Blood Sodium

yerrag

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What is the significance of blood sodium? Does my blood sodium level result give me an indication that my plasma is hyposmotic (hypotonic?), osmotic (isotonic?), or hyperosmotic (hypertonic?)? Am I correct in my understanding that our bodily fluids, including blood, has a salinity of 0.9%? Doesn’t blood plasma always stay constant at around 0.9%, regardless of whether my body’s sodium content is low, normal, or high?

If I am low in sodium, would the results of my blood sodium test give me any indication?

I'm doubtful though, as this is my reasoning: as the body will always adjust the blood volume by adding or subtracting water from my body’s supply of blood, in order to maintain an isotonic blood plasma concentration, I won't normally be able to tell if my body's sodium is low. That is, unless I came from running a marathon and have been drinking tons of plain water that would lead to hyponatremia. This being the case, wouldn’t the blood sodium test be pretty much useless for me?

From Salt, energy, metabolic rate, and longevity, “One important function of carbon dioxide is to regulate the movement of positively charged alkali metal ions, such as sodium and calcium. When too much calcium enters a cell it activates many enzymes, prevents muscle and nerve cells from relaxing, and ultimately kills the cell. The constant formation of acidic carbon dioxide in the cell allows the cell to remove calcium, along with the small amount of sodium which is constantly entering the cell.

When there is adequate sodium in the extracellular fluid, the continuous inward movement of sodium ions into the resting cell activates an enzyme, sodium-potassium ATPase, causing ATP to break down into ADP and phosphate, which stimulates the consumption of fuel and oxygen to maintain an adequate level of ATP. Increasing the concentration of sodium increases the energy consumption and carbon dioxide production of the cell. The sodium, by increasing carbon dioxide production, protects against the excitatory, toxic effects of the intracellular calcium.”

The point of my asking is how do I know I have adequate sodium in my body? How do I relate the blood sodium test result to determining if I have “adequate sodium in the extracellular fluid?”

For example, my blood sodium reading is 142 mmol/liter. Given that a molar weight of NaCl is 58.44g, this translates to 142 mmol NaCl/1 ltr water * 58.44g/1000 mmol NaCl * 1 lt/1000g water * 100 = .83 % salinity

Does my 0.83% salinity show that my sodium is low? In short, how do you use the sodium reading on the test and relate it to having "adequate sodium in the body's extracellular fluids?"

Out of curiosity, may I ask you to share your blood sodium results? I'm interested in knowing if anyone could possibly get results that indicate his blood is isotonic (at 154 mmol/ltr) or even higher (hypertonic)? Thanks.
 
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tara

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Hi Yerrag,
My lay understanding of this is that the body will do what it can with other mechanisms to maintain a suitable blood sodium homeostasis. Blood sodium will only go out of range when those mechanisms are overwhelmed. Though it may take a little while for other mechanisms to adapt if you have a significant change in sodium intake. Other mechanisms include aldosterone. So I don't think you can tell if you are getting enough sodium or too much by looking at blood sodium values unless it is getting quite extreme. Which you don't want.

142 is not low blood sodium. Normal range is 135-145.

I'm not sure, but I'm wondering if that ~0.9% number may applies to other molecules dissolved in the blood as well as the sodium? Probably someone else here knows that better than me.
 
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yerrag

yerrag

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Thanks Tara. I'm wondering if there has been a time anybody in this forum has made use of the blood sodium test in a way that would have led him to take any corrective action. It seems to me blood sodium results don't tell us anything other than "hey, this is the reason you didn't ever faint and didn't need to go to the ER on the way to the ICU." If we are conscious and lucid, it already means we don't need to get our blood sodium. If we do get readings, it's only because it doesn't cost much.

Let's suppose it costs $100, and you have to ask "what for?" when would you think it's worthwhile?
 

Faith

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I have had hyponatremia ( low blood sodium ) along with hypothyroidism ever since I became pregnant 29 years ago. My level usually runs about 126-127. The Dr. who diagnosed me told me to drink less water and eat more salt. I have always eaten plenty of salt, but haven't wanted to drink less water, especially since plenty of water is recommended by almost everyone. Since I have discovered Ray Peat, I have reduced my water consumption and am having less edema. Doing bloodwork again soon - fingers crossed that this has increased my sodium level. If anyone has had any experience with chronic hyponatremia it would be great to know what if anything has helped. Also, I really feel like the low sodium is linked to my fluctuating but almost constant edema, especially in my face and ankles.
 

JudiBlueHen

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On several occasions my daughter in her mid-thirties was taken to the ER in a nearly catatonic state. Unable to speak and could barely follow commands and could not eat or drink. Her serum sodium was 127, very low. After a saline IV, she recovered her ability to respond and speak. In every case she had had too much liquid and not enough food on the preceding day(s). As she is a psychiatric patient, they admitted her for observation for a few days.

We also discovered that if we found her in this condition and could get her to drink a (regular) Coke, she would be able to respond to commands and thus eat a little, and soon be able to speak (though not fully recovered nor safe to leave alone).
 
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yerrag

yerrag

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I have had hyponatremia ( low blood sodium ) along with hypothyroidism ever since I became pregnant 29 years ago.
Have you fixed your hypothyroid condition?
 
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yerrag

yerrag

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It would be hard I think to fix your hypothyroid condition given your low serum sodium condition. And hard to fix your low sodium condition given your hypothyroid condition. Perhaps that's why you're stuck in a loop. And drinking less water, it's not a permanent solution. You may be getting dehydrated as a result, and keeping at it may worsen more than it would help. Just to get an idea, what is your latest serum rbc, hemoglobin, and hemotocrit?

What is your urine pH? You can buy a Hydrion pH test strip, I think the range is 5 - 8 (or 9) and test your urine throughout the day, say, wake up, 1 hour after lunch, 5 pm, and 1 hour after dinner. Optimal range is 6.4- 6.8. I suspect you may be acidic.

The body is always going to try to get your blood to be isotonic (sodium 135 - 142 optimal). It will keep reducing your blood volume when there's too little salt, and to increase it when there's too much. That it's not able to further reduce your blood volume to increase your sodium concentration could mean that to further decrease blood volume would put you in greater harm. Between your having low sodium and too low blood volume, it chooses the lesser of two evils - low sodium.
 

Faith

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Yerrag, thank you for the info and suggestion about urine pH. None of the doctors I have had seem concerned at all about the low sodium, but I am certain it is affecting me negatively. I'll check the other values you mentioned. I haven't been tested to see if it is hypovolemic, hypervolemic, or euvolemic hyponatremia.
 

tara

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I have had hyponatremia ( low blood sodium ) along with hypothyroidism ever since I became pregnant 29 years ago. My level usually runs about 126-127. The Dr. who diagnosed me told me to drink less water and eat more salt. I have always eaten plenty of salt, but haven't wanted to drink less water, especially since plenty of water is recommended by almost everyone. Since I have discovered Ray Peat, I have reduced my water consumption and am having less edema. Doing bloodwork again soon - fingers crossed that this has increased my sodium level. If anyone has had any experience with chronic hyponatremia it would be great to know what if anything has helped. Also, I really feel like the low sodium is linked to my fluctuating but almost constant edema, especially in my face and ankles.

I have never had measured below-range blood sodium, but I know someone who has. I have no doubt that it can have very severe consequences if it gets too low.
I've seen doctors dismiss low blood sodium in the face of measurements like yours and severe symptoms. And others treat it very seriously.
I think you are probably on the right track reducing excessive water drinking.

You may have already read these articles from Peat on his website, but if not, I'd recommend:
Thyroid: Therapies, Confusion, and Fraud
Preventing and treating cancer with progesterone.
Water: swelling, tension, pain, fatigue, aging.

Wikipedia also reckons 127 is low:
'Hyponatremia is a low sodium concentration in the blood.[3] It is generally defined as a sodium concentration of less than 135 mmol/L (135 mEq/L), with severe hyponatremia being below 120 mEq/L.[2][7] Symptoms can be absent, mild or severe.[1][8] Mild symptoms include a decreased ability to think, headaches, nausea, and poor balance.[2] Severe symptoms include confusion, seizures, and coma.[1][8]'

I guess you all know that in case of severe hyponatremia, it is important to bring it up in a slow controlled way. Long-term harm can be done by increasing too fast, eg just eating lots of salt quickly.
 
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yerrag

yerrag

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Yerrag, thank you for the info and suggestion about urine pH. None of the doctors I have had seem concerned at all about the low sodium, but I am certain it is affecting me negatively. I'll check the other values you mentioned. I haven't been tested to see if it is hypovolemic, hypervolemic, or euvolemic hyponatremia.
If you can provide some values, that would be helpful. Many doctors are trained only to see problems when it gets to crisis point. They're not trained to spot a looming crisis. When it gets to crisis point, that's when they'll test you for blood volume. The CBC test is a very common test, and very affordable, but people look down on affordable tests. But the CBC is very helpful. It should be priced 10x so people will be forced to extract value from it.
 
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yerrag

yerrag

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@Faith since you said your problem had its origins in your pregnancy, there is a good chance that it stems from having low blood volume. Since you had to produce more blood for your child, it is probable that you didn't produce enough. Your child is fine and has enough blood volume, but you may not. I'm no doctor, but even a mechanic who knows how to troubleshoot cars would first consider the probable as a starting point. I don't know your doctor, but it's safe to say that he's acting like a clueless technician (with a piece of paper saying he's got an associate's degree) who's trained to follow directions and not to think.
 

Faith

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Thank you, yerrag and tara for your input. I'm seeing my current Doc on Friday and will ask for a full workup with as much info as possible. I have been using baking soda in my water for a couple of months, perhaps that will make a difference. Also, I have had several episodes of syncope, including passing out during a mammogram (scared the hell out of the tech). Possibly related to the hyponatremia?
 

tara

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I'm seeing my current Doc on Friday and will ask for a full workup with as much info as possible.
My non-expert hunch would that if you are getting lab tests, amongst others, see if you can get numbers for thyroid hormones (not just someone saying 'in range').
Also to monitor your own body temps and resting heart rate, as easy DIY measurements you can do at home to get an idea of how metabolism/thyroid function are going, both now and as you change things. If it is low, this could affect ability to retain sodium, as well as causing direct hypothyroid/low energy symptoms.
Also, a rough estimate of how many calories a day you maintain yourself on can give more of an indicator.

It wouldn't surprise me if the balance of other minerals along with sodium could be significant - including getting suitable amounts of K, Ca, Mg ...
 

Faith

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I had to reschedule my appointment so don't have current numbers. I will post previous info soon, but the most obvious issues beside the hyponatremia are chronically elevated heart rate, very high B12 (without supplementation), the episodes of syncope, histamine intolerance, chronic and fluctuating edema, and high blood pressure (diastolic).
 
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