It is quite possible that you are just one of those people who tends to run on the low side of sodium. If you are asymptomatic, it is likely not a big deal. Perhaps just drinking a bit of an electrolyte rich beverage each day will up the sodium levels if you are concerned.
It is worth checking all of your kidney function numbers just as a precaution. You will find those on your CMP. It would be worth comparing the numbers before and after starting on HU just to see if there is a significant difference.
If the sodium numbers continue to drop, then it is something worth following up on. Perhaps a consult with a nephrologist would be in order in that case. That is what I did when my kidney function numbers were off.
I would follow up to determine what is going on. It may be something quite minor and easily addressed. It may be an indicator of an issue with kidney function. May or may not be related to the hydroxy.
I don't want to be alarmist but I think that it should definitely be followed up if it continues to fall. I was admitted to hospital as an emergency in 2020. My sodium level was around 124 and they treated it as an emergency. At that point I had been on Furosemide and Omeprazole for a number of symptoms and I think these may have upset my electrolyte balance.
I assume they're fine as I'm sure I would be told and treated if otherwise. Post transplant care is incredibly thorough and I'm checked regularly for pretty much everything possible! I don't find it helpful to check through all my levels, although I ask about platelets and haemoglobin from time to time. I just want to work towards living my life again.
When the low sodium was discovered I was in hospital for two weeks and that's when MF was diagnosed.
This happened to me as well early this year. Only when I was in the hospital did I learn that thiazide diuretics are contraindicated for people with low sodium; my sodium levels had been borderline for some time, but my primary care doctor apparently didn't make the connection. Since I changed my blood pressure medication from a diuretic to a calcium channel blocker, my serum sodium has been normal.
I have to sympathise with the hesitation sometimes in consulting GP in UK about some random symptom or concern. The problem I feel with a chronic cancer diagnosis such as MPNs is that if not careful one tends to immediately associate everything one becomes aware of, be it a pain, rash, change in body function or whatever with either the condition itself or associated medication. Unfortunately there is also in the back of the mind the feeling that GPs in UK might be fobbing one off.............. As you say the best attitude probably is to be 'gently assertive' once anything like your query takes hold in your mind, but personally I try to put my PV in a mental box and treat other events as separate unless proven otherwise.
Am I understanding you correctly, your sodium level is relatively low, too. Like how low? I'm always one mark lower than the lowest number in the acceptable range, and it always flags my tests and makes my doctor want to send me to a kidney specialists, but my sodium has been lowish for years! What have you been told about this, because Dr. Google doesn't reveal many others with this issue. Thank you!
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