Tegretol can cause low sodium levels

Dizziness and falls: Low sodium levels often go unnoticed

Status: December 15, 2020 5:04 p.m.

Dizziness, unsteady gait, falls - there can be many causes behind this. But the role of blood salts - and especially that of sodium - is often underestimated.

Too low a sodium level in the blood is the most common electrolyte disorder in the emergency room. It affects up to 30 percent of all hospital patients and around every 20th elderly general practitioner patient. And yet the so-called hyponatremia is often not recognized.

There is a risk of a serious course or even the misdiagnosis of dementia. Because it is not uncommon for symptoms such as dizziness, nausea and vomiting, later paired with an unsteady, unsteady gait, memory disorders and confusion, to be interpreted as signs of the onset of Alzheimer's dementia. Since the complaints are so unspecific, they are often pushed back to old age, often not recognized correctly and thus treated too late. This can lead to falls and breaks - which would actually have been avoidable.

How does a sodium deficiency come about?

Sodium belongs to the blood salts and is responsible for the electrolyte balance. It is significantly involved in building up the electrical voltage in the cells and is indispensable for the transmission of nerve impulses, heart rhythm and muscle function. If the sodium level is too low, all of these vital functions are disturbed.

Incidentally, the term sodium or salt deficiency for a low sodium level in the blood is misleading, because sodium deficiency is very rare in Germany - and therefore neither a high-salt diet nor salt tablets help. In fact, the problem with hyponatremia is not too little salt or sodium, but too much water. This dangerous excess of water is sometimes referred to as water poisoning.

The water balance is regulated by hormones

The so-called antidiuretic hormone (ADH) regulates the water content in the blood. It can even compensate for extreme fluctuations in the water balance and keep the salt concentration in the blood as constant as possible by controlling the excretion of water through the kidneys. If the ADH release is disturbed, too much of the hormone is usually released. The result is too little sodium in the blood - and too much water in the body. This disease is called SIADH - syndrome of inadequate ADH secretion.

But there are also other possible causes: Above all, drainage tablets and other drugs such as antidepressants play a role, but heart and kidney weakness, liver cirrhosis and various tumors also have an influence on the sodium level. Sometimes a tumor in the bronchi that disrupts ADH regulation is hidden behind a low sodium level. Therefore, a low sodium level should always be clarified.

A blood test will determine if you lack sodium

A blood test can reveal whether a patient has a relative sodium deficiency. If there is not enough sodium in the blood, the brain tries to compensate for this deficiency. The brain cells begin to suck water from the blood to raise the sodium level. The brain cells swell and the intracranial pressure increases. The consequences can be a rapid loss of mental abilities, dizziness and insecurity when walking. Older people are particularly at risk - especially older thin women. People over 70 are more sensitive to fluctuations in sodium levels than younger people. Even a slight sodium deficiency affects them like too much alcohol - as if the patients were tipsy. This increases the risk of falls.

Medicines are often the cause

Sodium can be lost through infections: The body loses water and salts in the event of fever, vomiting and diarrhea. The most common causes of sodium deficiency, however, are drugs such as water tablets, antihypertensive drugs, antidepressants, anti-epileptic drugs and some painkillers and anti-rheumatic drugs (NSAIDs). There is often improvement when the dose is reduced or another preparation is given. If the sodium deficiency is corrected, the patient often gets better quickly - the mental dropouts, lack of concentration and other symptoms recede. In addition, the excretion of sodium-free water can be increased by infusion with liquid and salts or urea powder.

Have sodium levels checked regularly from 70

Table salt tablets do not help against sodium deficiency because they do not correct the relative sodium content. In order to prevent a sodium deficiency, older people should discuss the amount they drink with their family doctor so that the sodium in the blood is not diluted too much. Regular checks are advisable from the age of 70: Experts recommend having the sodium level determined once a quarter with the help of a blood test.

 

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Visit | 12/15/2020 | 8:15 pm