**UPDATE** Bloods: consistent low sodium levels... - Thyroid UK

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**UPDATE** Bloods: consistent low sodium levels (Bit freaked out!)

SydneySider123 profile image
47 Replies

**Update:

I just spoke with my Dr - my urine sample came back normal - no Addison's or anything else! Wow, what a massive relief. Thanks to all who have contributed and offered support. I am on day three of cutting back water and adding salt back into my diet.

All the best

Narelle **

Morning all

Does anyone else have consistently low sodium levels in their blood results? I've had this for years and I don't usually pay it any mind. In my most recent blood tests, my potassium was raised slightly and my B12 was high.

I'm asking because I saw a new doctor this time and he has sent off a urine sample to test for Addison's disease. I have to wait a week for the results (I'm 4 days into the waiting game) and I'm freaking out a bit.

Anyhow, I should say that I drink around 4 - 4.5 litres of water a day and several cups of tea - which I now know could be causing my electrolytes to be off kilter. Thing is, I'm always thirsty - but I have been like that my entire life - it's just the way I'm wired together. Luckily I don't like alcohol :-) ...OMG could you imagine???

I digress, I should also say that I have IBS-C with lose stools (...it's never simple is it??) and have had Hashi's since 2008. I'm on T4 and T3 and my thyroid symptoms are pretty much under control. However my IBS is kicking by butt and has been doing so for more than 2 years. One thing that has been helping lately with my digestion (i think) is drinking an electrolyte drink each day - on top of the multitude of other digestion supplements I take.

MY QUESTIONS...

* can anyone reassure me about the low sodium levels - do you have this too and it's simply a thyroid thing?

* can anyone relate to the digestive issues and what helps you to manage that (been on the low fodmap diet 2+ years - it helps a bit but is no magic bullet :)

* Does anyone have Addisons? (@Greygoose?). How did you know? How bad are the meds?

Any other advice or info would be wonderful.

[Sorry for the long post!!]

xo

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SydneySider123 profile image
SydneySider123
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47 Replies
SlowDragon profile image
SlowDragonAdministrator

As you have Hashimoto's are you on strictly gluten free diet?

This often helps many with Hashimoto's

According to Izabella Wentz the Thyroid Pharmacist approx 5% with Hashimoto's are coeliac, but over 80% find gluten free diet helps, sometimes significantly. Either due to direct gluten intolerance (no test available) or due to leaky gut and gluten causing molecular mimicry (see Amy Myers link)

Changing to a strictly gluten free diet may help reduce symptoms, help gut heal and slowly lower TPO antibodies

While still eating high gluten diet ask GP for coeliac blood test first or buy test online for under £20, just to rule it out first

Assuming test is negative you can immediately go on strictly gluten free diet

(If test is positive you will need to remain on high gluten diet until endoscopy, maximum 6 weeks wait officially)

Trying gluten free diet for 3-6 months. If no noticeable improvement then reintroduce gluten and see if symptoms get worse

chriskresser.com/the-gluten...

amymyersmd.com/2018/04/3-re...

thyroidpharmacist.com/artic...

drknews.com/changing-your-d...

restartmed.com/hashimotos-g...

What are your vitamin D, folate B12 and ferritin levels?

What vitamin supplements do you currently take?

SydneySider123 profile image
SydneySider123 in reply to SlowDragon

Hi SlowDragon

Thanks for you reply.

I am on a strick gluten free diet and have been for many years.

My vitamin D, folate and ferritin levels were all good. It's just low sodium and slightly elevated potassium and B12.

I take digestive enzymes, a strong probiotic, magnesium, betaine/HCL to replace stomach acid and a multivitamin powder.

greygoose profile image
greygoose

I don't have Addison's, I just had adrenal fatigue. :)

SydneySider123 profile image
SydneySider123 in reply to greygoose

Oh ok, how did you know that?

greygoose profile image
greygoose in reply to SydneySider123

An 8 am cortisol blood test, all that's available here in France. But, it was so low (can't remember the exact number, it was 14 years ago) that my doctor put me on HydroCortisone.

SydneySider123 profile image
SydneySider123 in reply to greygoose

Right.

Did you have low sodium blood levels to?

How did you go with the meds? Any side effects?

Are you still on them?

greygoose profile image
greygoose in reply to SydneySider123

No, I've never had low sodium levels - I like my salt too much!

The only side-effect I had with HC was water-retention. It's notorious for that.

I only took it for a couple of years, and then slowly weaned off it. :)

SydneySider123 profile image
SydneySider123 in reply to greygoose

Thanks, that's the side effect I'm most concerned about.

greygoose profile image
greygoose in reply to SydneySider123

I've never heard of low sodium being a side-effect of HC. Low potassium, possibly, but not low sodium.

SydneySider123 profile image
SydneySider123 in reply to greygoose

Oh, I meant that the fluid retention was the side effect I'm most concerned about. ...IF ever need to take HC. Praying I don't have Addison's and the low sodium I have is due to too much water intake daily.

greygoose profile image
greygoose in reply to SydneySider123

Or not enough sodium intake?

SydneySider123 profile image
SydneySider123 in reply to greygoose

Both actually, I don't eat salt and I drink 4litres of water (plus team and coffee) each day. Recipe for electrolyte imbalance it would seem...

humanbean profile image
humanbean in reply to SydneySider123

Why don't you eat salt?

greygoose profile image
greygoose in reply to SydneySider123

You don't 'eat' salt? You mean you don't use it in cooking? Or put it on your chips? No wonder you have adrenal problems!

SydneySider123 profile image
SydneySider123 in reply to greygoose

I cook the vast majority of my food due to IBS issues and I don't add salt to my cooking or my food. I didn't realise it could cause problems.

greygoose profile image
greygoose in reply to SydneySider123

It can indeed. Salt is essential for all sorts of reasons. Certainly the adrenal glands need salt.

manoa.hawaii.edu/exploringo...

chriskresser.com/shaking-up...

drstevenlin.com/salt-good-f...

SydneySider123 profile image
SydneySider123 in reply to greygoose

Thank you greygoose, I will read up on those links...I genuinely had no idea not did I realise that the amount of water I'm drinking could do more harm than good. *Sigh*

Are you better now in terms of the adrenal fatigue?

greygoose profile image
greygoose in reply to SydneySider123

And the reason for you needing to drink so much could be due to your low salt intake.

I don't have adrenal fatigue anymore, thank you. :)

Lora7again profile image
Lora7again in reply to greygoose

I always salt my vegetables before cooking them in water but my daughter won't put salt in anything because she has two year old son. I think we need some salt but not a lot. My husband and son cover their food in salt before they have even tasted it and I tell them that they do not need to add anymore salt but they just ignore me and continue to do it.

SydneySider123 profile image
SydneySider123 in reply to greygoose

yep could be...all linked i'm sure. will be interesting to see if my digestion improves with a better balance of salt to fluid. Glad you're over the adrenal fatigue.

SydneySider123 profile image
SydneySider123 in reply to greygoose

could be! glad you're over the adrenal fatigue.

humanbean profile image
humanbean in reply to SydneySider123

Your chloride levels must be very low too, since you don't use salt. Chloride levels aren't measured very often, so you wouldn't know.

I would guess that a good proportion of the sodium and the chloride in the body comes from the breakdown of salt. (The chemical name for salt is sodium chloride).

According to the wikipedia page on Electrolytes :

en.wikipedia.org/wiki/Elect...

In physiology, the primary ions of electrolytes are sodium (Na+), potassium (K+), calcium (Ca2+), magnesium (Mg2+), chloride (Cl−), hydrogen phosphate (HPO42−), and hydrogen carbonate (HCO3−). The electric charge symbols of plus (+) and minus (−) indicate that the substance is ionic in nature and has an imbalanced distribution of electrons, the result of chemical dissociation. Sodium is the main electrolyte found in extracellular fluid and potassium is the main intracellular electrolyte;[8] both are involved in fluid balance and blood pressure control.

You might be interested in the symptoms of low sodium (hyponatremia)

healthline.com/health/hypon...

and low chloride (hypochloremia) :

healthline.com/health/hypoc...

Based on the symptoms of hypochloremia given in that link it is likely to be the cause of you feeling thirsty all the time.

SydneySider123 profile image
SydneySider123

Thanks Scrumbler, I think you're right! Am trying to dial the water intake down.

giselajames profile image
giselajames

Dear Sydney,

I can’t explain why you have low sodium levels, as I am not medically qualified, but like you, I had persistent loose stools and low sodium. By chance I came across Monolaurin, a supplement which it said might help with diarrhoea. I ordered it from the States and now I have no more problems in this area and my sodium levels are back to normal. You might want to give that a try..

SydneySider123 profile image
SydneySider123 in reply to giselajames

I'll certainly look into that. Thanks very much giselajames

mourneadventurer profile image
mourneadventurer

Dr Carolyn Deans book Magnesium Miracle might be worth a read. Her liquid mineral products ReMag and ReMyte. ( Botanicahealth ) ensure that 100% is taken up at cellular level and don’t cause loose stools.

I think it is very sensible to be checked for Addisons. Loose stools, dizziness, nausea and fatigue are other symptoms, plus anything from patches of darker skin to a perma tan. Addisons is an autoimmune disease, but you might still have low cortisol or a pituitary problem. The meds are usually hydrocortisone.

Sally56 profile image
Sally56

Dear Sydneysider123,

I have no thyroid but also an adrenal disorder called Primary Aldosteronism Hyperplasia (bi-lateral). It is a condition which causes an imbalance between sodium and potassium, but usually low potassium and high sodium. Also very high difficult to manage BP. So I am not allowed to have salt at all. I am medicated with a potassium sparing diuretic. However, your post caught my eye because I have had an occasional complication of low sodium (potassium and sodium need to balance each other) through drinking too much water. It can get serious and I have been hospitalised twice with it, to get the balance back. Please speak to your Doctor about it.

Hantal profile image
Hantal

HiLow sodium, high potassium can be caused by Addison’s Disease, but your other medication or diet can have an effect on it. Many people with Addison’s have often problems with the thyroid as well. An ACTH test may be useful . I think you must insist to exclude or confirm Addison’s. I assume that you have an endocrinologist for the thyroid problems. He can be the best person to ask.

I have been always starving for pickles etc, and my sodium and potassium were just borderline almost in range. Following an accident I became very ill and weak and I had all the symptoms ( now I know!) for 16 months but my GP failed to diagnose me. I ended repeatedly at A&E, when finally I got the help and diagnosis. I almost died, but now I’m well. Yes, steroids have side effects and need monitoring. Both too little and too much have side effect. There is a small chance that your adrenal glands are not producing enough of the hormones essential for life. In this case you will be given the smallest necessary dosage that is significantly smaller dose than used for many conditions. If you, I wouldn’t worry about side effects right now. Often takes many years to be diagnosed, and happens gradually. Most of the people do not have symptoms until 90% of the adrenal function is gone. There is a big chance that you don’t have Addison’s.Sorry for the long essay. My advice is have it checked properly, even for antibodies if possible and do not worry. Even if you have it, there is not the end of word. I have got my life back, and al that matters for me and my family

Good luck.

SydneySider123 profile image
SydneySider123 in reply to Hantal

Thanks so much Hantal, I appreciate you sharing your experience and positive outlook.

Teresamarie profile image
Teresamarie

Hi! I have Secondary adrenal insufficiency and had the exact problems you have. Could not drink enough, eat potato chips with salt to counteract the fluid, and felt extremely fatigued. I’m on hydrocortisone and that helped almost immediately. Another issue I have is diabetes insipidus which also caused excessive thirst. Good luck to you on this journey, many here will help you.

Teresamarie

SydneySider123 profile image
SydneySider123 in reply to Teresamarie

Thanks for sharing your experience Teresamarie. Wishing you all the best.

momindenver profile image
momindenver

I'm wondering what your blood pressure runs throughout the day? Do you tend to run very low? also would be curious what your first morning cortisol and ACTH is? I've learned the pituitary needs enough free T3 to make ACTH, and ACTH releases cortisol and aldosterone from the adrenals. Aldosterone is involved with fluid and salt regulation. Best wishes!

SydneySider123 profile image
SydneySider123 in reply to momindenver

Hi momindenver

I had my blood pressure taken again yesterday and it was low but in the normal range and it actually went up by about 14 points when i stood up so that was good. I'm trying to cut back on the water and eat salt. I think those things will help me a lot. It seems like things have gotten out of balance.

Tasker profile image
Tasker

I suffered from adrenal fatigue; a home cortisol saliva test gave low enough morning results that the comments suggested I ask my GP to test for Addisons. I didn’t, as I didn’t think I had enough symptoms to do that. But based on learning from this forum and elsewhere I started taking an adrenal cocktail (google it for details, but basically vitamin C, sea salt, cream of tartar for potassium) and felt instant improvement. After a few weeks I decided to try Adrenavive instead which did me a lot of good (this was at a time when I was still building up to the right right level of thyroid meds). I also started adding sea salt to my food; I cook almost all of my own and never added salt, and I think that was a mistake. I have gradually felt able to reduce the Adrenavive and stopped it completely a few months ago after about a year of use. I now have Saltsticks electrolyte capsules which on occasional days I take one of if I feel a little lightheaded. My latest bloods showed sodium in range although near the top, so I don’t seem to be overdoing it, and it’s definitely helps. Plus giving in to the occasional craving for ready salted crisps!! Good luck.

Thyroid17 profile image
Thyroid17

Hi, I can't add much to these very informed replies but my father had low sodium (no known thyroid issues) and when quite low could affect his balance and cause temporary mild confusion - both resolved when levels corrected. His low sodium was caused my prescription medication from his doctor - therefore reviewed.

SydneySider123 profile image
SydneySider123 in reply to Thyroid17

Thanks Thyroid17 - good to know. My balance is a little off at times too.

vocalEK profile image
vocalEK

I drink a lot of water. I suspect because I have dry mouth. When I was in the hospital for surgery, they took blood, came in and took away my water pitcher, telling me that my sodium levels were too low. As a result, I was unable to eat the next meal because I couldn't generate enough saliva to swallow solid food. Ironically, they then ended up giving me liquid meal replacement. I am thinking that in my case a better solutions would have been to simply increase my salt intake and leave my liquids alone! If I'm ever in hospital again, I plan to send my husband out to buy me some nice salty potato chips (I think you call them "crisps" in the UK.) Oh, and yes I am hypothyroid, which is listed as one of the possible causes of hyponatremia.

SydneySider123 profile image
SydneySider123 in reply to vocalEK

Wow, that's so interesting vocalEK, thank you. I have a dry mouth too and some days, the more water i drink, the thirstier i seem to get. I have been trying to slowly decrease the amount of water I drink this week but so far am still at about 4 litres a day plus tea. I, like you, think it's a good idea to increase my salt intake from virtually none (ish) so I've been adding salt to my lunch and dinner and have eaten crisps too (great minds think alike :)

I don't know if it's my imagination but since doing that for the last, my mind feels clearer and i have more mental and physical energy. God, I hope i'm onto something because i've been dragging myself around for quite some time now :)

How are things with you now around your fluid intake, dry mouth and salt levels? Do you have to get them tested regularly?

vocalEK profile image
vocalEK in reply to SydneySider123

No. It seems the hospital was more concerned about my sodium levels than my regular doctors. Nevertheless, I have had a chem panel ordered rather regularly for whatever reason, and sodium has been in range every time. Averages around 138 (135 - 145 MEQ/L).

I am wondering whether it was the hospital diet that lowered my sodium level. I imagine the kitchen is super careful not to add too much salt to their cooking. Going from the small amount that I use in cooking (actually, zero, but we do add salt at the table) and my rare use of packaged foods, down to the hospital level of darn near zero might have been just enough to drop my sodium level below the bottom of the range.

Maybe I'll just take a salt shaker with me if I ever have to go into the hospital again.

SydneySider123 profile image
SydneySider123 in reply to vocalEK

Good idea on the salt shaker :)

SydneySider123 profile image
SydneySider123

**Update:

I just spoke with my Dr - my urine sample came back normal - no Addison's or anything else! Wow, what a massive relief. Thanks to all who have contributed and offered support. I am on day three of cutting back water and adding salt back into my diet.

All the best

Narelle **

Pomegranate33 profile image
Pomegranate33

I was diagnosed with Addison’s disease in 2013.

I’m curious about the urine testing for Addisons that you had? I thought it was only a synacthen test that could confirm a diagnosis?

What is the type of water that you are drinking?

Be careful of water filters that remove mineral content as well as the nasties eg, zero water.

Drinking this without remineralisation will actually draw out minerals from your body & in turn create a huge thirst & a dangerous predicament!

Salt is hugely important to our health. Just make sure it’s of a high quality. NOT table salt!

Himalayan pink salt, Cornish salt, Maldon etc.

I use it with EVERY meal & I still wind up low sodium on some blood tests..

SydneySider123 profile image
SydneySider123

Wow, thanks for your reply Pomegranate33.

I didn't know that about the water filters - i have a Britta water filter at home and i drink filtered water at work! So you think no filter? Just straight tap water? Or a mix of both?

I don't know the name of the tests my Dr did, I'm sorry but he was really thorough in his testing. Also did a follow up test on my sodium levels about 2 weeks later and they had come up a bit - but not fully.

He scared me so i've been taking electrolyte supplements and putting some pink Himalayan salt on my food...but not heaps. I've also cut back on the excessive water drinking.

How are you doing with the Addison's?

humanbean profile image
humanbean in reply to SydneySider123

I'm curious about whether you feel better with the electrolyte supplements and using more salt?

Do you still feel the urge to drink lots and lots of water or has that urge reduced?

SydneySider123 profile image
SydneySider123 in reply to humanbean

I definitely feel better with electrolytes and the salt. That endless thirst (ie: the more i drank, the thirstier I felt...) has all but gone.

Do you have low sodium too?

humanbean profile image
humanbean in reply to SydneySider123

Do you have low sodium too?

No, I make sure I have some salt every day. I feel unwell without at least some. My sodium and potassium are usually at a good level.

I'm glad your thirst has almost returned to normal levels.

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