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What is it about ?
Sodium, together with chlorine, forms the product we all know as (table) salt. Sodium plays an important role in the body’s water balance, in the regulation of blood pressure, and in the function of muscle cells and nerves.
The human body regulates very precisely the amount of sodium in the blood, among other things via the kidneys. This quantity (rate or concentration) is practically constant. The hormone responsible for this balance is the antidiuretic hormone (called “ADH”), which is produced in the pituitary gland (a small gland located under the brain). Normally, the sodium level in the blood is 136 to 146 millimoles per liter (mmol / L).
Too low sodium level in the blood (hyponatremia) usually occurs when the intake of fluids is greater than the removal of water from the kidneys. Water then accumulates in the body, sodium is then diluted in a larger quantity of water, this is called dilution hyponatremia. This can happen in the following situations:
- extremely high water consumption, certainly in the event of prolonged physical exertion,
- glucocorticoid deficiency and underactive thyroid (hypothyroidism),
- certain medications (certain antidepressants, antiepileptics, opiates (opioids), metoclopramide),
- diseases in which unusually large amounts of antidiuretic hormone (ADH) are released (lung cancer, brain damage and trauma to the head, tuberculosis, pneumonia),
- certain diseases (anorexia, psychosis, …)
Other possible causes of sodium deficiency include:
- increased sodium loss through the digestive tract (profuse vomiting and / or severe diarrhea) or through the kidney (diuretics, kidney disease, addison’s disease, …),
- extremely low sodium diet,
- cirrhosis of the liver and heart failure.
How to recognize it?
Sodium deficiency is particularly problematic for the brain. The symptoms are therefore most often neurological: drowsiness, headaches, confusion, falls, attention deficit, difficulty walking… The symptoms depend on the speed with which the deficit sets in and the degree of sodium deficiency.
With rapid and / or severe sodium loss, there are distinct and severe symptoms, such as seizures and loss of consciousness. If sodium deficiency develops slowly or is relatively small, the symptoms are vague, for example, feeling unwell, headache, drowsiness, lethargy, unsteady gait, or decreased blood pressure. ‘Warning.
How is the diagnosis made?
The diagnosis of sodium deficiency can be made quickly with a simple blood test and possibly a urine test. Depending on your story, the doctor may also stop certain medications or order additional tests to determine the cause.
What can you do ?
Always take your medicine at the prescribed dose. In case of vomiting, diarrhea or excessive sweating, be sure to drink enough. But don’t drink too much water.
Contact the doctor if you have any symptoms that you cannot explain. Consume alcohol in moderation. There is a form of sodium deficiency caused by excessive alcohol consumption (called “beer potomania”), certainly when the person no longer eats normally and “survives” on a diet that is virtually salt-free.
What can your doctor do?
In the event of serious disorders (loss of consciousness, epileptic seizure, etc.), the doctor will treat you urgently by infusion of sodium chloride solution. Treatment is intensively monitored with frequent blood and urine tests. Drugs that can cause sodium deficiency are stopped. Treatment for severe or rapidly onset sodium deficiency is always done in the hospital.
If there is an underlying disease causing the sodium deficiency, such as cirrhosis of the liver or heart failure, this disease is of course also treated.
Want to know more?
- Selective serotonin reuptake inhibitor antidepressants – CBIP – Belgian Center for Pharmacotherapeutic Information
- Tricyclic antidepressants – CBIP – Belgian Center for Pharmacotherapeutic Information
- Antiepileptics – CBIP – Belgian Center for Pharmacotherapeutic Information
- Opioids – CBIP – Belgian Center for Pharmacotherapeutic Information
- Metoclopramide – CBIP – Belgian Center for Pharmacotherapeutic Information
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