Low Sodium when taking Prednisolone

[JanetT58]

Has anyone else found that they have low sodium which could be due to taking Prednisolone? I have had it since January and didn’t have a blood test for 4 months due to lockdown but had another test last week and despite adding salt to jt food which I was advised to do my sodium level had gone down. Some Doctors day it could be the Prednisolone but another said it was unlikely to be as I’m only on 5mg (after two years) am starting this week to do the gradual taper to 4mg to see if it makes a difference. I’m having another blood text this afternoon and a urine test however they already did this earlier in the year

[SnazzyD]

Low sodium (and often raised potassium) can be caused by poor adrenal function which the docs should know. You are on 5mg and if you are one of those who don’t absorb 100% of your dose, you could in effect be lower. Perhaps ask for a Synacthen test to see if your adrenal glands are capable of making up the shortfall in cortisol you will now be getting. If your adrenal glands are struggling any trial or tribulation even travel could be tipping you over into a bit of a crisis. When my adrenals were sluggish at low doses I stopped my no salt Pred diet and started to take it again. My Synacthen test at 4mg said yes they were working but were not very special. People vary in how sensitive they are to Pred and the response of the adrenal function; even people on long term steroid inhalers can be effected. Presumably you were higher than 5mg at some point which would have switched them off and holding at 5mg could have been enough just to stop the memo getting through to get working.

It is worth having a read about adrenal insufficiency, in your case secondary insufficiency, and signs of crisis

mayoclinic.org/diseases-con...

[fmkkm in reply to SnazzyD]

Thanks for the info Snazzy! I knew it was all related and complicated. I suspect my adrenals were struggling for several years before GCA hit. I’ll blame mine on stress.

[JanetT58 in reply to SnazzyD]

Thanks I’ll take a look

[fmkkm]

I think low sodium can be a result of adrenal fatigue and cortisol levels. Maybe your adrenals are having trouble kicking in? I have had low sodium for several years even prior to the prednisone. Hopefully someone who knows the science behind it all will come along.😎

[JanetT58 in reply to fmkkm]

Thanks I think they did a cortisol test everything else seems fine it’s just the sodium

[PMRpro Ambassador]

How low is it?

[JanetT58 in reply to PMRpro]

It’s 127 at the moment

[PMRpro Ambassador in reply to JanetT58]

Hmmm - that is low! OH manages that sort of level too!!

[JanetT58 in reply to PMRpro]

Sorry what’s OH?

[PMRpro Ambassador in reply to JanetT58]

Other Half, common expression in the the UK for partner

[JanetT58 in reply to PMRpro]

Ok thanks I am in the UK but didn’t click! Have they said what’s causing his?

[PMRpro Ambassador in reply to JanetT58]

He probably doesn't have particularly good renal function - bit of a physical wreck really

[JanetT58 in reply to PMRpro]

Oh poor thing you

[Constance13]

I can't really help - I only know I used low-salt for years and when I was in hospital a couple of years ago they gave me salt tablets (!!!) because my sodium levels were so low. I've used normal salt since then.

[JanetT58 in reply to Constance13]

Yes I know they tell you to have a low salt diet and now I’m being to add salt to my food

[HeronNS in reply to JanetT58]

I don't think my sodium level was low because of pred, although changes in lifestyle when starting pred contributed:

I found out my sodium level was low, at least I think it must have been, wasn't tested at that time, by accident when I mentioned to someone I was waking up with headaches every morning - which would often go away when I ate something. She suggested I take a little table salt and if it tasted nice, almost sweet, it meant I needed more. Well, I consumed some salt, fingertip by fingertip for some time during that meal. And the next morning, no headache! Other symptoms went away, if I can remember them all: a "skippy" heartbeat, my blood pressure, which had been getting a bit high, went back to low normal again, legs which ached and felt cold at night stopped waking me up, even my skin now seems a bit more plumped up, so if you give it a gentle pinch the skin returns to normal right away, rather than staying a bit raised like when you're dehydrated. The heartbeat thing, the aching legs, the slack skin predated pred. I think the gradually rising blood pressure and the morning headaches were the last symptoms to develop, but even before pred I'd had the occasional morning headache, which was very unusual then.

I used a calculator available on line to find out how much sodium I was consuming daily and found, even trying to kind of over-estimate, that I was usually getting less than half the rather low recommended amount. This would have become really bad when I gave up so many prepared foods and things which contain sodium, like pasta sauces and bread, once I started pred. And we had taken the salt shaker off the table decades ago and I almost always reduced salt in recipes.

After months of heavily salting my morning eggs and my supper salad, sometimes eating a little salt all by itself with a glass of water at bedtime, eventually my doctor tested electrolyes, including sodium, and my level is normal, whatever that is.

[Sefu in reply to JanetT58]

They didn't tell me anything even when I asked about diet needs ! In Greece cousin tells me everyone gets told no salt and no sugar while on Pred. At least they get given a guideline.

[JanetT58 in reply to Sefu]

That’s why it seems strange that my sodium is low when I’m adding salt to every meal

[Kalacik]

I have to have regular saline drips as sodium levels drop. However I live in the med and my body can’t cope with the heat

[JanetT58 in reply to Kalacik]

I’m hoping to get a referral when I get my results if yesterday’s blood and urine tests. Lucky you living in the med!