Hyponatremia (Low Blood Sodium)
Tyra
Blanchard
Pathology
02/10/2015
The reason I chose the subject of hyponatremia
is because of how close it to home, my mother-in-law suffered from this
condition and I had a front row seat in experiencing the effects it can have on
a person.
I found it extremely fascinating that people can deplete their
systems of necessary sodium just by drinking too much water, taking
prescription medications and participating in endurance sports. I have found the following information to explain
the condition of Hyponatremia, the causes and the treatments as well as
observations of the elevated cases of Hyponatremia in the elderly.
Hyponatremia can occur in many
ways, one being drinking too much water, this causes the body's water levels to
become diluted causing the cells to swell. The swelling of the cells can cause
mild to life threatening conditions (Mayo Clinic 2014). Other conditions that
may cause hyponatremia are:
- certain medications
- diuretics
- antidepressants
- pain medications
- and a recreational drug called ecstasy.
These medications can cause you to urinate
and perspire more causing a drop in your sodium level. As a result people that have heart, kidney,
and liver problems can have a higher risk of fluids accumulating in their bodies
which dilutes the sodium levels. The more common conditions that can cause
hyponatremia is a person drinking too much water, excessive vomiting, diarrhea,
dehydration and hormonal imbalance (adrenal gland insufficiency) (Mayo 2014).
A normal
sodium level is between 135 and 145 mill equivalents per liter of sodium, hyponatremia
occurs when the sodium level in your blood falls below 135 mEq/L. (Mayo 2014).
Sodium
plays an important key role in your body, it is needed in order to maintain
blood pressure. Sodium is also needed to
nourish muscles, nerves and other tissues of the body. When a person depletes their bodies of sodium
it causes the fluids outside the cells to drop and water moves into the cells
to balance fluid levels. A significant
organ effected by this reaction is the brain, when effected it causes the
person to be confused, have headaches, nausea, loss of appetite, irritability
and many more conditions that can be as extreme as possible death (A.D.A.M.
encyclopedia, Inc. 2013).
The prevalence of hyponatremia is 15-20% in elderly
patients that reside in nursing homes.
Mild asymptomatic hyponatremia may influence gait and attention in the
elderly resulting in a higher incidence of falls (Nzerue 2003). Mortality rates
as high as 18-30% are reported for hyponatremia patients. High mortality rates reflect the severity of
underlying conditions and are not influenced by treatment of hyponatremia (Hochman et al 1989).
During examination, a health care
provider will perform a complete physical examination to help determine the
cause if the patients symptoms. To help
determine the condition blood and urine tests will most likely be done. There are 3 tests, both blood and urine that
can help diagnose hyponatremia.
- The
first is a comprehensive metabolic panel, including blood sodium, this test is
conducted while the patient has fasted for 8 hours . This test determines how your kidneys and
liver are working as well as blood sugars, cholesterol, and calcium
levels. It also checks for your sodium, potassium,
and chloride levels also known as electrolytes.
- The second test is called an osmolality blood test, this checks for your
body's water balance. An osmolality
urine test is performed to check the body's water balance and urine concentration.
- The final test performed is a urine sodium
test that determines how much fluid your
body has and to see if your kidneys are able to maintain and remove
sodium from the urine. It can also
determine if there is a kidney disease (A.D.A.M 2013).
In conclusion I find it fascinating
that in everyday life many take for granted how well the body functions even
though it is put it through so many extremes.
The neurological effects of sodium depletion can be from minor symptoms
such as dizziness, confusion or feeling faint to extreme effects such as
seizures, swelling of the brain, to
brain damage and eventual death.
Our
bodies need sodium to perform a number of biological transactions. It is important to keep a healthy balance of
sodium in our bodies, too little or too much can cause us to not function
properly. In fact most Americans get too
much sodium, most often people have other conditions that cause 1% of the
population to have hyponatremia (Angela Ogunjimi,
2011).
Our bodies are in a constant
battle to stay in homeostasis, with a low sodium level our bodies are not able
to balance the fluids in order to stay in this state. In order to maintain a healthy balance of
sodium, we need to be conscious of what we put in our bodies as nourishment. There are many people that drink a lot of
water thinking that they are doing a good thing for their bodies when in fact,
drinking too much water leads the body into a "waterlogged" state
that can cause digestive problems, such as chronic diarrhea as the food intake
is basically being washed away causing these patients to have to go to the
bathroom soon after eating (Your
Acupuncture Specialist 9/7/11).
In Chinese medicine, this is called
dampness, the condition in which your body is unable to metabolize water
effectively. In these instances the
dampness is brought on by drinking too much water In Chinese medicine, dampness
is almost always a digestive problem, in which your spleen is being taxed with
too much water causing it to not function efficiently.
Dampness can lead to many symptoms to
include; diarrhea, bladder infections, yeast, poor energy, joint pain,
headaches, and a feeling of heaviness.
In Chinese medicine the fat roll around your middle is considered to be
a "damp" issue. Dampness is a
drag, it's moist and heavy, like wet
sand. There are many ways that you can
become too damp; eating and drinking too much, eating the wrong foods (greasy
foods, rich foods, sweets (Your Acupuncture Specialist, 9/7/11).
Massage can be a very beneficial
for hyponatremia as it helps to reduce edema by increasing venous and
lymphatic flow. Some strategies to reduce edema may be
contraindicated in conditions such as CHF, but precautions can be taken to
still be beneficial without harm. You
must establish what type of edema you are dealing with. To establish this you can do a test on the
skin, if the skin doesn't rebound and becomes pitted (indentation remains after
pressure is applied) NO MASSAGE! (http://www.learn-massage-therapy-online.com/contact.html).
References
Ogunjani, A (2011) The
effects of low sodium levels. . Retrieved May 31. 2014
http://www.lifestrong.com
Skorecki K, Ausiello D. Disorders
of sodium and water homeostasis. In: Goldman L, Schafer AI, eds. Goldman’s Cecil Medicine.
24th ed. Philadelphia, Pa.: Elsevier Saunders; 2011:chap 118. Retrieved May 31,
2014 http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001431/
Mayo clinic staff (2014) diseases
and conditions, Hyponatremia. Retrieved May 31,2014
http://www.mayoclinic.org/about-this-site/welcome
Acupuncture in the Park (Your Acupuncture Specialist,
9/07/2011)
http://www.learn-massage-therapy-online.com/contact.html