One of the electrolyte disorders is hyponatremia. Hyponatremia is a condition in which the level of sodium (Na) in our body drops down. The normal range of sodium level is 135 – 145 mEq/L (milliequivalents per liter). If sodium level drops below 135 mEq/L then that condition is called as hyponatremia. In other words, hyponatremia indicates an excess of water level in plasma.
The ionic composition and interstitial fluids are essential to be normal for normal functioning of cells which is maintained by bidirectional pumps, one among them is 'sodium-potassium pump'. Thus, Sodium helps to maintain plasma, interstitial fluid and intracellular fluid balance. This indicates that sodium is an important factor for maintaining blood pressure and cellular functions in our body.
WHAT CAUSES REDUCTION IN SODIUM LEVEL IN OUR BODY?
There are many causes which may be responsible for hyponatremia, they are –
- Excessive water or fluid consumption – Excessive water or fluid consumption raises the water content in our body which in turn increases the extracellular water and reduces the sodium concentration in cells.
- Reduced osmolar concentration of fluids
- Various systems of our body are responsible for this condition, they are –
- Digestive system - Imbalance in alimentary tract due to vomiting and diarrhoea cause imbalance in the fluids.
- Sweat glands – Excessive loss of salt and water by sweating leads to mild hyponatremia. The cause of excessive sweating may be a high-grade fever or hot climate.
- Impaired renal function – Basically, kidney is the organ that maintains water and electrolyte balance by filtration. Thus, the foremost organ which affects the sodium level in our body is the kidney. This happens in maximum of all the renal disorders
- Medications – Diuretics and laxatives lead to water-electrolyte imbalance due to impaired excretion.
- Some diseases or conditions leads to hyponatremia, they are – burns, scalds (leads to dehydration) and diabetes (Frequent urination) is the cause for loss of electrolytes from the body, liver cirrhosis.
- Any impairment in Sodium-potassium pump leads to loss of sodium from the body.
- Less Salt (NaCl) intake.
- Hyperlipidemia - Psuedohyponatremia is seen with gross hyperlipidemia
- Hormonal imbalance, for example - Syndrome of inappropriate anti-diuretic hormone secretion (SIADH)
WHAT ARE THE SIGNS AND SYMPTOMS OF HYPONATREMIA?
It affects the whole body hence the signs and symptoms of this condition goes as -
- Nausea
- Vomiting
- Dizziness
- Fatigue
- Vertigo
- Edema
- Headache
- Irritability
- Restlessness
- Abnormality in neurological and muscular functions
- Mild confusion
- Lassitude
- Reduced appetite
- Sleepiness
- Myoclonic jerks
- Generalized seizures
- Convulsions
- Unconsciousness
- Severity leads to neurological damage
This condition affects the structure and functions of each cell. Automatically its impacts are seen on every organ and on every process in our body.
TYPES OF HYPONATREMIA
- Euvolemic hyponatremia (condition arises when the sodium level is normal but the water level is high, this impairs the sodium concentration)
- Hypervolemic hyponatremia (Increased extracellular and plasma volume, usually occurs in congestive cardiac failure and cirrhosis)
- Hypovolemic hyponatremia (Reduced sodium and plasma level)
DIAGNOSTIC CRITERIA
Because of the large number of possibilities or causes, it is very difficult to determine the exact cause, but to evaluate the sodium level we need to go for some laboratory investigations. They are -
- Blood and urine tests to measure plasma and urine sodium level
- Endocrine investigations may be required.
WHEN DO WE CALL IT A MEDICAL EMERGENCY?
If the plasma sodium level is < 110 mEq/L, this is considered a medical emergency because there is a high chance of neurological damage.
TREATMENT ASPECT ACCORDING TO AYURVEDA
As per Ayurveda, the medicines that are helpful -
1. Lavan
There are five types of salts explained in our classics they are – saindhava, samudrika, sauvarchala, vida and audbhida. They are a rich source of sodium hence useful in hyponatremia. Among all the salts saindhava lavana is the best one because it won't increase pitta dosha in our body thus this salt can be used in a hypertension person.
Reference – Bhavaprakasha Nighantu / Haritakiadi Varga / Shloka no. 241
Meaning – The meaning of this shloka goes as – Saindhava lavana possesses these qualities: swadishta (Increases taste), deepanam (Increases digestive fire), pachanam (Aids digestion), laghu (Light to digest), snighdham (Slimy in nature), ruchyam (Increases appetite), hima (Cold in potency), vrushya (Aphrodisiac in nature), sukshma (Subtle in nature), netryam (Good for eyesight) and balances all the three doshas in our body.
2. Sajjikhaar (Barilla / Impure carbonate of soda)
This medicine is used in the form of alkali, which contains some amount of sodium in it. Thus, beneficial in this condition.
3. Ashwagandha (Withania somnifera)
Ashwagandha (Withania somnifera) is an excellent nervine tonic. It helps to restore normal neurological functions of our body.
4. Brahmi (Bacopa monnieri)
Brahmi (Bacopa monnieri) is one among the rasayanas that helps to balance higher mental functions. It helps to maintain hormonal imbalance hence, it is beneficial in this condition.
"Intravenous transfusion of NaCl solution is required in extreme cases".
HOW WE CAN MANAGE HYPONATREMIA AT HOME?
Individuals who are suffering from hyponatremia condition and if the symptoms are very mild then they can follow some home remedies like -
- Coconut water
- Lemon water with salt
- Directly consume some amount of salt
- Avoid excessive water or fluid consumption.
- Hyponatremia patients should maintain the daily intake of salt approx. 2-3 grams.
PRECAUTIONS
Those who are already suffering from hyponatremia they should need to take precautions as follows –
- Avoid laxatives and diuretics
- Restrict water intake
- Frequent monitoring of sodium level and blood pressure is required. High salt intake is required in this condition thus, we should monitor blood pressure level.
- Diet should contain green leafy vegetables like spinach and celery and also the use of beetroot and carrot in this condition is proven beneficial.
WHAT ARE THE CONSEQUENCES OF HYPONATREMIA?
If you ignored this condition you may end up with some severe neurological damage or coma and this condition may also lead to death.
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