Hyponatremia (Low Blood Sodium): Symptoms, Causes, Treatment

Hyponatremia is diagnosed when there is too little sodium in your blood. It can be caused by a variety of factors.

Sodium is an essential electrolyte that helps maintain the balance of water in and around your cells. It’s important for proper muscle and nerve function. It also helps maintain stable blood pressure levels.

Insufficient sodium in your blood is known as hyponatremia. It occurs when water and sodium are out of balance. In other words, there’s either too much water or not enough sodium in your blood.

Normally, your sodium level should be between 135 and 145 milliequivalents per liter. Hyponatremia occurs when your sodium level goes below 135 mEq/L.

Symptoms of low blood sodium can vary from person to person. If your sodium levels fall gradually, you may not experience any symptoms at first, but they will eventually manifest. If they drop very quickly, your symptoms may be more obvious and severe.

Common symptoms of hyponatremia include:

• weakness
• fatigue or low energy
• headache
• nausea
• vomiting
• muscle cramps or spasms
• confusion
• irritability

Severe symptoms of hyponatremia

Losing sodium quickly is a medical emergency. It can cause:

• overactive reflexes
• loss of consciousness
• seizures
• coma
• and in the most severe cases, death

If you or someone you know seems to be losing consciousness or is having a seizure, call 911 immediately.

Many factors can cause hyponatremia. Your sodium levels may get too low if your body loses too much water and electrolytes. Hyponatremia may also be a symptom of certain medical conditions.

Causes of hyponatremia include:

• severe vomiting or diarrhea
• taking certain medications, including antidepressants and pain medications
• taking diuretics (water pills)
• drinking too much water during exercise (this is very rare)
• dehydration
• kidney disease or kidney failure
• liver disease
• heart problems, including congestive heart failure
• adrenal gland disorders, such as Addison’s disease, which affects your adrenal gland’s ability to regulate the balance of sodium, potassium, and water in your body
• hypothyroidism (underactive thyroid)
• syndrome of inappropriate antidiuretic hormone (SIADH), which makes your body retain water
• diabetes insipidus, a rare condition in which the body doesn’t make antidiuretic hormone
• Cushing’s syndrome, which causes high cortisol levels (this is rare)

Certain factors increase your risk of hyponatremia, including:

• older age
• diuretic use
• antidepressant use
• being a high-performance athlete (i. e., a marathon runner)
• living in a warmer climate
• eating a low-sodium diet
• having heart failure, kidney disease, syndrome of inappropriate antidiuretic hormone (SIADH), or other conditions

If you’re at risk for low sodium, you may need to be more careful about your intake of electrolytes and water. Make sure to talk to your doctor about your risk factors and if there are any steps you can take to lessen your risk.

If hyponatremia is not treated, it can lead to serious complications, including:

• osteoporosis
• brain swelling
• brain injury
• seizures
• death
• osteoporosis and bone fractures

If you are at a higher risk for hyponatremia due to preexisting conditions, it’s important to take any new symptom seriously and talk to a doctor as quickly as possible.

A blood test can help your doctor check for low sodium levels. Even if you don’t have symptoms of low blood sodium, your doctor may order a basic metabolic panel. This tests the amounts of electrolytes and minerals in your blood.

A basic metabolic panel is often part of a routine physical. It may identify low blood sodium in someone without any symptoms.

If your levels are abnormal, your doctor will order a urine test to check the amount of sodium in your urine. The results of this test will help your doctor determine the cause of your low blood sodium:

• If your blood sodium levels are low but your urine sodium levels are high, your body is losing too much sodium.
• Low sodium levels in both your blood and your urine mean your body isn’t taking in enough sodium. There may also be too much water in your body.

If your doctor is still unsure of a diagnosis, they may order a few other tests to check for hyponatremia, including:

• liver function tests
• a chest X-ray or computed tomography (CT) scan of your chest
• CT scan of your head

Treatment for low blood sodium varies depending on the cause, how severe the symptoms are, and how low your blood sodium levels are. It may include:

• cutting back on fluid intake
• adjusting the dosage of diuretics
• taking medications for symptoms such as headaches, nausea, and seizures
• treating underlying conditions
• stopping or changing a medication for a chronic condition that may be negatively affecting blood sodium
• an intravenous (IV) sodium solution

Keeping your water and electrolyte levels as balanced as possible can help prevent low blood sodium.

If you’re an athlete, it’s important to drink the right amount of water during exercise.

You may also want to consider drinking rehydration beverages. These drinks contain electrolytes, and help replenish sodium lost through sweating. These drinks are also helpful if you lose a lot of fluids through vomiting or diarrhea.

Staying hydrated throughout the day can help manage any wild swings in blood sodium. When you’re adequately hydrated, your urine will be pale yellow or clear, and you won’t feel thirsty.

It’s important to increase your fluid intake if:

• the weather is warm
• you’re at a high altitude
• you’re pregnant or breastfeeding
• you’re vomiting
• you have diarrhea
• you have a fever

Don’t forget that it’s possible to drink too much water too quickly. This is another reason to maintain good hydration throughout the day.

Hypernatremia is a condition that is closely related to hyponatremia.

What is hypernatremia?

While hyponatremia involves low levels of sodium in the blood, hypernatremia occurs when there is too much sodium.

When a person doesn’t get enough water, either because of limited access to water or an impaired thirst mechanism, they can develop hypernatremia. It’s caused less commonly by diabetes insipidus.

Hypernatremia occurs when your serum sodium level exceeds 145 milliequivalents per liter (Eq/L).

Hypernatremia can cause:

• confusion
• neuromuscular excitability
• hyperreflexia
• seizures
• coma

Hyponatremia is diagnosed when there is too little sodium in your blood. It can be caused by a variety of factors, from conditions like Addison’s disease or Cushing’s syndrome, to excessive vomiting or diarrhea.

Hyponatremia can be mild, and cause no symptoms, or it can be very severe and life threatening.

Typically, if hyponatremia is caught in the mild stage and treated, or treated swiftly in the severe stage, it can be reversed.

Salt, not high blood pressure, may be to blame for that headache

‘Tis the season to be, well, gluttonous. But with increasing intakes of fat and sugar also comes increased salt consumption. Now, a new study published in the journal BMJ Open suggests diets high in salt are implicated in pesky headaches, and this link may be independent of the “well-established link” between salt intake and high blood pressure, which is a common cause of headaches.

Share on PinterestThe new study suggests a salty diet may be the main culprit when it comes to that pesky holiday headache.

The study authors – led by Dr. Lawrence Appel, director of the Welch Center for Prevention, Epidemiology and Clinical Research at Johns Hopkins Medicine in Baltimore, MD – note that headache is a common medical problem around the world and is one of the most frequently reported nervous system disorders.

Worldwide, they note that 46% of adults have a reported active headache disorder, causing many to have a poor quality of life and higher number of days absent from work.

Dr. Appel and his colleagues say that current data support a link between blood pressure and headache; however, evidence on the link between headaches and sodium intake or other dietary factors is sparse, with most research focusing on the role of monosodium glutamate (MSG) consumption.

According to the American Heart Association (AHA), most people in the US consume about 3,400 mg of sodium a day, which is more than twice the 1,500 mg suggested by the organization.

In order to further investigate the effects of diet on headache occurrence, the researchers randomized 390 study participants to either the Dietary Approaches to Stop Hypertension (DASH) diet – which is rich in fruits, vegetables and low-fat dairy products with reduced saturated and total fat – or to a control diet that was a typical Western diet.

During the study, which consisted of three 30-day periods, each participant ate food with high sodium during one period, intermediate sodium during another and low sodium during another period. Then, at the end of each feeding period, the participants completed questionnaires on occurrence and severity of headache.

Results showed that people who ate foods high in sodium – around 8 g per day – had one third more headaches than those who ate foods low in sodium – around 4 g per day. Additionally, the researchers observed that this difference remained whether the volunteers ate the standard Western diet or the DASH diet.

The researchers say their results depart from the popular belief that a diet rich in fruits, vegetables and potassium and low in saturated fat can ease or prevent headaches.

They add:

“It is noteworthy that there was no significant relationship between diet pattern and headache. This suggests that a process that is independent of blood pressure may mediate the relationship between sodium and headaches. ”

What is more, the team says adults in the US are already consuming sodium “in excess of their physiological need,” and for many individuals, this intake is higher than the highest level tested in their research.

Though the study benefits from its randomized design, there were some limitations, including lack of information on prevalence of headaches in study participants at baseline. Additionally, the data collected on headache occurrence and severity was self-reported, which could be another limitation.

Still, Dr. Appel says their findings suggest that by reducing salt consumption, people might be able to avoid some headaches. He and his colleagues note that “additional studies are needed to replicate these findings and to explore mechanisms that mediate the association between sodium intake and headache.”

Medical News Today recently reported on a study that suggested added sugars may contribute to high blood pressure more than salt.

Salt can cause headaches

Unfortunately, the population consumes more and more food every year. But as fat and carbohydrate intake increases, salt intake also increases. The latest study, published in the journal BMJ Open, concluded that diets high in sodium chloride may be associated with persistent headaches, and this association may be independent of the generally accepted view that there is a correlation between sodium chloride intake and high blood pressure, which is a common cause of headaches.

Dr. Lawrence Appel and colleagues at the Johns Hopkins University Medical Research Center in Baltimore emphasized that headache is one of the most common medical problems in virtually the entire world and is one of the most common symptoms of diseases of the nervous system.

They note that according to statistics, 46% of adults report the presence of intense headaches, as a result of which, many of them have a reduced quality of life and an increase in the number of days of incapacity for work.

Dr. Appel and colleagues say that current evidence supports a link between blood pressure and headache; However, data on the association between headache and sodium chloride intake have not been studied, and most studies have focused on the role of monosodium glutamate intake.

According to the American Heart Association, most US adults consume about 3400 mg of sodium chloride per day, more than double the recommended dose of 1500 mg.

To further explore the effect of diet on headaches, the researchers randomized data from 390 participants in a study that compared the effects of different diets on hypertension, a diet rich in vegetables, fruits, and reduced-fat dairy products, with a control standard diet.

“Blood pressure independent process” may cause headache

The study included three periods of 30 days, each participant ate a high sodium chloride meal for one period, then a period of eating a meal with a medium content of sodium chloride and last period with low salt content. Then, at the end of each specific diet period, participants recorded the frequency and severity of headaches on questionnaires.

The results of the study showed that people who ate a diet high in sodium chloride – about 8 g per day – noted a third more frequency and intensity of headaches than those who ate a diet low in sodium – about 4 g per day. day. It was also noted that this difference remained no matter what the diet was (specialized or standard)

prevent headaches.

They add:

“It should be noted that there was no association between diet patterns and headaches. This suggests that a process that is independent of blood pressure may indirectly link dietary salt levels to headaches.”

What’s more, scientists say adults in the US consume much more salt than they should, and many consume more salt than was used in the study.

And although the results of the study are sufficient, reliable, there is a certain drawback of the study due to the fact that data on the presence of headaches and their intensity at the beginning of the study were not taken into account.

However, Dr. Appel says their results show that by reducing salt intake, people could avoid headaches. He and his colleagues note that “more research is needed to replicate these findings and to explore the mechanisms that mediate the association between sodium intake and headache.”

Salt: benefits, harms, daily allowance, nutritionist’s opinion

. Dietitian and endocrinologist

Dietitian Alexandra Razarenova: radical restriction of salt in the diet is ineffective and even harmful to the body

Updated April 10, 2023 11:56 AM

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Who should limit or eliminate salt from their diet? We understand together with experts what threatens the lack and excess of the product in the diet.

Content

1. Species
2. Benefit
3. Harm
4. Daily Value
5. Contraindications
6. Excess and deficiency 9005 0
7. Intake control
8. Nutritionist opinion

Salts

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In addition to the usual sea and rock salts, there are other types of salt

Salt is sodium chloride, a naturally occurring compound commonly used as a seasoning. In addition to enhancing the taste, it is also a food preservative that stops the growth of bacteria in food [1].

Salt has gotten a bad rap over the past few decades, being linked to conditions such as high blood pressure, heart disease, and even stomach cancer. Nutritionists recommend limiting its intake to 2300 mg per day [2]; it’s about one teaspoon.

Salt can be coarse, medium and fine, and according to the purity of the product, it is assigned the highest, first or second grade. In addition to the sea and rock salts that are familiar to most people, there are other types of salt; each of them differs in composition, color, smell and intensity of taste. For example, there are black Indian, pink Himalayan, Celtic, Maldon, kosher and flower salts on sale, as well as mixtures of the product with various spices and herbs for cooking. The following types are most commonly used.

Rock salt

Natural product from mines. Differs in a gray shade and intensive taste.

Table salt

The most common, bleached salt, which is prepared from rock salt.

Sea salt

Considered as useful as possible. It is a natural source of trace elements: calcium, potassium, phosphorus, magnesium, manganese, zinc, iron, selenium, silicon and iodine.

Iodized salt

The addition of iodine helps to avoid deficiency of this trace element. Keep in mind that such salt is contraindicated for people with diagnosed thyroid hyperactivity.

Black salt

Unrefined product that improves digestion. Black salt contains potassium, iodine, iron and sulfur.

“Extra”

Contains only pure sodium chloride. In the process of evaporating water and cleaning with soda, all useful trace elements are destroyed. Such salt, although it gives taste, is practically useless for the body.

Benefits of salt

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Salt intake is good, but only if you control the amount of salt in your daily diet

Salt consists of two minerals: sodium and chlorine, as well as minor substances that play an important role in health, participating in electrolyte balance, muscle contraction and the fight against microbes. Salt is important for many bodily functions, including maintaining hydration and replenishing iodine deficiency [3]::

1. Helps to recover. Sodium is involved in muscle contraction, and its loss through sweat or fluid can provoke muscle spasms [4].
2. Promotes electrolyte balance [5]. Electrolytes are atoms found in bodily fluids that carry an electrical charge and are essential for everything from nerve impulses to fluid balance.
3. Regulates blood pressure and supports the nervous system [6], [7]. Salt retains water in the body, and it, in turn, is necessary for all nervous processes.
4. Has an antibacterial effect [8]. Due to its antiseptic properties, salt inhibits putrefactive processes in the digestive system.
5. Replenishes iodine deficiency [9]. A prolonged lack of iodine can provoke diseases of the gastrointestinal tract, cardiovascular and skeletal systems, neurological disorders, and in children it can lead to developmental delays.
6. Maintains hydration by keeping cells hydrated . Lack of fluid in muscles and tissues is fraught with a feeling of chronic fatigue, spasms and lack of strength [10].

“Salt is 40% sodium and 60% chlorine. Both of these macronutrients play an important role in the body. Sodium is involved in the metabolism between the cell and the intercellular space, triggers the synthesis of steroid hormones of the adrenal glands. Sodium deficiency leads to an increase in the adrenal hormone aldosterone, which retains fluid in the body and removes potassium. So there is a violation of homeostasis – the constancy of the internal environment. Sodium deficiency is accompanied by various unpleasant symptoms: weakness and pain in the muscles, headache and others. Chlorine is necessary for the formation of hydrochloric acid.

Alexandra RazarenovaDietitian, nutritionist, therapist, member of the Russian Union of Nutritionists, Nutritionists and Food Industry Specialists

Harmful salt

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The main harm comes from an excess of salt in the diet

Consider the individual characteristics of the organism. Some people are not affected by a high-salt diet, while others may experience hypertension or bloating as a result of such a diet. The second category of people is considered sensitive to salt; they should carefully control the consumption of the product.

The main harm occurs due to an excess of salt in the diet. It can be expressed in the following symptoms and conditions:

1. Fluid retention. Excessive salt intake leads to swelling and impairs the functioning of internal organs.
2. Pressure increase . With an excess of moisture, the vessels narrow, which increases the load on the circulatory system.
3. Hypernatremia – sodium surplus, the symptoms of which are convulsions, drowsiness, intense thirst and even epileptic seizures. Especially this condition is promoted by dehydration against the background of poisoning and high temperature.

Salt is addictive, which is used by manufacturers of salty snacks and snacks. Studies have shown that it stimulates the brain in the same way as nicotine and narcotic substances [11].

Daily Salt

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Excessive salt intake distorts taste perception and reduces receptor sensitivity

“The daily intake for adults is 5-6 g (full teaspoon). Elderly and pregnant women, as a rule, require less salt, because they have a tendency to edema, arterial hypertension, preeclampsia (a condition that develops in the second half of pregnancy). That is, for a healthy person, 5 g is an acceptable norm, and with a tendency to puffiness, this amount should be limited to 3.5 g per day.

It is generally accepted that salt improves the taste of dishes. But studies also show the opposite: excessive salt consumption distorts the perception of taste, reduces the sensitivity of receptors [12]. It turns out that this product, on the one hand, is vital for the body, on the other hand, it can cause significant harm. Solution: monitor the amount in the diet and adjust the rate, consulting a doctor if necessary.

Elena Ostrovskaya endocrinologist, specialist in anti-age and preventive medicine at the European Medical Center

Contraindications

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People with hypertension, kidney disease, heart failure, and those with edematous syndrome should limit their salt intake

There are no recommendations for the complete elimination of salt, Elena Ostrovskaya believes. Sodium is essential for the body. Without it, the pressure in the tissues and cells is disturbed, the metabolism between the cell and the intercellular environment becomes more difficult, filtration in the kidneys decreases, and the work of the adrenal glands may suffer. There are categories of people who need to limit salt in their diet. First of all, these are people with arterial hypertension, kidney disease, heart failure, as well as those who have edematous syndrome.

Even if the edema is due to some other reason, such as severe protein deficiency, excess salt will contribute to fluid retention. Therefore, it is important to limit its quantity, the expert clarifies.

Symptoms of excess and deficiency of salt

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Both too much and too little salt in the diet can lead to headaches

Elena Ostrovskaya says that salt retains water; with its overabundance in the diet, headaches, increased blood pressure can be observed. As a rule, there is swelling. With a lack of salt, weakness, low blood pressure are diagnosed, and headaches are also not uncommon. “In principle, the symptoms are similar to the situation when there is too much salt (except that the pressure decreases rather than increases,” the endocrinologist clarifies.

When a person rarely adds salt to dishes, changes in taste sensations and eating habits are not excluded. Ten healthy people who took part in the doctors’ experiment ate unsalted food for ten days. They took taste tests before and after the diet, evaluating the taste of 29 different foods. In addition, doctors took blood and hormone tests from the respondents. The study confirmed that sodium deficiency increases cravings for salt, such dishes are rated as the most delicious [13].

How to control salt intake and how to replace it

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If you decide to reduce your salt intake and your food seems bland, try adding turmeric, peppers or asafoetida

“Before you reduce the amount of salt in your diet, you need to understand how much you eat. The WHO recommended salt intake is approximately one heaping teaspoon.

However, this amount may vary depending on comorbidities (eg, decrease with arterial hypertension and kidney disease) and lifestyle. If you are actively involved in sports, sweat a lot, and also in the hot season, the salt intake may be slightly increased due to the need to compensate for electrolyte losses. Do not forget about the added salt in finished products. If you salt a lot of food during cooking, add salt after, and use foods that obviously contain salt: there is a high degree of probability that there is an excess of it in your diet.

Changes should be introduced gradually. For example:

• start cooking homemade food without salt, and add it to the plate;
• , on the contrary, take it as a rule: if salt was added during cooking, do not add salt to food in finished form;
• minimize, or better yet, completely exclude processed meat products, chips, crackers, salty snacks and nuts from the diet;
• do not salt canned foods.

At the same time, it is also not worth drastically limiting salt in the diet. It is ineffective and even harmful to the body.

I advise you not to look for a substitute for salt, but to monitor its amount: you can add various types of salt to the diet, without limiting yourself exclusively to table salt. In addition, it is more often processed and may contain anti-caking additives. Pay attention to:

• pink Himalayan salt, which will not only give your dish the usual salty taste, but also enrich the diet with 84 trace elements;
• rock salt is a complete source of sodium and chlorine. Often it is enriched with potassium iodate, which helps in the prevention of iodine deficiency in endemic regions. You need to store it only in a closed salt shaker, since iodine is very volatile;
• sea salt is varied in taste, depending on the composition of sea water in terms of microelements;
• black salt is interesting due to its sulfur content, it has a specific “egg” taste. Less salty, in excess leads to a laxative effect.

Alexandra RazarenovaDietitian, nutritionist, therapist, member of the Russian Union of Nutritionists, Nutritionists and Food Industry Specialists

In addition, a variety of spices add flavor to dishes. So if you decide to reduce your salt intake and the food seems bland, try adding turmeric, peppers, or asafoetida.

Nutritionist’s opinion

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Dieticians do not recommend avoiding salt for a long time

“Complete elimination of salt from the diet has a temporary effect.

On a salt-free diet, water is excreted from the body, which visually, of course, can reduce body volume and make you a couple of kilograms lighter.