Track Your Sodium and Reduce Intake, Even if it’s Normal!

The Biomarker Handbook is a curated series that seeks to provide readers with insights on each biomarker we cover in our blood test packages and its relation to our body.

Sodium is one of the most widely consumed minerals in the diet. It is not just about making food taste better, it’s also about giving your body salt for proper functioning. Your body regulates sodium level to a very narrow concentration range in order to maintain optimal health. Abnormally high or low sodium are associated with a number of symptoms and various health consequences.

Definition of Sodium

Sodium is a vital electrolyte that works to maintain the optimal balance of water in and around your cells. This electrolyte is present in all fluids in our body, where it is required for normal function of nerves, muscles, and much more. Our sodium intake is largely in the form of table salt, and the foods that we eat.

Importance of Tracking Sodium

Sodium is more important than people realize. Without sodium, your body cannot function i.e. we would die without it. Sodium balances fluid in your cells, therefore participating in the normal function of nerves, and muscles and more. In the human body, sodium level is regulated by our kidneys and adrenal glands. The process of regulation of sodium involves the following hormones:

  • Anti-diuretic hormone (ADH) from the pituitary gland in our brain; ADH acts on the kidneys to stimulate reabsorption of water, preventing too much loss of water
  • Atrial natriuretic hormone (ANH) from the atrium of the heart; it acts on the kidneys to promote excretion of sodium in the urine
  • Aldosterone from adrenal gland; it acts on the kidney to promote sodium reabsorption

It is clear that sodium is regulated primarily in the kidneys through the amount excreted in the urine. Sodium is a biomarker for kidney health, and levels of this electrolyte are usually tested in persons with kidney problems. Doing a test to track sodium levels is also recommended for people who are experiencing dehydration, heart failure, liver disease, blood pressure problems or oedema (accumulation of excess fluid).

The most frequent manner of tracking levels of this biomarker is through a blood test. The sodium blood test is also used as a part of a basic metabolic panel or an electrolyte panel test during a routine checkup. A blood sample is collected in a standard fashion. A 24-hour urine sample may be required, to measure the sodium excretion.

It’s useful to bear in mind that normal sodium level is between 136 and 145 milliequivalents per litre (mEq/l).

Signs and Symptoms to Watch Out For

Sodium values lower than 136 mEq/l indicate a deficiency in this biomarker i.e. hyponatremia, while results showing sodium levels higher than 145 mEq/l points to the existence of hypernatremia. Both low and high levels of sodium are indicated by a number of symptoms which will be discussed below.


Hyponatremia is a term that refers to insufficient sodium in the body. The condition occurs when the body loses too many electrolytes and water, possibly as a result of an underlying disease process. The most common causes of low sodium are severe vomiting and diarrhoea, certain medications (like diuretics), dehydration, kidney disease, liver disease, heart problems, adrenal gland disorders, hypothyroidism, syndrome of the inappropriate anti-diuretic hormone, ecstasy use, just to name a few.

Signs and symptoms associated with low sodium are:

  • A headache
  • Fatigue
  • Weakness
  • Irritability
  • Confusion
  • Muscle spasms or cramps
  • Nausea and vomiting


Hypernatremia is a medical term that refers to excessive levels of sodium. The condition occurs due to too much sodium gain and too much water loss in the body. Risk of developing this condition increases in persons with kidney disease, diabetes insipidous, poorly managed diabetes, dehydration, and severe diarrhoea but some medications can cause it too.

Signs and symptoms associated with high sodium are:

  • Excessive thirst
  • Lethargy
  • Muscle twitching or spasms
  • Seizures and coma (in severe cases)

Consequences of Having Abnormal Sodium Levels

Both hypo- and hypernatremia can cause various complications if left unmanaged. For example, chronic hyponatremia can cause neurological complications that affect a patient’s gait and walk, ability to pay attention and reduced reaction time. Low sodium can increase the risk of osteoporosis and raise the likelihood of bone fractures. Acute hyponatremia can even cause brain swelling and death.

Complications associated with hypernatremia include cerebral bleeding, permanent brain damage, brain shrinkage, and brain swelling. High intake of sodium is associated with hypertension and thus heart disease. It is also important to mention that both conditions (high and low sodium) can make it more difficult to manage kidney disease and problems with your liver, heart, adrenal glands, and others.

Ways to Balance These Levels

Timely management is the best way to avoid potentially severe complications of abnormal levels of this biomarker. The primary route of hyponatremia treatment is to address the underlying cause. If the problem occurs due to medications, diuretics, or diet then it’s useful to reduce fluid intake. For severe cases of low sodium, your doctor may propose IV sodium solution to increase levels of sodium in your blood, but you may be required to stay in the hospital. Another potential treatment is via medications that manage symptoms of hyponatremia.

On the other hand, hypernatremia requires increasing fluid intake. More severe cases also require an IV drip that supplies blood with fluid. This may also require a hospital say. Balancing levels of sodium depends on the symptoms you experience and speed at which they develop. To prevent these problems, it is necessary to keep water and electrolyte levels in balance, stay hydrated, and consume the recommended amount of sodium. Hypernatremia, especially when chronic, should not be corrected too quickly as this may cause brain swelling.

When to See the Doctor?

You should see the doctor if you notice the above-mentioned symptoms. Also, it’s useful to schedule an appointment to see the physician if you have kidney, liver, or heart disease since all of them can be influenced by imbalances in sodium. You may also decide to see the doctor for a routine check of sodium, particularly if you are in a high-risk group of kidney disease and failure.

Other Tests to Consider

Besides sodium test, your doctor may order other tests to check for health conditions that are associated with high and low sodium. Some of these tests include:

  • Basic metabolic panel
  • Aldosterone test to detect problems with adrenal gland
  • Urinalysis to check kidney function
  • Lipid profile to evaluate cholesterol which has an impact on blood pressure and heart health
  • Complete blood count (CBC)
  • ADH
  • Renal panel including urea, creatinine, and eGFR


Sodium is an essential electrolyte without which humans cannot live. However, abnormal levels of this biomarker induce various symptoms and complications that put our health and life in grave danger. Tracking sodium levels is particularly important for persons with kidney, liver, heart disease and individuals who are experiencing problems with adrenal gland. Consult your doctor and get a routine checkup.

If you want to find out more about sodium and how to maintain healthy levels of it, take a look at our lifestyle article here!

Interested in other biomarkers? Check out the rest of The Biomarker Handbook.

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