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sodium deficiency symptoms
What does it mean to have hyponatremia?
Sodium is an essential electrolyte that helps maintain the balance of water in and around your cells. It’s important for proper muscle and nerve function. It also helps maintain stable blood pressure levels.
Insufficient sodium in your blood is known as hyponatremia. It occurs when water and sodium are out of balance. In other words, there’s either too much water or not enough sodium in your blood.
Normally, your sodium level should be between 135 and 145 milliequivalents per liter. Hyponatremia occurs when your sodium level goes below 135 mEq/L.
Symptoms of hyponatremia
Symptoms of low blood sodium can vary from person to person. If your sodium levels fall gradually, you may not experience any symptoms at first, but they will eventually manifest. If they drop very quickly, your symptoms may be more obvious and severe.
Common symptoms of hyponatremia include:
weakness
fatigue or low energy
headache
nausea
vomiting
muscle cramps or spasms
confusion
irritability
Severe symptoms of hyponatremia
Losing sodium quickly is a medical emergency. It can cause:
overactive reflexes
loss of consciousness
seizures
coma
and in the most severe cases, death
If you or someone you know seems to be losing consciousness or is having a seizure, call 911 immediately.
Causes of hyponatremia
Many factors can cause hyponatremia. Your sodium levels may get too low if your body loses too much water and electrolytes. Hyponatremia may also be a symptom of certain medical conditions.
Causes of hyponatremia include:
severe vomiting or diarrhea
taking certain medications, including antidepressants and pain medications
taking diuretics (water pills)
drinking too much water during exercise (this is very rare)
dehydration
kidney disease or kidney failure
liver disease
heart problems, including congestive heart failure
adrenal gland disorders, such as Addison’s disease, which affects your adrenal gland’s ability to regulate the balance of sodium, potassium, and water in your body
hypothyroidism (underactive thyroid)
syndrome of inappropriate antidiuretic hormone (SIADH), which makes your body retain water
diabetes insipidus, a rare condition in which the body doesn’t make antidiuretic hormone
Cushing’s syndrome, which causes high cortisol levels (this is rare)
Who is at risk for hyponatremia?
Certain factors increase your risk of hyponatremia, including:
older age
diuretic use
antidepressant use
being a high-performance athlete (i.e., a marathon runner)
living in a warmer climate
eating a low-sodium diet
having heart failure, kidney disease, syndrome of inappropriate antidiuretic hormone (SIADH), or other conditions
If you’re at risk for low sodium, you may need to be more careful about your intake of electrolytes and water. Make sure to talk to your doctor about your risk factors and if there are any steps you can take to lessen your risk.
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Hyponatremia complications
If hyponatremia is not treated, it can lead to serious complications, including:
osteoporosis
brain swelling
brain injury
seizures
death
osteoporosis and bone fractures
If you are at a higher risk for hyponatremia due to preexisting conditions, it’s important to take any new symptom seriously and talk to a doctor as quickly as possible.
Tests for low sodium in the blood
A blood test can help your doctor check for low sodium levels. Even if you don’t have symptoms of low blood sodium, your doctor may order a basic metabolic panel. This tests the amounts of electrolytes and minerals in your blood.
A basic metabolic panel is often part of a routine physical. It may identify low blood sodium in someone without any symptoms.
If your levels are abnormal, your doctor will order a urine test to check the amount of sodium in your urine. The results of this test will help your doctor determine the cause of your low blood sodium:
If your blood sodium levels are low but your urine sodium levels are high, your body is losing too much sodium.
Low sodium levels in both your blood and your urine mean your body isn’t taking in enough sodium. There may also be too much water in your body.
If your doctor is still unsure of a diagnosis, they may order a few other tests to check for hyponatremia, includingTrusted Source:
liver function tests
a chest X-ray or computed tomography (CT) scan of your chest
CT scan of your head
Treatment for hyponatremia
Treatment for low blood sodium varies depending on the cause, how severe the symptoms are, and how low your blood sodium levels are. It may include:
cutting back on fluid intake
adjusting the dosage of diuretics
taking medications for symptoms such as headaches, nausea, and seizures
treating underlying conditions
stopping or changing a medication for a chronic condition that may be negatively affecting blood sodium
an intravenous (IV) sodium solution
Prevention of hyponatremia
Keeping your water and electrolyte levels as balanced as possible can help prevent low blood sodium.
If you’re an athlete, it’s important to drink the right amount of water during exercise.
You may also want to consider drinking rehydration beverages. These drinks contain electrolytes, and help replenish sodium lost through sweating. These drinks are also helpful if you lose a lot of fluids through vomiting or diarrhea.
Staying hydrated throughout the day can help manage any wild swings in blood sodium. When you’re adequately hydrated, your urine will be pale yellow or clear, and you won’t feel thirsty.
It’s important to increase your fluid intake if:
the weather is warm
you’re at a high altitude
you’re pregnant or breastfeeding
you’re vomiting
you have diarrhea
you have a fever
Don’t forget that it’s possible to drink too much water too quickly. This is another reason to maintain good hydration throughout the day.
Hyponatremia vs Hypernatremia
Hypernatremia is a condition that is closely related to hyponatremia.
What is hypernatremia?
While hyponatremia involves low levels of sodium in the blood, hypernatremia occurs when there is too much sodium.
When a person doesn’t get enough water, either because of limited access to water or an impaired thirst mechanism, they can develop hypernatremia. It’s caused less commonly by diabetes insipidus.
Hypernatremia occurs when your serum sodium level exceeds 145 milliequivalents per liter (Eq/L)Trusted Source.
Hypernatremia can cause:
confusion
neuromuscular excitability
hyperreflexia
seizures
coma
Outlook
Hyponatremia is diagnosed when there is too little sodium in your blood. It can be caused by a variety of factors, from conditions like Addison’s disease or Cushing’s syndrome, to excessive vomiting or diarrhea.
Hyponatremia can be mild, and cause no symptoms, or it can be very severe and life threatening.
Typically, if hyponatremia is caught in the mild stage and treated, or treated swiftly in the severe stage, it can be reversed.
Last medically reviewed on March 9, 2022
8 sourcescollapsed
Medically reviewed by Meredith Goodwin, MD, FAAFP — Written by Janelle Martel — Updated on March 9, 2022
NUTRITION
6 Little-Known Dangers of Restricting Sodium Too Much
This article discusses sodium restriction in the general population. If you have been prescribed a low-sodium diet by your healthcare professional, or need to adhere to a low-sodium diet to manage a condition, the following information may not apply to you.
Sodium is an important electrolyte and main component of table salt.
Too much sodium has been linked to high blood pressure, and health organizations recommend that you limit your intake (1Trusted Source, 2Trusted Source, 3Trusted Source).
Most current guidelines recommend eating less than 2,300 mg per day. Some even go as low as 1,500 mg per day (4Trusted Source).
However, even though too much sodium causes problems, eating too little can be just as unhealthy.
Here are 6 little-known dangers of restricting sodium too much.
- May increase in insulin resistance
A few studies have linked low sodium diets to increased insulin resistance (5Trusted Source, 6Trusted Source, 7Trusted Source).
Insulin resistance is when your body’s cells don’t respond well to signals from the hormone insulin, leading to higher insulin and blood sugar levels.
Insulin resistance is believed to be a major driver of many serious diseases, including type 2 diabetes and heart disease (8Trusted Source, 9Trusted Source).
One study involving 152 healthy people found that insulin resistance increased after only 7 days on a low sodium diet (5Trusted Source).
Yet, not all studies agree. Some have found no effect, or even a decrease in insulin resistance (10Trusted Source, 11Trusted Source, 12Trusted Source).
However, these studies varied in length, study population, and degree of salt restriction, which may explain the inconsistent results.
SUMMARY
Low sodium diets have been associated with increased insulin resistance, a condition that causes higher blood sugar and insulin levels. This may lead to type 2 diabetes and other serious diseases.
- No clear benefit for heart disease
It’s true that reducing your sodium intake can reduce your blood pressure.
However, blood pressure is only a risk factor for disease. What’s really significant is hard endpoints like heart attacks or death.
Several observational studies have looked at the effects of low sodium diets on heart attacks, strokes, and the risk of death (13Trusted Source, 14Trusted Source, 15Trusted Source).
One study found that less than 3,000 mg of sodium per day is linked to an increased risk of dying from heart disease, including heart attacks and strokes (14Trusted Source).
Disturbingly, another study reported a higher risk of dying from heart disease at the lower sodium levels that many guidelines currently recommend (15Trusted Source).
However, other studies have reported conflicting results, so this matter is far from settled (16Trusted Source, 17Trusted Source, 18Trusted Source).
In a 2011 review, reducing sodium didn’t reduce the risk of dying from heart attacks or strokes, and it increased the risk of death from heart failure (19Trusted Source).
SUMMARY
Although the evidence is mixed, some observational studies show that low salt diets are linked to an increased risk of death from heart attacks or strokes. Controlled trials show no clear benefit.
- Increased risk of death from heart failure
Heart failure is when the heart is not able to pump enough blood around the body to meet its needs for blood and oxygen.
This doesn’t mean that your heart stops working completely, but it’s still a very serious health issue.
Interestingly, low sodium diets have been linked to an increased risk of death in people with heart failure.
One review found that for people with heart failure, limiting sodium intake increased the risk of dying (19Trusted Source).
In fact, the effect was strong — people who restricted their sodium intake had a 160% higher risk of death. This is concerning, as people with heart failure are often told to limit their sodium intake.
Yet, the results were strongly influenced by only one study, so more research is needed.
SUMMARY
There’s some evidence that people with heart failure may have a higher risk of dying on a low sodium diet. However, more studies are needed to confirm this.
- May raise LDL (bad) cholesterol and triglycerides
Many factors can increase the risk of heart disease, including elevated LDL (bad) cholesterol and triglycerides.
Some studies have found that low sodium diets may increase both LDL (bad) cholesterol and triglyceride levels.
In a 2003 review of studies in healthy people, low sodium diets caused a 4.6% increase in LDL (bad) cholesterol and a 5.9% increase in triglycerides (20Trusted Source).
A more recent review reported a 2.5% increase in cholesterol and a 7% increase in triglycerides (21Trusted Source).
What’s more, these studies found that salt restriction only caused minor reductions in blood pressure, on average, with a slightly stronger effect in people with high blood pressure.
SUMMARY
Studies have found that limiting salt may raise LDL (bad) cholesterol and triglycerides, which are common risk factors for heart disease.
- Increased risk of death for people with diabetes
People with diabetes have an increased risk of heart attack and stroke (22Trusted Source).
Therefore, many guidelines for those with diabetes recommend limiting salt intake (23Trusted Source, 24Trusted Source).
However, some studies have found an association between low sodium intake and an increased risk of death among those with both type 1 and type 2 diabetes (25Trusted Source, 26Trusted Source).
However, these were observational studies, and their results should be interpreted with caution.
SUMMARY
People with type 1 and type 2 diabetes may have an increased risk of death on a low sodium diet. However, this needs to be studied further.
- Higher risk of hyponatremia (low blood levels of sodium)
Hyponatremia is a condition characterized by low levels of sodium in the blood.
Its symptoms are similar to those caused by dehydration. In severe cases, the brain may swell, which can lead to headaches, seizures, coma, and even death (27Trusted Source).
Certain populations, like older adults, have a higher risk of hyponatremia (28Trusted Source).
That’s because older adults are more likely to have an illness or take medication that can reduce sodium levels in the blood.
Athletes, especially those who participate in long-distance endurance events, are also at a high risk of developing exercise-associated hyponatremia (29Trusted Source, 30Trusted Source).
In their case, it’s usually caused by drinking too much water and failing to replace the sodium that’s lost through sweat (31Trusted Source).
SUMMARY
A condition called hyponatremia, or low blood sodium levels, may affect certain people like older adults and some athletes. Eating less salt raises the risk of this condition.
The bottom line
The National Academy of Medicine (NAM) recommends a sodium intake of less than 2,300 mg per day, corresponding to 5.8 grams of salt.
Studies suggest that there’s a J-shaped curve when it comes to the effects of sodium.
Too much may be harmful, but too little can also have serious consequences.
The lowest risk of health issues and death seems to be somewhere in between.
Controversially, some researchers have suggested an intake of 3,000–5,000 mg of sodium per day is considered optimal.
This exceeds the maximum daily intake recommended by NAM, but it’s similar to what the average person already eats in the United States (32Trusted Source, 33Trusted Source).
This amounts to 7.5–12.5 grams of table salt per day, which equals 1.5–2.5 teaspoons per day (salt is only 40% sodium, so multiply sodium by 2.5 to find the amount of salt).
However, many people may benefit from restricted sodium intake, such as those with salt-sensitive high blood pressure (34Trusted Source).
If you have a medical condition that requires a diet low in sodium, or if your healthcare provider has advised you to limit your intake, by all means, continue to do so.
However, if you’re a healthy person trying to stay healthy, there’s no good evidence that following a low sodium diet will improve your health.
Most of the excess sodium people eat comes from processed, packaged foods — stuff you shouldn’t be eating much of anyway.
Adding some salt to your healthy foods to improve their flavor is both safe and healthy — and can make your diet much more pleasurable.