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Medical Forum / General / Nutrition / February 2005Blood sodium level of 133
After an isolated blood test gave a sodium level reading of 133, my father has been advised to increase his salt intake. I understand that normal sodium levels are 135 to 145. Is 133 too low?? (He is aged 96, more or less chair bound, diabetic and overweight but with normal blood pressure) > After an isolated blood test gave a sodium level reading of 133, my father > has been advised to increase his salt intake. I understand that normal > sodium levels are 135 to 145. Is 133 too low?? > > (He is aged 96, more or less chair bound, diabetic and overweight but with > normal blood pressure) There are a lot of factors that go on with sodium levels. The interpretation is based on clinical grounds. Dehydration may be associated with low, normal or high sodium levels. Sodium levels generally reflect the body water content and usually not the sodium content. What that means is that the body has too much water diluting out the sodium. That can happen for a variety of reasons from SIADH, to decreasing effective circulating volume such heart failure or kidney failure and other causes. The person would not be advised to take more sodium as that would cause more water retention. They treat it with diuretics to get rid of the excess water. What is really needed is a urine sodium level that would reflect as to what is happening in the body. A urine sodium level of 15 meQ or greater would reflect sodium excretion and one with a lower level would reflect sodium retention. In a normal person with a low sodium as when one drinks too much water the urine sodium would be low reflecting water excretion. A high urine sodium in a person with a low blood sodium level reflects inappropriate sodium retention as in SIADH or primary, secondary aldosteronism. Edema is important for clinical grounds as well. "Robert" <RobertJ@hotmail.com> wrote in message That last statement should say primary, secondary hypoaldosteronism. A good example of that would be adrenal gland insufficiency where the sodium is low along with a high potassium. Anti-diuretic hormones regulates the water and aldosterone regulates the sodium. In short the body regulates its own water and sodium levels through kidney modulation of retention or excretion. >> After an isolated blood test gave a sodium level reading of 133, my >> father [quoted text clipped - 32 lines] > or primary, secondary aldosteronism. > Edema is important for clinical grounds as well. Robert, I'm very grateful that you took the time to write such a full reply. It sounds like you know what you are talking about. Based on what you say, In the light of what you say, perhaps I should approach his doctor asking if a urine test would be possible and questioning the nurses advice re increasing dietary salt. > >> After an isolated blood test gave a sodium level reading of 133, my > >> father [quoted text clipped - 38 lines] > a urine test would be possible and questioning the nurses advice re > increasing dietary salt. I would approach the doctor on that and sometimes the cause of the water retention or dehydration is obvious and a urine sodium might not even be warranted. The above are generalizations and it might be that a salt pill might help under the circumstances. Without knowing the complete picture of physical and history and I am not a doctor so all I am saying is that approach the doctor and have some rational or understanding of the cause of the hyponatremia. It will be a life long challenge from here on out so the understanding needs to be there on how to treat it. You mention diabetes and if the blood glucose is high the water is lost in the urine as a result of an osmotic diuresis causing dehydration and because of the high glucose the sodium is lowered as the water is drawn into the vascular space. This with time results in the loss of water and the loss of sodium over the long run. t > I would approach the doctor on that and sometimes the cause of the water > retention or dehydration is obvious and a urine sodium might not even be [quoted text clipped - 13 lines] > of > sodium over the long run. The blood glucose has been high - around 12 to 14, since he stopped taking gliclazide (an "oral hypoglycemic medication" which is a sulphonylurea I understand) around a month ago, so it is interesting that you mention this as a possibly relevant. He is back on a reduced dose of the Glicazide now so if that is continued, it will be interesting to see how that affects blood sodium. Thanks again. (footnote: He stopped the Gliclazide as it seemed to be having an adverse effect - he had quite extreme symptoms of hypoglycemia and was as alert, strong and lucid as normal as usual almost as soon as he stopped it. Back on it now today, it looks like the symptoms are returning. I hope we can get a Doctor to take an interest and hope to buy a glucose meter soon to build up a better picture of what is happening - or to eliminate glucose levels from the problem) |
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