Woman with low blood sodium level should have an evaluation before any treatment is started.
Dear Dr. Roach: My mother’s blood test has a sodium level of 130 mEq/L. She is not on diuretics, and she does not have heart or kidney problems. She is on thyroid medication and omeprazole. Do I need to be concerned? Due to the heat, I was encouraging her to drink more water. Should I have her add more salt to her diet and drink less water? I am concerned about the syndrome of inappropriate antidiuretic hormone secretion . Any advice is appreciated.
A person with fluid overload, usually from heart failure, can often have low sodium, while volume depletion form poor water intake or shock can sometimes cause a low sodium level. But a person who has the appropriate amount of volume should have their urine tested. A high urine sodium level will confirm the diagnosis of SIADH, meaning that the kidney is holding on to more water than it should.
With mild SIADH and a sodium level of 130 mEq/L, treatment may not be necessary beyond moderate fluid restriction and increased sodium intake with salt tablets or salty foods. Tirzepatide’s brand name is Mounjaro when used for diabetes and Zepbound when used for weight loss. Oral tirzepatide is not approved.
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