The dangers of low blood sodium

According to medical experts, if the sodium in your blood is too low, you have a condition called hyponatremia. It can happen because of certain medical conditions, some medicines you might be taking, or if you drink too much water.

Sodium also helps maintain normal blood pressure, and supports the work of the nerves and muscles.

Dr Charles Sindabimenya, a specialist in internal medicine at Doctors Plaza in Kimironko, says sodium is an electrolyte which helps regulate the amount of water that’s in and around our cells.


When sodium levels in the blood are too low, Sindabimenya says the extra water goes into the body’s cells, causing them to swell.

He explains that this swelling can be dangerous for brain cells which results in neurological symptoms such as headache, confusion, irritability, seizures or even coma.

He says hyponatremia is caused by a range of factors, including drinking too much water which can dilute the sodium in one’s body.

“When this happens, the body’s water levels rise, and the cells begin to swell. This swelling can cause many health problems, ranging from mild to life-threatening,” he says.

Sindabimenya says signs of hyponatremia include nausea and vomiting, headache, confusion, loss of energy, drowsiness and fatigue, muscle weakness, spasms or cramps, among others.

Depending on the extent and duration of these signs and symptoms, he says seeking immediate medical care is important.

Gerald Ruzindana, a health and wellness specialist at Amazon Nutrition Cabinet, a clinic in Remera, says there are many possible conditions and lifestyle factors that can lead to hyponatremia.

He says that some medications—like diuretics (also called water pills), antidepressants and pain medications—can interfere with the normal hormonal and kidney processes that keep sodium concentrations within a healthy normal range.

Also, Ruzindana points out that heart, kidney and liver problems can also lead to low sodium levels in the blood.

“Congestive heart failure and certain diseases affecting the kidneys or liver can cause fluids to accumulate in the body, which dilutes the sodium in the body, lowering the overall level,” he says.

Daniel Gahungu, a general practitioner at Clinic Galien in Gasabo, says chronic headache, severe vomiting or diarrhoea and other causes of dehydration can lead to hyponatremia.

He notes that this causes the body to lose electrolytes, such as sodium, and also increases anti-diuretic hormone (ADH) levels.

Gahungu says although drinking enough water is healthy, excessive amounts can cause low sodium levels by overwhelming the kidneys’ ability to excrete water.

“Because one loses sodium through sweat, drinking too much water during endurance activities, such as running, can also dilute the sodium content of the blood,” he says.

Hormonal changes can also lead to low sodium levels, Gahungu says.

He notes that adrenal gland insufficiency affects the adrenal glands ability to produce hormones that help maintain the body’s balance of sodium, potassium and water.

He adds that low levels of thyroid hormone can also cause a low blood sodium level.

Some drugs such as the recreational drug ‘ecstasy’ can as well lead to low sodium levels. He says this amphetamine (stimulant drugs that speed up the messages travelling between the brain and the body), increases the risk of severe and even fatal cases of hyponatremia.


Dr Sindabimenya says there are different factors that may increase one’s risk of hyponatremia.

For instance, he says, older adults may have more contributing factors for hyponatremia, like age-related changes and taking certain medications, and there is a greater likelihood of developing a chronic disease, which alters the body’s sodium balance.

Also, medications that increase the risk of hyponatremia include some antidepressants and pain medications.

Sindabimenya notes that conditions that decrease the body’s water excretion could be also a risk factor for low sodium levels in the blood. He says medical conditions that may increase the risk of hyponatremia include kidney disease, syndrome of inappropriate anti-diuretic hormone, heart failure, among others.

Ruzindana notes that intensive physical activity is also another risk factor.

In chronic hyponatremia, Ruzindana says sodium levels drop gradually over 48 hours or longer, and symptoms and complications are more moderate.

Whereas in acute hyponatremia, he says, sodium levels drop rapidly, resulting in potentially dangerous effects, such as rapid brain swelling, which can result in a coma and death.

“Premenopausal women tend to be at the greatest risk of hyponatremia-related brain damage. This may be related to the effect of women’s sex hormones on the body’s ability to balance sodium levels,” he says.


Hyponatremia treatment is aimed at resolving the underlying condition.

Depending on the cause of hyponatremia, Gahungu says one may simply need to cut back on how much water they drink.

In other cases of hyponatremia, he says one may need intravenous electrolyte solutions and medications.

For prevention, Gahungu says treating associated conditions is helpful.

He explains that getting treatment for conditions that contribute to hyponatremia, such as adrenal gland insufficiency, can help control low sodium levels in the blood.

Alternatively, Gahungu says, one can as well embrace the culture of educating themselves.

Here, he notes that if one has a medical condition that increases their risk of hyponatremia, or they take diuretic medications, they should be aware of the signs and symptoms of low sodium levels.

It’s also important to take precaution during high intensity activities.

“People who are involved in intensive sports should drink only as much fluid as they lose due to sweating. Thirst is generally a good guide to how much water or other fluids one needs,” Gahungu advises.

Also, he notes that it’s important for one to consider drinking sports beverages during demanding activities, albeit they should seek help from a medical practitioner about replacing water with sports beverages that contain electrolytes.

Sindabimenya says one should drink water in moderation.

He notes that drinking water is important for one’s health, so making sure one drinks enough fluids is important, however, do not overdo it.

“Thirst and the colour of one’s urine are usually the best indications of how much water one needs. If one is not thirsty and the urine is pale yellow, this is a good indicator that one is getting enough water,” he says.