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Serum Sodium Level


songcanary

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On my initial visit with the rheumy who diagnosed me with dysautonomia, I asked him about this. I said that based on the normal serum reading, doesn't that mean I don't have a salt related problem? He said not necessarily. I did not question him further because the appt was already long at that point and he is otherwise a great guy who has literally saved my life.

But I am still clueless as to the reason and wonder if any of you have the answer? I can usually figure out things like that but I gotta say this one has me stumped. I just wish I understood the connection between the serum reading and the illness, if there is any.

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This is actually a very good question and I have wondered that myself. When I get my labs back it never appears I am low on sodium so why do I need to eat a ton of salt I wonder? Maybe it's the way our bodies use the sodium to raise our B/P than anything else. Hopefully one of the long timers can answer this one for you!

KC

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Water follows salt. If your serum sodium level is high, you are water/plasma deficient (as long as your kidneys and pituitary are working normally.) Serum sodium and potassium are usually very tightly regulated and only severe dehydration will elevate sodium. The big "problem" with this theory is that our kidneys DON'T work normally = the renin-aldosterone paradox. In most people, they restrict salt because the increase in sodium expands the blood volume and causes hypertension. That affect is blunted in POTS.

See? Clear as mud. ;)

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Yes, definitely clear as mud!

I know people who have high cortisol with Cushing's disease usually have a high sodium/low potassium issue. They usually have high b/p as a result. People with low cortisol, on the other hand, have low sodium/high potassium, and are dehydrated with a resultant low blood volume and low b/p. So, it is definitely not clear in us. Why can't the researchers just delve into the research of "defective fluid control" or something like that in us? Why don't they REALLY look at the renin-aldosterone system in SUPER depth to maybe find out what's going on with our lack of fluid control?

I know, they think that the sypathetic overdrive might be the cause of our hypovolemia, but I think it is the opposite.

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TBMR,

I think she is referring to 'Some Out of the Box Thinking - Need some Feedback', Aug 28 2010, and also 'More on Aldosterone and Renin', Sept 1 2010. I did a forum search and found them. I remember reading them at the time but it was a little over my head. Now I'm ready to dig in LOL.

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I am new to all of this, but I am trying to apply some of my cardiac nursing knowledge into my understanding. My EP told me to increase my salt intake to help regulate my BP. I may be completely wrong in regards to POTS, but this is the way I understand sodium regulation.

In the body, "where sodium goes, water follows". If you consume more salt, you increase your serum sodium (salt level in the blood); therefore, you increase the amount of water your body is holding onto in the vascular spaces (vessels). This adversely increases your blood pressure by the concept of "more volume, more pressure." Florinef helps your body hold onto more sodium/water at the kidney level (reuptake) before excretion. The simple way my EP descibed it is, the Florinef makes a last ditch effort to grab onto any sodium that your kidneys are naturally trying to excrete.

My serum sodium level is normal, but the concept is to get it elevated to help increase the BP. The tricky part is, my BP is normal, but then just bottoms out.

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That's true. But, if you increase your salt levels you lower your aldesterone levels even more. Aldesterone is the naturally occuring component in your body that regulates the fluid level. I'll see if I can post my paper on the forum site and put it into a new topic. I'll see if it will work. I have lots more info in it. But, they didn't want to publish it in the paper because of how controversial it is in relationship to what the doctors do "at present". I really question everything about how we're being treated. They didn't want to alinate the supporting doctors they have for the site. But, since this is a disscussion and it's not them promoting the idea - maybe they will let me get it on here. I'll try. If not, maybe if you're interested PM be your e-mail and I'll send it to you that way.

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