when addressing issues like lightheadedness. While sodium intake may play a role, it’s crucial to consider other potential contributing factors:
- Medications: Some blood pressure medications, diuretics, or other drugs can cause lightheadedness as a side effect.
- Dehydration: Insufficient fluid intake can lead to reduced blood volume and lightheadedness.
- Anemia: Low red blood cell count can result in inadequate oxygen delivery to the brain, causing lightheadedness.
- Heart conditions: Arrhythmias or structural heart problems may affect blood flow and cause lightheadedness.
- Neurological issues: Conditions affecting the autonomic nervous system can impair blood pressure regulation upon standing.
- Endocrine disorders: Conditions such as diabetes or thyroid dysfunction can influence blood pressure and cause lightheadedness.
Healthcare providers should conduct thorough evaluations to identify the underlying causes of lightheadedness and develop comprehensive treatment plans that address all contributing factors, not just sodium intake.
Dietary Strategies Beyond Sodium Management
While the DASH-Sodium trial focused on sodium intake, it’s important to consider other dietary strategies that may help manage lightheadedness and promote overall cardiovascular health:
- Potassium intake: Adequate potassium consumption can help balance the effects of sodium and support healthy blood pressure.
- Magnesium-rich foods: Magnesium plays a role in blood pressure regulation and may help reduce lightheadedness.
- Hydration: Consuming water-rich foods like fruits and vegetables can support proper hydration.
- Balanced meals: Eating regular, balanced meals can help maintain stable blood sugar levels and reduce the risk of lightheadedness.
- Iron-rich foods: For individuals with anemia-related lightheadedness, increasing iron intake may be beneficial.
- Vitamin B12 sources: Adequate B12 intake is important for neurological function and may help prevent certain types of dizziness.
These dietary strategies should be considered in conjunction with appropriate sodium intake as part of a holistic approach to managing lightheadedness and promoting cardiovascular health.
The Role of Patient Education and Self-Monitoring
The complex relationship between sodium intake, diet, and lightheadedness underscores the importance of patient education and self-monitoring. Empowering individuals with knowledge and tools can lead to better management of symptoms and improved overall health outcomes.
Key components of patient education and self-monitoring include:
- Understanding sodium sources: Learning to identify high-sodium foods and read nutrition labels.
- Recognizing symptoms: Being able to differentiate between various types of dizziness and lightheadedness.
- Keeping a symptom diary: Tracking episodes of lightheadedness along with dietary intake and other potential triggers.
- Home blood pressure monitoring: Regular blood pressure checks can help individuals and their healthcare providers make informed decisions about sodium intake and medication adjustments.
- Learning proper standing techniques: Understanding how to rise slowly and safely to minimize the risk of lightheadedness.
- Awareness of hydration status: Monitoring urine color and thirst levels to maintain proper hydration.
By actively participating in their care and monitoring their symptoms, individuals can work more effectively with their healthcare providers to develop personalized strategies for managing lightheadedness and optimizing their overall health.
Effects of sodium intake on postural lightheadedness: Results from the DASH-sodium trial
Randomized Controlled Trial
. 2019 Mar;21(3):355-362.
doi: 10.1111/jch.13487.
Epub 2019 Jan 28.
Allison W Peng
1
, Lawrence J Appel
1
, Noel T Mueller
1
, Olive Tang
1
, Edgar R Miller 3rd
1
, Stephen P Juraschek
2
Affiliations
Affiliations
- 1 The Johns Hopkins University School of Medicine, The Johns Hopkins Bloomberg School of Public Health, and The Welch Center for Prevention, Epidemiology and Clinical Research, Baltimore, Maryland.
- 2 Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.
PMID:
30690866
PMCID:
PMC6420359
DOI:
10.1111/jch.13487
Free PMC article
Randomized Controlled Trial
Allison W Peng et al.
J Clin Hypertens (Greenwich).
2019 Mar.
Free PMC article
. 2019 Mar;21(3):355-362.
doi: 10.1111/jch.13487.
Epub 2019 Jan 28.
Authors
Allison W Peng
1
, Lawrence J Appel
1
, Noel T Mueller
1
, Olive Tang
1
, Edgar R Miller 3rd
1
, Stephen P Juraschek
2
Affiliations
- 1 The Johns Hopkins University School of Medicine, The Johns Hopkins Bloomberg School of Public Health, and The Welch Center for Prevention, Epidemiology and Clinical Research, Baltimore, Maryland.
- 2 Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.
PMID:
30690866
PMCID:
PMC6420359
DOI:
10. 1111/jch.13487
Abstract
Lightheadedness after standing contributes to adverse clinical events, including falls. Recommendations for higher sodium intake to treat postural lightheadedness have not been evaluated in a trial setting. The Dietary Approaches to Stop Hypertension (DASH)-Sodium trial (1998-1999) tested the effects of the DASH diet and sodium reduction on blood pressure (BP). Participants were randomly assigned to DASH or a typical Western diet (control). During either diet, participants ate three sodium levels (50, 100, 150 meq/d at 2100 kcal) in random order for 30-days, separated by 5-day breaks. Participants reported the presence and severity of postural lightheadedness at baseline and after each feeding period. There were 412 participants (mean age 48 years; 57% women; 57% black). Mean baseline SBP/DBP was 135/86 mm Hg; 9.5% reported baseline lightheadedness. Among those consuming the DASH diet, high vs low sodium increased lightheadedness (OR 1. 71; 95% CI: 1.01, 2.90; P = 0.047) and severity of lightheadedness (P = 0.02), but did not affect lightheadedness in those consuming the control diet (OR 0.77; 95% CI: 0.46, 1.29; P = 0.32). Among those consuming high vs low sodium in the context of the DASH diet, adults <60 vs ≥60 years old experienced more lightheadedness (P-interaction = 0.04), along with obese vs non-obese adults (P-interaction = 0.01). In the context of the DASH diet, higher sodium intake was associated with more frequent and severe lightheadedness. These findings challenge traditional recommendations to increase sodium intake to prevent lightheadedness.
Trial registration:
ClinicalTrials.gov NCT00000608.
Keywords:
DASH diet; orthostatic lightheadedness; sodium; trial.
©2019 Wiley Periodicals, Inc.
Conflict of interest statement
w3.org/1999/xlink” xmlns:mml=”http://www.w3.org/1998/Math/MathML” xmlns:p1=”http://pubmed.gov/pub-one”>The authors have no conflicts of interest to report. Figures
Figure 1
Frequency of postural lightheadedness by…
Figure 1
Frequency of postural lightheadedness by diet and sodium level
Figure 1
Frequency of postural lightheadedness by diet and sodium level
Figure 2
Odds are presented on a…
Figure 2
Odds are presented on a natural log scale. A, Odds of postural lightheadedness…
Figure 2
Odds are presented on a natural log scale. A, Odds of postural lightheadedness (high vs low sodium) by subgroup, in the control diet. B, Odds of postural lightheadedness (high vs low sodium) by subgroup, in the DASH diet. DASH, Dietary Approaches to Stop Hypertension
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Why Am I Lightheaded? | Symptoms of Too Much Sodium
- Endurance athletes like runners need to consume sodium—one of the main electrolytes—to help their performance, but too much can be a problem.
- A high sodium intake can cause lightheadedness upon standing, according to new research published in the Journal of Clinical Hypertension.
- Shoot for no more than than 2,300 milligrams of sodium per day to reduce the risk of lightheadedness, as well as for other issues like high blood pressure.
As runners, we know that electrolytes help us fuel our miles. One of the most common? Sodium. If you don’t get enough, you might experience things like muscle cramps or spasms, loss of energy, and nausea.
What’s more, we lose electrolytes through sweat, so we tend to try to make up for it by adding more to our diets. However, going overboard on salty foods—even if you generally eat healthy—can lead to some unwanted side effects, according to a new study in the Journal of Clinical Hypertension. And not just for your heart, either.
Related Story
- 23 Foods That Pack a Ton of Electrolytes
In the study, researchers crunched the data from the completed DASH-Sodium trial, which was carried out from September 1998 to November 1999 and looked at how sodium affects blood pressure. Each of the trial’s 412 participants had to follow either the Dietary Approaches to Stop Hypertension (DASH) diet—rich in whole grains, fruits, vegetables, and low-fat dairy products—or a typical Western diet, which includes a lot of processed foods, red meat, and sugar.
Everyone ate each of the three sodium levels (a target of 1,500, 2,300, and 3,300 milligrams per day, varying slightly due to activity level and body weight) in a random order for four weeks. Half of the participants ate these sodium levels while eating foods that corresponded with the Western diet, while the other half ate these sodium levels eating foods from the DASH diet.
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Participants were also asked to answer if they were bothered by lightheadedness at each sodium level—and, if so, if it was mild, moderate, or severe.
Their findings? There was no relationship between sodium intake and lightheadedness when people ate the highly processed Western diet, but when they were eating the healthy DASH diet, another picture emerged: People who ate more sodium on DASH were more likely to experience it. In fact, 15 percent of people in the highest-sodium group experienced lightheadedness, which was the highest occurrence.
The link was also stronger in younger people and those were obese, the study found.
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While the study authors aren’t 100 percent clear about why lightheadedness was common among DASH dieters who consumed a high amount of sodium (since there were a number of differences between the two diets), they do have some theories. One of which is that a higher sodium intake can increase your resting blood pressure, which can cause greater fluctuations in it upon standing. The result? Feeling lightheaded.
The findings may be particularly important for runners, since they consume sodium regularly—and tend to already place an importance on healthy eating, including the types of foods commonly associated with the DASH diet.
“Our findings question traditional notions about the value of sodium in daily life and highlight how its effects can vary based on body weight, age, and background diet,” Stephen P. Juraschek, M.D., study coauthor and primary care physician at Beth Israel Deaconess Medical Center told Runner’s World. “Most Americans consume well above the recommended amount of sodium, which has negative effects on long-term heart health. Often, athletes are exposed to even more total sodium because they consume more calories for their training regimens.”
Juraschek recommends getting no more than 2,300 mg of sodium per day—the medium intake level in the study—to help decrease your risk of high blood pressure, which has also been linked to more sodium.
“Most Americans consume way too much sodium already, with 75 percent of sodium coming from processed foods,” he said. “As a result, I think this study should cause all adults—non-athletes and athletes alike—to become aware of how much sodium they are consuming and consider ways to cut down. ”
The bottom line? While sodium is necessary for fueling your runs, getting too much of it still puts you at risk for health issues like lightheadedness and high blood pressure—both of which are dangerous if left unchecked.
Danielle Zickl
Senior Editor
Danielle Zickl for Runner’s World and Bicycling.
Addisonian crisis – causes, symptoms, diagnosis, prevention and treatment
Synonyms
Addisonian crisis is also known as acute adrenal crisis or acute adrenal insufficiency.
General information
This is a serious complication of a disease called Addison’s disease or primary Addison’s disease. It is characterized by a sharp decrease in the level of adrenal hormones such as cortisol and aldosterone.
Addisonian crisis may result from stress, trauma, surgery, or improper use or withdrawal of glucocorticosteroid drugs. It may also be the first manifestation of Addison’s disease if the diagnosis has not yet been made.
Addisonian crisis symptoms may include:
- Severe weakness and fatigue
- Severe abdominal pain
- Loss of appetite and weight
- Low blood pressure
- Nausea and vomiting
- Increased thirst and urination
- Increased skin pigmentation (darkness)
Addisonian crisis is a medical emergency requiring immediate treatment. If an Addisonian crisis is suspected, seek immediate medical attention or call an ambulance. Treatment usually includes injections of glucocorticosteroids and restoration of normal electrolyte levels in the body.
Statistics
Addison’s disease occurs in about 1 case per 100,000 people per year. Addisonian crisis, as a complication of this disease, is a rarer event. The exact frequency of Addisonian crisis is unknown, but it is estimated at about 4 to 6 cases per 100,000 people per year.
However, statistics may vary depending on geographic location, presence of risk factors and other factors.
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Causes
Addisonian crisis usually occurs as a result of acute adrenal insufficiency. The predominant cause of an Addisonian crisis is Addison’s disease or primary Addison’s disease. This is a chronic disease in which the adrenal cortex does not produce enough hormones such as cortisol and aldosterone.
Major causes of Addison’s disease include:
- Autoimmune disorders: Most cases of Addison’s disease are caused by autoimmune destruction of the adrenal cortex, where the body’s immune system attacks and destroys its own tissues.
- Tuberculosis of the adrenal glands: In rare cases, especially in developing countries, tuberculosis can affect the adrenal glands and lead to their insufficiency.
- Adrenal Infections, Tumors, or Injuries: Rare cases of Addison’s disease can be caused by infections (eg, the flu), tumors, or injuries that damage the adrenal glands and impair their function.
It is important to note that an Addisonian crisis can occur with an acute loss of adrenal hormones, eg, when glucocorticosteroid drugs are discontinued or reduced (eg, when self-medicating or improperly discontinuing drugs).
Addisonian crisis symptoms
Severe weakness and fatigue: Patients may experience extreme weakness and lack of energy, significantly reducing their ability to perform normal tasks.
Low blood pressure: Very low blood pressure (hypotension) can cause dizziness, fainting, or loss of consciousness.
Loss of Appetite and Weight: Patients may experience decreased appetite resulting in weight loss.
Severe abdominal pain: Severe abdominal pain is possible, which can lead to confusion with other pathological processes in the abdomen.
Nausea and vomiting: Uncontrolled nausea and vomiting may be symptoms of an Addisonian crisis.
Increased thirst and urination: Patients may experience a strong desire to drink and frequent urination.
Increased skin pigmentation (darkness): Patients may notice the appearance of dark spots or pigmentation on the skin, especially in the folds, nipples, lips, mucous membranes and other areas with increased solar exposure.
Mood Disorders: Patients may experience irritability, depression, decreased mood and general emotional instability.
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Which doctor treats
The main specialists who may be involved in the treatment of Addisonian crisis include:
Endocrinologist: A doctor who specializes in endocrine disorders such as Addison’s disease. The endocrinologist diagnoses, determines the cause of the Addisonian crisis and prescribes the appropriate treatment.
Emergency Physician: An Emergency or Critical Care Physician may be involved in the management of an Addisonian crisis while providing emergency medical care and stabilizing the patient.
General Practitioner: The local physician may be the first point of contact for a patient with Addisonian crisis and may provide emergency care before referral to the hospital.
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Diagnosis of Addisonian crisis
Diagnosis of Addisonian crisis is made through a medical examination and laboratory tests. The doctor will take into account the clinical picture, symptoms, anamnesis and will carry out the following diagnostic procedures:
History and Physical Examination: The doctor will collect detailed information about symptoms, medical and family history, and perform a physical examination to evaluate the patient’s general condition.
Lab Tests: Blood will be taken to analyze levels of cortisol and other hormones such as aldosterone and adrenocorticotropic hormone (ACTH). Low cortisol levels with elevated ACTH may indicate an Addisonian crisis.
Electrolyte balance: Blood tests will be done to assess electrolyte levels such as sodium, potassium, and others that may be disturbed in an Addisonian crisis.
Immunological tests: Immunological tests may be done to detect autoimmune antibodies that may be indicative of Addison’s disease or other autoimmune disorders.
Additional tests: In some cases, additional tests, such as tests for adrenal function, imaging (eg, CT or MRI of the adrenal glands), and others, may be done to further evaluate the condition.
Diagnosis of Addisonian crisis includes a medical assessment of symptoms and laboratory tests that measure hormone and electrolyte levels.
Treatment of Addisonian crisis
Treatment of Addisonian crisis is aimed at restoring normal hormone levels and stabilizing the patient. It includes the following measures:
Glucocorticosteroid replacement therapy: Patients with Addisonian crisis are usually given injections of glucocorticosteroids such as hydrocortisone or dexamethasone. It helps restore cortisol levels in the body.
Mineralocorticosteroid replacement therapy: If aldosterone levels are also low, patients may be given a mineralocorticosteroid such as fludrocortisone. This helps to compensate for the loss of electrolytes and maintain a normal balance of sodium and potassium.
Fluid and Electrolyte Restoration: Patients may be given fluid and electrolyte infusions to compensate for fluid and electrolyte loss, especially with accompanying vomiting and diarrhea.
Anti-shock therapy: In the case of low blood pressure, patients may be given vasoconstrictor drugs or infusions of vasoconstrictor drugs to maintain stable blood pressure.
Keep warm: Patients with Addisonian crisis may need to keep warm and avoid hypothermia.
If left untreated
If Addisonian crisis is left untreated, it can lead to serious complications and even a life-threatening situation. Addison’s disease, which is the main cause of an Addisonian crisis, is characterized by a deficiency of cortisol and sometimes aldosterone in the body. Without adequate treatment, low levels of these hormones can cause the following problems:
Hypotension: Low cortisol levels can lead to a decrease in blood pressure, which can cause dizziness, weakness, loss of consciousness, and other symptoms associated with insufficient blood supply to organs and tissues.
Electrolyte Disorder: Low aldosterone levels can disrupt the body’s electrolyte balance, especially sodium and potassium levels. This can lead to heart arrhythmias, muscle cramps, nervous system dysfunction, and other serious problems.
Stress resistance: Cortisol plays an important role in regulating the body’s stress response. A lack of cortisol can lead to a decrease in the body’s ability to adapt to stress and cause complications from surgery, injury, or other stressful situations.
Convulsions: Lack of cortisol and low sodium levels in the blood can cause seizures and convulsions.
Hypoglycemia: Low cortisol levels can lead to low blood glucose levels, which can cause hypoglycemia accompanied by weakness, dizziness, seizures, and even loss of consciousness.
Self-help
If Addisonian crisis is suspected, self-treatment is not recommended. However, it is important to know what actions can be taken before the ambulance arrives:
Call 911: If you experience or suspect symptoms of an Addisonian crisis, call 911 immediately or go to the nearest medical facility.
Do not stop taking your medications: If you are already taking medications for Addison’s disease, do not stop using them unless your doctor tells you to.
Stay safe: If you are alone, make sure you are in a safe environment. If necessary, call someone from your loved ones or neighbors for help.
Avoid stressful situations: Diligently avoid physical and emotional stress, which can aggravate an Addisonian crisis. Try to stay calm and relaxed.
It is important to note that self-treatment of Addisonian crisis is neither effective nor safe. The most important thing is to seek immediate medical attention and follow the doctor’s recommendations.
Risks
Arterial hypotension: A lack of cortisol can lead to a decrease in blood pressure, which can cause serious problems with blood circulation, including organs and tissues.
Electrolyte disturbance: Low levels of aldosterone, a hormone responsible for managing electrolyte balance, can cause disturbances in sodium and potassium levels. This can lead to serious heart rhythm disturbances, muscle cramps, and other problems.
Convulsions: Lack of cortisol and low sodium levels in the blood can cause seizures and convulsions.
Hypoglycemia: Insufficient levels of cortisol can lead to low blood glucose levels, which can cause hypoglycemia. This can lead to convulsions, loss of consciousness and even fall into a coma.
Organ failure: A lack of cortisol and aldosterone can lead to the weakening of the function of various organs such as the kidneys, heart and liver, which can lead to serious complications.
Sepsis: An uncontrolled Addisonian crisis can cause an infection that can develop into sepsis, a life-threatening inflammatory process that affects the entire body.
Prevention of Addisonian crisis
Prevention of Addisonian crisis involves regular treatment and monitoring of patients with Addison’s disease. Here are some tips for preventing an Addisonian crisis:
Continue your regular treatment: Take your medicines prescribed by your doctor regularly and at the correct dosage. Do not skip your medications and follow your doctor’s instructions for taking hormone replacement therapy (corticosteroids).
Know the signs of a pre-crisis condition: Talk to your doctor to find out what symptoms may indicate that you may be developing an Addisonian crisis. Knowing the harbingers will help you recognize the onset of a crisis early and take action.
Carry medical information about your condition: Carry a card or wristband with information about your diagnosis and doctor’s contact details. This will help medical professionals quickly determine your condition and provide appropriate assistance in the event of a crisis.
Discuss emergency situations with your doctor: Find out when and how to seek medical attention if you develop an Addisonian crisis. This will allow you to respond quickly and correctly if necessary.
Avoid stress and traumatic situations: Stress and traumatic situations can trigger an Addisonian crisis. Try to avoid stress, maintain emotional balance and pay attention to psychological well-being.
Plan trips and excursions: If you are planning long trips or excursions, be sure to consult your doctor about possible changes in medication dosage and special recommendations for maintaining a stable condition.
There are contraindications. Specialist consultation is required.
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Personal care: Self-care: Lenta.
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We are all used to being afraid of a sharp increase in blood pressure – a harbinger of hypertensive crises and strokes. However, blood pressure can also be low, and this condition is also the cause of many problems. Hypotension occurs when blood pressure drops below 90/60. To combat hypotension, there are many means: this is a healthy lifestyle, and proper nutrition, and taking the necessary medications. Lenta.ru learned from experts what is dangerous low blood pressure and how to deal with it.
Our autonomic nervous system controls body functions – sweating, digestion, heart rate. It also monitors the expansion and contraction of blood vessels. If its work fails, the blood vessels remain too wide, which causes low blood pressure.
It is autonomic disorders that most often cause the so-called orthostatic hypotension – a decrease in blood pressure when a person who is lying down suddenly gets up. Due to insufficient blood flow to the brain, dizziness begins, it darkens in the eyes, and fainting may even occur.
Photo: Shutterstock
What is normal blood pressure?
The normal pressure is 120/80 mm Hg, however, there may be individual differences depending on weight, age, nutrition, overwork and other factors. Low blood pressure is considered to be below 90/60 mm Hg, high pressure is more than 140/90 mm Hg.
Among other things, blood pressure is affected by age, time of day, physical activity of a person at the moment, and his psychological state. For example, in older people, blood pressure is generally higher than in young people, it also increases with stress, but after eating, blood is involved in the digestion of food, so blood pressure, on the contrary, becomes lower. Hereditary predisposition should also be taken into account – the tendency to low blood pressure can be transmitted genetically. However, one of the main factors is nutrition
Alexander Tulyankincardiologist
Hypotension (low blood pressure) causes the following symptoms:
- dizziness;
- nausea;
- weakness, fatigue;
- decreased concentration;
- blackout in the eyes.
If these symptoms appear after eating, then we are talking about the so-called postprandial hypotension, more characteristic of the elderly. The fact is that after lunch or dinner, the digestive system needs a lot of blood to digest the incoming food. Other people experience symptoms of hypotension after standing for a long time, which is more common in children and adolescents.
There are two main types of arterial hypotension – physiological and pathological. In the first case, a person feels normal, since the reduced indicators correspond to his physiological norm. If low pressure is a sign of disease, the patient experiences the above symptoms, which reduce the quality of life and require action on the original cause.
According to the cardiologist, secondary (symptomatic) hypotension often develops due to the following reasons:
- diabetes mellitus;
- Parkinson’s disease;
- vegetovascular dystonia;
- injuries and diseases of the spinal cord;
- pathology of the adrenal glands;
- infectious diseases;
- allergic reactions;
- acute or chronic blood loss;
- fasting;
- early pregnancy;
- prolonged bed rest;
- dehydration due to vomiting and diarrhoea.
Photo: Shutterstock
How do foods affect blood pressure?
Diet affects almost every aspect of health, and blood pressure is no exception. A healthy balanced diet is one of the main conditions for the well-being of the cardiovascular system and normal blood counts, and this is directly related to blood pressure values.
If we talk about hypotension, then some foods can increase the tone of the walls of blood vessels and the volume of pumped blood and, as a result, increase pressure. This is primarily salt, as well as seasonings containing sodium: they retain fluid in the body, increasing the volume of pumped blood. However, too much salt should not be consumed even by hypotensive patients.
Coffee, cocoa, strong black or green tea tone up, increase heart rate, as well as pastries, meat, high-fat dairy products – high-calorie food increases blood sugar and, as a result, pressure.
With a deficiency of foods containing vitamins E, C, group B, anemia can develop, which leads to hypotension. Therefore, citrus fruits, parsley, eggs, olive oil, avocados, nuts are indicated for hypotensive patients
Olga Fadeeva dietician
The diet of a hypotensive patient (as well as hypertensive patient) should include:
- fresh vegetables and fruits;
- nuts;
- whole grain bread;
- cereals;
- dairy and fermented milk products;
- lean meat, poultry and fish;
- boiled and baked vegetables.
The nutritionist advises to eat often, but in small portions, drink enough water, especially in the heat and during physical exertion, do not abuse alcohol, which causes dehydration.
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Treatment of arterial hypotension
It should be borne in mind that with a sharp decrease in pressure, there is a significant weakening of vascular tone and cardiac activity, as a result of which the blood supply to the brain decreases. And this is fraught with fainting, which, in turn, can cause injury.
In the event of a sudden drop in blood pressure, the first thing to do is lie down with your legs elevated to ensure blood flow to your brain and heart. Fresh air is also needed – open a window, unbutton your clothes. Drink hot sweet tea or coffee, eat something salty. If there are drugs for hypotension, take them
Alexander Tulyankincardiologist
In general, arterial hypotension is less dangerous than hypertension, and you can usually do without drugs. If medication is needed, it usually includes drugs to increase blood volume or narrow the arteries, which raises blood pressure. At first, tinctures of ginseng, magnolia vine, eleutherococcus can raise the tone of blood vessels – they are added a few drops to tea.
Cardiologists also recommend baths with herbs, natural mineral waters, massage, physical education.
The following medicines are used:
- citramon, paracetamol, caffeine – have a psychostimulating, non-steroidal anti-inflammatory effect;
- arteriole — reduces the concentration of blood cholesterol, contains fish oil, a complex of vitamins and minerals;
- Aralia root — CNS stimulant, lowers blood sugar, has general tonic properties;
- glycine – improves cerebral circulation, stimulates the flow of oxygen to the brain.
About the role of physical culture and sports
An active lifestyle is shown to hypotensive patients like no one else. Low mobility, sedentary life initially slows down blood flow, and in themselves contribute to the development of hypotension. Therefore, moderate exercise can be considered a necessity, practically a cure for people with low blood pressure. Walking in the fresh air helps, but sports are even better.
The choice of suitable sports is quite wide. You can go swimming, aerobics, athletics, cycling, horseback riding. However, it is important not to overdo it – you need to understand that your task is not to set records, that you are not engaged in sports of high achievements, but in the general improvement of the body. In case of fatigue and deterioration of health, training should be stopped.
Hypotensive patients should stay away from certain sports. First of all, this is weightlifting and, in general, any sports training related to power loads and weight lifting
right angle in the hip joint, “scissors”, pulling the knees to the chest, squats, etc.