The term “hyponatremia” itself can be translated as “sodium deficiency”, which is essentially a salt deficiency. Sodium is the key electrolyte found in the intercellular space: it accounts for more than 60% of the total amount of electrolytes. It is needed to transmit impulses from muscle contraction and enable motor activity.
The normal concentration of sodium in human plasma is 135-145 mmol/L. With a slight decrease in these indicators, doctors diagnose a mild form of hyponatremia. If the plasma sodium concentration falls below 125 mmol/L, the symptoms become more pronounced and may require medical attention.
Causes of hyponatremia
Hyponatremia can occur for both physiologic and pathologic reasons. Physiologic factors include a salt-free diet and prolonged excessive sweating. Pathologic causes include:
- Excessive sodium loss: chronic diarrhea, vomiting, kidney disease (e.g., nephritis or polycystic kidney disease).
- Fluid retention: renal failure, liver cirrhosis, syndrome of inadequate secretion of antidiuretic hormone.
- Hemodilution: excessive water intake in diabetes or psychogenic polydipsia, administration of large volumes of fluids.
- Endocrine disorders: mineralocorticoid deficiency, hypothyroidism, severe hyperglycemia.
- Medications: diuretics, sugar-reducing and psychotropic drugs.
- Other causes: pancreatitis, peritonitis, burns, and surgery.
Symptoms
The severity of symptoms depends on the degree and speed of the fall in plasma sodium levels. Signs of hyponatremia in the initial stages: weakness, irritability, swelling of the extremities. Due to the decrease in concentration, there is an increased risk of stumbling and injury.
But all these are very non-specific signs, especially when it comes to endurance sports. After all, for ultramarathon runners, tired legs are a common occurrence.
Experienced runners know that swollen fingers on the hands – already a dangerous symptom. This moment is easier to trace and even feel, if the rings began to unpleasantly squeeze the skin. Also alert should be scanty and rare excretion of fluid from the body: this means that the kidneys can not cope with the load.
If you do not take action in time, the level of sodium in the blood plasma will continue to decline. Hyponatremia in severe form can be accompanied by convulsions, headaches and vomiting. When the concentration of sodium ions drops to 115 mmol/L, life-threatening neurological problems may occur.
What are the risk factors associated with hyponatremia?
Various factors increase the risk of hyponatremia. Here are some of them:
- Age: Older people may have more factors that contribute to hyponatremia.
- Medications.
- Chronic diseases
- Intense exercise: drinking too much water while participating in marathons, ultramarathons, triathlons, and other high-intensity long-distance activities increases the risk of hyponatremia.
Diagnosing hyponatremia
To diagnose hyponatremia, the doctor will use several methods. First of all, it is a blood test, which will help to determine the level of sodium in the plasma. If the result is below the norm (135-145 mmol / l), additional examination will be required to identify the cause of the condition. It is important to determine whether there are signs of impaired water-electrolyte balance, as well as to assess the function of the kidneys and other organs.
In addition, the doctor may order a urinalysis to assess electrolyte levels and examine the kidneys’ ability to excrete sodium. In some cases, ultrasound or other diagnostic procedures will also be needed to rule out diseases such as kidney failure or cirrhosis.
Prognosis and possible complications
The prognosis of hyponatremia depends on its cause, the timeliness of diagnosis and the start of treatment. With proper therapy, the condition is usually stabilized, and the level of sodium in the blood is restored to normal values. However, if untreated or improperly treated, hyponatremia can lead to serious complications such as:
- Brain swelling: This is one of the most dangerous complications of hyponatremia, especially if the sodium level is quickly restored.
- Seizures: Lack of sodium in the cells can lead to seizures and other neurological symptoms.
- Critical drop in blood pressure: In some cases, hyponatremia causes a significant drop in blood pressure, which can be life-threatening.
Prevention of hyponatremia
To prevent the development of hyponatremia, it is important to follow a few simple rules:
- Control fluid intake: Drink enough water, especially in hot weather or during intense physical activity, but do not overdo it.
- Regularly monitor electrolyte levels: It is especially important for people with chronic kidney, heart and endocrine system diseases.
- Correction of the regime in case of intensive training: Sports people should monitor the balance of fluids and salts in the body, avoid excessive water intake and replace it with electrolytes in case of intensive physical activity.
- Consultation with a doctor when taking medications: People taking diuretics or other medications that may affect sodium levels should consult a doctor regularly and adjust treatment if necessary.
Treatment
The treatment of hyponatremia depends on its severity and underlying causes. For mild cases, reducing excessive fluid intake and treating any contributing conditions, such as kidney disease or hormonal imbalances, may be sufficient. In more severe cases, medical intervention is necessary. This may include administering intravenous sodium solutions to gradually restore the sodium balance in the blood. In certain conditions, medications such as vasopressin receptor antagonists are used to help regulate water retention. In extreme situations, where hyponatremia has caused significant complications, dialysis may be required to remove excess water from the body. It is important to monitor the correction of sodium levels carefully, as rapid changes can lead to dangerous consequences, such as brain swelling.
Conclusion
Hyponatremia is a dangerous condition associated with sodium deficiency in the body that can occur for a variety of reasons, including inadequate fluid intake, chronic illness, intense physical activity, and taking certain medications. Symptoms of hyponatremia can range from mild weakness to serious neurological disorders that are life-threatening.
It is important to diagnose and treat this condition promptly to avoid complications such as brain swelling or seizures. Prevention of hyponatremia consists of balanced water intake, careful attention to health and regular medical check-ups, especially for people with chronic diseases or those who engage in strenuous physical activity.
