Our body needs sodium to regulate fluids and transport electrolytes between cells, but when sodium levels are below normal, the body is faced with hyponatremia.

What is hyponatremia?

A hyponatremia is a metabolic dysfunction resulting from low sodium levels in the blood (below 135 mEq/L). It can be a result, for example, of too much water in the body or from heavy sweating, i.e., excess sweat released by the body. It can also be related to aging.

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Possible causes of hyponatremia

In principle, the most common cause for hyponatremia is excess water intake and low sodium intake. In other words, what results in the excessive secretion of the diuretic hormone vasopressin (HAD or ADH). Through the urine, sodium is eliminated.

Not only that, sodium is also eliminated through sweat, so excessive sweating can be another culprit in hyponatremia. That is, when exercising on hot days, for example, it is possible that the sodium level in the body will drop abruptly.

In addition, a deficit in the sensitivity of the receptors present in the chest, kidneys, and blood vessels responsible for detecting the drop in sodium in the blood plasma is another possible cause. So is renin-angiotensin-aldosterone, an insufficiency of the endocrine (hormonal) system, in which the reabsorption of part of the sodium excreted by the body occurs.

Other reasons for sodium deficiency

There are several factors that favor hyponatremia, see other reasons:

• Cardiac, hepatic and renal insufficiencies.
• Presence of tumors.
• Addison's disease and others that cause hormonal changes, such as hypothyroidism.
• Chronic vomiting and diarrhea.
• Inappropriate antidiuretic hormone secretion syndrome (ISADH), which produces high levels of antidiuretic hormone (ADH).

How does the body lose sodium?

The sodium that accumulates in the body is released in various ways, such as sweat and urine. However, if an individual undergoes any of the above-mentioned situations (intense physical exercise and heavy fluid intake, for example), the body eliminates more sodium than it should. In addition, if a person is suffering from a virus or food poisoning, sodium may be lost throughvomiting and diarrhea.

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Symptoms and possible side effects of hyponatremia

• Cerebral edema (swelling of part or all of the brain)
• Seizures
• Eat
• Headache
• Sleepiness and fatigue
• Vomiting and cramps
• Muscle spasms

How is the diagnosis made?

The diagnosis of hyponatremia is made from blood tests in which the sodium level in the blood is checked. Thus, with a concentration lower than 135 mEq/L, the doctor can determine hyponatremia.

Recommended treatment

The care for hyponatremia varies according to the severity of the symptoms and whether the condition is acute or chronic. If the individual has severe acute hyponatremia, the most common treatment is sodium replacement via saline solution, but the amount must be evaluated by the doctor, as it depends on the level of sodium loss and individual need.

On the other hand, if the illness is related to other diseases, it is important to treat them together to stabilize the patient's health.

Who can have hyponatremia?

Anyone is subject to sodium deficiency; however, children, the elderly, and the frail need more attention, because hyponatremia can worsen and cause complications.

Which doctors to look for?

If you have suspicious symptoms of hyponatremia, you should see a general practitioner to evaluate your health, so that, if necessary, the specialist can refer you to other doctors.

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Source : Natan Chehter, geriatrician, member of the Brazilian Society of Geriatrics and Gerontology and of the Beneficência Portuguesa Hospital of São Paulo.