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Chronic hyponatremia
Anyone else have chronic hyponatremia? I'm a 62 year old male on meds for hypertensiona and high cholesterol and prone to anxiety and depression. My sodium numbers have been low for a couple of decades now, most often just below normal at around 131 or 132, but as low as 127 (and once 124 due to a specific medication).
Different doctors reacted differently when they saw those numbers. Some basically ignoring it since I told them its always low, others expressing more concern. (I've never had any obvious symptoms.) My total fluid intake, including coffee, soda, protein shake, etc, and water is around 124 oz a day. I often feel thirsty, so 64 oz of that total intake is water.
Last week during a visit to a kidney guy, partly due to curiosity about this issue and some high blood pressure issues, my sodium level was 128 (down from 131 the month before at another doctor.) He wants to restrict my fluid intake to 1 liter a day, which I said was basically impossible, but that I would do what I could -- likely reduce from 124 oz a day to perhaps 80 oz total and half my straight water intake -- and see if that moves the needle and we'll retest on Wednesday.
Thoughts, anyone?
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My aged dad, starting when he was 88, had his first event and ended up at the ER. He was hyponatremic, which they corrected with salt tablets. Three years later, the same thing, he felt awful, we went to the ER, and as the nurse was prepping him with IV and such, I casually mentioned to her that he had been found to be low on sodium three years previously. She noted what I said, and sure enough...
Starting last August, my dad had a series of falls, one that broke a vertebra. He was found again to be hyponatremic. His GP agreed to make a house call, and when he learned of the problem, I asked if we could set up periodic monitoring, which he agreed to do.
I don't know/think you need the monitoring, especially if you keep tabs on your sodium intake and levels. My dad's levels are at your lower than yours when he is 'found out'. Maybe, if you are not feeling unwell, getting dizzy, falling, you are at your tolerable point...and should do little except to keep an eye on the natremic levels and your blood pressure...it's surely a fine line.
I don't see a problem with adding a wee bit of salt to drinking water, provided it is just enough to keep you healthy, and provided it doesn't raise your blood pressure unduly. Has your doctor not asked you to try it for a month to see what effect it might have? Of course, you'd run this past that person first, and not do it because I have said it might be worth trying...yes?
@heycal Low sodium can be dangerous, as @gloaming described below. One of the things that can cause it is diuretics for blood pressure control (Hydrochlorothyizide or Hcl, alone or in other meds.)
Sometimes a medication that worked in the past begins to cause unwanted side effects, and needs to be changed. Also, changes in another medication (or supplement), weight or diet can change how a medication affects you.
What would I do? By all means, get it checked again. If there are questions about interactions, ask for a complete med review by a Clinical Pharmacist or Medication nurse, and tell them EVERYTHING you take, Rx, OTC, supplements, botanical or herbal preparations, alcohol. They have training, experiences and detailed interaction checking software. At our clinic, this service is offered once a year to anyone who takes 5 or more medications.
Has anyone ever performed a med check for you?
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1 ReactionThe first thing my doctor wants me to do is reduce fluid intake since he believes 124 oz per day is a lot and that could be the cause. There has bee no talk of any other treatment or investigation yet -- we'll do this first and go from there.
I was once on Hcl for a couple of weeks which sent my sodium down to 124, so I went off that, as per Sue's point above.
I think the key thing to keep in mind when considering my case is that my sodium has been low since the previous century, and that is regardless of what meds I was on or not on over these many years, and that I've never experienced any obvious problems and live an active life of weight lifting, playing tennis, softball, etc. (That said, it's possible there are subtle symptoms I've been experiencing for so long they don't even register as problems at this point, and I might feel better if my sodium were higher.)
I know low sodium is dangerous in theory, but in my case, decades of experiencing it has not shown it to produce any of the classic or dangerous symptoms of hyponatremia you read about. Now, I'd still like to know what's causing it -- which could just be excessive water intake -- but I do sort of wonder at times why it's a problem at all just because of a specific number on a test.
124 ounces of fluid does not sound like an excessive amount to me. I drink a little less than 2 quarts, and do very well. But my father must drink three or more quarts during a typical day. Mind you, he also has to beware of becoming hyponatremic. He gets thirsty easily and sips water all day long.
This article describes the disorder state and what the typical causes are:
https://www.ncbi.nlm.nih.gov/books/NBK470386/ Perhaps your answer as to why you keep circling that drain is in there.
I agree that a gallon a fluid a day is not excessive, and many sources on the internet back us up on this. The true cause could very well be one of the conditions found in your very helpful and informative link.
This was my first meeting with this doctor, who seems well regarded and who struck me as quite smart and thorough, so I'm sure all these things will be explored after this little fluid restriction experiment.