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Meg Mangin R.N.
Research Team
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Posted: Thu Mar 8th, 2007 01:53 |
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My sodium is low. What should I do?
Rarely folks develop low sodium (hyponatremia) due to the unavoidable immunopathology experienced during recovery from Th1 inflammation on the Marshall Protocol.
If you doctor is concerned, share with him/her the following comprehensive article on diagnosing and treating hyponatremia. Hyponatremia (click here for pdf version suitable for printing) by Horacio J. Adrogue & Nicolaos E. Madias New England Journal of Medicine May, 2006
Measure serum sodium
Do not assume your sodium is low unless it has been measured by a lab test. Values on the low end of the normal range are still considered normal. Low sodium is rarely cause for immediate concern but your doctor will want to monitor your sodium level to be sure it doesn't go too low.
Fluid intake
Are you drinking too much water? Please see Water. If your fluid intake has been high (more than 2 Liters/day) drinking a little less may bring your sodium up to normal. If fluid intake has not been excessive, consult your doctor before you restrict fluids to increase your serum sodium level.
Salt intake
You may increase your serum sodium by increasing your intake of salt (sodium) but consult your doctor before you increase your salt intake to be sure it is safe for you to do.
Foods that are canned, pickled, processed or cured are high in salt. You can also drink 1/4 tsp of salt in a large glass of water to increase sodium. There are some foods high in sodium, like canned soups and canned vegetable juice drinks (V-8). These are sometimes used to bring sodium up quickly in certain circumstances. Maybe your doctor wants you to increase sodium slowly, so check to be sure. Here is a list of sodium values in foods.
Drugs
Numerous drugs can cause hyponatremia by increasing the release of AVP from the neurohypophyseal system, by enhancing AVP action on the kidney, or by acting directly on the kidney.In particular, Selective Serotonin Reuptake Ihibitors (SSRIs) such as citalopram, fluoxetine, fluvoxamine, paroxetine, and sertraline and opiods, NSAIDs, barbiturates, carbamazepine, orinase and diabinese.
Immunopathology
If your doctor wants you to stop the MP, ask if you can first try to slow down immunopathology by adjusting the MP meds as instructed in My immune system reaction is too strong. What should I do?
Then recheck serum sodium in a week or two to see if these measures have been successful.
Stopping the MP is rarely the answer because once the immune system is 'turned on' with the MP, it may continue to function effectively with continuing immune system reactions.
Ask your doctor if fluid restriction is appropriate for you since dilutional hyponatremia is the most common form of this disorder. If Doc thinks your hyponatremia is caused by fluid retention, remind him/her that thiazide diuretics are contraindicated on the MP.
Rarely, high dose demeclocycline (a form of tetracycline) is used to manage chronic hyponatremia due to syndrome of inappropriate antidiuretic hormone (SIADH) only. This antibiotic is not contraindicated on the MP.
Factors that influence test accuracy
Electrolytes, especially sodium and potassium, are frequently measured in the office laboratory. The predominant methodology in use for these analytes is that of potentiometry as employed by the ion selective electrode. The potentiometry may be either direct or indirect. In indirect methods, the sample is first mixed with a diluent before measurement. Direct methods usually involve whole blood; the sample is untreated before contacting the electrode.
Indirect methods show interference from factors which change the ratio of plasma water to non-water elements. Elevated lipids and proteins reduce the amount of plasma water in a sample and since the electrolytes are dissolved only in the water phase an effectively smaller sample is mixed without diluent prior to measurement. Normal plasma is about 93% water while samples with elevated lipid or protein may contain only 80-85% water. This can cause pseudohyponatremia since sodium is most notably affected in these samples; minimizing pre-analytical variation is an important element in accurate electrolyte measurements.
Related FAQs:
My kidney function tests are worse since I started the MP. What should I do?
My potassium is elevated. What should I do?
Do I need to take extra salt because of Benicar?
Last edited on Fri Jun 13th, 2008 02:40 by Meg Mangin R.N.
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