Hyponatremia (low sodium in the blood) in the elderly.

Hyponatremia (low sodium in the blood) in the elderly.

Hyponatremia is a condition where the amount of sodium in the blood is lower than normal. When the body gets less sodium than the sodium excreted. Causing the sodium content in the body to decrease which also reduces the extracellular water volume and harmful to blood circulation.

People with elderly living at home who have frequent anorexia, fatigue, dizziness, or delirium. Do not forget to think about this disease is called low sodium. Because it is often found with the elderly.

Meaning of low blood sodium (Hyponatremia).
Hyponatremia is a condition where there is a lower than normal amount of sodium in the blood. As a result, the patient may have a headache, spasm fatigue, exhaustion, lethargy, nausea, and vomiting. Which may be caused by water loss, drinking too much water or abnormal hormones, etc.

Sodium is an electrolyte mineral that helps maintain the water balance surrounding and inside the cells. It is important for the functioning of the nervous system and muscles. It also helps control blood pressure levels.

Which patients with low sodium, The amount of sodium in the blood is below 135 milli-equivalent liters Which the normal value should be 135-145 milli-equivalent liters. The body normally gets sodium in the form of sodium chloride, or commonly known as “salt” through the daily diet and water intake. Excess sodium is excreted from the body in three ways:

(1) Excretion of sodium through sweat. The body loses sodium through sweat, about 25 mmol per day. The excretion of sodium through sweat, as a result of the body’s need to expel heat to maintain normal body temperature but in hot weather or after exercising or having a fever, it will make you sweat more. Will cause more sodium to be excreted.


(2) Excretion of sodium through urine. The body excretes excess sodium through the kidneys. In the urine as possible or almost equal to the amount of sodium received. The excretion of sodium through the kidneys is very important. It is an important mechanism for maintaining the normal state of sodium in the entire body. You will see more or less sodium excreted in the urine. Therefore depends on the amount of sodium in the food.


(3) Excretion of sodium through feces. The body loses sodium by not mixing much in the feces. In the case of diarrhea or have severe vomiting will result in increased sodium loss.

Symptoms of people with low blood sodium (Hyponatremia)

The severity of Hyponatremia may depend on the amount and rate of drop in blood sodium levels. If the sodium is gradually reduced in small increments The patient may not have any symptoms or there may be symptoms such as headache, nausea, vomiting, fatigue, exhaustion, confusion, numbness, muscle weakness, spasms, or twitching, restlessness, and irritability.
But if the sodium is reduced a lot or reduced too quickly, May cause more serious symptoms such as severe unconscious seizures and unresponsive to stimulation.

  • If there is little sodium deficiency There will be no malfunctions. Patients may experience fatigue and exhaustion.
  • If moderate sodium deficiency The patient will feel dizzy. When standing, you will faint, very exhaustion, and urination is reduced. Blood pressure in a sitting or standing position lower than sleeping position, rapid pulse, sagging skin, feeling thirsty.
  • If there is a severe lack of sodium Patients are delirious restless Later, it was less conscious and finally lost consciousness, hypotension in the lying position, fast pulse, sagging skin, deep eyelids, less urine output, cold hands and feet, goosebumps, sweating, shock, and death.

Causes of low blood sodium.
Hyponatremia can be caused by fluid loss and electrolytes in the body for many reasons such as lifestyle, or any of the following illnesses and conditions.

Dehydration
This causes the body to lose fluid and electrolytes. Which may be caused by heavy vomiting or severe diarrhea.

Drinking too much water
May be found in marathon runners Or triathletes That drank a lot of water to replace the sweat that was lost Drinking too much water can cause blood sodium levels to drop.

Abnormal hormones
The adrenal glands secrete hormones to help maintain the balance of water, sodium, and potassium in the body. If the adrenal glands are malfunctioning may cause low thyroid hormone levels or Syndrome Of Inappropriate Anti-Diuretic Hormone (SIADH) may cause the body to retain water. Instead of a normal diuretic Until affecting the amount of sodium in the blood.

Have heart, kidney, and liver problems
Heart attack or other condition that affects kidney and liver function May prevent the body from excreting excess water And resulting in lower blood sodium levels.

Use of certain drugs
Certain medications, such as antidepressants, pain relievers, and diuretics, May cause dehydration in the body or urinating more often than usual.

Substance abuse
Ecstasy use can make Hyponatremia more severe and can be fatal.

Diagnosis of hyponatremia
The doctor may take a medical history and ask for symptoms for diagnosis such as excessive sweating and constant vomiting.

The symptoms of Hyponatremia have no specific characteristics. Doctors are unable to make a clear diagnosis based on physical examination or symptoms, so additional tests may be required by the following methods:

A blood test for sodium levels
To test the function of thyroid hormones and cortisol hormones which is released by the adrenal glands and check kidney function.

Blood and urine concentration test
Detect osmolality or the concentration of substances in solution. May help identify the cause of hyponatremia.

Urine test
To look for the sodium levels in the urine that could indicate the cause of hyponatremia.

Treatment for low blood sodium
Hyponatremia treatment depends on the underlying cause. During the treatment, Patients may be under close medical supervision. This is because your doctor may need to measure your pulse. Check blood pressure Including urinary catheter insertion to measure the amount of liquid ejected but if the patient has acute low blood sodium or has severe symptoms Patients may need the following treatments.

  • Give sodium intravenously
  • Refrain from giving drugs that may lower blood sodium levels.
  • Refrain from giving liquids temporarily and use diuretics to help increase blood sodium levels (If the cause is excessive water intake).

Complications of low blood sodium
The occurrence of hyponatremia complications varies with the severity of symptoms. If the patient has symptoms that are not very serious There may be side effects from illness such as the risk of falls, fractures, memory problems. (In elderly patients), etc. If the symptoms are more severe. Patients may have other complications such as:

  • Swelling of the brain, which can lead to seizures, unconsciousness, or death. (In case of acute hyponatremia)
  • Permanent nervous system changes or seizures (in the case of chronic hyponatremia).

However, Hyponatremia patients should be treated appropriately. To reduce the risk of developing dangerous complications. In some cases, if treated at a rate that is too fast may cause brain injury (Central Pontine Myelinolysis), which will appear 2-4 days later and may paralyze the patient. It is often found in patients who are addicted to alcohol. Received liver transplants in female patients and those with low blood potassium levels (Hypokalaemia).

Prevention of hyponatremia
There are various ways that may help prevent hyponatremia, such as:

  • Study the symptoms of Hyponatremia to increase your vigilance. When using diuretics Or when having health problems that may increase the risk of hyponatremia.
  • When exercising or doing strenuous activities, Do not drink too much water. Should drink in moderation. Only to replace the lost liquid.
  • Consult your doctor before choosing an electrolyte drink to quench your thirst instead of water. Because electrolytes from sports drinks may not be necessary. If not exercising really hard.
  • Should be substituted with mineral water If it is a disease or condition that can lead to hyponatremia, such as vomiting or acute diarrhea (especially in children and the elderly).
  • before using diuretics The potential side effects should be carefully studied first. Because diuretics can cause hyponatremia, some patients may need to check their blood sodium levels 2-3 weeks after starting the drug, especially those who have had the condition Hyponatremia before.
  • If there is an underlying disease or any medical condition that may lead to hyponatremia should be treated properly To reduce the risk of developing hyponatremia.

However, the above methods may not always be used to prevent hyponatremia in some cases if the illness is caused by hormonal changes in the body. Cannot be prevented by this method

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