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 (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).
Causes
The possible causes of too high sodium level in the blood (hypernatremia) are:
- insufficient hydration due to not drinking enough or not feeling thirsty
- excessive loss of fluids, for example in the event of fever, of burns, of too frequent urination (urinating too frequently) (due to diabetes), taking diuretics or kidney disease;
- excessive salt intake in the diet or tube feeding containing salt;
- an inadequate effect of antidiuretic hormone (ADH).
Where does it occur?
Too high a sodium level is found especially in seriously ill people, for example people in intensive care units or who have undergone major surgery. This is because these people are often not able to eat and drink on their own, but depend on the administration of fluid by infusion.
How to recognize it?
The symptoms of dehydration, due to fluid deficiency, are characteristic. These include, among others:
- dry mouth ;
- sunken eyes;
- difficulty swallowing;
- decreased elasticity of the skin;
- low blood pressure (hypotension).
In addition, there are also signs indicating central nervous system disorders :
- confusion ;
- drowsiness;
- decreased state of consciousness;
- stiff neck;
- in extreme cases: convulsions.
How is the diagnosis made?
The doctor will suspect excess sodium if there are signs of dehydration. It confirms the diagnosis by determining the sodium level in the blood. A urine test helps to clarify the diagnosis. To measure an ADH deficiency, there are special tests. For this, the doctor will refer you to a specialist.
What can you do ?
Always make sure you drink enough; this is especially the case in the elderly and people with dementia because they do not feel thirst very well. We need drink 1.5 to 2 liters per day. It doesn’t have to be water; coffee, soup, etc. also count. In hot weather, it is better to drink more. Preferably drink small amounts regularly.
What can the doctor do?
Treatment consists of restoring the water balance in the body. This is done by administering an infusion of serum containing salt and sugar. The doctor calculates the amount to be administered based on the sodium level measured in the blood. The serum is always administered slowly; a brief hospitalization is therefore necessary. Too rapid administration causes fluid to build up in the brain, which can lead to overpressure, which can be dangerous.
If the fluid loss is due to illness (diabetes, ADH deficiency), the doctor will of course treat this disease.
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