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Low Sodium (Hyponatremia): Symptoms, Causes and When It Is an Emergency

Headache, nausea, muscle cramps and a foggy head can come from a sodium level that has drifted too low. It is common with water pills, heart or kidney disease, and heavy vomiting or sweating. Serenity By A Dr. Sareen sees adults at its Loxahatchee, West Palm Beach, and Belle Glade offices to check your blood work, find the cause and tell you when it cannot wait.

We accept Medicare & Medicaid

What it involves

MedlinePlus explains that low blood sodium, medically called hyponatremia, is a condition in which the sodium level in the blood is lower than normal. Sodium is an electrolyte that helps maintain blood pressure and lets nerves and muscles work. When it drops, water moves into cells and makes them swell, and brain cells are especially sensitive. The listed normal range is 136 to 144 mEq/L.

Who this is for

  • Patients who take water pills (diuretics) and have new headache, nausea or confusion.
  • Adults with heart failure, kidney disease or cirrhosis whose sodium has been low before.
  • People who had a lot of vomiting, diarrhea or heavy sweating and still feel unwell.
  • Anyone whose blood work showed a low sodium result and who wants to understand it.

What to expect

  • A review of your medicines, fluids, recent illness, heart, kidney and liver history, and symptoms
  • Blood work, which is among the services the practice lists, including a basic metabolic panel
  • Urine tests when they are needed to find the cause
  • A treatment plan aimed at the cause, with a repeat blood test to confirm the level is recovering

Why sodium drops

The MedlinePlus encyclopedia describes three patterns. In one, total body water rises but sodium stays the same. In another, both sodium and water rise but the water gain is greater. In the third, both are lost but the sodium loss is greater. Real-life causes include diuretic medicines, diarrhea, vomiting, sweating, large burns, heart failure, kidney disease, cirrhosis and a hormone problem called SIADH, where the body holds on to water. Finding which pattern applies is the whole point of the workup.

Symptoms, from mild to severe

Mild low sodium can feel like little more than tiredness and a headache, which is why it hides in plain sight. The encyclopedia lists confusion, irritability and restlessness, headache, loss of appetite, muscle weakness, spasms or cramps, and nausea or vomiting as common. Convulsions can occur. Several of these overlap with other problems, such as the fatigue guide and the muscle weakness guide, so the blood test is what separates them.

How it is tested

A provider examines you and asks about your symptoms, then orders blood and urine tests. MedlinePlus lists a basic metabolic panel, which includes blood sodium, a comprehensive metabolic panel, blood osmolality, urine osmolality and urine sodium as tests that can confirm and explain a low level. The basic metabolic panel explainer shows what the first of those includes. Blood work is among the services the practice lists, and results are reviewed with you, including whether to repeat the test. Sodium and potassium are measured together on an electrolyte panel, so a result that shows potassium running high is explained in the high potassium guide.

Treatment depends on the cause

MedlinePlus says the cause of low blood sodium must be diagnosed and treated, and that treatments depend on the specific type. They may include fluids through a vein, medicines to relieve symptoms, and limiting water intake. If cancer is the cause, treating the tumor may correct the imbalance. Correcting sodium too quickly can itself be harmful, which is why more serious cases are managed in a hospital. At a primary care visit, the job is to find the cause, change medicines if needed and arrange urgent care when the level is dangerous.

Fast versus slow drops

The encyclopedia explains that hyponatremia that occurs in less than 48 hours is more dangerous than one that develops slowly over days or weeks, because brain cells have time to adjust when the fall is gradual. That is why a sodium result that has been low for a while may cause fewer symptoms than a sudden dip. Both deserve follow-up. Heat and heavy exertion can also play a part, as described in the heat exhaustion and heat stroke guide.

When it is an emergency

MedlinePlus states that when sodium drops too much it can be a life-threatening emergency, and to call your provider right away if you have symptoms. Severe cases can lead to decreased consciousness, hallucinations, coma and brain herniation. Call 911 or go to the emergency room for confusion that is new, a seizure, fainting, repeated vomiting that you cannot stop, or extreme drowsiness. People who take diuretics or have heart, kidney or liver disease should not wait for a routine appointment if symptoms start.

What symptoms does low blood sodium cause?

MedlinePlus lists confusion, irritability, restlessness, fatigue, headache, loss of appetite, muscle weakness or cramps, and nausea or vomiting. In severe cases it can cause convulsions or coma. Serenity By A Dr. Sareen can check your sodium with blood work. Confusion, seizures or fainting are emergencies, so call 911.

Does Serenity By A Dr. Sareen accept Medicare and Medicaid for low sodium (hyponatremia) symptoms evaluation?

Yes. Serenity By A Dr. Sareen accepts Medicare and Medicaid, along with major commercial insurance, at our South Florida locations. Call your nearest office and our staff will confirm your specific plan and any coverage details before scheduling your low sodium (hyponatremia) symptoms evaluation visit.

What are your office hours?

We're open Monday through Friday, 8:00 AM to 5:00 PM, with same-day appointments and walk-ins welcome at our Loxahatchee, West Palm Beach, and Belle Glade offices. Call ahead of your visit if you'd like to confirm availability before you come in to see us.

Who is low sodium (hyponatremia) symptoms evaluation for?

Patients who take water pills (diuretics) and have new headache, nausea or confusion. Our family and internal medicine team can talk through whether this fits your situation when you call to schedule a visit at one of our South Florida offices.

Can drinking too much water lower my sodium?

It can. MedlinePlus describes the problem as an imbalance between water and sodium, and one cause is the body keeping too much water. Drinking large amounts during long exercise with only plain water is a recognized way to dilute sodium, which is why it advises electrolyte drinks for vigorous activity.

Should I cut salt if my sodium is low?

Not on your own. Low blood sodium is about water balance and the underlying cause, so the right advice depends on whether you have heart, kidney or liver disease and which medicines you take. Ask your provider before changing salt or fluid intake, especially if you have been told to restrict either.

Sources

Available at all locations

Schedule a Visit

Contact your nearest Serenity By A Dr. Sareen office to schedule a blood test and visit about low sodium symptoms.