For individuals experiencing a low sodium level, medically known as hyponatremia, the symptoms can be frightening and confusing. It often manifests as profound fatigue, headache, nausea, and mental cloudiness. In severe cases, it can affect balance or lead to seizures, disrupting not just daily routines but posing immediate health risks. While the body relies on a delicate balance of water and electrolytes to function, this balance can be disrupted by various factors ranging from medications to underlying heart or kidney conditions.

Treatment is critical to safely restore the sodium balance in the blood and prevent complications such as brain swelling. The approach is rarely “one size fits all.” Because hyponatremia can occur because the body lacks salt or because it holds onto too much water, the treatment strategy depends entirely on the root cause and the speed at which the condition developed (Mayo Clinic, 2023).

Overview of treatment options for Low Sodium Level

The primary goal of treatment is to raise the sodium concentration in the blood to a safe range. However, this must be done carefully; correcting the level too quickly can be dangerous. Treatment strategies are generally categorized based on the patient’s fluid status: those who are dehydrated need fluids, while those retaining water (such as in heart failure or Syndrome of Inappropriate Antidiuretic Hormone Secretion, SIADH) often need to eliminate excess fluid.

While mild cases may be managed simply by restricting fluid intake, limiting how much water a patient drinks daily, moderate to severe cases typically require pharmacological intervention. Medications are used to either directly replenish sodium or to help the kidneys excrete excess water while retaining salt.

Medications used for Low Sodium Level

Intravenous (IV) sodium solutions are the standard treatment for severe or acute hyponatremia. In emergency settings, doctors use hypertonic saline, a concentrated solution that rapidly elevates sodium levels to prevent seizures or coma. For less severe cases associated with dehydration, isotonic saline (normal saline) is typically used to restore fluid and electrolyte balance simultaneously.

For patients with chronic hyponatremia caused by fluid retention (euvolemic or hypervolemic), a class of drugs called vasopressin receptor antagonists, or “vaptans,” is often prescribed. Drugs such as tolvaptan and conivaptan are used specifically to raise sodium levels without the need for severe fluid restriction. Clinical studies suggest these medications are effective for conditions like SIADH or heart failure where the body holds too much water.

In other cases, loop diuretics like furosemide may be prescribed. While diuretics typically remove fluid, they can be used alongside increased salt intake to help the kidneys flush out free water. For long-term management of chronic mild hyponatremia, doctors may prescribe oral sodium chloride (salt tablets) or urea supplements to maintain stable levels (National Institute of Diabetes and Digestive and Kidney Diseases, 2022).

How these medications work

IV saline introduces sodium directly, increasing plasma electrolytes. This pulls fluid from swollen cells back into the bloodstream, easing pressure on the brain.

“Vaptans” block antidiuretic hormone (ADH) in the kidneys. By stopping ADH’s signal to retain water, vaptans act as “aquaretics,” causing the excretion of large amounts of water while conserving sodium, thus concentrating and raising blood sodium levels.

Diuretics prompt the kidneys to release more salt and water into the urine. For hyponatremia, they are carefully managed to ensure more water than salt is lost, often necessitating a simultaneous high-salt diet.

Side effects and safety considerations

Rapid correction of hyponatremia is the most critical safety concern, as it risks Osmotic Demyelination Syndrome (ODS), an irreversible brain stem injury. Frequent blood tests are mandatory during treatment.

Vaptan side effects include thirst, dry mouth, and frequent urination. Tolvaptan is limited to short-term use with liver monitoring due to liver injury risk. IV saline can cause fluid overload (e.g., leg swelling, fluid in lungs). Patients should seek immediate medical care for new symptoms like trouble speaking, muscle weakness, or confusion (Food and Drug Administration, 2021).

Since everyone’s experience with the condition and its treatments can vary, working closely with a qualified healthcare provider helps ensure safe and effective care.

References

1. Food and Drug Administration. https://www.fda.gov
2. Mayo Clinic. https://www.mayoclinic.org
3. National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov
4. MedlinePlus. https://medlineplus.gov