Re: Sodium - A comprehensive Analysis

[Guest guest]

Just a question about low NA. I have been DASHing and my bp is running 110/72. My NA was 136 which was the lowest in the normal range. Should I be concerned if it gets below the normal range?40 yo WF, 20 MEQ K dailyTo: hyperaldosteronism Cc: Clarence Grim

Sent: Wed, May 18, 2011 2:02:03 AMSubject: Re: Sodium - A comprehensive Analysis

I would suggest they eat better or stop the HCTZ first.CE Grim MDAn important thing about Na is the range of sodium when its bad is narrower than other common electrolytes. for instance someone on here just had a sodium of 130 when their lab said 133 was low of normal. I know i would usually treat that in the er with some iv fluids, but not brush it

off.

[Guest guest]

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Low blood sodium in older adults: A concern?

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With Mayo Clinic geriatrician Y. Takahashi, M.D.read biography close window Biography of

Y. Takahashi, M.D.

Y. Takahashi, M.D.

"The Internet will impact the lives of all patients young and old. Older and mature patients are no exception to this information explosion." — Dr. Takahashi

Dr. Yoshio Takahashi works with elderly patients as a member of the geriatric consultative group at Mayo Clinic. He works in all medical settings, including the outpatient clinic, the nursing home and occasionally the patient's home. He is especially interested in strategies for successful aging, preventing elder abuse and mistreatment, home telemonitoring, frailty, and cognitive screening in elderly patients.

Dr. Takahashi is a consultant in the Division of Primary Care Internal Medicine at Mayo Clinic. He is an associate professor of medicine at College of Medicine, Mayo Clinic, and a fellow of the American College of Physicians. He had a fellowship in geriatric medicine at Mayo Graduate School of Medicine from 1997 to 1998.

Dr. Takahashi cares for all of a patient's acute needs and chronic problems and focuses on specialty issues such as memory problems, safety in the home, healthy aging, proper medications and end-of-life concerns.

He sees the Internet playing a growing role in the health information field.

"Patients and their families want and expect the most up-to-date information about life, health, disease and death. Healthy aging as a concept has grown quickly over the last 20 years as we have all lived longer and hopefully better," he says. "I expect that Mayo Clinic will be a significant part of this growing movement of a healthy maturity."

Dr. Takahashi, a native of Pittsfield, Ill., joined Mayo Clinic in 1998 and is board certified in internal medicine with added qualification in geriatric medicine. He is a fellow of the American Geriatrics Society.

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Question

Low blood sodium in older adults: A concern?

Why is low blood sodium (hyponatremia) a health concern for older adults? How is it treated?

Answer

from Y. Takahashi, M.D.

Low blood sodium (hyponatremia) occurs when you have an abnormally low amount of sodium in your blood or when you have an excess of water in your blood. Low blood sodium is common in older adults, especially those who are hospitalized or living in long term care facilities.

Older adults usually become ill with hyponatremia due to age-related causes that affect the way the body handles the balance of sodium and water such as:

Drinking too much water

Urinating less frequently

Changes in the kidneys, such as decreased kidney size or decreased blood flow through the kidneys

Taking certain medications, such as diuretics, antidepressants and pain medications

Underactive thyroid (hypothyroidism)

's disease, a condition affecting the adrenal gland

Severe vomiting or diarrhea

Liver failure (cirrhosis)

Kidney failure

Heart failure

Having high levels of anti-diuretic hormone, which causes you to retain water

The signs and symptoms of hyponatremia vary. The only way a doctor can confirm whether you have hyponatremia is by a blood test. Signs and symptoms of hyponatremia may include:

Nausea

Headache

Confusion

Restlessness

Drowsiness

Loss of consciousness or coma

Severe hyponatremia may lead to rapid, fatal swelling of the brain. Treatment of hyponatremia varies, depending on its cause. Treatments may include:

Changing a medication that affects blood-sodium levels

Increasing or decreasing how much water you drink

Increasing or decreasing the amount of salt in your diet

References

Kugler JP, et al. Hyponatremia and hypernatremia in the elderly. American Family Physician. 2000;61:3623.

Rose BD. Causes of hyponatremia. http://www.uptodate.com/home/index.html. Accessed June 24, 2009.

Rose BD. Treatment of hyponatremia. http://www.uptodate.com/home/index.html. Accessed June 24, 2009.

Rose BD. Diuretic-induced hyponatremia. http://www.uptodate.com/home/index.html. Accessed June 24, 2009.

AN00621 Aug. 21, 2009

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Text Size: smaller largerlarger

> > An important thing about Na is the range of sodium when its bad is narrower than > other common electrolytes. for instance someone on here just had a sodium of 130 > when their lab said 133 was low of normal. I know i would usually treat that in > the er with some iv fluids, but not brush it off.> >>

[Guest guest]

Don't worry about the blood Na. It has nothing to do with your salt intake. Sounds like you are getting a good BP response. Be sure to let your Dr. know what you are doing.CE Grim MDJust a question about low NA. I have been DASHing and my bp is running 110/72. My NA was 136 which was the lowest in the normal range. Should I be concerned if it gets below the normal range?40 yo WF, 20 MEQ K dailyTo: hyperaldosteronism Cc: Clarence Grim Sent: Wed, May 18, 2011 2:02:03 AMSubject: Re: Sodium - A comprehensive Analysis I would suggest they eat better or stop the HCTZ first.CE Grim MDAn important thing about Na is the range of sodium when its bad is narrower than other common electrolytes. for instance someone on here just had a sodium of 130 when their lab said 133 was low of normal. I know i would usually treat that in the er with some iv fluids, but not brush it off.

[Guest guest]

Ah but does he know HTN?CE Grim MDOn May 22, 2011, at 7:31 PM, Francis Bill SUSPECTED PA wrote:Patient CareRequest an AppointmentLog in to Patient AccountSee Treatment & Diagnosis ServicesPlan Your VisitFind a DoctorHealth InformationDiseases & Conditions A-ZSymptom CheckerDrugs & Supplements A-ZTests & Procedures A-ZHealthy LivingExpert BlogsMayo Clinic BookstoreFor Medical ProfessionalsOnline Services for Referring PhysiciansGrand RoundsPublicationsContinuing Medical EducationMayo Medical LaboratoriesResearchExplore Research AreasFind Clinical TrialsResearch FacultyPostdoctoral FellowshipsDiscovery's Edge MagazineSearch PublicationsEducationMayo Graduate SchoolMayo Medical SchoolMayo School of Continuous Professional DevelopmentMayo School of Graduate Medical EducationMayo School of Health SciencesAlumni AssociationRequest an AppointmentFind a DoctorFind a JobLog in to Patient AccountDiseases and ConditionsSymptomsDrugs and SupplementsTests and ProceduresHealthy LifestyleFirst AidHomeDiseases and ConditionsHyponatremiaExpert AnswersLow blood sodium in older adults: A concern?HyponatremiaBasicsIn-DepthExpert AnswersWith Mayo Clinic geriatrician Y. Takahashi, M.D.read biographyclose windowBiography of Y. Takahashi, M.D. Y. Takahashi, M.D."The Internet will impact the lives of all patients young and old. Older and mature patients are no exception to this information explosion." — Dr. TakahashiDr. Yoshio Takahashi works with elderly patients as a member of the geriatric consultative group at Mayo Clinic. He works in all medical settings, including the outpatient clinic, the nursing home and occasionally the patient's home. He is especially interested in strategies for successful aging, preventing elder abuse and mistreatment, home telemonitoring, frailty, and cognitive screening in elderly patients.Dr. Takahashi is a consultant in the Division of Primary Care Internal Medicine at Mayo Clinic. He is an associate professor of medicine at College of Medicine, Mayo Clinic, and a fellow of the American College of Physicians. He had a fellowship in geriatric medicine at Mayo Graduate School of Medicine from 1997 to 1998.Dr. Takahashi cares for all of a patient's acute needs and chronic problems and focuses on specialty issues such as memory problems, safety in the home, healthy aging, proper medications and end-of-life concerns.He sees the Internet playing a growing role in the health information field."Patients and their families want and expect the most up-to-date information about life, health, disease and death. Healthy aging as a concept has grown quickly over the last 20 years as we have all lived longer and hopefully better," he says. "I expect that Mayo Clinic will be a significant part of this growing movement of a healthy maturity."Dr. Takahashi, a native of Pittsfield, Ill., joined Mayo Clinic in 1998 and is board certified in internal medicine with added qualification in geriatric medicine. He is a fellow of the American Geriatrics Society.FreeE-NewslettersSubscribe to receive the latest updates on health topics. About our newslettersHousecallAlzheimer's caregivingLiving with cancer close windowAbout our e-newslettersFree e-newslettersMayo Clinic expertiseWe do not share your e-mail addressHousecall, our weekly general-interest e-newsletter, keeps you up to date on a wide variety of health topics with timely, reliable, practical information, recipes, blogs, questions and answers with Mayo Clinic experts and more. Our biweekly topic-specific e-newsletters also include blogs, questions and answers with Mayo Clinic experts, and other useful information that will help you manage your health. Housecall ArchivesRSS Feedsclose window Mayo Clinic HousecallStay up to date on the latest health information.What you getFree weekly e-newsletterMayo Clinic expertiseRecipes, tools and other helpful informationWe do not share your e-mail addressSign upView past issuesMayo Clinic Health ManagerGet free personalized health guidance for you and your family.Get StartedQuestionLow blood sodium in older adults: A concern?Why is low blood sodium (hyponatremia) a health concern for older adults? How is it treated?Answerfrom Y. Takahashi, M.D.Low blood sodium (hyponatremia) occurs when you have an abnormally low amount of sodium in your blood or when you have an excess of water in your blood. Low blood sodium is common in older adults, especially those who are hospitalized or living in long term care facilities.Older adults usually become ill with hyponatremia due to age-related causes that affect the way the body handles the balance of sodium and water such as:Drinking too much waterUrinating less frequentlyChanges in the kidneys, such as decreased kidney size or decreased blood flow through the kidneysTaking certain medications, such as diuretics, antidepressants and pain medicationsUnderactive thyroid (hypothyroidism)'s disease, a condition affecting the adrenal glandSevere vomiting or diarrheaLiver failure (cirrhosis)Kidney failureHeart failureHaving high levels of anti-diuretic hormone, which causes you to retain waterThe signs and symptoms of hyponatremia vary. The only way a doctor can confirm whether you have hyponatremia is by a blood test. Signs and symptoms of hyponatremia may include:NauseaHeadacheConfusionRestlessnessDrowsinessLoss of consciousness or comaSevere hyponatremia may lead to rapid, fatal swelling of the brain. Treatment of hyponatremia varies, depending on its cause. Treatments may include:Changing a medication that affects blood-sodium levelsIncreasing or decreasing how much water you drinkIncreasing or decreasing the amount of salt in your dietReferencesKugler JP, et al. Hyponatremia and hypernatremia in the elderly. American Family Physician. 2000;61:3623.Rose BD. Causes of hyponatremia. http://www.uptodate.com/home/index.html. Accessed June 24, 2009.Rose BD. Treatment of hyponatremia. http://www.uptodate.com/home/index.html. Accessed June 24, 2009.Rose BD. Diuretic-induced hyponatremia. http://www.uptodate.com/home/index.html. Accessed June 24, 2009.AN00621 Aug. 21, 2009© 1998-2011 Mayo Foundation for Medical Education and Research (MFMER). All rights reserved. A single copy of these materials may be reprinted for noncommercial personal use only. "Mayo," "Mayo Clinic," "MayoClinic.com," "EmbodyHealth," "Enhance your life," and the triple-shield Mayo Clinic logo are trademarks of Mayo Foundation for Medical Education and Research.Print Share Reprintsclose windowE-mail this page* Required fields* Recipient's e-mail address * Your name * Your e-mail Clicking "send" signifies that you have read and agree to our privacy policy. Share this on ...StumbleUponDiggdel.icio.usFacebookMySpace Link to this pageTo link to this page, copy this HTML and paste it onto your Web page.<a href="http://www.mayoclinic.com/health/low-blood-sodium/AN00621">Low blood sodium in older adults: A concern?</a>Guidelines for sites linking to MayoClinic.comAdvertisementCheck out these best-sellers and special offers on books and newsletters from Mayo Clinic.Try Mayo Clinic Health Letter free!Mayo Clinic Book of Alternative MedicineMayo Clinic Five Steps to Controlling High Blood PressureThe Mayo Clinic Diet — Eat well. Enjoy life. Lose weight.Mayo Clinic BookstoreAdvertising and sponsorship policyAdvertising and sponsorship opportunitiesAbout this siteSite helpContact usE-newsletterBlogsPodcastsSlide showsVideosSite mapReprints and permissionsFind Mayo Clinic onFacebookTwitterYouTubePrivacy policy (Updated Nov. 5, 2010) Terms and conditions of use policy (Updated July 8, 2010)LEGAL CONDITIONS AND TERMS OF USE APPLICABLE TO ALL USERS OF THIS SITE. ANY USE OF THIS SITE CONSTITUTES YOUR AGREEMENT TO THESE TERMS AND CONDITIONS OF USE.© 1998-2011 Mayo Foundation for Medical Education and Research. All rights reserved. We comply with the HONcode standard for trustworthy health information: verify here.Text Size: smaller largerlarger> > An important thing about Na is the range of sodium when its bad is narrower than > other common electrolytes. for instance someone on here just had a sodium of 130 > when their lab said 133 was low of normal. I know i would usually treat that in > the er with some iv fluids, but not brush it off.> >>

[Guest guest]

Thanks for the info. My doc does know what I am doing. I am moving this summer so will be changing dr.s. To: hyperaldosteronism Cc: Clarence Grim Sent: Sun, May 22, 2011 11:57:08 PMSubject: Re: Sodium - A comprehensive Analysis

Don't worry about the blood Na. It has nothing to do with your salt intake. Sounds like you are getting a good BP response. Be sure to let your Dr. know what you are doing.CE Grim MDJust a

question about low NA. I have been DASHing and my bp is running 110/72. My NA was 136 which was the lowest in the normal range. Should I be concerned if it gets below the normal range?40 yo WF, 20 MEQ K dailyTo: hyperaldosteronism Cc: Clarence Grim Sent: Wed, May 18, 2011 2:02:03 AMSubject: Re: Sodium - A comprehensive Analysis I would suggest they eat better or stop the HCTZ first.CE Grim MDAn important thing about Na is the range of sodium when its bad is narrower than other common electrolytes. for instance someone on here just had a sodium of 130 when their lab said 133 was low of normal. I know i would usually treat that in the er with some iv fluids, but not brush it off.

[Guest guest]

Where are u moving? I might know someone. Tiped sad Send form miiPhone ;-)May your pressure be low!CE Grim MDSpecializing in DifficultHypertension

Thanks for the info. My doc does know what I am doing. I am moving this summer so will be changing dr.s. To: hyperaldosteronism Cc: Clarence Grim Sent: Sun, May 22, 2011 11:57:08 PMSubject: Re: Sodium - A comprehensive Analysis

Don't worry about the blood Na. It has nothing to do with your salt intake. Sounds like you are getting a good BP response. Be sure to let your Dr. know what you are doing.CE Grim MDJust a

question about low NA. I have been DASHing and my bp is running 110/72. My NA was 136 which was the lowest in the normal range. Should I be concerned if it gets below the normal range?40 yo WF, 20 MEQ K dailyTo: hyperaldosteronism Cc: Clarence Grim Sent: Wed, May 18, 2011 2:02:03 AMSubject: Re: Sodium - A comprehensive Analysis I would suggest they eat better or stop the HCTZ first.CE Grim MDAn important thing about Na is the range of sodium when its bad is narrower than other common electrolytes. for instance someone on here just had a sodium of 130 when their lab said 133 was low of normal. I know i would usually treat that in the er with some iv fluids, but not brush it off.