Chronic hyponatremia

I'm on medication for high blood pressure too. My kidney doc was well aware of that when he prescribed it. And being on it hasn't changed my BP any.

Thank you so much for letting me know! I will ask my doctor about that.

Where would you get that and what dosage

sodium chloride is table salt. If you can stand to drink it, a half tsp (teaspoon) in a glass of water is often what is recommended. Or, half that if it is easier for you to get down. But really, unless prescribed a certain dose by a qualified person, and unless that prescription comes in a tablet form (issued specifically to address your needs), you should be able to take table salt in water, or just add a few more shakes to your food.
Note that this is not qualified advice, except that I'm NOT qualified. I would ask you to consult a physician, if it's a problem with your metabolism, and ask that person if adding a bit more salt to food would help. If blood pressure rises, and you can't afford that, then you'll have to listen to a doctor advise differently.

I have a prescription of it, but it's the exact same thing as sold over the counter. I take 1gm twice a day. I just swallow them at the same time as my other meds, though you do taste them a bit.
https://www.amazon.com/Safrel-Sodium-Chloride-Tablets-15-4gr/dp/B091NKB9ZG/ref=sr_1_2_sspa

Heycal,

Oh, my goodness! I just found this thread and will be joining in soon.

For now, in short, yes! I am 49 years old and have had serum sodium readings of 130/131 since February 2020. Like you, I am not usually symptomatic but I have dropped to 125 in the wake of digestive issues/medication interaction. This landed me in the hospital for two days and was very unsettling.

I have much to say on this topic and look forward to joining the discussion soon!

Jon

@guitarman76 I look forward to hearing more. What exactly landed you in the hospital, the low numbers alone or additional issues? I think the lowest I've seen mine is 124, and don't recall every noticing anything.

Meanwhile, I'm up to 1 gm sodium tablet three times a day, and my last reading was 132. I think I managed to reach a normal score like 135 or 136 twice in the last year.

It appears that I will need to post my story in parts, so here goes part 1:

@heycal

Here I am, Sir! 🙂

I am blessed with (and cursed) with a very strong memory, so I am going to share in great detail just in case this testimony might help someone feel less alone in the future.

After 5 straight years of 130/131 readings, I went to the ER on 3/10/25 due to having the following symptoms: extreme dizziness (it was as though my brain was clanging around inside my head), major muscle weakness (it was hard to even hold up my head), waking up with a pounding heart (even though the pulse rate was around 90, it was so strong that I couldn't sleep), restlessness, a major uptick in anxiety, and muscle cramps in my abdomen.

When I arrived, I had been eating very poorly for days and not too well for the preceding two weeks beginning. I "think" the gastrointestinal issues were also due to a sodium level less than my general 130, as I woke up with my heart pounding at around 90 the evening of 2/23/25. I had been going through a very stressful period at work and was coming off of a rough cold virus, as well. I had never had IBS-D before or IBS-C, but I alternated between them for about a month after first experiencing that pounding heart rate of around 90 on the evening of 1/19/25.

Part 2:

The "pounding" heart rate is like nothing I've ever experienced before or since... It was as though my heart was going to beat out of my chest; it was harrowing! (I have a double ear infection presently, and the heart rate of 90 going up the stairs is nice and comfy in comparison.) Apart from the evening of 1/19 and 2/23, it happened again after a panic attack on the morning of 3/3. By this point, I had become very worried about my gastrointestinal issues; I also had become worried that I might have some major adrenal issues, as I had been diagnosed with very low DHEA levels back in October 2024.

After the panic attack on the morning of 3/3, I did not sleep well. I would wake up after sleeping a couple of hours and my heart would be pounding at 90 bpm or so... but I wasn't anxious. I would try to sleep, and then jolt awake from my loud, pounding heart. At that point, I was probably already around 127 or so on the scale... but then I made a HUGE mistake. I thought that perhaps I was dehydrated, so I began drinking too much water. I was adding an electrolyte solution to my water, but, given it was quite minimal (150 mg per 32 oz.), I diluted my sodium levels quickly.

By 3/7, I was extremely dizzy and was unable to pick my son up from school. I had to lie down and could barely move. Again, my head felt as though it were going to clang out of my skull. I wrote to my PCP with my concern that I might be suffering the effects of moderate to severe hyponatremia, as I had many of the symptoms. As I had never gone low enough for an ER visit, I thought, "Hey, we can bring this up with chicken soup." Knowing what I know now, I likely overcorrected by taking in way too much sodium at once, which caused me to retain fluid, further lowering my sodium.

On the evening of 3/8, I barely slept. I kept waking up with a clanging heart... I genuinely thought I was losing my mind at this point. I hadn't slept well all week and was trending towards delirium. So, I took a beta blocker - after a quick call with virtual care - and was able to sleep a lot that Sunday morning and afternoon.

The next morning, 3/10, after not sleeping well again, I was very worried about my digestive issues, having no energy, and feeling so faint. I told her that if I didn't go to the ER, I feared I wouldn't be here much longer. She thought it was just anxiety, but I felt in my bones that it was well beyond.

Part 3:

I took an Uber to the ER with all the symptoms I detailed at the start of this message. My friend from work came to sit with me, as my wife was sick and in bed that day. She could not believe how bad I looked - hunched over in a wheel chair, scarcely able to move or raise my head up. She is a licensed therapist, and she could not help me to relax at all.

When the doctor told me that they would have to keep me a couple of days due to low sodium, I said, "How low?" When he told me 125, I was both terrified and relieved at once! I thought, "Thank God it's likely not cancer or some major adrenal issue!"

When administered a normal saline bolus and then full bag, I felt so much better. By the next morning, I was at 128. The morning after, I was at 131 and was sent home.

I would like to say that all was great after that... but... it truly wasn't. Despite regaining my appetite the morning after admission - which tells me that low sodium was likely the culprit behind my poor digestion for weeks - I was very anxious in the hospital, as my room was in the ER due to no general rooms being available. I also worried that I would have permanent brain and muscle damage from my low of 125, as this all was brand new territory. (Admittedly, I should not have been consulting Dr. Google from my hospital bed...)

Three days after my discharge on 3/12, I became very weak and felt nearly bad as I had in the days leading up to my hospital stay. I woke up with my heart pounding again and did not sleep well on 3/14 through 3/16. I had been diagnosed with SIADH in the hospital, prescribed 3x 1000mg tablets of sodium chloride per day, and asked to limit my fluid intake to 42 oz. per day. By 3/15, I was severely dehydrated and began increasing both my fluid intake and my sodium intake. Even though I had regained my appetite, I was still not eating very much. Therefore, the amount of dietary sodium I was getting each day was not much more than the 1200mg of sodium from the 3000mg of sodium chloride tablets I was taking.

On 3/17, I visited my PCP to let her know what was going on and to get my sodium tested. (Gosh, I wish we could test our sodium at home with a prick of the skin...) Due to dehydration (my throat was completely parched and my skin was very dry), I made the case to her that I should try 70 oz. of fluid per day while also increasing fluid. Even though she agreed that the hospital numbers indicated SIADH, she agreed.

Fast forward to 3/21, and I head over to LabCorp and pay out of pocket for a sodium test. The result the next day was... 130. I was SO bummed! "I'm going down, not up!" I thought to myself.