Hyponatremia is an electrolyte disturbance that occurs when the level of sodium ( sodium ) in the blood is lower than normal. Abnormal sodium levels can be caused by many things, ranging from health conditions to the use of certain drugs. 

In our body, sodium has many functions, including controlling water levels in the body, maintaining blood pressure, and regulating the nervous system and muscle performance.

In hyponatremia, the level of sodium in the blood is less than it should be. This results in increased water levels in the body and makes the body's cells swell. Swelling of these cells can cause a variety of health problems, ranging from headaches to loss of consciousness.

Causes of Hyponatremia

Under normal conditions, the sodium level in the blood is 135–145 mEq/liter (milliequivalents per liter). A person with a sodium level of less than 135 mEq/liter is considered to have hyponatremia. This decrease in sodium levels can be caused by various factors, including:

  • Hormonal changes
    Deficiency of adrenal hormones, for example due to Addison's disease , can affect the balance of water, sodium and potassium levels in the body. Low thyroid hormone levels can also cause hyponatremia.
  • Syndrome of inappropriate anti-diuretic hormone (SIADH)
    This condition produces large amounts of anti-diuretic hormone (ADH), which makes the body retain water that should be excreted in the urine. Excess water in the body will dissolve sodium and make its levels decrease.
  • Severe and chronic diarrhea or vomiting.
    This condition can cause the body to lose sodium and increase ADH production.
  • Certain medications
    Medications, such as diuretics , antidepressants, and pain relievers, can interfere with the function of hormones or the kidneys in maintaining sodium levels.
  • Health conditions
    Heart failure, kidney disease , and cirrhosis, can cause fluid buildup in the body and dissolve sodium, resulting in low sodium levels in the blood.
  • DRUG Amphetamine
    class drugs , such as ecstasy, can make a person experience severe hyponatremia.

Hyponatremia Risk Factors

The following are several factors that can increase a person's risk of experiencing hyponatremia:

  • Consuming too much water when you are exercising hard enough and sweating a lot, for example a marathon or doing the wrong water therapy
  • Older and already difficult to communicate
  • Using diuretic drugs (eg due to heart failure) or antidepressants (eg due to major depression)
  • Rarely consume food or drinks that contain sodium

Symptoms of Hyponatremia

Symptoms of hyponatremia can be different for each patient. If the sodium level in the body decreases gradually (within 2 days or more), the sufferer may not experience any symptoms. This condition is called chronic hyponatremia.

However, when sodium levels fall rapidly (acute hyponatremia), the symptoms can be serious. Some of the common symptoms experienced by sufferers of acute hyponatremia include:

  • Headache
  • dazed
  • Nausea and vomiting
  • Weak and tired
  • Cramps or muscle weakness
  • Restless and irritable
  • seizures
  • Loss of consciousness

When to see a doctor

Immediately seek medical help to the nearest doctor or emergency room if you experience serious symptoms of hyponatremia, such as vomiting, confusion, seizures, and decreased consciousness.

Check with your doctor if you have factors that may increase your risk of hyponatremia, especially if you are already experiencing symptoms of nausea, headaches, cramps, or weakness.

Diagnosis of Hyponatremia

Diagnosis of hyponatremia begins with a question and answer regarding the patient's symptoms and medical history, which is then followed by a thorough physical examination.

After the question and answer session and physical examination are finished, the doctor will carry out a supporting examination in the form of a blood test which functions to measure electrolyte and mineral levels in the body, including sodium levels.

If the blood test finds that the sodium level in the patient's blood is abnormal, the doctor will re-examine the sodium level with a urine test. The results of the urine test will help the doctor to confirm the condition and determine the cause of hyponatremia.

If the sodium level in the blood is low but high in the urine, it means that the patient's body is excreting too much sodium. However, if the sodium levels in the blood and urine are both low, this can indicate that the patient's body is not getting enough sodium or the patient's body is excess fluid.

Treatment of Hyponatremia

Treatment of hyponatremia is adjusted to the severity and cause. In mild hyponatremia, treatment can be done by improving diet, lifestyle, and adjusting the types and doses of drugs used. The doctor will also ask the patient to temporarily reduce fluid intake.

Whereas in hyponatremia that occurs quickly and causes severe symptoms, treatment that can be done includes:

  • Provision of drugs that aim to overcome the symptoms of headaches, nausea, and seizures
  • Giving electrolyte fluids through an IV, to slowly increase sodium levels in the blood
  • Dialysis , to remove excess fluid from the body, if hyponatremia occurs due to the kidneys not functioning properly

Hyponatremia Complications

In chronic hyponatremia, the complications that can arise are indeed not emergency, but they still cannot be underestimated. These complications include decreased concentration, the body becomes unbalanced, and osteoporosis.

Meanwhile, in acute hyponatremia, the complications that can arise tend to be more dangerous, namely swelling of the brain which can cause coma and even death. Although it can be experienced by all sufferers of acute hyponatremia, this complication is more common in women approaching menopause .

Prevention n Hyponatremia

There are several ways you can do to prevent hyponatremia, namely:

  • Treat conditions that can trigger hyponatremia.
  • Drink drinks that can replace the body's electrolytes that are lost during activities or exercise.
  • Drink enough water, which is about 2.2 liters/day for women and 3 liters/day for men.

Adequacy of water consumption can be determined by observing the color of the urine. Urine color that is more concentrated (orange or dark yellow) indicates the body is still lacking water.

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