Sodium is an essential mineral in the body that helps to regulate certain bodily functions. It is located in the blood and in the fluid around cells and is regulated by the kidneys. Sodium keeps fluids in a normal balance and it plays an important role in normal muscle and nerve function.
Like other minerals in the body, when levels become too high or too low, the affected person can experience several symptoms and possible complications. This is especially true when the elderly are affected. Understanding why sodium is important and how to identify and treat levels that are not within normal range is important.
Increasing Sodium Levels
Before beginning or ending treatment regimen, it is always advisable to visit with your primary doctor and let him/her guide you. Because low sodium levels that are not resolved can lead to other health issues, your doctor will want to monitor the medications you are on and your sodium blood levels.
Treatment for hyponatremia is aimed at getting sodium levels back in balance. There are several things your doctor may suggest.
- Review Medications: Your doctor needs to know about any prescription, over-the-counter AND illegal drugs you may be taking. Any, or a combination of all of these could impact your sodium levels. Before making any medication changes, your physician will need a complete list to determine if this is a step you should take. Never stop taking prescribed medications without talking to your physician first.
- Address Underlying Conditions: Low sodium levels may be the result of another health issue. Sometimes treating the underlying condition can help resolve the low sodium level. However, if it is not treatable, medication may be ordered.
- Limit Your Water Intake (If Your Doctor Advises It): Drinking too much water can dilute the sodium in the bloodstream, causing decreased blood sodium levels. It may be possible to increase your blood sodium levels by decreasing the amount of fluid you consume.
- Sodium-Rich Beverages: If you are advised to drink a beverage to increase sodium levels, vegetable juice is a great choice. Many vegetable juices contain as much as 500 milligrams of sodium per cup. If you are not a fan of the taste of vegetable juice, there are fruit and juice blends that offer the same sodium content.
- Add foods that are sodium rich. Many seniors find it easier to prepare ready-made foods, such as processed canned meat, pasta, or cereals. All of these options have high sodium levels.
What Causes Low Sodium Levels?
Low sodium levels, clinically known as hyponatremia, can be caused by one or multiple factors. It is the result of the concentration of sodium in the blood becoming abnormally low. As the body’s water levels rise, cells begin to swell and the sodium in the body becomes diluted. If the condition of excess fluid is not resolved, it can result in other health problems.
The elderly are more prone to hyponatremia because of impaired ability to rid the body of water, which can be attributed to age-related changes in the kidneys. Additionally, older adults have a lower percentage of total body water content, which can cause greater changes in the blood level of sodium. Underlying medical conditions or medications also increase the risk of experiencing low sodium levels.
Common risk factors for developing hyponatremia include:
- Medications. Diuretics (fluid pills), antidepressants and some pain medications can cause increased urination or sweating.
- Heart failure and kidney or liver disease
- Diarrhea and/or vomiting can deplete the body of fluids and sodium
- Hormone imbalances
- Drinking too much water can dilute the amount of sodium in the blood.
- Underactive thyroid or adrenal glands
- Certain cancers, including lung cancer
- Acute illnesses, such as pneumonia or urinary tract infections, which can cause dehydration
Age-Related Changes that Affect Water/Sodium Balance
The aging body is less able to maintain fluid and sodium balance for several reasons.
- Decreased thirst: As people grow older, we sense thirst less intensely or less quickly, thus may not drink fluids when needed.
- Changes in the kidneys: Aging kidneys may become less able to concentrate urine by pulling water and electrolytes from the waste. As a result, more water is excreted in the urine.
- Less fluid in the body: Approximately 60% of a younger person’s total body weight is water. That number decreases to around 45% in older adults. This means that even a slight loss of fluid and sodium can have more serious consequences in older people.
- Inability to obtain water: Some older people have physical problems that prevent them from getting something to drink when they are thirsty. Others may have dementia, which may prevent them from realizing they are thirsty or from saying so. These people may have to depend on other people to provide them with water.
- Drugs: Some medications used to treat high blood pressure, diabetes, or heart disorders can make the body excrete excess fluid or worsen the effects of a low sodium level in blood.
Mild cases of hyponatremia may have few to no symptoms. However, when sodium levels drop suddenly, some of the following symptoms may appear.
- Nausea with vomiting
- Headache or confusion
- Muscle spasms
- Irritability and restlessness
- Severe cases can lead to seizures or even coma.
Things to Consider
How low is too low? Your blood sodium level is normal if it’s 135 to 145 milliequivalents per liter (mEq/L). If it’s below 135 mEq/L, it’s hyponatremia. Your doctor will be able to tell you whether your level is too low or not.
Low sodium levels can usually be managed/resolved with medication and diet changes. While there are ways that the elderly can increase sodium levels at home, it is vital that the primary care provider is aware of symptoms so he can monitor levels and any adverse side effects of medications and/or treatments.