Low blood sodium

[Baileyw06]

I just got diagnosed with a low blood sodium level .

I have been on prednisone since April of 2017 , I am now on 6mg of prednisone for about 9 months. I have Been doing ok and than I had a symptoms of being light headed , night sweats, muscle pain,extreme fatigue and my blood pressure went very high, The Doctor gave me a low dose of LIsopril and did Blood Tests. He called me and said that my blood sodium was low and decreased my Hydrochlorothiazide to12 1/2 mg. I hope that works but I also saw that the same symptoms an low blood sodium can be caused by your Adrenal glands not working!He checked my CRP level and it was fine.

Has anyone else had a similar problem ?

[PMRpro Ambassador]

Do you know the sodium level?

[Baileyw06 in reply to PMRpro]

Yes, it is 131

[PMRpro Ambassador in reply to Baileyw06]

My husband had that level for a few years and no-one even twitched! They did get a bit panicked when it fell to 124 - and at last they moved a bit. Think it is now better!

He was just told to eat more salt, much to his delight! But patients on diuretics for their BP do need monitoring better than they seem to be.

Should have also asked - what is your BP now?

[Baileyw06 in reply to PMRpro]

Thanks,

It is in the 130’s over the 70’ and low 80’s which is under control.

[PMRpro Ambassador in reply to Baileyw06]

So a bit more salt isn't going to be a problem is it!

[Baileyw06 in reply to PMRpro]

No

[Slowdown]

I was recently hospitalised with suspected stroke (no evidence found during many tests) and my sodium levels dropped to122 during admission. My notes say 'patient found to be drinking over 3litres of water a day. Fluid restriction of 2.5l. was put in place. Hyponatraemia resolved' . Not to say this is so in your case, just my experience. Hope it gets sorted soon.

[SnazzyD]

After being on low sodium on higher doses of Pred, at this level I had to introduce small amounts again due to adrenal insufficiency.

[Baileyw06 in reply to SnazzyD]

Did that help your symptoms and your Adrenal gland function?

[SnazzyD in reply to Baileyw06]

I don’t think it kick starts the adrenals or pituitary glands, but is addressing a lack. If you’ve been restricting salt because of Pred, it is at this point you stop retaining it as much due to Pred so your need to add more goes up. I didn’t need much of an increase at all, just the reintroduction of foods that have salt already like sauces and condiments. I also had the odd packet of crisps/chips, though I still had to watch my carbs like a hawk.

The adrenal glands will come back on line when they decide to, there is no quick fix. I felt pretty rough at this point. I don’t think mine were reliable until 3mg and my Synacthen test wasn’t very exciting until 1-0.5mg. Don’t forget it isn’t just the adrenal glands that have been switched off but the pituitary gland‘s role as well so even if the adrenal gland can work (as tested by the Synacthen test) if it doesn’t get the memo from the pituitary it’ll be sitting there filing it’s nails and reading magazines.

[Baileyw06 in reply to SnazzyD]

Thanks For the information on the adrenals.

[PMRpro Ambassador]

Yes - in asking for more detail I forgot to ask if you are "pred dieting" - if you dropped salt, add some back in!

[Baileyw06 in reply to PMRpro]

I was watching how much salt that I used because of a high blood pressure problem.

I haven’t been eating out because of the pandemic so maybe I didn’t use enough

[PMRpro Ambassador in reply to Baileyw06]

There is some research that suggests salt ISN'T as implicated in hypertension as they claimed. And googling this

journals.lww.com/co-cardiol...

has the tantalising statement "Salt restriction in hypertensive patients increases plasma lipoproteins and inflammation." in the search result. Needless to say, it appears in the part of the paper we CAN'T see!!!!

Is this going to be the next dietary myth after fat?

[Constance13 in reply to PMRpro]

And you have to be very careful not to have too little salt in your diet. I had to take salt tablets when I was last in hospital.

[Baileyw06 in reply to PMRpro]

I don’t need any more inflammation! I will do as my mother said ,moderation won’t hurt anyone.

[Baileyw06 in reply to PMRpro]

Thanks, that is what I am doing now.

[nuigini]

I had borderline low salt levels years before PMR and prednisone. Was taken off the small dose of Hydrochlorothiazide and put on another type of BP meds and told to eat salt. That was more than 10 years ago and my salt levels still hover at normal. BP meds have changed at various times due to the effects of prednisone.

[Baileyw06 in reply to nuigini]

Thanks, I never had that problem before but when I had a bout of high blood pressure I watched my salt.Now I am adding more to my diet.