The excessively low sodium level caught my eye as I reviewed her outside labs. Is this correct? Is she ok? A normal blood sodium should range between 135-145 millequivalents per liter (mEq/L); subsequently, a sodium of 123 is deadly. I called my patient immediately.
“I feel fine, Dr. Sadler!”, my patient quickly reassured me. She had been on a diet that promoted drinking large quantities of water and she was drinking gup to 2 gallons daily! She denied nausea, vomiting, or dizziness. Most likely, her drop in blood sodium had been gradual and tolerated over time. Luckily, she had requested the diet center draw her blood levels and forward results to me for general review. Her critically low levels were concerning.
Hyponatremia occurs when sodium in the blood is abnormally low. Sodium helps to regulate the amount of water in and around the body’s cells. Severe hyponatremia can cause swelling in the brain. For most people, a similar drop in sodium similar to “Jenny’s”, could result in seizures, coma, and death.
However, Jenny was tolerating the dangerously low sodium level only because her levels had slowly dropped over a long course of time. Her body had somehow adapted, but she was teetering near death. The popular diet did not call for oversight by a medical provider.
Jenny reassured me she was doing well and that her diabetes was under much better control with her successful weight loss, and that her blood sugars were trending towards normal levels. “That is great!”, I told her as I IMMEDIATELY placed her on TIGHT fluid restrictions. She was told to have someone drive her to the clinic and follow up in a few days.
Success. With reasonable fluid restrictions, her sodium was up to 123 two days later, then 128 five days later. We will check my patient again next week, and I suspect she will have normal sodium levels. On the other hand, her sugars have returned to normal since her successful weight loss.
BOTTOM LINE: Water is the symbol of life in Egyptian culture, but water in over-abundance can be problematic. Drink water responsibly.
Thank you for very good advice!
Will u have another book signing?