Materiały źródłowe

• #1 Diagnosis and Management of Sodium Disorders: Hyponatremia and Hypernatremia | AAFP

  https://www.aafp.org/pubs/afp/issues/2015/0301/p299.html

  Hyponatremia is a common electrolyte disorder defined as a serum sodium level of less than 135 mEq per L. A Dutch systematic review of 53 studies showed that the prevalence of mild hyponatremia was 22.2% in geriatric hospital wards, 6.0% in nongeriatric wards, and 17.2% in the intensive care unit. The prevalence of severe hyponatremia (serum sodium level less than 125 mEq per L) was 4.5%, 0.8%, and 10.3%, respectively. It is estimated that hyponatremia occurs in 4% to 7% of the ambulatory population, with rates of 18.8% in nursing homes. […] Hyponatremia is associated with increased morbidity and mortality. In patients with heart failure who undergo cardiac surgery, hyponatremia increases rates of postoperative complications, length of hospital stay, and mortality. Mild hyponatremia in the ambulatory setting is associated with increased mortality (hazard ratio = 1.94) compared with normal sodium levels. Patients who develop hyponatremia during hospitalization have increased mortality rates compared with those who have hyponatremia on admission. It is unclear if hyponatremia is a marker for poor prognostic outcomes or merely a reflection of disease severity. Its presence suggests a worse prognosis in patients with liver cirrhosis, pulmonary hypertension, myocardial infarction, chronic kidney disease, hip fractures, and pulmonary embolism.

• #2 Hyponatremia: Causes, Symptoms, Diagnosis & Treatment

  https://my.clevelandclinic.org/health/diseases/17762-hyponatremia

  Symptoms of hyponatremia include muscle cramps or weakness, lethargy, nausea, vomiting, headache, confusion and seizures. […] Symptoms of hyponatremia (low sodium) can come on suddenly or slowly, over time. […] Chronic hyponatremia can happen over a long time, with symptoms coming on slowly and your body making adjustments for the low sodium levels. With acute hyponatremia, blood sodium levels fall quickly, and your symptoms may become severe suddenly. […] Symptoms of hyponatremia include muscle cramps or weakness, nausea and vomiting, lethargy, or extreme low energy, headache, confusion or other mental changes, seizures. […] Severe hyponatremia can cause swelling in your tissues, including your brain. Untreated, this can lead to coma, permanent brain damage or death. […] The outlook for hyponatremia depends a lot on the cause. Many people who get quick treatment can make a full recovery. If you have brain swelling that doesn’t resolve quickly, it can lead to permanent damage. […] Chronic hyponatremia may have symptoms that come on slowly, like tiredness or difficulty thinking.

• #3 Hyponatremia: Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/242166-overview

  Symptoms range from nausea and malaise, in persons with mild reduction in the serum sodium, to lethargy, decreased level of consciousness, headache, and (with severe hyponatremia) seizures and coma. Overt neurologic symptoms most often are due to very low serum sodium levels (usually 115 mEq/L), resulting in intracerebral osmotic fluid shifts and brain edema. […] Correction of hyponatremia varies according to its source, its severity, and its duration. In patients whose hyponatremia has a known duration of 48 hours, treatment must be calibrated to avoid osmotic demyelination syndrome (ODS), which may result from overly rapid correction. […] Therefore, correction of hyponatremia must take into account the chronicity of the condition. Acute hyponatremia (duration 48 h) can be corrected more quickly than chronic hyponatremia. Most individuals who present with symptomatic hyponatremia (as opposed to those who develop hyponatremia in an inpatient setting) have had hyponatremia for some time, so their condition is chronic, and correction should proceed accordingly. Overly rapid correction of serum sodium levels in these individuals can precipitate a severe neurologic complication, ODS. Consequently, when the duration of hyponatremia is uncertain, the condition should be considered chronic.

• #4 Hyponatremia – Wikipedia

  https://en.wikipedia.org/wiki/Hyponatremia

  Symptoms can be absent, mild or severe. […] Mild symptoms include a decreased ability to think, headaches, nausea, and poor balance. […] Severe symptoms include confusion, seizures, and coma; death can ensue. […] Signs and symptoms of hyponatremia include nausea and vomiting, headache, short-term memory loss, confusion, lethargy, fatigue, loss of appetite, irritability, muscle weakness, spasms or cramps, seizures, and decreased consciousness or coma. […] Lower levels of plasma sodium are associated with more severe symptoms. […] Neurological symptoms typically occur with very low levels of plasma sodium (usually 115 mmol/L). […] When sodium levels in the blood become very low, water enters the brain cells and causes them to swell (cerebral edema). […] This results in increased pressure in the skull and causes hyponatremic encephalopathy.

• #5 Hyponatremia Clinical Presentation: History, Physical Examination

  https://emedicine.medscape.com/article/242166-clinical

  Patients may present to medical attention with symptoms related to low serum sodium concentrations. […] Symptoms of hyponatremia range from nausea and malaise, which occur with mild reduction in the serum sodium, to lethargy, decreased level of consciousness, headache, and (with severe hyponatremia) seizures and coma. […] Overt neurologic symptoms most often are due to very low serum sodium levels (usually 115 mEq/L), resulting in intracerebral osmotic fluid shifts and brain edema. […] The severity of neurologic symptoms correlates well with the rate, degree, and duration of the drop in serum sodium. […] A gradual drop in serum sodium, even to very low levels, may be tolerated well if it occurs over several days or weeks, because of neuronal adaptation.

• #6 Hyponatraemia: Causes, Symptoms, and Treatment

  https://patient.info/treatment-medication/hyponatraemia-leaflet

  Hyponatraemia is a low level of sodium in the blood. […] The symptoms and severity of hyponatraemia depend on the following two factors: The level of the blood sodium. […] How quickly the sodium level falls – hyponatraemia can be divided into acute or chronic. In acute there is usually a sudden fall in blood sodium levels (over hours), whereas a chronic fall occurs over days to weeks. […] If the levels are only mildly abnormal you may feel completely fine, or only have mild symptoms. […] The clinical picture can be confusing, as mild hyponatraemia can cause significant symptoms if the drop in sodium level is sudden. […] On the other hand severe chronic hyponatraemia can cause no symptoms, due to the body (especially the brain) adapting over time to the lower levels. Symptoms include: Mild hyponatraemia – lack or loss of appetite (anorexia), headache, feeling sick (nausea), being sick (vomiting), and lack of energy and enthusiasm (lethargy).

• #7 Signs and symptoms of hyponatremia

  https://science.drinklmnt.com/electrolytes/hyponatremia-signs-and-symptoms/

  Hyponatremia is an electrolyte imbalance defined by low blood sodium levels. Although it often requires medical attention, the earliest signs and symptoms can often be subtle and include muscle cramps, headaches, and fatigue. Symptoms (often neurological) get more severe as sodium levels continue to fall. […] Symptoms of mild hyponatremia (marginally low sodium levels) include: Headaches, Brain fog, Muscle cramps, Low energy, Fatigue. […] Moderate to severe hyponatremia can have serious, neurological symptoms that can be life-threatening if left untreated. Here’s a list of what to look out for: Confusion, Seizures, Lethargy, Light sensitivity, Loss of consciousness, Brain damage, Brain swelling.

• #8 Hyponatraemia: Causes, Symptoms, and Treatment

  https://patient.info/treatment-medication/hyponatraemia-leaflet

  Moderate hyponatraemia – personality change, muscle cramps and weakness, confusion, and lack of muscle co-ordination (ataxia). […] Severe – drowsiness and fits (seizures). […] Sudden hyponatraemia can result in life-threatening complications as a result of sudden swelling of the brain (cerebral oedema), which can lead to coma and to fits (seizures), and which can be fatal. […] Chronic hyponatraemia can also lead to cerebral oedema and permanent neurological changes – for example, seizures. […] The speed with which the blood sodium is corrected is vital, as too rapid correction in a patient where low blood sodium has been present for several days or weeks, can lead to convulsions and may even be fatal. […] Too rapid correction of hyponatraemia can cause a condition called central pontine myelinolysis. Symptoms occur 2-4 days after onset and may present with paralysis of all four limbs (quadriplegia).

• #9 Hyponatraemia: Symptoms and Treatment | Doctor

  https://patient.info/doctor/hyponatraemia-pro

  Hyponatraemia symptoms depend upon severity and are dictated not only by the absolute serum sodium level but also by the rate of fall. […] Hyponatraemia is often asymptomatic if it is mild to moderate and also chronic (lasting more than 48 hours). […] Chronic mild hyponatraemia may be asymptomatic whilst a sudden fall to only 125 mmol/L from normal values can result in convulsions (usually from inappropriate intravenous fluids). […] The clinical picture can be confusing, because mild hyponatraemia can cause significant symptoms if the drop in sodium level is sudden, whereas severe chronic hyponatraemia can cause no symptoms, due to cerebral adaption. […] However, the following symptoms may occur: Mild – anorexia, headache, nausea, vomiting, lethargy. […] Moderate – personality change, muscle cramps and weakness, confusion, ataxia.

• #10 Hyponatremia – Wikipedia

  https://en.wikipedia.org/wiki/Hyponatremia

  Symptoms can be absent, mild or severe. […] Mild symptoms include a decreased ability to think, headaches, nausea, and poor balance. […] Severe symptoms include confusion, seizures, and coma; death can ensue. […] Signs and symptoms of hyponatremia include nausea and vomiting, headache, short-term memory loss, confusion, lethargy, fatigue, loss of appetite, irritability, muscle weakness, spasms or cramps, seizures, and decreased consciousness or coma. […] Lower levels of plasma sodium are associated with more severe symptoms. […] Neurological symptoms typically occur with very low levels of plasma sodium (usually 115 mmol/L). […] When sodium levels in the blood become very low, water enters the brain cells and causes them to swell (cerebral edema). […] This results in increased pressure in the skull and causes hyponatremic encephalopathy.

• #11

• #12 Hyponatremia – Wikipedia

  https://en.wikipedia.org/wiki/Hyponatremia

  Symptoms can be absent, mild or severe. […] Mild symptoms include a decreased ability to think, headaches, nausea, and poor balance. […] Severe symptoms include confusion, seizures, and coma; death can ensue. […] Signs and symptoms of hyponatremia include nausea and vomiting, headache, short-term memory loss, confusion, lethargy, fatigue, loss of appetite, irritability, muscle weakness, spasms or cramps, seizures, and decreased consciousness or coma. […] Lower levels of plasma sodium are associated with more severe symptoms. […] Neurological symptoms typically occur with very low levels of plasma sodium (usually 115 mmol/L). […] When sodium levels in the blood become very low, water enters the brain cells and causes them to swell (cerebral edema). […] This results in increased pressure in the skull and causes hyponatremic encephalopathy.

• #13 Hyponatremia – Symptoms, Types, Causes & Diagnosis

  https://www.ganeshdiagnostic.com/blog/hyponatremia-symptoms-types-causes-and-diagnosis

  Hyponatremia can manifest as nausea, vomiting, headache, disorientation, lethargy, weariness, loss of appetite, irritability, muscle weakness, tremors or convulsions, seizures, unconsciousness or coma, and short-term memory loss. The severity of the symptoms increases with a decrease in plasma sodium concentration. […] Neurological symptoms usually develop when plasma sodium concentrations are very low (usually 115 mmol/L). When blood sodium levels become very low, water enters the brain cells and causes cerebral edema. This increases intracranial pressure and causes hyponatremic encephalopathy. Increased pressure within the skull can cause brain herniation, where the brain is squeezed onto the internal structures of the skull. This can lead to headache, nausea, vomiting, confusion, seizures, compression of the brainstem, respiratory failure, and accumulation of non-cardiogenic fluid in the lungs. Usually fatal. Chronic hyponatremia can lead to complications such as neuropathy. These neurological deficits most commonly affect gait (gait) and attention and can lead to increased reaction times and falls. Hyponatremia is associated with a dual risk of osteoporosis and an increased risk of fracture due to impaired bone metabolism. […] In chronic hyponatremia, sodium levels gradually decrease over 48 hours or so – and symptoms and complications are usually milder. During acute hyponatremia, sodium levels drop rapidly, leading to potentially dangerous effects, such as rapid brain swelling, which can lead to coma and death.

• #14 Hyponatremia – Wikipedia

  https://en.wikipedia.org/wiki/Hyponatremia

  Symptom severity depends on how fast and how severe the drop in blood sodium level is. […] Chronic hyponatremia is when sodium levels drop gradually over several days or weeks and symptoms and complications are typically moderate. […] Acute hyponatremia is when sodium levels drop rapidly, resulting in potentially dangerous effects, such as rapid brain swelling, which can result in coma and death.

• #15 Hyponatremia: Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/242166-overview

  Symptoms range from nausea and malaise, in persons with mild reduction in the serum sodium, to lethargy, decreased level of consciousness, headache, and (with severe hyponatremia) seizures and coma. Overt neurologic symptoms most often are due to very low serum sodium levels (usually 115 mEq/L), resulting in intracerebral osmotic fluid shifts and brain edema. […] Correction of hyponatremia varies according to its source, its severity, and its duration. In patients whose hyponatremia has a known duration of 48 hours, treatment must be calibrated to avoid osmotic demyelination syndrome (ODS), which may result from overly rapid correction. […] Therefore, correction of hyponatremia must take into account the chronicity of the condition. Acute hyponatremia (duration 48 h) can be corrected more quickly than chronic hyponatremia. Most individuals who present with symptomatic hyponatremia (as opposed to those who develop hyponatremia in an inpatient setting) have had hyponatremia for some time, so their condition is chronic, and correction should proceed accordingly. Overly rapid correction of serum sodium levels in these individuals can precipitate a severe neurologic complication, ODS. Consequently, when the duration of hyponatremia is uncertain, the condition should be considered chronic.

• #16 Low blood sodium: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/000394.htm

  Low blood sodium is a condition in which the sodium level in the blood is lower than normal. The medical name of this condition is hyponatremia. […] When the amount of sodium in fluids outside cells drops below normal, water moves into the cells. This causes the cells to swell with too much water. Brain cells are especially sensitive to swelling, and this causes many of the symptoms of low blood sodium. […] Common symptoms include: Confusion, irritability, restlessness, Convulsions, Fatigue, Headache, Loss of appetite, Muscle weakness, spasms, or cramps, Nausea, vomiting. […] Outcome depends on the condition that is causing the problem. Hyponatremia that occurs in less than 48 hours (acute hyponatremia), is more dangerous than hyponatremia that develops slowly over time. When blood sodium level falls slowly over days or weeks (chronic hyponatremia), the brain cells have time to adjust and swelling may be minimal. […] In severe cases, low blood sodium can lead to: Decreased consciousness, hallucinations or coma, Brain herniation, Death. […] When your body’s sodium level drops too much, it can be a life-threatening emergency. Call your provider right away if you have symptoms of this condition.

• #17 Hyponatremia – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/hyponatremia/symptoms-causes/syc-20373711

  Hyponatremia signs and symptoms may include: Nausea and vomiting […] Seek emergency care for anyone who develops severe signs and symptoms of hyponatremia, such as nausea and vomiting, confusion, seizures, or lost consciousness. […] In chronic hyponatremia, sodium levels drop gradually over 48 hours or longer and symptoms and complications are typically more moderate. […] In acute hyponatremia, sodium levels drop rapidly resulting in potentially dangerous effects, such as rapid brain swelling, which can result in a coma and death.

• #18 Hyponatremia: A practical approach

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4192979/

  Acute hyponatremia is characterized by onset of symptoms 48h. Patients with acute hyponatremia develop neurologic symptoms resulting from cerebral edema induced by water movement into the brain. These may include seizures, impaired mental status or coma and death. […] Chronic hyponatremia- Hyponatremia developing over 48 h should be considered chronic. Most patients have chronic hyponatremia. The serum sodium concentration is usually above 120meq/L. Brain adapts itself to hyponatremia by generation of idiogenic osmoles. This is a protective mechanism that reduces the degree of cerebral edema; it begins on the first day and is complete within several days. Hence in chronic hyponatremia patients may appear asymptomatic. Mild hyponatremia is characterized by gastrointestinal tract symptoms nausea, vomiting, loss of appetite. Sometimes, subtle neurologic abnormalities may be present when the serum sodium is between 120 and 130 meq/L. Hyponatremia in the elderly may manifest with frequent falls and gait disturbances.

• #19 Hyponatremia | Beacon Health System

  https://www.beaconhealthsystem.org/library/diseases-and-conditions/hyponatremia?content_id=CON-20373694

  Hyponatremia signs and symptoms may include: Nausea and vomiting […] Headache […] Confusion […] Loss of energy, drowsiness and fatigue […] Restlessness and irritability […] Muscle weakness, spasms or cramps […] Seizures […] Coma […] In chronic hyponatremia, sodium levels drop gradually over 48 hours or longer and symptoms and complications are typically more moderate. […] In acute hyponatremia, sodium levels drop rapidly resulting in potentially dangerous effects, such as rapid brain swelling, which can result in a coma and death.

• #20 Hyponatremia – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/hyponatremia/diagnosis-treatment/drc-20373715

  Seek emergency care for anyone who develops severe signs and symptoms of hyponatremia, such as nausea and vomiting, confusion, seizures, or lost consciousness. […] Call your doctor if you know you are at risk of hyponatremia and are experiencing nausea, headaches, cramping or weakness. Depending on the extent and duration of these signs and symptoms, your doctor may recommend seeking immediate medical care. […] Have your symptoms included any mental changes, such as feeling confused, agitated or depressed? […] Have you had nausea, vomiting or diarrhea? […] Have you felt faint, had seizures or lost consciousness?

• #21 Hyponatremia: A practical approach

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4192979/

  Acute hyponatremia is characterized by onset of symptoms 48h. Patients with acute hyponatremia develop neurologic symptoms resulting from cerebral edema induced by water movement into the brain. These may include seizures, impaired mental status or coma and death. […] Chronic hyponatremia- Hyponatremia developing over 48 h should be considered chronic. Most patients have chronic hyponatremia. The serum sodium concentration is usually above 120meq/L. Brain adapts itself to hyponatremia by generation of idiogenic osmoles. This is a protective mechanism that reduces the degree of cerebral edema; it begins on the first day and is complete within several days. Hence in chronic hyponatremia patients may appear asymptomatic. Mild hyponatremia is characterized by gastrointestinal tract symptoms nausea, vomiting, loss of appetite. Sometimes, subtle neurologic abnormalities may be present when the serum sodium is between 120 and 130 meq/L. Hyponatremia in the elderly may manifest with frequent falls and gait disturbances.

• #22 Low blood sodium: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/000394.htm

  Low blood sodium is a condition in which the sodium level in the blood is lower than normal. The medical name of this condition is hyponatremia. […] When the amount of sodium in fluids outside cells drops below normal, water moves into the cells. This causes the cells to swell with too much water. Brain cells are especially sensitive to swelling, and this causes many of the symptoms of low blood sodium. […] Common symptoms include: Confusion, irritability, restlessness, Convulsions, Fatigue, Headache, Loss of appetite, Muscle weakness, spasms, or cramps, Nausea, vomiting. […] Outcome depends on the condition that is causing the problem. Hyponatremia that occurs in less than 48 hours (acute hyponatremia), is more dangerous than hyponatremia that develops slowly over time. When blood sodium level falls slowly over days or weeks (chronic hyponatremia), the brain cells have time to adjust and swelling may be minimal. […] In severe cases, low blood sodium can lead to: Decreased consciousness, hallucinations or coma, Brain herniation, Death. […] When your body’s sodium level drops too much, it can be a life-threatening emergency. Call your provider right away if you have symptoms of this condition.

• #23 Hyponatremia: Causes, Symptoms, Diagnosis & Treatment

  https://my.clevelandclinic.org/health/diseases/17762-hyponatremia

  Symptoms of hyponatremia include muscle cramps or weakness, lethargy, nausea, vomiting, headache, confusion and seizures. […] Symptoms of hyponatremia (low sodium) can come on suddenly or slowly, over time. […] Chronic hyponatremia can happen over a long time, with symptoms coming on slowly and your body making adjustments for the low sodium levels. With acute hyponatremia, blood sodium levels fall quickly, and your symptoms may become severe suddenly. […] Symptoms of hyponatremia include muscle cramps or weakness, nausea and vomiting, lethargy, or extreme low energy, headache, confusion or other mental changes, seizures. […] Severe hyponatremia can cause swelling in your tissues, including your brain. Untreated, this can lead to coma, permanent brain damage or death. […] The outlook for hyponatremia depends a lot on the cause. Many people who get quick treatment can make a full recovery. If you have brain swelling that doesn’t resolve quickly, it can lead to permanent damage. […] Chronic hyponatremia may have symptoms that come on slowly, like tiredness or difficulty thinking.

• #24 Hyponatremia – Symptoms, Types, Causes & Diagnosis

  https://www.ganeshdiagnostic.com/blog/hyponatremia-symptoms-types-causes-and-diagnosis

  Hyponatremia can manifest as nausea, vomiting, headache, disorientation, lethargy, weariness, loss of appetite, irritability, muscle weakness, tremors or convulsions, seizures, unconsciousness or coma, and short-term memory loss. The severity of the symptoms increases with a decrease in plasma sodium concentration. […] Neurological symptoms usually develop when plasma sodium concentrations are very low (usually 115 mmol/L). When blood sodium levels become very low, water enters the brain cells and causes cerebral edema. This increases intracranial pressure and causes hyponatremic encephalopathy. Increased pressure within the skull can cause brain herniation, where the brain is squeezed onto the internal structures of the skull. This can lead to headache, nausea, vomiting, confusion, seizures, compression of the brainstem, respiratory failure, and accumulation of non-cardiogenic fluid in the lungs. Usually fatal. Chronic hyponatremia can lead to complications such as neuropathy. These neurological deficits most commonly affect gait (gait) and attention and can lead to increased reaction times and falls. Hyponatremia is associated with a dual risk of osteoporosis and an increased risk of fracture due to impaired bone metabolism. […] In chronic hyponatremia, sodium levels gradually decrease over 48 hours or so – and symptoms and complications are usually milder. During acute hyponatremia, sodium levels drop rapidly, leading to potentially dangerous effects, such as rapid brain swelling, which can lead to coma and death.

• #25 SIADH (Syndrome of Inappropriate Antidiuretic Hormone Secretion)

  https://my.clevelandclinic.org/health/diseases/23976-siadh-syndrome-of-inappropriate-antidiuretic-hormone-secretion

  The main sign and consequence of ADH is hyponatremia, which is when you have low levels of sodium (salt) in your blood. […] A low blood sodium level (hyponatremia) is the most common cause of symptoms of SIADH. […] Often, mildly low sodium levels dont cause symptoms, but moderate to severe hyponatremia can cause the following symptoms: Muscle cramps or weakness. Nausea and vomiting. Headache. Problems with balance, which may result in falls. Mental changes, such as confusion, memory problems and/or strange behavior. Seizures or coma (in severe cases). […] Low sodium that occurs rapidly, in less than 48 hours (acute hyponatremia), is more dangerous than low sodium that develops slowly over time. […] Chronic hyponatremia is associated with nervous system issues, such as poor balance and poor memory. […] In severe cases of SIADH, very low sodium levels can lead to: Decreased consciousness, hallucinations or coma. Brain herniation. Death.

• #26 Hyponatremia Clinical Presentation: History, Physical Examination

  https://emedicine.medscape.com/article/242166-clinical

  Patients may present to medical attention with symptoms related to low serum sodium concentrations. […] Symptoms of hyponatremia range from nausea and malaise, which occur with mild reduction in the serum sodium, to lethargy, decreased level of consciousness, headache, and (with severe hyponatremia) seizures and coma. […] Overt neurologic symptoms most often are due to very low serum sodium levels (usually 115 mEq/L), resulting in intracerebral osmotic fluid shifts and brain edema. […] The severity of neurologic symptoms correlates well with the rate, degree, and duration of the drop in serum sodium. […] A gradual drop in serum sodium, even to very low levels, may be tolerated well if it occurs over several days or weeks, because of neuronal adaptation.

• #27 Hyponatremia (Low Level of Sodium in the Blood) – Hormonal and Metabolic Disorders – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/hormonal-and-metabolic-disorders/electrolyte-balance/hyponatremia-low-level-of-sodium-in-the-blood

  Symptoms result from brain dysfunction. […] At first, people become sluggish and confused, and if hyponatremia worsens, they may have muscle twitches and seizures and become progressively unresponsive. […] The brain is particularly sensitive to changes in the sodium level in blood. Therefore, symptoms of brain dysfunction, such as sluggishness (lethargy) and confusion, occur first. If the sodium level in blood falls quickly, symptoms tend to develop rapidly and be more severe. Older adults are more likely to have severe symptoms. […] As hyponatremia becomes more severe, muscle twitching and seizures may occur. People may become unresponsive, aroused only by vigorous stimulation (stupor), and eventually cannot be aroused (coma). Death may follow.

• #28 Hyponatremia Symptoms, Causes and Natural Treatments – Dr. Axe

  https://draxe.com/health/hyponatremia/

  When hyponatremia is mild or sometimes even moderate, its commonly asymptomatic. This means no noticeable symptoms occur that the patient is aware of. […] However, when its more severe, hyponatremia symptoms typically include headaches, nausea, and in some cases even seizures or a coma. […] The most common hyponatremia symptoms include: Digestive issues, like nausea, diarrhea and vomiting, Headaches, Dizziness and instability, Muscle weakness, Trouble concentrating and confusion, Low energy, lethargy, even if youve slept enough, and fatigue, Mood changes and increased irritability, Muscle pains, spasms or cramps, Rhabdomyolysis, Excessive thirst. […] In severe cases when the condition isnt treated, brain swelling, seizures, and possibly coma or death can occur. In the elderly, hyponatremia can also cause falls, injuries and gait disturbances due to instability and weakness.

• #29 Auditory Hallucinations Induced by Hyponatremia

  https://www.psychiatrist.com/pcc/auditory-hallucinations-induced-hyponatremia/

  Hyponatremia (serum sodium135 mEq/L) is a commonly encountered electrolyte abnormality in day-to-day clinical practice. Patients with hyponatremia manifest various symptoms, ranging from mild symptoms like nausea, vomiting, loss of appetite, fatigue, and lethargy to severe symptoms such as confusion, seizures, coma, and death. […] Hallucinations are rarely reported among nonpsychiatric patients with hyponatremia. A previous study reported 0.5% of patients with hyponatremia presenting with hallucinations. […] Our patient developed auditory hallucinations acutely in the absence of any past or family history of psychiatric illness that resolved with the correction of hyponatremia. The temporal correlation of onset of hallucinations with hyponatremia and resolution with the normalization of sodium levels without use of antipsychotic medications suggest a causal relationship.

• #30 Hyponatremia: Symptoms, Causes, and Treatments

  https://www.webmd.com/a-to-z-guides/what-is-hyponatremia

  You may not have any symptoms if you have a mild case of hyponatremia. Symptoms usually appear when your level of sodium suddenly rises or drops. […] Moderate to severe signs of hyponatremia may include: Nausea with vomiting, Fatigue or low energy, Headache, Confusion, Cramps or spasms in your muscles, Crankiness and restlessness, Weakness. […] If your hyponatremia came on suddenly and its severe, youll need emergency treatment to boost your sodium level. […] If you have chronic hyponatremia, your sodium levels are likely to drop very slowly over a few days and your symptoms and complications will be milder. With acute hyponatremia, your sodium levels drop very quickly. This can cause: Rapid brain swelling, Seizures, Coma, Death. […] Some research suggests that hyponatremia, both chronic and acute, can also increase your risk for bone fractures and osteoporosis.

• #31 Hyponatremia – Symptoms, causes, treatment | National Kidney Foundation

  https://www.kidney.org/kidney-topics/hyponatremia-low-sodium-level-blood

  Most people with mild hyponatremia may not have any symptoms. If symptoms are present, it is usually when the level of sodium in your blood goes very low or drops very fast. These symptoms can include: […] More serious symptoms can happen in severe cases when the level of sodium in your blood is extremely low. These include: […] Sudden hyponatremia (dramatic drop in less than 48 hours) and/or severely decreased sodium levels can cause serious problems if left untreated, including: […] Hyponatremia that develops slowly over time and/or is only mildly decreased is not likely to cause complications, especially if treated promptly.

• #32 Management of Hyponatremia | AAFP

  https://www.aafp.org/pubs/afp/issues/2004/0515/p2387.html

  Hyponatremia is an important electrolyte abnormality with the potential for significant morbidity and mortality. […] Acute or symptomatic hyponatremia can lead to significant rates of morbidity and mortality. […] Mortality rates as high as 17.9 percent have been quoted, but rates this extreme usually occur in the context of hospitalized patients. […] Most patients with hyponatremia are asymptomatic. Symptoms do not usually appear until the plasma sodium level drops below 120 mEq per L (120 mmol per L) and usually are nonspecific (e.g., headache, lethargy, nausea). […] In cases of severe hyponatremia, neurologic and gastrointestinal symptoms predominate. […] The risk of seizures and coma increases as the sodium level decreases. […] The development of clinical signs and symptoms also depends on the rapidity with which the plasma sodium level decreases.

• #33 What to Know About Hyponatremia and Hypernatremia | UPMC HealthBeat

  https://share.upmc.com/2022/02/hyponatremia-and-hypernatremia/

  Hyponatremia happens when blood levels of sodium fall below 135 mEq/L. The symptoms of hyponatremia depend on how severe it is and how fast it develops. With mild or moderate hyponatremia, you might feel nothing or feel tired, nauseous, or have a headache. If its more severe (less than 120 mEq/L), you can have seizures, lose consciousness, or go into a coma. In addition, acute hyponatremia which develops rapidly (within 48 hours) tends to cause more symptoms that chronic hyponatremia (over 48 hours) which allows your body to adapt and have very little or no symptoms, even when it is severe. […] The problem is drinking excess water or having too much water in your body. This dilutes the amount of sodium in your blood.

• #34 Hyponatremia (Low Level of Sodium in the Blood) – Hormonal and Metabolic Disorders – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/hormonal-and-metabolic-disorders/electrolyte-balance/hyponatremia-low-level-of-sodium-in-the-blood

  Symptoms result from brain dysfunction. […] At first, people become sluggish and confused, and if hyponatremia worsens, they may have muscle twitches and seizures and become progressively unresponsive. […] The brain is particularly sensitive to changes in the sodium level in blood. Therefore, symptoms of brain dysfunction, such as sluggishness (lethargy) and confusion, occur first. If the sodium level in blood falls quickly, symptoms tend to develop rapidly and be more severe. Older adults are more likely to have severe symptoms. […] As hyponatremia becomes more severe, muscle twitching and seizures may occur. People may become unresponsive, aroused only by vigorous stimulation (stupor), and eventually cannot be aroused (coma). Death may follow.

• #35 Hyponatremia – Endocrine and Metabolic Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/endocrine-and-metabolic-disorders/electrolyte-disorders/hyponatremia

  Symptoms mainly involve central nervous system dysfunction. However, when hyponatremia is accompanied by disturbances in total body sodium content, signs of ECF volume depletion or volume overload also occur. In general, in patients who are older and/or chronically ill with hyponatremia develop more symptoms than patients who are younger and/or otherwise healthy. Symptoms are also more severe with faster-onset hyponatremia. Symptoms generally occur when the effective plasma osmolality falls to 240 mOsm/L ( 115 mEq/L […] Severe cerebral edema may occur in premenopausal women with acute hyponatremia, perhaps because estrogen and progesterone inhibit brain Na+,K+-ATPase and decrease solute extrusion from brain cells. Sequelae include hypothalamic and posterior pituitary infarction and occasionally osmotic demyelination syndrome or brain stem herniation.

• #36 What Are the Symptoms of Low Sodium?

  https://redcliffelabs.com/myhealth/health/what-are-the-symptoms-of-low-sodium/

  Common neurologic symptoms of low sodium include confusion, seizures, and coma. The amount of bloodstream sodium that is depleted and how rapidly depends on the severity of the symptoms. Many times, a drop in blood sodium levels occurs gradually, resulting in very minor symptoms while the body adjusts. When blood salt levels drop quickly, symptoms worsen. The following are typical signs of hyponatremia: […] Rapid salt loss requires immediate medical attention. It may lead to: […] Sodium levels drop quickly in acute hyponatremia resulting in enlarged brain tissue, which can have potentially harmful implications. Complications that may arise if untreated include: […] If you’re a woman who has not yet experienced menopause, you run a higher chance of developing brain damage from hyponatremia. Doctors speculate that this may be related to how sodium levels are impacted by female sex hormones. […] Hyponatremia can range from moderate, with no symptoms, to quite severe, with life-threatening consequences.

• #37 Diagnosis and Management of Sodium Disorders: Hyponatremia and Hypernatremia | AAFP

  https://www.aafp.org/pubs/afp/issues/2015/0301/p299.html

  Hyponatremia is a common electrolyte disorder defined as a serum sodium level of less than 135 mEq per L. A Dutch systematic review of 53 studies showed that the prevalence of mild hyponatremia was 22.2% in geriatric hospital wards, 6.0% in nongeriatric wards, and 17.2% in the intensive care unit. The prevalence of severe hyponatremia (serum sodium level less than 125 mEq per L) was 4.5%, 0.8%, and 10.3%, respectively. It is estimated that hyponatremia occurs in 4% to 7% of the ambulatory population, with rates of 18.8% in nursing homes. […] Hyponatremia is associated with increased morbidity and mortality. In patients with heart failure who undergo cardiac surgery, hyponatremia increases rates of postoperative complications, length of hospital stay, and mortality. Mild hyponatremia in the ambulatory setting is associated with increased mortality (hazard ratio = 1.94) compared with normal sodium levels. Patients who develop hyponatremia during hospitalization have increased mortality rates compared with those who have hyponatremia on admission. It is unclear if hyponatremia is a marker for poor prognostic outcomes or merely a reflection of disease severity. Its presence suggests a worse prognosis in patients with liver cirrhosis, pulmonary hypertension, myocardial infarction, chronic kidney disease, hip fractures, and pulmonary embolism.

• #38 Management of Hyponatremia | AAFP

  https://www.aafp.org/pubs/afp/issues/2004/0515/p2387.html

  Poor prognostic factors for severe hyponatremia in hospitalized patients include the presence of symptoms, sepsis, and respiratory failure. […] Acute severe hyponatremia (i.e., less than 125 mmol per L) usually is associated with neurologic symptoms such as seizures and should be treated urgently because of the high risk of cerebral edema and hyponatremic encephalopathy. […] In patients with chronic hyponatremia, overzealous and rapid correction should be avoided because it can lead to central pontine myelinolysis. […] In central pontine myelinolysis, neurologic symptoms usually occur one to six days after correction and often are irreversible.

• #39 Hyponatremia – PsychDB

  https://www.psychdb.com/cl/hyponatremia

  Hyponatremia is an electrolyte disturbance of low serum sodium that can result in neuropsychiatric symptoms. […] Early signs and symptoms of hyponatremia includes nausea, vomiting, anorexia, disorientation, headache, fatigue, weakness, irritability, lethargy, confusion, and muscle cramps. […] Falls and confusion in the due to hyponatremia is common in the elderly. […] With severe hyponatremia, seizures can develop. […] Severe hyponatremia from SIADH can result in cerebral edema, and/or seizures. […] However, in severe cases, mortality can occur when the polydipsia results in severe water intoxication. […] Excessive consumption of beer (which has a low solute content) to the exclusion of other fluid intake can result in severe hyponatremia, known as beer potomania. […] The incidence of hyponatremia caused by SSRIs varies widely, from 0.5% to 32%. […] In rare cases, antipsychotics can cause hyponatremia.

• #40 Hyponatremia: Causes, Symptoms, Diagnosis & Treatment

  https://my.clevelandclinic.org/health/diseases/17762-hyponatremia

  Symptoms of hyponatremia include muscle cramps or weakness, lethargy, nausea, vomiting, headache, confusion and seizures. […] Symptoms of hyponatremia (low sodium) can come on suddenly or slowly, over time. […] Chronic hyponatremia can happen over a long time, with symptoms coming on slowly and your body making adjustments for the low sodium levels. With acute hyponatremia, blood sodium levels fall quickly, and your symptoms may become severe suddenly. […] Symptoms of hyponatremia include muscle cramps or weakness, nausea and vomiting, lethargy, or extreme low energy, headache, confusion or other mental changes, seizures. […] Severe hyponatremia can cause swelling in your tissues, including your brain. Untreated, this can lead to coma, permanent brain damage or death. […] The outlook for hyponatremia depends a lot on the cause. Many people who get quick treatment can make a full recovery. If you have brain swelling that doesn’t resolve quickly, it can lead to permanent damage. […] Chronic hyponatremia may have symptoms that come on slowly, like tiredness or difficulty thinking.

• #41 Hyponatremia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK470386/

  Symptoms depend upon the degree and chronicity of hyponatremia. Patients with mild-to-moderate hyponatremia (greater than 120 mEq/L) or a gradual decrease in sodium (greater than 48 hours) have minimal symptoms. Patients with severe hyponatremia (less than 120 mEq/L) or rapid decrease in sodium levels have multiple varied symptoms. […] Symptoms can range from anorexia, nausea and vomiting, fatigue, headache, and muscle cramps to altered mental status, agitation, seizures, and even coma. […] Patients with neurological symptoms and signs need to be treated promptly to prevent permanent neurological damage. […] The prognosis in patients with hyponatremia depends on the severity of hyponatremia and the underlying condition causing it. The prognosis is poor in patients with severe hyponatremia, acute hyponatremia, and older patients.

• #42 Hyponatremia: Causes, Symptoms, Diagnosis & Treatment

  https://my.clevelandclinic.org/health/diseases/17762-hyponatremia

  Symptoms of hyponatremia include muscle cramps or weakness, lethargy, nausea, vomiting, headache, confusion and seizures. […] Symptoms of hyponatremia (low sodium) can come on suddenly or slowly, over time. […] Chronic hyponatremia can happen over a long time, with symptoms coming on slowly and your body making adjustments for the low sodium levels. With acute hyponatremia, blood sodium levels fall quickly, and your symptoms may become severe suddenly. […] Symptoms of hyponatremia include muscle cramps or weakness, nausea and vomiting, lethargy, or extreme low energy, headache, confusion or other mental changes, seizures. […] Severe hyponatremia can cause swelling in your tissues, including your brain. Untreated, this can lead to coma, permanent brain damage or death. […] The outlook for hyponatremia depends a lot on the cause. Many people who get quick treatment can make a full recovery. If you have brain swelling that doesn’t resolve quickly, it can lead to permanent damage. […] Chronic hyponatremia may have symptoms that come on slowly, like tiredness or difficulty thinking.

• #43

  https://consensus.app/questions/hyponatremia-symptoms/

  Hyponatremia is the most common electrolyte disorder, characterized by a serum sodium level of less than 135 mEq/L. It affects approximately 5% of adults and 35% of hospitalized patients, often resulting from water retention. The severity of symptoms varies based on the rapidity of onset, duration, and severity of the condition. […] Mild to moderate hyponatremia often presents with nonspecific symptoms such as lethargy, restlessness, disorientation, headache, nausea, vomiting, muscle cramps, and depressed neural reflexes. These symptoms can be easily overlooked or attributed to other conditions, making diagnosis challenging. […] Chronic mild hyponatremia is associated with cognitive impairments, gait disturbances, and an increased risk of falls and fractures. Studies have shown that patients with hyponatremia report a higher incidence of falls and new fractures compared to those with normal sodium levels.

• #44

  https://consensus.app/questions/hyponatremia-symptoms/

  Hyponatremia is the most common electrolyte disorder, characterized by a serum sodium level of less than 135 mEq/L. It affects approximately 5% of adults and 35% of hospitalized patients, often resulting from water retention. The severity of symptoms varies based on the rapidity of onset, duration, and severity of the condition. […] Mild to moderate hyponatremia often presents with nonspecific symptoms such as lethargy, restlessness, disorientation, headache, nausea, vomiting, muscle cramps, and depressed neural reflexes. These symptoms can be easily overlooked or attributed to other conditions, making diagnosis challenging. […] Chronic mild hyponatremia is associated with cognitive impairments, gait disturbances, and an increased risk of falls and fractures. Studies have shown that patients with hyponatremia report a higher incidence of falls and new fractures compared to those with normal sodium levels.

• #45 Hyponatremia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK470386/

  If left untreated or inadequately treated, patients with hyponatremia can develop rhabdomyolysis, altered mental status, seizures, and even coma. […] Rapid correction of chronic hyponatremia (greater than 10 mEq/L to 12 mEq/L of sodium in 24 hrs) can lead to osmotic demyelination syndrome. […] Osmotic demyelination syndrome, formerly known as central pontine myelinolysis, is a complication of rapid correction of sodium in patients with chronic hyponatremia.

• #46 Hyponatraemia: Causes, Symptoms, and Treatment

  https://patient.info/treatment-medication/hyponatraemia-leaflet

  Moderate hyponatraemia – personality change, muscle cramps and weakness, confusion, and lack of muscle co-ordination (ataxia). […] Severe – drowsiness and fits (seizures). […] Sudden hyponatraemia can result in life-threatening complications as a result of sudden swelling of the brain (cerebral oedema), which can lead to coma and to fits (seizures), and which can be fatal. […] Chronic hyponatraemia can also lead to cerebral oedema and permanent neurological changes – for example, seizures. […] The speed with which the blood sodium is corrected is vital, as too rapid correction in a patient where low blood sodium has been present for several days or weeks, can lead to convulsions and may even be fatal. […] Too rapid correction of hyponatraemia can cause a condition called central pontine myelinolysis. Symptoms occur 2-4 days after onset and may present with paralysis of all four limbs (quadriplegia).

• #47 Hyponatremia: Symptoms, Causes, and Treatments

  https://www.webmd.com/a-to-z-guides/what-is-hyponatremia

  You may not have any symptoms if you have a mild case of hyponatremia. Symptoms usually appear when your level of sodium suddenly rises or drops. […] Moderate to severe signs of hyponatremia may include: Nausea with vomiting, Fatigue or low energy, Headache, Confusion, Cramps or spasms in your muscles, Crankiness and restlessness, Weakness. […] If your hyponatremia came on suddenly and its severe, youll need emergency treatment to boost your sodium level. […] If you have chronic hyponatremia, your sodium levels are likely to drop very slowly over a few days and your symptoms and complications will be milder. With acute hyponatremia, your sodium levels drop very quickly. This can cause: Rapid brain swelling, Seizures, Coma, Death. […] Some research suggests that hyponatremia, both chronic and acute, can also increase your risk for bone fractures and osteoporosis.

• #48 Hyponatremia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK470386/

  Symptoms depend upon the degree and chronicity of hyponatremia. Patients with mild-to-moderate hyponatremia (greater than 120 mEq/L) or a gradual decrease in sodium (greater than 48 hours) have minimal symptoms. Patients with severe hyponatremia (less than 120 mEq/L) or rapid decrease in sodium levels have multiple varied symptoms. […] Symptoms can range from anorexia, nausea and vomiting, fatigue, headache, and muscle cramps to altered mental status, agitation, seizures, and even coma. […] Patients with neurological symptoms and signs need to be treated promptly to prevent permanent neurological damage. […] The prognosis in patients with hyponatremia depends on the severity of hyponatremia and the underlying condition causing it. The prognosis is poor in patients with severe hyponatremia, acute hyponatremia, and older patients.

• #49 Prevalence, risk factors, and potential symptoms of hyponatremia after spinal surgery in elderly patients | Scientific Reports

  https://www.nature.com/articles/s41598-022-23583-1

  Old age and spinal surgery significantly increase the risk of postoperative hyponatremia. […] A total of 92 (15.8%) patients showed postoperative hyponatremia. […] In total, 47/92 (51%) cases could have been symptomatic; vomiting was noted in 34 cases (37%), nausea in 19 cases (21%), headache in 14 cases (15%), and disturbances in consciousness, including delirium, in ten cases (21%); all incidences of these symptoms were significantly higher in elderly patients with postoperative hyponatremia than in the matched control group without postoperative hyponatremia. […] Mild-to-severe hyponatremia may present with symptoms such as nausea, headache, gait instability, attention impairment, and falls, which may be considered as normal postoperative reactions. […] More than 50% of elderly patients with postoperative hyponatremia could be symptomatic, and symptoms include disturbances in consciousness. […] The length of hospital stay was 2 days longer in patients with hyponatremia than in matched control patients.

• #50 Diagnosis and Management of Sodium Disorders: Hyponatremia and Hypernatremia | AAFP

  https://www.aafp.org/pubs/afp/issues/2015/0301/p299.html

  Hyponatremia is a common electrolyte disorder defined as a serum sodium level of less than 135 mEq per L. A Dutch systematic review of 53 studies showed that the prevalence of mild hyponatremia was 22.2% in geriatric hospital wards, 6.0% in nongeriatric wards, and 17.2% in the intensive care unit. The prevalence of severe hyponatremia (serum sodium level less than 125 mEq per L) was 4.5%, 0.8%, and 10.3%, respectively. It is estimated that hyponatremia occurs in 4% to 7% of the ambulatory population, with rates of 18.8% in nursing homes. […] Hyponatremia is associated with increased morbidity and mortality. In patients with heart failure who undergo cardiac surgery, hyponatremia increases rates of postoperative complications, length of hospital stay, and mortality. Mild hyponatremia in the ambulatory setting is associated with increased mortality (hazard ratio = 1.94) compared with normal sodium levels. Patients who develop hyponatremia during hospitalization have increased mortality rates compared with those who have hyponatremia on admission. It is unclear if hyponatremia is a marker for poor prognostic outcomes or merely a reflection of disease severity. Its presence suggests a worse prognosis in patients with liver cirrhosis, pulmonary hypertension, myocardial infarction, chronic kidney disease, hip fractures, and pulmonary embolism.

• #51 Hyponatremia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK470386/

  Symptoms depend upon the degree and chronicity of hyponatremia. Patients with mild-to-moderate hyponatremia (greater than 120 mEq/L) or a gradual decrease in sodium (greater than 48 hours) have minimal symptoms. Patients with severe hyponatremia (less than 120 mEq/L) or rapid decrease in sodium levels have multiple varied symptoms. […] Symptoms can range from anorexia, nausea and vomiting, fatigue, headache, and muscle cramps to altered mental status, agitation, seizures, and even coma. […] Patients with neurological symptoms and signs need to be treated promptly to prevent permanent neurological damage. […] The prognosis in patients with hyponatremia depends on the severity of hyponatremia and the underlying condition causing it. The prognosis is poor in patients with severe hyponatremia, acute hyponatremia, and older patients.

• #52 Hyponatremia: Causes, Symptoms, Diagnosis & Treatment

  https://my.clevelandclinic.org/health/diseases/17762-hyponatremia

  Symptoms of hyponatremia include muscle cramps or weakness, lethargy, nausea, vomiting, headache, confusion and seizures. […] Symptoms of hyponatremia (low sodium) can come on suddenly or slowly, over time. […] Chronic hyponatremia can happen over a long time, with symptoms coming on slowly and your body making adjustments for the low sodium levels. With acute hyponatremia, blood sodium levels fall quickly, and your symptoms may become severe suddenly. […] Symptoms of hyponatremia include muscle cramps or weakness, nausea and vomiting, lethargy, or extreme low energy, headache, confusion or other mental changes, seizures. […] Severe hyponatremia can cause swelling in your tissues, including your brain. Untreated, this can lead to coma, permanent brain damage or death. […] The outlook for hyponatremia depends a lot on the cause. Many people who get quick treatment can make a full recovery. If you have brain swelling that doesn’t resolve quickly, it can lead to permanent damage. […] Chronic hyponatremia may have symptoms that come on slowly, like tiredness or difficulty thinking.

• #53 Hyponatremia: Causes, Symptoms, Diagnosis & Treatment

  https://my.clevelandclinic.org/health/diseases/17762-hyponatremia

  Symptoms of hyponatremia include muscle cramps or weakness, lethargy, nausea, vomiting, headache, confusion and seizures. […] Symptoms of hyponatremia (low sodium) can come on suddenly or slowly, over time. […] Chronic hyponatremia can happen over a long time, with symptoms coming on slowly and your body making adjustments for the low sodium levels. With acute hyponatremia, blood sodium levels fall quickly, and your symptoms may become severe suddenly. […] Symptoms of hyponatremia include muscle cramps or weakness, nausea and vomiting, lethargy, or extreme low energy, headache, confusion or other mental changes, seizures. […] Severe hyponatremia can cause swelling in your tissues, including your brain. Untreated, this can lead to coma, permanent brain damage or death. […] The outlook for hyponatremia depends a lot on the cause. Many people who get quick treatment can make a full recovery. If you have brain swelling that doesn’t resolve quickly, it can lead to permanent damage. […] Chronic hyponatremia may have symptoms that come on slowly, like tiredness or difficulty thinking.

• #54 Hyponatremia: Causes, Symptoms, Diagnosis & Treatment

  https://my.clevelandclinic.org/health/diseases/17762-hyponatremia

  Symptoms of hyponatremia include muscle cramps or weakness, lethargy, nausea, vomiting, headache, confusion and seizures. […] Symptoms of hyponatremia (low sodium) can come on suddenly or slowly, over time. […] Chronic hyponatremia can happen over a long time, with symptoms coming on slowly and your body making adjustments for the low sodium levels. With acute hyponatremia, blood sodium levels fall quickly, and your symptoms may become severe suddenly. […] Symptoms of hyponatremia include muscle cramps or weakness, nausea and vomiting, lethargy, or extreme low energy, headache, confusion or other mental changes, seizures. […] Severe hyponatremia can cause swelling in your tissues, including your brain. Untreated, this can lead to coma, permanent brain damage or death. […] The outlook for hyponatremia depends a lot on the cause. Many people who get quick treatment can make a full recovery. If you have brain swelling that doesn’t resolve quickly, it can lead to permanent damage. […] Chronic hyponatremia may have symptoms that come on slowly, like tiredness or difficulty thinking.

• #55 Diagnosis and Management of Sodium Disorders: Hyponatremia and Hypernatremia | AAFP

  https://www.aafp.org/pubs/afp/issues/2015/0301/p299.html

  Hyponatremia is a common electrolyte disorder defined as a serum sodium level of less than 135 mEq per L. A Dutch systematic review of 53 studies showed that the prevalence of mild hyponatremia was 22.2% in geriatric hospital wards, 6.0% in nongeriatric wards, and 17.2% in the intensive care unit. The prevalence of severe hyponatremia (serum sodium level less than 125 mEq per L) was 4.5%, 0.8%, and 10.3%, respectively. It is estimated that hyponatremia occurs in 4% to 7% of the ambulatory population, with rates of 18.8% in nursing homes. […] Hyponatremia is associated with increased morbidity and mortality. In patients with heart failure who undergo cardiac surgery, hyponatremia increases rates of postoperative complications, length of hospital stay, and mortality. Mild hyponatremia in the ambulatory setting is associated with increased mortality (hazard ratio = 1.94) compared with normal sodium levels. Patients who develop hyponatremia during hospitalization have increased mortality rates compared with those who have hyponatremia on admission. It is unclear if hyponatremia is a marker for poor prognostic outcomes or merely a reflection of disease severity. Its presence suggests a worse prognosis in patients with liver cirrhosis, pulmonary hypertension, myocardial infarction, chronic kidney disease, hip fractures, and pulmonary embolism.

• #56 Hyponatremia (Low Sodium Levels) and Lung Cancer: Causes and Symptoms | MyLungCancerTeam

  https://www.mylungcancerteam.com/resources/hyponatremia-low-sodium-levels-and-lung-cancer-causes-and-symptoms

  Sodium levels that are too low can also cause health problems in people with lung cancer. […] If you have mild hyponatremia, you likely won’t notice any symptoms. Moderate hyponatremia (125 to 129 mEq/L) can cause: Headache, Nausea and vomiting, Fatigue or drowsiness, Confusion or hallucinations (seeing or hearing things that aren’t real), Changes in mood, like irritability or restlessness, Muscle cramps, weakness, or spasms (uncontrollable movements). […] Severe hyponatremia (115 to 120 mEq/L) can lead to life-threatening complications such as seizures or coma. Respiratory arrest can also occur, meaning a person stops breathing. […] Did you know that your sodium levels may help predict your prognosis (outlook) with lung cancer? Researchers have found that people with hyponatremia are more likely to: Be hospitalized for a while to treat low sodium levels, Reschedule chemotherapy treatments due to side effects, Have worse performance status, meaning you have a harder time completing daily activities like walking and working, Have a lower quality of life. […] Some studies have also shown that people with lung cancer and hyponatremia may have worse overall survival (OS).

• #57

  https://consensus.app/questions/hyponatremia-symptoms/

  Severe hyponatremia can lead to life-threatening complications such as seizures, coma, and cardiopulmonary arrest. Acute hyponatremia, particularly in the context of central nervous system infections, can present with symptoms of water intoxication and requires prompt treatment with hypertonic saline. […] In some cases, acute hyponatremia can mimic acute ischemic stroke, presenting with confusion, facial droop, hemiparesis, dysarthria, and aphasia. These symptoms improve with appropriate treatment, highlighting the importance of differential diagnosis in acute settings. […] Hyponatremia is particularly prevalent among the elderly and hospitalized patients, often exacerbated by underlying conditions and treatments. Symptoms in these populations can include cerebral edema and other neurological manifestations due to decreased extracellular osmolality.

• #58 Hyponatremia – Endocrine and Metabolic Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/endocrine-and-metabolic-disorders/electrolyte-disorders/hyponatremia

  Symptoms mainly involve central nervous system dysfunction. However, when hyponatremia is accompanied by disturbances in total body sodium content, signs of ECF volume depletion or volume overload also occur. In general, in patients who are older and/or chronically ill with hyponatremia develop more symptoms than patients who are younger and/or otherwise healthy. Symptoms are also more severe with faster-onset hyponatremia. Symptoms generally occur when the effective plasma osmolality falls to 240 mOsm/L ( 115 mEq/L […] Severe cerebral edema may occur in premenopausal women with acute hyponatremia, perhaps because estrogen and progesterone inhibit brain Na+,K+-ATPase and decrease solute extrusion from brain cells. Sequelae include hypothalamic and posterior pituitary infarction and occasionally osmotic demyelination syndrome or brain stem herniation.

• #59 Hyponatremia (Low Sodium Levels) and Lung Cancer: Causes and Symptoms | MyLungCancerTeam

  https://www.mylungcancerteam.com/resources/hyponatremia-low-sodium-levels-and-lung-cancer-causes-and-symptoms

  Sodium levels that are too low can also cause health problems in people with lung cancer. […] If you have mild hyponatremia, you likely won’t notice any symptoms. Moderate hyponatremia (125 to 129 mEq/L) can cause: Headache, Nausea and vomiting, Fatigue or drowsiness, Confusion or hallucinations (seeing or hearing things that aren’t real), Changes in mood, like irritability or restlessness, Muscle cramps, weakness, or spasms (uncontrollable movements). […] Severe hyponatremia (115 to 120 mEq/L) can lead to life-threatening complications such as seizures or coma. Respiratory arrest can also occur, meaning a person stops breathing. […] Did you know that your sodium levels may help predict your prognosis (outlook) with lung cancer? Researchers have found that people with hyponatremia are more likely to: Be hospitalized for a while to treat low sodium levels, Reschedule chemotherapy treatments due to side effects, Have worse performance status, meaning you have a harder time completing daily activities like walking and working, Have a lower quality of life. […] Some studies have also shown that people with lung cancer and hyponatremia may have worse overall survival (OS).

• #60

  https://consensus.app/questions/hyponatremia-symptoms/

  Exercise-associated hyponatremia is a risk for athletes and hikers, particularly in hot conditions. Symptoms can range from nausea and dizziness to severe neurological disturbances such as seizures and altered mental status. […] Hyponatremia presents a wide spectrum of symptoms, from mild cognitive and motor impairments to severe neurological crises. The condition’s impact on patient morbidity and mortality underscores the importance of timely diagnosis and appropriate management. Clinicians must be vigilant in recognizing the diverse presentations of hyponatremia to mitigate its potentially severe consequences.

• #61 RacingThePlanet – Hyponatremia (low Sodium) In Runners

  https://www.racingtheplanet.com/hyponatremia-low-sodium-in-runners

  Mild symptoms of low sodium levels are nonspecific and include confusion, headaches, nausea, dizziness, malaise and fatigue. […] When sodium concentration drops further, more specific symptoms such as seizures, coma, altered mental status and death can occur. […] Studies of long distance triathletes looking at sodium and body weight, pre- and post-race, found that runners who stayed the same weight or gained weight (mainly water weight) were more likely to develop hyponatremia. […] Other studies of marathoners have demonstrated a higher incidence of hyponatremia in slower runners the highest incidence of hyponatremia seen in runners finishing a marathon after 4 hours 20 minutes.

• #62 Dilutional Hyponatremia & Mental Illness Symptoms, Causes, and Treatment

  https://www.therecoveryvillage.com/mental-health/dilutional-hyponatremia/

  Water intoxication deaths occur most often when exorbitant amounts of water are ingested in a short duration of time, but can also occur when water is consumed over a longer period of time. The most frequent deaths from dilutional hyponatremia occur in the psychogenic polydipsia population, comprised of individuals who drink compulsively and who commonly have mental health conditions.

• #63 Hyponatremia and Alcoholism

  https://practicingclinicians.com/the-exchange/hyponatremia-and-alcoholism

  „Beer potomania” is a syndrome used to describe patients who present with hyponatremia along with a history of excessive beer drinking. These patients are at serious risk of rapid decompensation secondary to hyponatremia and its neurological sequelae. […] The symptoms of beer potomania are related to hyponatremia and hypokalemia, and include dizziness, muscular weakness, neurological impairment, and seizures. […] The severity of symptoms in patients with acute hyponatremia almost always reflects the severity of cerebral overhydration, which is related to the degree of hyponatremia. Seizures (typically generalized tonic-clonic) can be caused by severe and rapidly evolving hyponatremia. If plasma sodium concentration rapidly decreases to 115 mEq/L, it will generally result in these seizures.

• #64 Hyponatremia and Alcoholism

  https://practicingclinicians.com/the-exchange/hyponatremia-and-alcoholism

  The following symptoms of beer potomania often follow an episode of binge drinking and poor nutritional intake: Acutely altered mental state, Muscle weakness, spasms, or cramps, Loss of energy or fatigue, Trouble walking, Irritability or restlessness, Confusion, Nausea or vomiting (early finding and may be seen when the serum sodium concentration falls below 125-130 mEq/L), Headache, seizures, coma (occurs if the serum sodium concentration falls below 115-120 mEq/L). […] Additionally, when caring for chronic alcoholics, keep in mind that hyponatremia is a common electrolyte abnormality and can be due to conditions such as cirrhosis, congestive heart failure, syndrome of inappropriate antidiuretic hormone (SIADH) secretion, and hypovolemia.

• #65 Prevalence, risk factors, and potential symptoms of hyponatremia after spinal surgery in elderly patients | Scientific Reports

  https://www.nature.com/articles/s41598-022-23583-1

  Old age and spinal surgery significantly increase the risk of postoperative hyponatremia. […] A total of 92 (15.8%) patients showed postoperative hyponatremia. […] In total, 47/92 (51%) cases could have been symptomatic; vomiting was noted in 34 cases (37%), nausea in 19 cases (21%), headache in 14 cases (15%), and disturbances in consciousness, including delirium, in ten cases (21%); all incidences of these symptoms were significantly higher in elderly patients with postoperative hyponatremia than in the matched control group without postoperative hyponatremia. […] Mild-to-severe hyponatremia may present with symptoms such as nausea, headache, gait instability, attention impairment, and falls, which may be considered as normal postoperative reactions. […] More than 50% of elderly patients with postoperative hyponatremia could be symptomatic, and symptoms include disturbances in consciousness. […] The length of hospital stay was 2 days longer in patients with hyponatremia than in matched control patients.

• #66 Hyponatremia – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/hyponatremia/diagnosis-treatment/drc-20373715

  Seek emergency care for anyone who develops severe signs and symptoms of hyponatremia, such as nausea and vomiting, confusion, seizures, or lost consciousness. […] Call your doctor if you know you are at risk of hyponatremia and are experiencing nausea, headaches, cramping or weakness. Depending on the extent and duration of these signs and symptoms, your doctor may recommend seeking immediate medical care. […] Have your symptoms included any mental changes, such as feeling confused, agitated or depressed? […] Have you had nausea, vomiting or diarrhea? […] Have you felt faint, had seizures or lost consciousness?

• #67 Low blood sodium: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/000394.htm

  Low blood sodium is a condition in which the sodium level in the blood is lower than normal. The medical name of this condition is hyponatremia. […] When the amount of sodium in fluids outside cells drops below normal, water moves into the cells. This causes the cells to swell with too much water. Brain cells are especially sensitive to swelling, and this causes many of the symptoms of low blood sodium. […] Common symptoms include: Confusion, irritability, restlessness, Convulsions, Fatigue, Headache, Loss of appetite, Muscle weakness, spasms, or cramps, Nausea, vomiting. […] Outcome depends on the condition that is causing the problem. Hyponatremia that occurs in less than 48 hours (acute hyponatremia), is more dangerous than hyponatremia that develops slowly over time. When blood sodium level falls slowly over days or weeks (chronic hyponatremia), the brain cells have time to adjust and swelling may be minimal. […] In severe cases, low blood sodium can lead to: Decreased consciousness, hallucinations or coma, Brain herniation, Death. […] When your body’s sodium level drops too much, it can be a life-threatening emergency. Call your provider right away if you have symptoms of this condition.

• #68 Hyponatremia (Low Sodium): Symptoms, Causes, Treatment

  https://www.eroftexas.com/hyponatremia/

  Severe symptoms. If you or someone you know is experiencing severe symptoms of hyponatremia, such as seizures, loss of consciousness, severe confusion, or difficulty breathing, it is essential to seek emergency medical care. […] Rapid onset or worsening symptoms. If low sodium symptoms appear suddenly and rapidly worsen, it may indicate a more severe underlying condition. Seeking urgent medical attention can help determine the cause and initiate appropriate treatment promptly. […] Sodium levels approaching critical levels. If blood sodium levels are dangerously low, near critical levels, or rapidly dropping, immediate medical intervention is necessary to prevent life-threatening complications.

• #69 Hyponatremia – EMCrit Project

  https://emcrit.org/ibcc/hyponatremia/

  the presence of symptoms is extremely important: […] Even mild symptoms are an indication for IV hypertonic fluid. […] Symptoms generally imply one of the following: […] Acute hyponatremia. […] Chronic hyponatremia that is severe (e.g., Na115 mM). […] severe moderately severe symptoms […] Seizure. […] Delirium (may progress to coma and herniation). […] Headache. […] Neurogenic pulmonary edema, especially following endurance sports or intoxication with 3,4-methylenedioxymethamphetamine (ecstasy). […] Vomiting. This is worrisome since it may reflect elevated intracranial pressure. Additionally, vomiting may cause SIAD and hypovolemia, thereby exacerbating the hyponatremia. […] non-severe symptoms […] Malaise/lethargy. […] Nausea without vomiting. […] Dizziness, gait instability. […] Tremor, multifocal myoclonus. […] Muscle cramps, myalgia.

• #70 Diagnosis and Management of Sodium Disorders: Hyponatremia and Hypernatremia | AAFP

  https://www.aafp.org/pubs/afp/issues/2015/0301/p299.html

  Symptoms of hyponatremia depend on its severity and on the rate of sodium decline. Gradual decreases in sodium usually result in minimal symptoms, whereas rapid decreases can result in severe symptoms. Polydipsia, muscle cramps, headaches, falls, confusion, altered mental status, obtundation, coma, and status epilepticus may indicate the need for acute intervention. Most patients with hyponatremia are asymptomatic, and hyponatremia is noted incidentally. […] Severe symptomatic hyponatremia occurs when sodium levels decrease over less than 24 hours. Severe symptoms (e.g., coma, seizures) typically occur when the sodium level falls below 120 mEq per L, but can occur at less than 125 mEq per L. Severe symptomatic hyponatremia must be corrected promptly because it can lead to cerebral edema, irreversible neurologic damage, respiratory arrest, brainstem herniation, and death. Treatment includes the use of hypertonic 3% saline infused at a rate of 0.5 to 2 mL per kg per hour until symptoms resolve. The rate of sodium correction should be 6 to 12 mEq per L in the first 24 hours and 18 mEq per L or less in 48 hours. An increase of 4 to 6 mEq per L is usually sufficient to reduce symptoms of acute hyponatremia. Rapid correction of sodium can result in osmotic demyelination. Overcorrection is common and is typically caused by rapid diuresis secondary to decreasing ADH levels. Every attempt should be made not to overcorrect sodium levels.

• #71 Hyponatraemia

  https://pch.health.wa.gov.au/For-health-professionals/Emergency-Department-Guidelines/Hyponatraemia

  Hyponatraemia is defined as serum sodium 135mmol/L. It results from an excess of water relative to sodium in the extracellular fluid compartment. Symptoms are likely if sodium 125mmol/L or if there has been a rapid fall in the sodium level. […] Most children with mild to moderate hyponatraemia will be asymptomatic or have symptoms of their underlying condition. Rapid changes in sodium levels may cause headache, nausea, vomiting, and weakness. […] Symptoms of severe hyponatraemia include: Headache, Nausea, Vomiting, Weakness, Impaired level of consciousness, Seizures, Encephalopathy, Respiratory depression. […] If there is evidence of hyponatraemic encephalopathy (seizures, impaired level of consciousness) seek senior clinician advice as urgent treatment is required. […] Symptomatic hyponatraemia is a medical emergency. Notify Paediatric Critical Care (PCC) urgently and arrange for senior medical review.

• #72 Diagnosis and Management of Sodium Disorders: Hyponatremia and Hypernatremia | AAFP

  https://www.aafp.org/pubs/afp/issues/2015/0301/p299.html

  Symptoms of hyponatremia depend on its severity and on the rate of sodium decline. Gradual decreases in sodium usually result in minimal symptoms, whereas rapid decreases can result in severe symptoms. Polydipsia, muscle cramps, headaches, falls, confusion, altered mental status, obtundation, coma, and status epilepticus may indicate the need for acute intervention. Most patients with hyponatremia are asymptomatic, and hyponatremia is noted incidentally. […] Severe symptomatic hyponatremia occurs when sodium levels decrease over less than 24 hours. Severe symptoms (e.g., coma, seizures) typically occur when the sodium level falls below 120 mEq per L, but can occur at less than 125 mEq per L. Severe symptomatic hyponatremia must be corrected promptly because it can lead to cerebral edema, irreversible neurologic damage, respiratory arrest, brainstem herniation, and death. Treatment includes the use of hypertonic 3% saline infused at a rate of 0.5 to 2 mL per kg per hour until symptoms resolve. The rate of sodium correction should be 6 to 12 mEq per L in the first 24 hours and 18 mEq per L or less in 48 hours. An increase of 4 to 6 mEq per L is usually sufficient to reduce symptoms of acute hyponatremia. Rapid correction of sodium can result in osmotic demyelination. Overcorrection is common and is typically caused by rapid diuresis secondary to decreasing ADH levels. Every attempt should be made not to overcorrect sodium levels.

• #73

  https://www.pulmccm.org/p/hyponatremia-corrected-too-quickly-and-dangerously-in-many-patients

  Severe hyponatremia (often defined as a serum sodium 120 mEq/L) occurs most often in people with pituitary or lung tumors, those taking antipsychotic or other neuroleptic drugs, heavy beer drinkers, or the elderly. […] Symptoms may not manifest for several days after a sodium overcorrection, and can include impaired speech or swallowing, limb weakness, seizures, confusion or depressed consciousness — or in the most severe cases of pontine myolysis, locked-in syndrome. The damage and dysfunction can be permanent. […] Over half of patients had their sodium corrected faster than experts recommend (6 mEq/L in 24 hours). In more than 40%, the rate of correction was above what is considered dangerous (8 mEq/L in 24 hours). […] The new neurologic symptoms attributed to osmotic demyelination were persistent in three of the eight patients with identified ODS, and resolved in the other five patients. Almost all of the patients with ODS had their sodium corrected too quickly.

• #74 Diagnosis and Management of Sodium Disorders: Hyponatremia and Hypernatremia | AAFP

  https://www.aafp.org/pubs/afp/issues/2015/0301/p299.html

  Symptoms of hyponatremia depend on its severity and on the rate of sodium decline. Gradual decreases in sodium usually result in minimal symptoms, whereas rapid decreases can result in severe symptoms. Polydipsia, muscle cramps, headaches, falls, confusion, altered mental status, obtundation, coma, and status epilepticus may indicate the need for acute intervention. Most patients with hyponatremia are asymptomatic, and hyponatremia is noted incidentally. […] Severe symptomatic hyponatremia occurs when sodium levels decrease over less than 24 hours. Severe symptoms (e.g., coma, seizures) typically occur when the sodium level falls below 120 mEq per L, but can occur at less than 125 mEq per L. Severe symptomatic hyponatremia must be corrected promptly because it can lead to cerebral edema, irreversible neurologic damage, respiratory arrest, brainstem herniation, and death. Treatment includes the use of hypertonic 3% saline infused at a rate of 0.5 to 2 mL per kg per hour until symptoms resolve. The rate of sodium correction should be 6 to 12 mEq per L in the first 24 hours and 18 mEq per L or less in 48 hours. An increase of 4 to 6 mEq per L is usually sufficient to reduce symptoms of acute hyponatremia. Rapid correction of sodium can result in osmotic demyelination. Overcorrection is common and is typically caused by rapid diuresis secondary to decreasing ADH levels. Every attempt should be made not to overcorrect sodium levels.

• #75 Dilutional Hyponatremia & Mental Illness Symptoms, Causes, and Treatment

  https://www.therecoveryvillage.com/mental-health/dilutional-hyponatremia/

  Dilutional hyponatremia symptoms occur as water moves into brain cells, causing them to fill and swell. Dilutional hyponatremia is a potentially life-threatening condition. The severity and duration of symptoms can warrant emergency intervention. Individuals who show severe water intoxication symptoms should seek emergency medical care right away. […] Signs of water intoxication can include: […] Headaches […] Decreased energy and fatigue […] Seizures […] Irritability […] Increased mental confusion […] Impaired reflexes […] Slurred speech […] Nausea and vomiting […] Muscle spasms or cramps. […] Dilutional hyponatremia is often misdiagnosed or goes unrecognized during early stages. Early detection and accurate diagnosis are paramount to prevent severe dilutional hyponatremia, which can result in seizures, brain edema, swelling, coma or death.

• #76

  https://consensus.app/questions/hyponatremia-symptoms/

  Hyponatremia is the most common electrolyte disorder, characterized by a serum sodium level of less than 135 mEq/L. It affects approximately 5% of adults and 35% of hospitalized patients, often resulting from water retention. The severity of symptoms varies based on the rapidity of onset, duration, and severity of the condition. […] Mild to moderate hyponatremia often presents with nonspecific symptoms such as lethargy, restlessness, disorientation, headache, nausea, vomiting, muscle cramps, and depressed neural reflexes. These symptoms can be easily overlooked or attributed to other conditions, making diagnosis challenging. […] Chronic mild hyponatremia is associated with cognitive impairments, gait disturbances, and an increased risk of falls and fractures. Studies have shown that patients with hyponatremia report a higher incidence of falls and new fractures compared to those with normal sodium levels.

• #77 Low sodium levels (hyponatremia): Symptoms and causes

  https://www.medicalnewstoday.com/articles/323831

  If the condition worsens, it can cause severe symptoms, particularly in older adults. Severe symptoms and complications may include: vomiting, muscle weakness, spasms, and twitching, lethargy, disorientation. […] Without adequate treatment, people with hyponatremia can experience: rhabdomyolysis, where the skeletal muscle tissues die, altered mental status, such as severe confusion, seizures, a coma. […] The outlook for people with low sodium levels depends on the severity of the condition and the underlying cause. […] Acute hyponatremia, which develops quickly, is more severe than chronic cases, which have a longer onset time. In severe cases, the condition can be fatal. […] To improve their outlook, people need to be aware of the symptoms of hyponatremia and seek prompt medical attention if they experience them. Those at risk of low sodium levels should be especially vigilant.

• #78 Evaluation of hyponatremia – Differential diagnosis of symptoms | BMJ Best Practice US

  https://bestpractice.bmj.com/topics/en-us/57

  Failure to correct hyponatremia can lead to permanent neurologic damage, as can correcting sodium levels too rapidly. When hyponatremia is chronic and the serum sodium concentration increases too rapidly, osmotic demyelination syndrome (ODS; also known as central pontine myelinolysis) may develop. ODS is characterized by altered mental status, reduced motor functioning, and/or abnormalities of balance.

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