Sodium Deficiency (hyponatremia); Symptoms, Causes & Treatment

Sodium has a bad reputation in the health community because of many health problems associated with high sodium levels, including high blood pressure, headache, heart diseases, and thrombosis. The root of this problem comes from fast-food chains, junk foods, processed foods, and even juices that use sodium as a flavor enhancer. This problem is a part of our modern society because older generations didn’t have processed food, and most of their diet was fresh food directly from the earth without modification. Thus, high sodium levels in the blood were not common in these past generations as it is now.

However, sodium is an essential mineral of the human body, and the majority of body functions depend on this mineral. Sodium is critical for regulating fluid volume in the body, nerve conduction, muscle contractions, and blood pressure. Low sodium levels are not as common as high sodium levels, but it is common in people with certain conditions like kidney and liver diseases, and it should not be overlooked because severe sodium deficiency is a life-threatening condition.

What does sodium do for the body?

Sodium and potassium oppose each other in their function, but they also have similar benefits and actions in different aspects of our physiology.

Boosts energy

Sodium is essential as energy source because it is important for muscle contraction and nerve transmission to perform brain orders such as walking and running.

Maintains Normal blood pressure

Normal sodium levels are important to maintain normal blood pressure levels. Healthy people with no underlining diseases may suffer from low blood pressure, a condition called idiopathic hypotension. These people can benefit from an increase in sodium levels in the blood to increase their naturally low blood pressure levels.

Strengthens muscle contraction

Muscle contraction is affected by many factors and minerals like potassium and sodium. Sodium and potassium work together to stimulate and strengthen muscle contraction by stimulating minerals influx (calcium) into the muscles to induce contraction. They also promote nerve impulses to the muscles to assist with muscle contraction.

Protects the heart

All the negative effects of sodium occur when levels are too high, but normal sodium levels are essential for heart contraction and to regulate its rhythm.

Prevents diabetes

Keeping the sodium at standard levels prevents hypertension, which can cause secondary type 2 diabetes.

Elevates mood and brain functions

Research shows that sodium can act as an antidepressant and that is why the body usually craves more sodium, leading to a vicious cycle that may increase sodium levels in the blood.

Where can I get sodium from?

  • Sodium is an essential mineral that is found in any food, specially processed ones. Consumption of sodium-rich food should be closely monitored as it can affect the body negatively and may cause diseases like hypertension.
  • Sodium can be found in a lot of food, especially food preserved in salt like pickles, meat, and fish.
  • The highest sodium source is table salt, which is added to all sorts of food, including bread, pizza, chicken, soups, sandwiches, pasta, sauces, meats and even sweets like cake, brownies, cookies, and ice-cream in small amounts to enhance their flavors.
  • Fruits and vegetables are low in sodium, but there are fruits and vegetables naturally high in sodium but without the side effect of table salt, including beets, carrots, meat, celery, spinach, and swiss chard.

Here are some of the highest sodium sources and the amount of sodium in 100 grams of each source:

  • Table salt: 38758 mg, 1615% of daily sodium intake
  • Sunflower seeds: 6008 mg, 250% of daily sodium intake
  • Soy sauce: 5493 mg, 229% of daily sodium intake
  • Canned anchovies: 3668 mg, 153% of daily sodium intake
  • Yeast extract: 3380 mg, 141% of daily sodium intake
  • Chili powder: 2867 mg, 119% of daily sodium intake
  • Hot sauce: 2643 mg, 110% of daily sodium intake
  • Salami: 2260 mg, 94% of daily sodium intake
  • Parmesan cheese: 1804 mg, 75% of daily sodium intake
  • Bacon: 1684 mg, 70% of daily sodium intake

How do our bodies absorb sodium?

The body absorbs almost all of the ingested sodium because the body execrates any excess amount of sodium into the urine, so for balancing sodium levels in blood it should be ingested regularly in diet.

Here are some factors that may enhance or reduce sodium absorption:

  1. Aldosterone: It is a hormone that responsible for electrolytes regulation, which are sodium, potassium, and chloride. Aldosterone hormone prevents the excretion of sodium in urine in exchange for potassium and stimulates sodium absorption from the intestine.
  2. Alcohol: It acts as a diuretic, and that will cause loss of sodium in the urine, and it damages digestive system lining, which causes malabsorption of sodium.
  3. Medication: Medications that prevent glucose absorption in the intestine will directly inhibit sodium absorption because its absorption depends on glucose absorption.
  4. Coffee: Caffeine found in coffee, tea, chocolate, and some beverages may decrease sodium absorption in the intestine and increase its excretion in the urine.

How much sodium per day?

Daily recommendations of sodium differ according to age, sex, daily activity, the person’s status of health, metabolic, and medical conditions. But, the recommended sodium amount according to the World Health Organization (WHO).

Recommended daily sodium intake:

  • From birth to 6 months: 120 mg
  • Infants from 7 to 12 months: 370 mg
  • Children from 1 to 3 years: 1000 mg
  • Children from 4 to 8 years: 1200 mg
  • Children from 9 to 13 years: 1500 mg
  • Teen from 14 to 18 years: 1500 mg
  • Adults from 19 to 50 years: 1500 mg
  • Pregnant and breastfeeding teens and women from 19 to 50: 1500 mg
  • Seniors from 51 to 70 years: 1300 mg
  • Seniors from 71 years and older: 1200 mg

People at risk of sodium deficiency may need more than the daily sodium recommendation.

Who is at risk of sodium deficiency?

Low sodium intake

Low sodium intake is not considered an important cause for sodium deficiency but can be happened in case of severe food deprivation like homeless people and starvation.

Chronic diarrhea

Diarrhea increases sodium loss in the stool and also decreases its absorption.


In chronic alcohol consumption, there is an increase in sodium execration in the urine. The downside of regular alcohol intake is causing damage in the digestive system epithelium, leading to malabsorption of many nutrients including sodium.

Excess sweating

It usually happens in athletes, and it causes a sudden drop in sodium levels because of excess water and sodium loss, giving rise to acute sodium deficiency, which should be treated by increasing fluid intake to replace the amount of lost water and sodium-rich food to replace these electrolytes.


Certain medications such as diuretics and laxatives may cause excessive sodium loss in the stool and urine.

Kidney diseases

Patients with kidney diseases are at high risk of developing sodium deficiency because the kidneys are the organs that responsible for electrolyte regulation and balance in blood, including sodium.

Hydration status

Overhydration may cause false sodium deficiency as the sodium levels are normal but diluted because of excess fluids in the blood.

Antidiuretic hormone deficiency

The anti-diuretic hormone is responsible for water and sodium retention in the body and with its deficiency, excess water is eliminated along with sodium leading to sodium deficiency.

When do you consider sodium deficiency?

Normal sodium levels range from 135 to 145 milliequivalents Per Liter (mEq/L). If the test is lower than 135 mEq/L means sodium deficiency. A sodium blood test can be easily affected by some factors like person hydration status, food high in sodium and medications.

Sodium deficiency symptoms

Muscles weakness

Sodium facilitates calcium influx inside muscle cells, directly affecting muscle contraction and the transmission of nerve impulses to the muscles. With sodium deficiency, both nerve impulses and minerals flow into the cells will be decreased, giving rise to muscle ache and spasms.

Low blood pressure

Lower levels of sodium in the blood will decrease the blood volume and decrease muscle contraction of the heart and blood vessels, which decreases heart pulse rate and dilatation of the blood vessels leading to lower blood pressure or hypotension.


Rapid loss of sodium may affect the brain by causing swelling, which is known as cerebral edema. Increasing the fluids inside the brain cells will cause swelling and rupture, which may lead to coma and eventually death.


It is an early sign of sodium deficiency but is not specific to it. Headaches ensue after an increase of fluids around the brain, which compresses the brain nerves.

How to increase sodium levels?

  • If you’re at risk of sodium deficiency or have been diagnosed, eat food that rich in sodium which can be made by adding table salt to foods like bread, pizza, chicken, soups, sandwiches, pasta, sauces, meats, cakes, brownies, cookies and ice-cream or natural sodium sources like beets, carrots, beef, celery, spinach and swiss chard.
  • Treat your medical conditions that affect sodium absorption and excretion, such as liver and kidney diseases.
  • Avoid alcohol consumption and tried to drink fruit juices or water instead of alcohol as they are good sources of sodium.
  • Drink water in a moderate amount to avoid sodium dilution in blood.

How can you treat a sodium deficiency?

  • The first line to treat sodium deficiency is to treat the underlying cause because many cases of sodium deficiency is a secondary symptom of other diseases.
  • You should elevate sodium levels in the blood by working on the same points as in the prevention of sodium deficiency. Treating sodium deficiency is very easy by just adding table salt to meals, and for most adults, the recommended daily allowance is 1500 mg.
  • In the case of acute sodium deficiency after intense exercise or prolonged exposure to the sun, this condition should be treated with sports drinks, and in the hospital when there’s no improvement or in severe cases, because it is a life-threatening condition. The patient usually receives fluid and mineral replacements by a cannula in the arm or the palm of the hand, and the doctor may combine glucose with them to facilitate its influx inside the cells to rehydrate them.
Sodium Deficiency