Sodium deficiency and excess

An optimal sodium supply maintains our physical performance and mental capacity. The mineral serves as a kind of fluid distributor and supplies the muscles with nutrients. If the sodium level becomes chronically unbalanced, important bodily functions can be disturbed to such an extent that a patient can fall into a coma and even die. Therefore, it is important to know the alarm signals of sodium deficiency.

Sodium, together with other minerals, ensures that our water balance is correct, the heart beats properly and the muscles can do their work. The two counterparts sodium and potassium ensure the electrical excitability of the cells. They build up an electrical charge between the inside and outside of the cell, which enables impulses to be passed between nerve and muscle cells. Sodium is also used as an active ingredient in medicines, for example in "Diclofenac Sodium Micro Labs", which has an analgesic and anti-inflammatory effect. The drug is used, among other things, for chronic joint diseases or sports injuries.

Our body is smart. It has a regulatory circuit that keeps the sodium content in the blood as constant as possible. If a person consumes too much sodium, it increases excretion via the kidneys. If he loses sodium or takes in too little, sodium is reabsorbed. Sodium is also stored in the bones and cartilage. In the event of a sodium deficiency, our body can fall back on this supply. According to the German Nutrition Society (Deutsche Gesellschaft für Ernährung e. V.), the average daily requirement of sodium is 1500 mg. This requirement is sufficiently covered by a balanced diet. Nevertheless, certain circumstances can lead to a disturbed sodium ratio.

If the sodium levels in the blood are too low, this is called hyponatremia. A sodium deficiency can be caused by pre-existing conditions (such as hypothyroidism or adrenal insufficiency) or by taking certain medications (for example, drainage tablets, antidepressants or antihypertensives). A low-sodium diet, fasting cures or gastrointestinal diseases are also possible triggers. As a result, important functions in the body are disturbed:

• Water balance: when there is a lack of sodium, more water is excreted through urine and sweat, which can lead to dehydration. Many processes are disturbed, for example, blood circulation is reduced.
• Muscles and nerves: tremors, cramps and muscle weakness can occur. Since sodium is partly responsible for the conduction of impulses between the nerves, sensory disturbances are possible in addition to slower reactions. Blood pressure can drop with a sodium deficiency. This can trigger attacks of weakness.
• Body and mind: If sodium is lacking, this has an impact on our general well-being and physical and mental performance. Fatigue, headaches, nausea, dizziness and a decline in mental performance are the consequences.

The course of hyponatremia can be treacherous. It can develop slowly or occur from one day to the next. Whether the symptoms are severe or mild also depends on the person's daily condition and general state of health. In severe cases, hyponatremia can become chronic. The signals from the brain are insufficiently transmitted to the muscles. Those affected have a wobbly gait and tend to fall more often. Fatal: Since the bones are also poorly supplied in the case of a deficiency, bone fractures occur more quickly in the event of a fall.

During high physical exertion, more sodium is transported via the blood to the muscles under stress and to the heart. At the same time, there is increased excretion through sweat. If there is too little sodium in the body, muscles and organs can only be inadequately supplied. Physical performance decreases. Athletes, road workers, construction site workers or gardeners, for example, are affected, especially in the summer months. However, sodium loss varies from person to person. Some only sweat selectively, others are drenched in sweat after sport or work.

In dehydration, also called dehydration, the body dries out. There are three forms: Isotonic dehydration (too little sodium and too little water in the body), hypotonic dehydration (too little sodium in relation to water) and hypertonic dehydration (too much sodium in relation to water). Mild dehydration can be remedied with increased fluid intake, at best several times a day in small amounts. In hypotonic dehydration, it is also important to drink salty drinks or broths. Severe, untreated dehydration can be fatal. The risk group includes older people in particular, as their sense of thirst is less pronounced.

It is unnecessary to buy special supplements (such as over-the-counter tablets) for mild sodium deficiency. Low sodium levels can be corrected by consuming salted food or water containing sodium. In acute cases, salt water can help. This involves stirring a teaspoon of table salt into a glass of water and drinking it. The dissolved salt quickly enters the bloodstream and raises the sodium level within a few minutes.

A common cause of increased sodium levels in the blood is extreme fluid loss, for example after watery diarrhoea. The lack of fluid causes the blood volume to decrease and the sodium concentration to increase relatively. Too much salt intake with the diet, too little drinking, pre-existing diseases with limited urine excretion and diabetes can also cause elevated sodium levels.

Sodium binds water in the blood vessels. An over-supply of sodium can therefore cause oedema (water retention in the tissues). It can also increase blood pressure, which can lead to cardiovascular disease. Since our body increases the excretion of sodium via the kidneys when there is an excess, more calcium is lost at the same time. This increases the risk of osteoporosis.

Hypernatremia leads to dehydration of the cells. The first alarm signs can be severe thirst, restlessness, lethargy or general weakness. If pronounced hypernatremia remains undetected, muscle cramps, epileptic seizures, states of confusion or clouding of consciousness may occur. In severe cases, those affected can even fall into a coma.

The family doctor is the first point of contact in case of suspicion. He can find out with a blood test whether his patient's sodium level is OK. Measurements in the 24-hour urine are also possible. The normal value in the blood is 135 to 145 mmol/l, in the collected urine 120 to 220 mmol/l. If the values deviate, the cause must be found. In the case of deviating values, the cause of the disorder must be found and remedied in order to achieve a normalisation of the sodium level. If a drug is the trigger, it is replaced by other preparations. In an emergency, appropriate intravenous solutions can be administered by the doctor.

For healthy people, a short-term sodium over- or undersupply is harmless due to the kidney's regulatory capacity. In the case of a slight deficiency, it is sufficient to eat more salty food and drink sodium-containing water. Or in the opposite case: reduce the salt in the diet. However, if the sodium level is disturbed in the long term, both physical and mental performance suffers. A doctor can initiate appropriate measures.