Hypernatremia - Salt Imbalance

Overview, Causes, & Risk Factors

An imbalance occurs when there is too little or too much sodium, also known as salt, in the bloodstream. The condition is called hyponatremia when there is too little sodium. It is called hypernatremia when there is too much sodium in the bloodstream.

What is going on in the body?

The kidneys absorb most of the sodium in the body. Sodium helps the kidneys to regulate water levels in the body. Normally, the sodium-water balance in the body is regulated by the hormone aldosterone. This hormone causes the kidneys to hold onto water. When this system is out of balance, the body either gets rid of or absorbs too much sodium.

What are the causes and risks of the condition?

Too little sodium in the blood may be caused by:

severe vomiting

severe diarrhea

excessive exercise and sweating

burns

diuretics, which are medications that eliminate excess water from the body

poor kidney function, such as chronic renal failure

infections or high fever

Addison's disease, a condition in which there is not enough of the hormone cortisol in the bloodstream

excessive water or fluid intake

congestive heart failure

Too much sodium in the blood may be caused by:

corticosteroid medicines, such as prednisone

aldosteronism, a condition in which the body makes too much aldosterone

inability to drink water or not drinking enough water

excessive intake of salty foods

diabetes

kidney disease

heart disease

Symptoms & Signs

What are the signs and symptoms of the condition?

Common signs and symptoms of salt imbalance include:

muscle cramps, especially after exercise

weakness, often the first symptom of hyponatremia

irritability

confusion

restlessness and agitation

changes in heart rate, heartbeat, and blood pressure

tissue swelling

retaining fluid in the body

eliminating large amounts of urine

nausea

depression

lack of coordination

seizures

coma

Diagnosis & Tests

How is the condition diagnosed?

A doctor can diagnose salt imbalance by taking a complete medical history and ordering blood and urine tests. Other tests may be done depending on the person's symptoms.

The doctor may also want to know:

What was happening when the symptoms started?

Was there any illness before the symptoms began?

Was the person exercising or working and sweating a lot?

Does anything help the symptoms improve?

What makes the symptoms worse?

Is there any chest pain, weakness, or dizziness?

Is the person taking any medicines?

Prevention & Expectations

What can be done to prevent the condition?

A person can take these actions to help prevent salt imbalance:

avoid salty foods, salt tablets, or salty liquids, such as sports drinks

drink plenty of water during exercise

drink plenty of water when taking diuretics

keep follow-up appointments with the doctor for chronic disease treatment

A person who has the flu and uncontrollable vomiting needs to be monitored carefully. He or she may need to be admitted to a hospital to get fluids to prevent dehydration and salt imbalance.

What are the long-term effects of the condition?

The long-term effects of salt imbalance depend on the underlying cause. If the imbalance is caught early and treated, there may be few long-term effects. Severe salt imbalance that is not treated can lead to extreme weakness, confusion, coma, or death.

What are the risks to others?

A salt imbalance itself is not catching, although the underlying cause may be. For example, if a person has low sodium due to vomiting and diarrhea caused by the flu, the flu may be catching. If the sodium imbalance is due to a kidney disorder, this is not catching.

Treatment & Monitoring

What are the treatments for the condition?

Treatment for sodium imbalance will depend on the underlying cause.

If the sodium imbalance is caused by the flu along with vomiting and diarrhea, fluids need to be replaced in the body.

The person may need medicine to help decrease the vomiting.

Fluids given into the veins can help replace sodium, or in other cases, can help lower sodium levels in the blood.

Sodium imbalance due to kidney disease or diabetes can be treated with medicines.

Low sodium diets may help prevent high levels of sodium in the blood.

Diuretics, also known as water pills, may be given to decrease high sodium levels in the blood.

What are the side effects of the treatments?

Side effects depend on the treatments used, but may include allergic reactions to the medicine and stomach upset.

What happens after treatment for the condition?

Hyponatremia that is the result of vomiting and diarrhea caused by the flu may be treated and need no further treatment. On the other hand, a person who has diabetes will need lifelong treatment once the condition is under control. A person with kidney disease may need follow-up treatment and close monitoring of blood levels of sodium and many other electrolytes.

How is the condition monitored?

Carefully monitoring of blood levels can help keep a balance between too little and too much sodium in the blood. If the salt imbalance is due to a short-term condition, such as vomiting, no further monitoring may be necessary. If a person is on diuretics or has other long-term conditions, periodic blood tests are needed to check the blood levels of various electrolytes. Any new or worsening symptoms should be reported to the doctor.