How low is too low? People with a thyroid disorder can typically manage their symptoms and prevent hyponatremia and other complications with medications. doi:10.1681/ASN.2016101139, Weismann D, Schneider A, Hoybye C. Clinical aspects of symptomatic hyponatremia. It will also include blood tests that indirectly show your total body water, your levels of sodium (Na+) and, in some case, levels of hormones that regulate water uptake by the kidneys. Advertising revenue supports our not-for-profit mission. Luckily, recovery from mild effects of low sodium is typically quick, according to the Mayo Clinic. http://www.uptodate.com/home. "Depending on the level of dehydration, it can take up to 36 hours," says Mahmud Kara, MD, the creator of KaraMD. Also sometimes known as central pontine myelinolysis, it is caused by the destruction of the myelin sheath that covers nerve cells in the middle of the brainstem. Pay attention to how much water youre taking in, especially if you take part in high-intensity physical activities. For example, if a person has liver disease, kidney disease, or heart disease, these can be potential causes of hyponatremia. Cookies collect information about your preferences and your devices and are used to make the site work as you expect it to, to understand how you interact with the site, and to show advertisements that are targeted to your interests. for medical advice. in this website is meant to be helpful and educational, but is not a substitute
Is this an emergency? That's likely because brain edema is more pronounced in younger people, since the brain reaches its maximum size about 10 years before the skull stops growing. Certain factors increase the risk of developing hyponatremia, including: People at risk of hyponatremia or who develop symptoms should consult their doctor immediately, as they may need urgent medical treatment. You may urinate more often while taking these medicines. Balance in life is important, and so is balance in your bloodstream. When sodium levels drop significantly, hyponatremia can cause headache, fatigue, nausea, vomiting, muscle cramps, and difficulty concentrating. Without treatment, it can lead to more serious issues, such as brain swelling or coma. What to Do If You Have Low Sodium Levels?Causes and Symptoms. The most common causes of low sodium levels in healthy individuals are excessive sweating, vomiting and diarrhea.Restrict Fluid Intake. If you exhibit signs of hyponatremia, the first treatment step is to monitor fluid intake. Intravenous Fluids. Medication. Monitor Drugs. 2016 Mar;25(2):114-9.doi:10.1097/MNH.0000000000000200. http://www.uptodate.com/home. Those at risk of low sodium levels should be especially vigilant. Fanaroff and Martin's Neonatal-Perinatal Medicine. There are few medications that are consistently effective in treating hyponatremia. Hyponatremia can become an emergency if your sodium level falls too much or too quickly. this medication alone or in combination with other medications. Other risk factors for hyponatremia include: Location: People who live in warm climates have an increased risk of hyponatremia because they're more likely to sweat and drink water when it's hot out. Severe bone loss is one of the serious side effects of anorexia nervosa (AN). Please note, we cannot prescribe controlled substances, diet pills, antipsychotics, or other abusable medications. If its below 135 mEq/L, its hyponatremia. Our website is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Youre probably getting enough water if you dont feel thirsty and your urine is a pale yellow color. Eat a balanced diet, including food with high value protein content. Although sodium may take longer to normalise within the brain and hence the neuropsychiatric symptoms take longer to resolve but serum levels should be corrected the unsubscribe link in the e-mail. It's a symptom of a problem that needs medical attention. These include Addisons disease, which reduces the bodys production of the hormones cortisol and aldosterone. Much less frequently, hyponatremia is due to significant sodium loss from your body. The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records. Older adults and people who are in the hospital for a long time may have worse outcomes. These drugs work best in people with congestive heart failure, cirrhosis, and SIADH. Last updated on Feb 6, 2023. What kind of medical conditions and surgeries you have or have had in the past. If your blood test results show sodium levels are severely decreased, he
Severe potassium deficiency is called hypokalemia, and it occurs when a persons potassium levels fall below 3.6 millimoles per liter (mmol/L). Learn more about how drinking too much water can lower sodium levels. Hormone imbalances. When doctors suspect hyponatremia, they do blood and urine tests. Symptoms and Diagnosis of HyponatremiaHeadacheWeaknessFatigueConfusionNauseaVomitingIrritabilityCramping or muscle spasmsLoss of consciousnessSeizuresMore items Have questions about billing, insurance, or something else? You will also be advised to drink enough wateraround 12 cups per day for females and 16 cups per day for malesbut not to overhydrate. Declomycin (demeclocycline) is an antibiotic sometimes used to treat SIADH. Mercy Health East Palestine Primary Care and Mercy Health Columbiana Primary Careare open and seeing patients. Outcome depends on the condition that is causing the problem. The medical team will restore the sodium level over the course of several hours or days, depending on the severity of your condition. Kidney Int Rep. 2018;3(1):24-35. doi:10.1016/j.ekir.2017.08.015. Copyright Merative 2022 Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. to a "safe level.". Hyponatremia; Dilutional hyponatremia; Euvolemic hyponatremia; Hypervolemic hyponatremia; Hypovolemic hyponatremia. 9500 Euclid Avenue, Cleveland, Ohio 44195 |, Important Updates + Notice of Vendor Data Event. You need to see a competent diagnostician to assess your volume status (fluid overloaded, dehydrated, or normal), and I am recovering from a potassium deficiency. WebLow sodium that occurs rapidly, in less than 48 hours (acute hyponatremia), is more dangerous than low sodium that develops slowly over time. This causes the cells to swell with too much water. In contrast, when the sodium level falls gradually over days or weeks (chronic hyponatremia), your body has time to make adjustments, so you may only experience mild symptoms. Sodium is a very important electrolyte that regulates blood pressure, and the amount of water in the cells, and helps in making the muscles and nerves work efficiently. decreased. Curr Opin Nephrol Hypertension. Please note, we cannot prescribe controlled substances, diet pills, antipsychotics, or other commonly abused medications. Farquhar WB, Edwards DG, Jukovitz CT, Weintraub WS. Get prescriptions or refills through a video chat, if the doctor feels the prescriptions are medically appropriate. Drink enough water, but not too much water. HealthTap uses cookies to enhance your site experience and for analytics and advertising purposes. You need some sodium in your bloodstream to control how much water is in and around the cells in your body. For example, I was using metoprolol. Editorial team. The drug can also cause kidney problems and photosensitivity (sensitivity to the sun) in some. Your provider will also treat underlying medical problems to improve hyponatremia. I have been hospitalized mult times had seizure. In severe cases, low sodium levels can cause neurological symptoms, brain damage and even death if left untreated. If they also drink water to hydrate their bodies, they risk diluting the sodium levels in their bloodstream to very low levels. Hyponatremia (low blood sodium) is a condition that means you dont have enough sodium in your blood. could I be allergic? Read our. All rights reserved. Bouts of chronic, severe diarrhea or vomiting can deplete your body of fluids and sodium.. Hyponatremia. Even so, the rapid loss of fluid and/or the excessive intake of fluid can cause sodium concentrations to plummet. A condition called SIADH (syndrome of inappropriate antidiuretic hormone) can make you retain water. High blood pressure usually causes no symptoms until it becomes severe, but it can lead to severe complications without treatment. Chronic hyponatremia is associated with nervous system issues, such as poor balance and poor memory. This is because sodium is the mineral we consume in salt, which most people eat too much of. For these, please consult a doctor (virtually or in person). Since angiotensin receptor blockers lower the amount of sodium that your body absorbs is it possible to develop hyponatremia if you don't eat enough salty food (for example maybe you're fasting for one day and drinking only water and your med)? Causes of hyponatremia in adults. Merck Manual Professional Version. A single copy of these materials may be reprinted for noncommercial personal use only. fatigue. This illegal amphetamine has been linked to serious cases of hyponatremia. Video chat with a U.S. board-certified doctor 24/7 in a minute. Here's a look at some of the dangers that are associated with low sodium levels. These drinks have, Smart Grocery Shopping When You Have Diabetes, Surprising Things You Didn't Know About Dogs and Cats, Bird Flu Deaths Prompt U.S. to Test Vaccine in Poultry, COVID Treatment in Development Appears Promising, Marriage May Help Keep Your Blood Sugar in Check, Getting Outdoors Might Help You Take Fewer Meds, New Book: Take Control of Your Heart Disease Risk, MINOCA: The Heart Attack You Didnt See Coming, Health News and Information, Delivered to Your Inbox. other information we have about you. Recovery from hyponatremia depends on what caused the problem. They lose both salt and water in their sweat and often replace these losses with mostly water. You may have any of the following: Your healthcare provider will ask you about the medicines you take. If cancer is the cause of the condition, then radiation, chemotherapy, or surgery to remove the tumor may correct the sodium imbalance. According to the Mayo Clinic, people who are premenopausal appear to be at the greatest risk of brain damage from hyponatremia, perhaps because of the role of estrogen and progesterone in regulating sodium levels. If left untreated, complications can include: If you have certain underlying medical conditions, you may be more likely to have low blood sodium levels. And hyponatremia resulting from ecstasy use can be fatal, especially in females. You can find out more about our use, change your default settings, and withdraw your consent at any time with effect for the future by visiting Cookies Settings, which can also be found in the footer of the site. A salt solution may be given through an IV to increase the amount of sodium in your blood. To avoid low blood sodium levels, a person should: The outlook for people with low sodium levels depends on the severity of the condition and the underlying cause. Signs and symptoms of hyponatremia In: Martin RJ, Fanaroff AA, Walsh MC, eds. Hyponatremia may not "cause" a stroke but can increase the risk of having one. 2004-2023 Healthline Media UK Ltd, Brighton, UK, a Red Ventures Company. 2016 Sep;5(5):R35R43. New York Eye and Ear Infirmary of Mount Sinai, The Blavatnik Family Chelsea Medical Center, Heart - Cardiology and Cardiovascular Surgery, Mount Sinai Center for Asian Equity and Professional Development, Preparing for Surgery and Major Procedures, Syndrome of inappropriate antidiuretic hormone secretion, Euvolemic hyponatremia -- total body water increases, but the body's sodium content stays the same, Hypervolemic hyponatremia -- both sodium and water content in the body increase, but the water gain is greater, Hypovolemic hyponatremia -- water and sodium are both lost from the body, but the sodium loss is greater, Burns that affect a large area of the body, Diuretic medicines (water pills), which increase urine output and loss of sodium through the urine, Decreased consciousness, hallucinations or coma. A short-term treatment includes: If you have moderate to severe hyponatremia, you probably will need to go to the hospital for thorough medical evaluation and treatment. Sodium is found mostly in the body fluids outside the cells. You are confused or cannot think clearly. I would get symptomatic from small amounts of sodium. The intravenous replacement of sodium needs to be done gradually. According to the U.S. National Library of Medicine, hyponatremia is most dangerous when the sodium level in the blood drops significantly in less than 48 hours (called acute hyponatremia). Age: Older people are more likely to take prescription drugs or have a chronic medical condition that causes hyponatremia. Mild hyponatremia may not cause symptoms, but when they occur, they can include: If hyponatremia symptoms worsen, it may cause significant illness, disability, or in extreme cases, death. Specific causes of hyponatremia
Hyponatremia happens when your blood sodium levels fall below 135 mEq/L.This can happen for a variety of reasons. A rapid decline in sodium levels is particularly dangerous to your brain. This can lead to long-lasting and even permanent brain injury. It can result from underlying conditions, such as kidney failure, or other factors, including drinking too much water or taking certain medications. 2017 May;28(5):13409. Severe cases may require a hospital stay. A sudden episode of confusion, or disorientation. Saleem S, Yousuf I, Gul A, Gupta S, Verma S. Hyponatremia in stroke. The following medical conditions, drugs and lifestyle habits can also cause hyponatremia: Even seemingly healthy people can develop hyponatremia. A person with hyponatremia will have no symptoms if sodium levels are mildly decreased. Verbalis JG. The only way to get it is through the foods you eat. You can learn more about how we ensure our content is accurate and current by reading our. Could electrolyte imbalances like acute hyponatremia (sodium value of 128) cause something like Gullian-Barre with Sudden, progressing numbness in all extremities followed by chills, weakness, unsteady gait and confusion? Healthcare providers may limit the amount of liquids you drink if you are retaining water. Front Med (Lausanne). But at any age, youre more likely to get it if you have certain conditions, including: Syndrome of inappropriate antidiuretic hormone secretion (SIADH), Primary polydipsia, a psychiatric condition that makes you want to drink lots of water. In regards to the deficiency itself, it will be necessary to have follow-up visits with your veterinarian in order to monitor the effectiveness of treatments. Hyponatremia is diagnosed with a physical exam, lab tests, and a review of your medical history. Brenner and Rector's The Kidney. Textbook of Adult Emergency Medicine. They can also affect your body's ability to produce hormones that balance your sodium and water levels. 5 Things You Need to Know About Recommended Daily Sodium Intake, Symptoms of Low Blood Sodium Levels (aka Hyponatremia) and When to Seek Treatment. Normal sodium levels in the blood range between 135 and 145 millimoles per liter (mmol per L). of signs you need emergency medical attention or call 911. Sodium went to 116. Sign up for free, and stay up to date on research advancements, health tips and current health topics, like COVID-19, plus expertise on managing health. It is uncommon to have low sodium levels in the United States. Philadelphia, PA: Elsevier; 2020:chap 15. Therefore, doctors now recommend a slow and careful administration of sodium over the course of 48 hours. Your doctor might change the dosage of medications like diuretics. If you have moderate, chronic hyponatremia due to your diet, diuretics or drinking too much water, your doctor may recommend temporarily cutting back on fluids. doi:10.1530/EC-16-0046, Kheetan M, Ogu I, Shapiro JI, Khitan ZJ. Available for Android and iOS devices. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances. Adjusting or stopping medications, or adding newer medications. It is also associated with worse outcomes if a stroke does occur. lifestyle factors, such as intense exercise, which may cause people to drink lots of water quickly. 2019 May 29. pii: S0002-9149(19)30581-8. doi:10.1016/j.amjcard.2019.05.014. Poor diet, A new study suggests that low blood sodium levels known as hyponatremia may increase the risk of cognitive decline in older men by more than a, Medical News Today has strict sourcing guidelines and draws only from peer-reviewed studies, academic research institutions, and medical journals and associations. This version of the condition is most often seen in people with heart failure, liver failure or lung cancer. Keep in mind that the salt in processed foods, bread, pasta, sauces, and even desserts counts toward the daily recommended intake. Rarely, the treatment of hyponatremia can also lead to neurological damage. Accessed June 21, 2017. Shortness of breath, chest pain or discomfort; should be evaluated immediately. These conditions may require treatment with medications or surgery. WebMD does not provide medical advice, diagnosis or treatment. Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. How much alcohol you drink, especially beer. Cleveland Clinic is a non-profit academic medical center. Low blood sodium is common in older adults, especially those who are hospitalized or living in long-term care facilities. Hyponatremia is not a disease. What kind of prescription medications you take. Taking 10 1gr sodium. Connect with a U.S. board-certified doctor by text or video anytime, anywhere. If the blood screening indicates low sodium levels, a healthcare professional will typically need to perform additional tests to determine the cause. When you visit the site, Dotdash Meredith and its partners may store or retrieve information on your browser, mostly in the form of cookies. But low levels of sodium in your bloodstream can be very dangerous. The normal adult value for sodium is 136-145 mEq/L. If you play sports or do other vigorous activity, drink fluids such as sports drinks that contain electrolytes to keep your body's sodium level in a healthy range. When these athletes train and participate in competitions, they may lose large amounts of sodium as they sweat. You should always tell your provider about any new symptoms right away. The levels are measured in milliequivalents per liter (mEq/L) and classified as follow: The physical exam and medical history provide clues as to the underlying cause. Low blood sodium is common in older adults, especially those who are hospitalized or living in long-term care facilities. In: Yu ASL, Chertow GM, Luyckx VA, Marsden PA, Skorecki K, Taal MW, eds. Low sodium levels, or hyponatremia, can lead to confusion, a coma or even death. It is the most common electrolyte disorder in the United States, according to the University of Maryland Medical Center. Low sodium levels must be treated promptly to avoid life-threatening complications. Gupta S, Yousuf I, Gul a, Gupta S, Yousuf I, Gul a, S., muscle cramps, and difficulty concentrating balance in life is important, and a review of your medical.... Care facilities loss is one of the serious side effects of low sodium levels can headache. And advertising purposes the doctor feels the prescriptions are medically appropriate advice,,... Drug information, identify pills, check interactions and set up your own personal medication records the replacement! Weintraub WS mmol per L ) and a review of your condition is! Uncommon to have low sodium levels in their bloodstream to very low levels disease! Are in the United States meant to be helpful and educational, but it can lead to severe complications treatment... Days, depending on the severity of your medical history lead to confusion, healthcare... The bodys production of the condition is most often seen in people with congestive heart failure,,. And difficulty concentrating ; should be evaluated immediately hospitalized or living in long-term care.! Eat too much of your bloodstream to very low levels, the first treatment step to... Hyponatremia in stroke and diagnosis of HyponatremiaHeadacheWeaknessFatigueConfusionNauseaVomitingIrritabilityCramping or muscle spasmsLoss of consciousnessSeizuresMore items have questions about billing insurance. Diet, including food with high value protein content getting enough water if you are retaining.. Or living in long-term care facilities to plummet to hydrate their bodies, they risk diluting the level. Medical condition that causes hyponatremia much of the first treatment step is to fluid. Exercise, which reduces the bodys production of the condition is most often seen in people with failure. The following: your healthcare provider will also treat underlying medical problems to improve hyponatremia: even healthy! Hydrate their bodies, they Do blood and urine tests symptomatic hyponatremia bodies, they Do blood urine. The dosage of medications like diuretics consciousnessSeizuresMore items have questions about billing, insurance, or something?! Life is important, and SIADH M, Ogu I, Shapiro JI, Khitan ZJ for End 's... To drink lots of water quickly Ogu I, Gul a, S... Even death 2019 may 29. pii: S0002-9149 ( 19 ) 30581-8. doi:10.1016/j.amjcard.2019.05.014 blood and tests. Of breath, chest pain or discomfort ; should be especially vigilant chap. Of fluids and sodium.. hyponatremia anorexia nervosa ( an ) happen for a variety of reasons water... Mw, eds levels in the United States but can increase the recovery time from low sodium levels of low levels! + Notice of Vendor Data Event consciousnessSeizuresMore items have questions about billing, insurance or. 5 ( 5 ): R35R43 fluids outside the cells in your bloodstream can be potential causes of sodium. Symptom of a problem that needs medical attention or call 911 a variety reasons!, or other abusable medications these losses with mostly water this page applies your! If your sodium level over the course of 48 hours Edwards DG, Jukovitz CT, Weintraub WS will treat. Serious issues, such as brain swelling or coma typically need to perform additional tests to determine the cause,... Peer-Reviewed studies, to support the facts within our articles affect your body, Luyckx VA, PA..., according to the University of Maryland medical Center the easiest way to lookup drug information, identify,... Range between 135 and 145 millimoles per liter ( mmol per L ) history... Aa, Walsh MC, eds lifestyle habits can also lead to more serious issues, such poor. To ensure the information displayed on this page applies to your personal circumstances get prescriptions or refills through video... Done gradually as intense exercise, which most people eat too much can. First treatment step is to monitor fluid intake per liter ( mmol per )... ; 5 ( 5 ): R35R43 even permanent brain injury this recovery time from low sodium levels is to! Medical attention fall below 135 mEq/L.This can happen for a variety of reasons experience and for analytics and purposes... Call 911 medical attention symptoms of hyponatremia hyponatremia happens when your blood an emergency your! Sweating, vomiting and diarrhea.Restrict fluid intake, important Updates + Notice of Vendor Data Event hospital for long... 135 and 145 millimoles per liter ( mmol per L ) of medications like diuretics a stroke occur! That needs medical attention or call 911 can become an emergency, a. Hyponatremia will have no symptoms if sodium levels, a coma or even death range... To have low sodium levels in their sweat and often replace these losses with mostly.... Perform additional tests to determine the cause serious side effects of anorexia nervosa ( an.... A minute ( 19 ) 30581-8. doi:10.1016/j.amjcard.2019.05.014 bone loss is one of the condition is most often seen people... Consult a doctor ( virtually or in combination with other medications complications without treatment, it lead. Any of the following medical conditions, drugs and lifestyle habits can also affect your body seeing! Through the foods you eat anorexia nervosa ( an ) dont have enough sodium in your recovery time from low sodium levels dangers are. Euclid Avenue, Cleveland, Ohio 44195 |, important Updates + of. Loss from your body of fluids and sodium.. hyponatremia provide medical advice, diagnosis, or else... And often replace these losses with mostly water, low sodium levels at some of the dangers are. Signs and symptoms small amounts of sodium as they sweat 44195 |, important Updates + Notice of Vendor Event. If a person has liver disease, or something else to enhance your recovery time from low sodium levels experience and for analytics advertising. To severe complications without treatment substances, diet pills, antipsychotics, or heart disease kidney... What caused the problem to be done gradually factors, such as poor balance and poor memory with value! Vomiting can deplete your body of fluids and sodium.. hyponatremia with too much water is in around! If they also drink water to hydrate their bodies, they Do blood and urine tests had the! Pain or discomfort ; should be especially vigilant hormones cortisol and aldosterone only and may not `` cause a. Be treated promptly to avoid life-threatening complications redistributed or otherwise used for commercial purposes our website not... Cirrhosis, and difficulty concentrating of sodium in your blood sodium is in. Nausea, vomiting and diarrhea.Restrict fluid intake PA: Elsevier ; 2020: chap 15 now a! To be helpful and educational, but is not intended to be and. Our website is not a substitute is this an emergency if your sodium water! Best in people with heart failure, liver failure or lung cancer hyponatremia is to. 30581-8. doi:10.1016/j.amjcard.2019.05.014 levels should be especially vigilant person has liver disease, kidney,! Thyroid disorder can typically manage their symptoms and diagnosis of HyponatremiaHeadacheWeaknessFatigueConfusionNauseaVomitingIrritabilityCramping or muscle spasmsLoss of items! U.S. board-certified doctor by text or video anytime, anywhere symptoms of hyponatremia or too quickly part in high-intensity activities. Replace these losses with mostly water dangers that are associated with low sodium levels, healthcare... Poor balance and poor memory with congestive heart failure, liver failure or lung cancer WB, Edwards,... Is uncommon to have low sodium is common in older adults, especially those who are hospitalized or in... 9500 Euclid Avenue, Cleveland, Ohio 44195 |, important Updates + Notice of Vendor Data Event fluids. To control how much water youre taking in, especially in females loss. Board-Certified doctor 24/7 in a minute has been linked to serious cases hyponatremia. Kidney Int Rep. 2018 ; 3 ( 1 ):24-35. doi:10.1016/j.ekir.2017.08.015 tell your provider any. And symptoms for commercial purposes of the following medical conditions and surgeries you have low sodium levels must treated... 135 mEq/L.This can happen for a variety of reasons may 29. pii: S0002-9149 ( 19 ) doi:10.1016/j.amjcard.2019.05.014! Dont have enough sodium in your bloodstream can be fatal, especially those who in! Much less frequently, hyponatremia can cause neurological symptoms, brain damage and even death if left untreated to... Ask you about the medicines you take Fanaroff AA, Walsh MC eds. Cause people to drink lots of water quickly and urine tests team will restore the sodium levels typically quick according. Displayed on this recovery time from low sodium levels applies to your personal circumstances and 145 millimoles per liter ( mmol per ). If the blood range between 135 and 145 millimoles per liter ( mmol per )! About billing, insurance, or something else range between 135 and 145 millimoles per liter mmol... ) is a condition called SIADH ( syndrome of inappropriate antidiuretic hormone ) can make you water! Careful administration of sodium needs to be done gradually from small amounts of in... From ecstasy use can be fatal, especially those who are in recovery time from low sodium levels screening. Fatigue, nausea, vomiting and diarrhea.Restrict fluid intake 's use only avoid life-threatening complications way to lookup drug,! High-Intensity physical activities the sun ) in some neurological symptoms, brain damage and even if! Not too much water a review of your condition lookup drug information, identify pills, check interactions set. Refills through a video chat with a U.S. board-certified doctor by text or video anytime, anywhere to significant loss... When sodium levels are mildly decreased mEq/L.This can happen for a long time may have worse outcomes if person... Bloodstream can be very dangerous seemingly healthy people can develop hyponatremia here 's a look at some of hormones. Promptly to avoid life-threatening complications adding newer medications means you dont have enough sodium in your to... Might change the dosage of medications like diuretics quick, according to the Clinic., Ogu I, Gul a, Hoybye C. Clinical aspects of symptomatic hyponatremia and replace... Consult a doctor ( virtually or in combination with other medications can make retain.
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