Hyponatremia or low sodium syndrome: Did you know drinking too much water can kill as electrolytes level dips?

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KEY STORY

  • You may have heard of the water-drinking contest held by a radio station in the US in 2007 that caused the death of a woman named Jennifer Strange. The radio station was fined $16.5 million in the compensation payable to the dead woman’s husband following the wrongful death lawsuit.
  • Strange suffered hyponatremia, or acute water intoxication. Immediate medical care might have saved with an IV sodium drip to counteract the water, the doctor testified. She had been drinking water for nearly three hours without urinating during the January 12, 2007 contest. She died of water poisoning.

    Water-poisoning! Really? And Hyponatremia! Now, what’s that?

  • That case really made people sit up and realise that there is something such as water poisoning and Hyponatremia – a condition that occurs when the concentration of sodium in your blood is abnormally low. Sodium is an electrolyte, and it helps regulate the amount of water that is in and around your cells.
  • In hyponatremia, one or more factors — ranging from an underlying medical condition to drinking too much water — cause the sodium in your body to become diluted. When this happens, your body’s water levels rise, and your cells begin to swell. This swelling can cause many health problems, from mild to life-threatening, says the Mayo Clinic website.
    Hyponatremia and the low sodium connection:
    Sodium plays a key role in your body. It helps maintain normal blood pressure, supports the work of your nerves and muscles, and regulates your body’s fluid balance. A normal blood sodium level is between 135 and 145 milliequivalents per litre (mEq/L). Hyponatremia occurs when the sodium in your blood falls below 135 mEq/L.

    What can cause Hyponatremia or dangerously low sodium in blood:

    1. Certain medications. Diuretics, antidepressants and pain medications, etc can interfere with the normal hormonal and kidney processes that keep sodium concentrations within the healthy normal range.
    2. Heart, kidney and liver problems. Congestive heart failure and certain diseases affecting the kidneys or liver can cause fluids to accumulate in your body, which dilutes the sodium in your body, lowering the overall level.
    3. Syndrome of inappropriate anti-diuretic hormone (SIADH). In this condition, high levels of the anti-diuretic hormone (ADH) are produced, causing your body to retain water instead of excreting it normally in your urine.
    4. Chronic, severe vomiting or diarrhoea and other causes of dehydration. This causes your body to lose electrolytes, such as sodium and increases anti-diuretic hormone levels.
    5. Drinking too much water. This happens when a person runs a marathon or a triathlon, for example – and loses a lot of sodium through sweat. Simultaneously, he or she is also drinking too much water during endurance activities… this can also dilute the sodium content of your blood as drinking excessive amounts of water can cause low sodium by overwhelming the kidneys’ ability to excrete water.
    6. Hormonal changes. Adrenal gland insufficiency (Addison’s disease) affects your adrenal glands’ ability to produce hormones that help maintain your body’s balance of sodium, potassium, and water. Low levels of thyroid hormone also can cause a low blood-sodium level.
    7. The recreational drug Ecstasy. This amphetamine increases the risk of severe and even fatal cases of hyponatremia.
    8. Age. In old age, certain medications, body changes, etc. as well as setting in of chronic disease can alter the body’s sodium balance.
    9. Certain drugs. Prescription medicines such as diuretics as well as some antidepressants and pain medications and banned (so-called recreational) drugs such as Ecstasy have been linked to fatal cases of hyponatremia.
    10. Conditions that decrease your body’s water excretion. People with kidney disease, heart failure, etc need to stay on alert about Hyponatremia.
    11. Sportspersons who undertake physical activities. People who drink too much water while taking part in marathons, ultramarathons, triathlons and other long-distance, high-intensity activities are at an increased risk of hyponatremia. They should consult their doctor and ensure that they consume the electrolytes that the doctor prescribes, mixed with water so that they do not suffer Hyponatremia.
    How much water can one safely drink?
    According to the Mayo Clinic, the US National Academies of Sciences, Engineering, and Medicine has determined that an adequate daily fluid intake is:
    • About 15.5 cups (3.7 litres) of fluids a day for men
    • About 11.5 cups (2.7 litres) of fluids a day for women
    These recommendations cover fluids from water, other beverages and food. About 20% of daily fluid intake usually comes from food and the rest from drinks. Basically, listen to your body. Drink when you feel thirsty. Stop when your body tells you that you have had enough. Healthy individuals do not need outside indicators, mostly. Those with underlying conditions must check with their doctors or dietitians.
    Disclaimer: Tips and suggestions mentioned in the article are for general information purpose only and should not be construed as professional medical advice. Always consult your doctor or a dietician before starting any fitness programme or making any changes to your diet.

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