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Hypernatremia - Salt Imbalance

Overview, Causes, & Risk Factors

An imbalance occurs when there is too little or too much sodium, also known as salt, in the bloodstream. The condition is called hyponatremia when there is too little sodium. It is called hypernatremia when there is too much sodium in the bloodstream.

What is going on in the body?

The kidneys absorb most of the sodium in the body. Sodium helps the kidneys to regulate water levels in the body. Normally, the sodium-water balance in the body is regulated by the hormone aldosterone. This hormone causes the kidneys to hold onto water. When this system is out of balance, the body either gets rid of or absorbs too much sodium.

What are the causes and risks of the condition?

Too little sodium in the blood may be caused by:

  • severe vomiting
  • severe diarrhea
  • excessive exercise and sweating
  • burns
  • diuretics, which are medications that eliminate excess water from the body
  • poor kidney function, such as chronic renal failure
  • infections or high fever
  • Addison's disease, a condition in which there is not enough of the hormone cortisol in the bloodstream
  • excessive water or fluid intake
  • congestive heart failure
  • Too much sodium in the blood may be caused by:

  • corticosteroid medicines, such as prednisone
  • aldosteronism, a condition in which the body makes too much aldosterone
  • inability to drink water or not drinking enough water
  • excessive intake of salty foods
  • diabetes
  • kidney disease
  • heart disease

  • Symptoms & Signs

    What are the signs and symptoms of the condition?

    Common signs and symptoms of salt imbalance include:

  • muscle cramps, especially after exercise
  • weakness, often the first symptom of hyponatremia
  • irritability
  • confusion
  • restlessness and agitation
  • changes in heart rate, heartbeat, and blood pressure
  • tissue swelling
  • retaining fluid in the body
  • eliminating large amounts of urine
  • nausea
  • depression
  • lack of coordination
  • seizures
  • coma

  • Diagnosis & Tests

    How is the condition diagnosed?

    A doctor can diagnose salt imbalance by taking a complete medical history and ordering blood and urine tests. Other tests may be done depending on the person's symptoms.

    The doctor may also want to know:

  • What was happening when the symptoms started?
  • Was there any illness before the symptoms began?
  • Was the person exercising or working and sweating a lot?
  • Does anything help the symptoms improve?
  • What makes the symptoms worse?
  • Is there any chest pain, weakness, or dizziness?
  • Is the person taking any medicines?

  • Prevention & Expectations

    What can be done to prevent the condition?

    A person can take these actions to help prevent salt imbalance:

  • avoid salty foods, salt tablets, or salty liquids, such as sports drinks
  • drink plenty of water during exercise
  • drink plenty of water when taking diuretics
  • keep follow-up appointments with the doctor for chronic disease treatment
  • A person who has the flu and uncontrollable vomiting needs to be monitored carefully. He or she may need to be admitted to a hospital to get fluids to prevent dehydration and salt imbalance.

    What are the long-term effects of the condition?

    The long-term effects of salt imbalance depend on the underlying cause. If the imbalance is caught early and treated, there may be few long-term effects. Severe salt imbalance that is not treated can lead to extreme weakness, confusion, coma, or death.

    What are the risks to others?

    A salt imbalance itself is not catching, although the underlying cause may be. For example, if a person has low sodium due to vomiting and diarrhea caused by the flu, the flu may be catching. If the sodium imbalance is due to a kidney disorder, this is not catching.


    Treatment & Monitoring

    What are the treatments for the condition?

    Treatment for sodium imbalance will depend on the underlying cause.

  • If the sodium imbalance is caused by the flu along with vomiting and diarrhea, fluids need to be replaced in the body.
  • The person may need medicine to help decrease the vomiting.
  • Fluids given into the veins can help replace sodium, or in other cases, can help lower sodium levels in the blood.
  • Sodium imbalance due to kidney disease or diabetes can be treated with medicines.
  • Low sodium diets may help prevent high levels of sodium in the blood.
  • Diuretics, also known as water pills, may be given to decrease high sodium levels in the blood.
  • What are the side effects of the treatments?

    Side effects depend on the treatments used, but may include allergic reactions to the medicine and stomach upset.

    What happens after treatment for the condition?

    Hyponatremia that is the result of vomiting and diarrhea caused by the flu may be treated and need no further treatment. On the other hand, a person who has diabetes will need lifelong treatment once the condition is under control. A person with kidney disease may need follow-up treatment and close monitoring of blood levels of sodium and many other electrolytes.

    How is the condition monitored?

    Carefully monitoring of blood levels can help keep a balance between too little and too much sodium in the blood. If the salt imbalance is due to a short-term condition, such as vomiting, no further monitoring may be necessary. If a person is on diuretics or has other long-term conditions, periodic blood tests are needed to check the blood levels of various electrolytes. Any new or worsening symptoms should be reported to the doctor.



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