Hypernatremia refers to an above-normal serum sodium concentration, i.e., sodium levels in the blood that are too high. In most cases, hypernatremia is mild and does not require specific treatment. However, in severe cases, it can cause health issues and serious complications unless it is corrected. This article will talk about the causes, symptoms, and treatments for hypernatremia. 

Understanding fluid and sodium balance

Sodium is an important nutrient that plays a vital role in many processes in the body, including muscle contraction, nerve impulses, and fluid balance. Most of the sodium in the body is present in the extracellular fluid (the fluid outside cells). The kidneys and adrenal glands regulate sodium levels. Changes in sodium levels in the blood can lead to sodium disorders and disrupt the fluid balance. Very high or very low sodium levels in the blood can cause severe symptoms.

What is hypernatremia? 

The normal range of sodium in the blood is 135-145 milliequivalents per liter (mEq/L). Hypernatremia is defined as a serum sodium concentration over 145  mEq/L. It should not be confused with hyponatremia, which is the opposite of hypernatremia, and is defined as a serum sodium concentration under 135 mEq/L.

What causes hypernatremia?

The main cause of hypernatremia is an inadequate amount of fluid in the blood. This can be due to too little fluid intake or too much fluid loss. Some of the common causes of hypernatremia include:

• Dehydration
• Vomiting
• Severe diarrhea
• Excessive sweating
• Large areas of burns
• Kidney disease
• Uncontrolled type 2 diabetes mellitus with excessive urination and dehydration
• Diabetes insipidus (this is a disorder that causes you to produce large amounts of urine)
• Certain medications like diuretics (water pills)

Elderly patients, those receiving IV treatments, those in long-term care facilities, and people with altered mental status are at higher risk of developing hypernatremia. 

What are high sodium symptoms?

Frequently, having too much sodium in the blood does not cause any symptoms, and the person remains unaware of any abnormality. When symptoms are present, the most common symptom of hypernatremia is excessive thirst. 

Other hypernatremia symptoms occur due to a fluid imbalance in the brain cells, which can cause muscle twitching, spasms, muscle weakness, fatigue, confusion, seizures, coma, and even death in severe cases. 

How do you fix sodium hypernatremia?

Doctors can diagnose hypernatremia with urine tests and blood tests. If the serum sodium level is high on blood test results, successful treatment for hypernatremia usually involves addressing the underlying reason for the disruption in the fluid and sodium balance in the body. 

For instance, if a person has poorly controlled diabetes, doctors may recommend increasing water intake to offset ongoing fluid losses in the urine. 

In people with very high serum sodium concentration, it may be necessary for healthcare professionals to monitor sodium levels carefully and adjust fluid levels accordingly through IV fluid administration.

How can I lower my sodium levels quickly?

As mentioned above, the management of hypernatremia involves replacing fluids. Doctors give diluted fluids (water with a small amount of carefully measured sodium) intravenously. This helps to bring down sodium in the blood gradually through a dilution effect. Correcting hypernatremia too rapidly can lead to brain swelling, seizures, permanent brain damage, and even death.

How fast can you lower sodium in severe hypernatremia?

The rate of correction of hypernatremia in patients with too much sodium in the blood should not exceed 12 mEq/L in a 24-hour period. More rapid correction can be potentially dangerous.

How can I lower my sodium naturally?

Mild cases of hypernatremia can usually be corrected by replacing fluids to fix dehydration. If you start to get dehydrated and feel excessively thirsty, you can reverse the mild hypernatremia by drinking water or a sports drink that contains electrolytes.

How to prevent hypernatremia?

Hypernatremia is frequently the result of a health problem that requires treatment. Therefore, you should make sure that medical conditions like kidney problems and diabetes are well controlled. 

It is also important to drink plenty of water and stay well hydrated, especially in hot weather and during physical activity. 

A high sodium (salt) intake through diet usually does not cause hypernatremia (too much sodium in the blood), but it can cause other health problems like high blood pressure, so you should eat a balanced, healthy diet. 

Wrapping Up

The medical term hypernatremia refers to a sodium level in the blood that is too high (over 145 mEq/L). It typically occurs due to reduced water intake or excessive water loss. Certain people, such as older adults, are at higher risk of hypernatremia. 

Common symptoms of hypernatremia include excessive thirst. When severe, hypernatremia can cause serious problems and may even be a medical emergency. 

Treatment of hypernatremia usually involves managing the underlying health condition causing high sodium levels and restoring water balance by increasing fluid intake.

References:

1. https://www.msdmanuals.com/en-in/home/hormonal-and-metabolic-disorders/electrolyte-balance/hypernatremia-high-level-of-sodium-in-the-blood#
2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3894528/