Hyponatraemia

[araminta]

Just got blood test results, was told all OK except for mild hyponatraemia (low sodium).   Is this a thing with Sjogrens?   In any case I am going to try to speak to a GP, as this fairly normal blood result comes after several weeks of swollen hand, pains in joints etc.   I seem doomed to never show anything very much in my blood tests.

[Linda196]

While it may not be an actual "Sjogren's thing" it could be the result of "washing out" sodium with excessive water intake. I've had to deal with it a few times, by limiting water intake, but the last time was a bit more complex, dealing with the sodium wasting caused by the diuretic (fluid pill) I was taking to help control my BP.That required changing medication, limiting water intake and actually ingesting sodium tablets. The sodium tablets evolved to adding salt to food, which my husband had to constantly remind me to do, because I don't like it! To make matters worse, he's sodium restricted and was encouraging me to have something I didn't want, but he was craving but couldn't have!

Was the swelling in your hands caused by inflammation, or something else and treated in any way with diuretics?

If the chloride is also low, it leans toward wash out, while if the potassium is low, there could be other clinical or organic causes to look into.

[araminta]

Many thanks for your reply, Linda.   I'm sorry about all your difficulties with the salt!   Luckily I do like salty food,so will be upping that a bit.

The only abnormal result was the low sodium (which I've had once before).   I believe the swelling was caused by inflammation, but have had no follow-up.   I was given the result over the phone by a receptionist, there was no note from the GP about follow-up, only a note to come back in three months time for another blood test.   I said this got me no further forward re. the hand problems, and was told I'd need to ring back if I wanted to make an appointment with a doctor.  It's the NHS, which is under terrible strain at present, and it's like entering a raffle trying to get an appointment where I live - everyone has to ring at 8 a.m., usually you can't get through.

I expect it's all Sjogrens related, and that the low sodium comes from maybe drinking too much water.   At this rate I'll never know ...

[Carolina]

Dear Araminta,

I was first diagnosed with lower than normal salt on a blood test in 2010.  The first time I've heard of a doctor ordering MORE intake of salt!  I was 68 at that point and about 8 years into Sjogren's with rapidly progressing neurological damage.

Now I'm 81 and my last sodium level in March was 131 on a scale of 135 - 145.  Still get an L for low next to the results.

Elaine

[araminta]

Thank you for your comment, Elaine.   Perhaps it is related to drinking too much, as Linda suggested.   Or maybe it's just one of those things they call "idiopathic".   I'm often surprised how apparently abnormal some people's test results are, and yet they remain in good health.   My MIL had extremely low iron at one point, so that doctors thought she must have a bleed somewhere.   However it turned out she was just fine, and she always had bags of energy!

PS.   I'm so sorry to hear about your flare-up of  symptoms.   I've never been on Methotrexate so can't offer any advice about that, however it sounds quite possible that coming off a strong drug like that could provoke a reaction.   Take care, I hope you feel better soon.