Seniors: It’s a balancing act when it comes to salt

Everyone knows too much salt is bad for us. But what if the salt level in your body is low? Well, that is also a major health concern, especially if you are an older adult. So success lies in maintaining a balance.

Low sodium or hyponatrmeia occurs when the concentration of sodium in our blood is abnormally low. Sodium is an electrolyte, which helps regulate the amount of water in and around the cells in our body. It helps maintain normal blood pressure, supports the normal functioning of our nerves and muscles, and regulates our body’s fluid balance.

In hyponatremia, one or more factors cause the sodium in our body to become diluted. When this happens, our body’s water content rises and our cells begin to swell.

This swelling can cause many health problems, from mild to life-threatening.

When the sodium levels drop gradually over 48 hours or longer, symptoms and complications are typically more moderate. In acute hyponatremia, sodium levels drop rapidly — resulting in potentially dangerous effects, such as rapid brain swelling, which can result in a coma and death.

A normal blood sodium level is between 135 and 145 milliequivalents per liter (mEq/L). Hyponatremia occurs when the blood sodium level falls below 135 mEq/L.

Older adults may have more contributing factors for hyponatremia, including age-related changes, medication use, and a greater likelihood of developing a chronic disease that alters the body’s sodium balance.

Severe vomiting and diarrhea causes our body to lose electrolytes and increases the level of anti-diuretic hormone (ADH) causing the body to retain water.

Some medications such as water pills (diuretics), antidepressants and pain medications, can interfere with the normal hormonal and kidney processes that keep sodium concentrations within the normal range. So if you are on these medications you have an increased risk of developing hyponatremia.

Congestive heart failure and certain diseases affecting the kidneys or liver can cause fluids to accumulate in our body, which results in low sodium level.

Diseases of adrenal gland and thyroid gland can also cause a low blood-sodium level. Therefore, older adults having these conditions have a higher risk of hyponatremia.

Drinking excessive amounts of water can cause low sodium by overwhelming the kidneys’ ability to excrete water. This happens more commonly in people who engage in high-intensity activities such as marathons.

So what are the common signs and symptoms of low sodium state? These include loss of energy, drowsiness and fatigue, restlessness and irritability, muscle weakness, or cramps, and some non-specific symptoms such as headache, confusion, and nausea and vomiting. Acute hyponatremia can also cause seizures and coma.

How can you prevent hyponatremia? If you have a medical condition that increases your risk of hyponatremia or you take diuretic medications, be aware of the signs and symptoms of low blood sodium. It is a good idea to monitor your sodium levels periodically if you are on a water pill. Always discuss with your doctor about the risks of a new medication.

Getting treatment for conditions that contribute to hyponatremia, such as adrenal gland insufficiency, can help prevent low blood sodium.

Drinking water is vital for your health, so make sure you drink enough fluids. Thirst and the color of your urine are usually good indications of how much water you need. If you’re not thirsty and your urine is pale yellow, you are likely getting enough water.

Consult your doctor if you know you are at risk of hyponatremia and are experiencing nausea, headaches, cramping or weakness. Depending on the extent and duration of these signs and symptoms, your doctor may recommend seeking immediate medical care.

In short, it is all a balancing act and with the help of your physician you can achieve it.

Padmaja Genesh, who holds a bachelor degree in medicine and surgery as well as a bachelor degree in Gerontology, has spent several years teaching and working with health care agencies. A past resident of Red Deer, and a past board member of Red Deer Golden Circle, she is now a Learning Specialist at the Alzheimer Society of Calgary. Please send your comments to

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