Disorders of Sodium Balance

Instructions for Hypernatremia

You have been diagnosed with hypernatremia. This means you have too much sodium (salt)  in the blood. It can be caused by a high salt intake. But it's more often due to fluid loss. Loss of too much fluid can occur if the kidneys excrete too much urine. This is called polyuria. Fluid loss can also be caused by excessive sweating. This can happen during hot weather or exercise. It can be caused by diarrhea or vomiting. It can also be caused if you don't drink enough water. If not treated right away, it is a seriouis problem that can cause a seizure or a loss of consciousness. It can also lead to death. 

Symptoms of hypernatremia include:

• Extreme thirst
• Fatigue
• Confusion
• Low blood pressure

Diet changes

Limit all foods that are high in sodium, including: 

• Canned soups
• Canned beans
• Frozen dinners
• Commercially prepared tomato sauce and spaghetti sauce
• Pizza
• Potato and corn chips
• Salted pretzels and crackers
• Olives
• Pickles
• Sauerkraut
• Soy sauce
• Cottage, american, or feta cheeses
• Canned chili and stew
• Lunch meats
• Processed meats, such as hot dogs and salami
• Instant hot cereal
• Quick breads made with baking soda or baking powder, including pancakes, bisquits, waffles, and muffles
• Packaged dessert mixes

Other home care

• Drink more fluids as advised.
• Have your sodium levels checked as often as advised by your healthcare provider. This is very important if you are taking a diuretic. This is a medicine that helps flush water from the body.
• Replace your body fluids after vomiting or diarrhea. Ask your healthcare provider for the best way to do this.
• Tell your doctor about all medicines you are taking. These include both prescribed and over-the-counter medicines. Some of these can raise sodium levels.
• Take all medicine as directed.

Follow-up care

Follow up with your healthcare provider, or as advised.  Your healthcare provider will need to watch your condition closely. You may need extra care if you have a health condition that causes your hypernatremia.

When to call your healthcare provider

Call  your healthcare provider right away if you have any of the following:

• Muscle twitching, spasms or cramps
• Farigue
• Confusion
• Seizures
• Loss of consciousness or fainting
• Dizziness or lightheadedness

Hyponatremia

Hyponatremia means low sodium levels in the blood. This condition most often occurs after prolonged vomiting or diarrhea, which causes your body to lose too much water and sodium. It can also result from drinking excess amounts of water or the use of diuretics (water pills). Rarely, it can be associated with disorders of your endocrine system, as side effects of illicit drug use (ecstasy), as a complication of some cancers especially small cell lung cancer, or as a complication of renal and liver disease or heart failure.

Mild hyponatremia causes no symptoms. It is only discovered with a blood test. As sodium levels in the blood decreases, symptoms begin to appear. This includes weakness, confusion, muscle cramping and seizures.

Home care

• Reduce your daily water intake until the problem is corrected.
• If you have been taking diuretics, you may be asked to stop taking them for a short time.
• If you are having symptoms of weakness or confusion, do not drive or operate dangerous machinery until symptoms resolve.
• If your sodium levels are too low to be managed at home with the above recommendations, you will be asked to go to the hospital to have your sodium replaced through your vein.

Follow-up care

Follow up with your healthcare provider for a repeat blood test within the next week, or as advised.

When to seek medical advice

Call your healthcare provider if any of the following occur:

• Increasing weakness
• Dizziness
• Irregular heartbeat, extra beats or very fast heart rate
• Increasing confusion
• Fainting or loss of consciousness
• Seizure

Instructions for Hyponatremia

You were diagnosed with hyponatremia, which means your blood level of sodium (salt) is too low. Salt is needed for the body and brain to work. Very low blood levels of sodium can be fatal. Symptoms can include headache, confusion, fatigue, muscle cramps, hallucinations, seizures, and coma. You have been treated to raise your blood levels of sodium. These instructions will help you care for yourself at home as you have been instructed.

Home care

• Limit your intake of fluids. Drink only the amounts directed by your healthcare provider.
• Ask your healthcare provider what you should use to replace fluids if you are throwing up.
• Keep all follow-up appointments. Your provider needs to watch your condition closely.

To help prevent hyponatremia:

• Take all medicines exactly as directed. Certain medicines can lower blood sodium levels.
• If you have done something that makes you sweat a lot, drink fluids that contain salt and other electrolytes. 
• Tell all healthcare providers what medicines you take. Mention all prescription and over-the-counter drugs and herbs.
• Have your sodium levels checked often. This is vital if you take a diuretic (medicine that helps your body get rid of water).

Follow-up

Follow up with your healthcare provider, or as advised. 

When to call your healthcare provider

Call your provider right away if you have any of the following:

• Severe tiredness
• Fainting
• Dizziness
• Loss of appetite
• Nausea or Vomiting
• Confusion or forgetfulness
• Muscle spasms, cramping or twitching
• Seizures
• Gait disturbances

Disclaimer: The UCLA Health System cannot guarantee the accuracy of such information. The information is provided without warranty or guarantee of any kind. Please speak to your Physician before making any changes.