Depending on the extent and duration of these signs and symptoms, your doctor may recommend seeking immediate medical care. If you have time to prepare, here's some information to help you get ready for your appointment, and what to expect from your doctor. Being ready to answer your doctor's questions may reserve time to go over any points you want to talk about in-depth. Your doctor may ask:. Mayo Clinic does not endorse companies or products. Advertising revenue supports our not-for-profit mission.
This content does not have an English version. This content does not have an Arabic version. Diagnosis Your doctor will start by asking about your medical history and doing a physical examination. With low blood sodium hyponatremia , the imbalance of water to sodium is caused by one of three conditions:. The health care provider will perform a complete physical examination and ask about your symptoms. Blood and urine tests will be done.
The cause of low sodium must be diagnosed and treated. If cancer is the cause of the condition, then radiation, chemotherapy , or surgery to remove the tumor may correct the sodium imbalance. Outcome depends on the condition that is causing the problem.
Low sodium that occurs in less than 48 hours acute hyponatremia , is more dangerous than low sodium that develops slowly over time. When sodium level falls slowly over days or weeks chronic hyponatremia , the brain cells have time to adjust and swelling may be minimal.
Call your provider right away if you have symptoms of this condition. If you play sports or do other vigorous activity, drink fluids such as sports drinks that contain electrolytes to keep your body's sodium level in a healthy range. The second step is to determine the most appropriate method of correcting the hyponatremia. Shock resulting from volume depletion should be treated with intravenous isotonic saline.
Acute severe hyponatremia i. In patients with chronic hyponatremia, overzealous and rapid correction should be avoided because it can lead to central pontine myelinolysis. In patients who have difficulty adhering to fluid restriction or who have persistent severe hyponatremia despite the above measures, demeclocycline Declomycin in a dosage of to 1, mg daily can be used to induce a negative free-water balance by causing nephrogenic diabetes insipidus. Loop diuretics can be used in severe cases.
Newer agents such as the arginine vasopressin receptor antagonists have shown promising results 39 and may be useful in patients with chronic hyponatremia. In all patients with hyponatremia, the cause should be identified and treated. Some causes, such as congestive heart failure or use of diuretics, are obvious. Other causes, such as SIADH and endocrine deficiencies, usually require further evaluation before identification and appropriate treatment. The initial rate of sodium correction with hypertonic saline should not exceed 1 to 2 mmol per L per hour.
Overzealous correction of chronic hyponatremia can lead to central pontine myelinolysis. Demeclocycline Declomycin in a dosage of to 1, mg daily is effective in patients with refractory hyponatremia.
Arginine vasopressin receptor antagonists may be useful in patients with chronic hyponatremia. Already a member or subscriber? Log in. Interested in AAFP membership? Learn more. Address correspondence to Kian Peng Goh, M. Reprints are not available from the author. The author indicates that he does not have any conflicts of interest.
Sources of funding: none reported. The author thanks Evelyn Koay, S. Incidence and etiology of hyponatremia in an intensive care unit. Clin Nephrol. Hyponatremia as observed in a chronic disease facility. J Am Geriatr Soc. Kumar S, Berl T. Hyponatremia in a nursing home population.
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What are the symptoms of low sodium levels? Medically reviewed by Gerhard Whitworth, R. Share on Pinterest Hyponatremia can cause fatigue and headaches. What are the causes? Risk factors. Share on Pinterest Some medications may increase the risk of hyponatremia. Diagnosis and when to see a doctor. Share on Pinterest Sports drinks containing electrolytes can help prevent low blood sodium levels after intense exercise. Latest news Could 'cupping' technique boost vaccine delivery?
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