Hyponatremia, or low blood sodium levels, is a common electrolyte imbalance that can occur in elderly people. As an essential electrolyte, sodium helps regulate fluid balance and helps nerve and muscle function, so when its level in the blood is too low, it can cause various symptoms. The elderly are at a higher risk for developing hyponatremia due to multiple factors that come with age.
In this article, we have shared what causes it, as well as its diagnosis and ways how to increase sodium levels in elderly naturally. Keep on reading to find all the necessary information you need to know!
Causes of Hyponatremia
Sodium is essential for our bodies. When its levels drop, it can cause the cells to swell, leading to serious and potentially life-threatening complications. The most common factors that cause hyponatremia include:
- Medications: Certain medications, such as diuretics, antidepressants, and pain medications, lead to excess sodium loss through urine.
- Chronic Medical Conditions: For example, heart failure and kidney disease can cause the body to keep too much water and dilute sodium levels in the blood.
- Malnutrition: Elderly individuals who are malnourished may have low levels of sodium in their blood because of a lack of sodium in their diet.
- Dehydration: Dehydration causes the body to retain too much water, decreasing sodium levels in the blood.
- Syndrome of Inappropriate Antidiuretic Hormone (SIADH): This is a condition in which the body produces too much of the hormone vasopressin, which regulates fluid balance in the body. It causes low sodium in the elderly, which then might lead to hyponatremia.
- Drinking excessive water can dilute the blood’s sodium level and cause hyponatremia.
Elderly patients with hyponatremia can have multiple causes; sometimes, the cause may not be identified.
Diagnosis and Treatment For Hyponatremia in Elderly 
Diagnosis and treatment for hyponatremia in elderly can be determined by physical examination and laboratory tests. Some of the most common symptoms are:
- Confusion
- Headache
- Nausea
- Fatigue
- Dizziness
- Loss of appetite
Physical examination may reveal signs such as decreased reflexes, muscle cramps or weakness, and in severe cases, seizures or coma.
Diagnosis is confirmed by measuring the level of sodium in the blood. The normal range for sodium levels is 135-145 mEq/L. A low sodium level (< 135 mEq/L) is considered diagnostic of hyponatremia.
One might need additional laboratory tests to evaluate the underlying cause of the hyponatremia, such as blood tests to measure kidney and liver function and a urinalysis to check for the presence of protein or glucose in the urine.
The treatment of hyponatremia in the elderly will depend on the underlying cause, the severity of symptoms, and the rate at which the sodium level is decreasing.
- Mild cases of hyponatremia can be treated with fluid restriction, which means the patient should limit the amount of water and other fluids he is drinking.
- Moderate to severe cases may require hospitalization and more serious treatment such as intravenous (IV) fluids, medications to remove excess water from the body, and in some cases, increasing sodium levels through IV administration of sodium chloride.
- If a medication causes hyponatremia, the dose should be adjusted, or the patient should switch to a different medication.
- If a chronic medical condition is the underlying cause of hyponatremia, treatment will focus on managing the underlying condition.
- It’s important to note that the treatment of hyponatremia, especially in elderly patients, should be done under close medical supervision, as rapid correction of sodium levels can lead to serious complications.
Prevention of Hyponatremia
Preventing hyponatremia in the elderly is important to maintain their health and well-being. Here are some ways how to increase sodium levels in elderly naturally:
- Monitoring medication use: Elderly patients need regular check-ups with their healthcare provider to monitor their medication use and potential side effects.
- Maintaining proper hydration and nutrition: Proper hydration and nutrition are important to maintain electrolyte balance and prevent hyponatremia. Elderly individuals should drink enough fluids to maintain good hydration but avoid drinking excessive amounts of water, which can dilute sodium levels in the blood. They also must maintain a healthy and balanced diet with appropriate amounts of sodium.
- Regular check-ups with a healthcare provider: Regular check-ups can help identify and prevent hyponatremia by monitoring electrolyte levels and identifying any underlying medical conditions or risk factors.
- Avoiding alcohol and caffeine: alcohol and caffeine are diuretics that can increase urine output and lower the blood sodium level.
- Monitoring of fluid balance: Patients at risk for hyponatremia should be monitored for signs of fluid overload, such as weight gain, edema, and shortness of breath.
- Avoiding self-treatment: Elderly patients should avoid self-treating hyponatremia and should seek medical attention if they suspect they have low sodium levels.
How Common is Hyponatremia?
Hyponatremia is relatively common and affects around 1-2% of the U.S. population. It is more prevalent in certain populations, such as older adults, people with certain underlying medical conditions, and those who take certain medications. In hospital settings, it can occur in up to 30% of patients in certain high-risk groups, such as critically ill patients, those with heart failure, or cirrhosis.
It’s important to note that the prevalence of hyponatremia can vary depending on the population and setting being studied, and more recent studies may have different estimates. Also, the diagnosis of hyponatremia has increased with the use of more sensitive laboratory methods.
Are There Complications Associated With Hyponatremia?
There can be serious and potentially life-threatening complications associated with hyponatremia. The most severe difficulty is brain edema, which occurs when the cells in the brain swell due to the influx of water. This can cause headaches, nausea, confusion, seizures, and coma. In the worst cases, it can lead to permanent brain damage and even death.
Other complications can include muscle cramps, spasms, weakness, respiratory failure, and cardiac arrest in the worst cases. Hyponatremia can also have an impact on other organ systems. For example, it can affect the cardiovascular system by lowering blood pressure and the respiratory system by causing shortness of breath.
If you suspect hyponatremia, you must immediately seek medical help, as prompt treatment can prevent or minimize these complications.
What Are the Results After Treatment for Hyponatremia?
Treatment for hyponatremia is aimed at correcting the underlying cause and re-balancing sodium levels in the blood. The appropriate treatment will depend on the condition’s cause, the severity of the symptoms, and the individual patient’s needs.
Treatment for patients with mild hyponatremia involves fluid restriction and increased electrolytes such as sodium intake. Medications such as diuretics can help remove excess water from the body. Sometimes, patients may be advised to stop taking certain medications contributing to the condition.
Treatment for patients with moderate to severe hyponatremia may involve hospitalization and administering fluids and electrolytes through an intravenous (IV) line. In some cases, hypertonic saline (a solution with a higher sodium concentration) may be administered to raise sodium levels in the blood rapidly. However, the correction rate should be done cautiously to avoid the osmotic demyelination syndrome that can cause permanent brain damage.
In most cases, treatment successfully restores normal levels of sodium in the blood and relieves symptoms. However, it’s important to note that the recovery time can vary depending on the condition’s cause and the severity of the symptoms.
Also, hyponatremia can recur if the underlying cause is not addressed. Therefore, patients should be closely monitored after treatment and may need to change their lifestyle or continue taking medications to prevent the condition from recurring.
Conclusion
Hyponatremia is a common condition in older adults that various factors, including medication use, chronic medical conditions, dehydration, and the natural aging process, can cause. It is important for older adults to be aware of the signs and symptoms and to seek prompt medical attention if suspected. Regular check-ups with healthcare professionals can help identify and prevent the development of low sodium in the elderly.
