Low Sodium and How to Prevent Osmotic Demyelination Syndrome

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  • Опубликовано: 17 июн 2024
  • Roger Seheult, MD of MedCram discusses, the pathophysiology of hypovolemic hyponatremia, and the pitfalls of replenishing sodium too quickly See all Dr. Seheult's videos at: www.medcram.com/
    (This video was recorded on May 30th, 2024)
    Roger Seheult, MD is the co-founder and lead professor at www.medcram.com/
    He is Board Certified in Internal Medicine, Pulmonary Disease, Critical Care, and Sleep Medicine and an Associate Professor at the University of California, Riverside School of Medicine.
    00:00 Hyponatremia Overview
    01:11 Osmotic Demyelination Syndrome
    03:06 Neurophysiology
    05:03 Standard Practices
    07:42 Physiology
    13:00 Recommendations
    16:23 Conclusion
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    #hyponatremia #ods #sodium

Комментарии • 167

  • @Gustav.J
    @Gustav.J 17 дней назад +70

    I'm not even in the medical field - I just enjoy how well he explains medicine. Communication skills aren't just useful and important, but also an art to be enjoyed. The distinguishing characteristic of an educator is the ability to communicate well.

    • @suhailym4116
      @suhailym4116 17 дней назад +7

      I agree, he is very good at presenting the information and speaking very clearly.

    • @OttoBoy
      @OttoBoy 17 дней назад +5

      Wholeheartedly agree. Like you, I am not a medical professional. But Dr. Seheult’s ability to explain just about any aspects in the medical arena to where even I can grasp things must be gold to anyone in his profession. 🙏

  • @justsayin3600
    @justsayin3600 17 дней назад +32

    The doctor found the perfect occupation. What an incredible teacher! Not all doctors are equal, just like mechanics, and master mechanics have gaps in knowledge, experience, and applied knowledge.
    What a great doctor!

  • @GrahamTodd-ca
    @GrahamTodd-ca 17 дней назад +30

    Your communication skills are spectacular. Not only are you educating a broad audience about the particular topic, you are demonstrating that the ability to make complicated information accessible to non-specialists is an important part of the profession - perhaps all professions.
    Everybody should be working to up their game in this way.
    👍🏼

    • @GrahamTodd-ca
      @GrahamTodd-ca 17 дней назад +2

      I'll admit that sometimes I watch just see how you're going to do it.

    • @StofStuiver
      @StofStuiver 17 дней назад

      There is a reason DR Seheult is so good.
      I started following 4 years ago as i was seeking info on that disease...
      And he was a treasure trove of information, which was founded not only in current medical, but in chem aswell, in history, etc.
      He is someone of not only more than normal intelligence, but has the capacity to venture into different fields of science and go to the essence of things and understand what is actually happening.
      Apart from the fact ive found huge differences between specialists in other fields in my life, i discovered with the contacts i had from 2020 on wrt medical field, that many MD specialists may be able to do the work, but lack in so many ways in 1) being curious as to something new and capable of diving in and understanding and willing to spend a lot of extra time and 2 not even extend this to their very specialty. Which means they are basically useless when something new comes along and they cant fall back on their daily routine.
      It also means they cannot teach. Even in their own specialty.
      You cant be teaching anything if you dont fully grasp the topic.
      And this man has that vast knowledge and is capable and im sure even in his spare time is still reading up on things and thinking about it. Thats rare nowadays.
      And yes, we benefit from that, by what he uploads. Even the drawings are always right on point.
      I would have no problem trusting my life in his hands. That means something, specially coming from me. Bc i never shy away from critisizing, no matter who it is.

  • @robdawg828
    @robdawg828 17 дней назад +13

    Ugh. My mom had low sodium levels and they over corrected her sodium levels. She was never the same after. She immediately became dementia-like. It was crazy. She recently passed away. RIP Mom.

    • @bferrell1797
      @bferrell1797 17 дней назад +5

      So sorry for your loss.

    • @KMx108
      @KMx108 17 дней назад +1

      Seems like a screw up that could easily be blamed on your mom and not the hospital or doctor. I'm so sorry for your loss.

    • @jumpnsmashbadminton3948
      @jumpnsmashbadminton3948 17 дней назад

      I m sorry for your loss

    • @Gamma-jl4ib
      @Gamma-jl4ib 17 дней назад

      Really sorry for your loss

    • @hippopotamusanonymous1580
      @hippopotamusanonymous1580 17 дней назад

      I’m sorry for your loss but her soul is eternal.

  • @FirstnameLastname-pe5ib
    @FirstnameLastname-pe5ib 17 дней назад +24

    I ended up in the hospital with low sodium before because when I had covid, I was eating 0 salt, (thinking this would lower my blood pressure) & was drinking lots of water. The ammount of sodium in my blood was almost 0. Obviously I would never do that again but thought i'd share. The dehydratuon becomes severe pretty quickly, despite drinking 10-20 glasses of water a day. You need adequate sodium.

    • @DIABETESHEALTHS
      @DIABETESHEALTHS 17 дней назад +1

      Thanks

    • @jac1161
      @jac1161 17 дней назад +7

      Na level of 0 = impossible, even when we're dead ;) Yes, I did the same during severe covaids in march 2020. I could't eat (I forced it but then I was dying/passing out. I did have a seizure...I NEEDED to be admitted to the hospital but they refused to admit me when I refused the vent that I did not need. I was so out of it that I didn't remember what I learned as a nurse that we give IV fluids with ...SODIUM and so I was drinking (contaminated, no less) so much water to prevent dehydration.....what happened? I wasn't holding onto water due to not adding the salt!! Healthcare system ALSO caused this problem with thinking..."low sodium diet"....SICK, evil.

    • @FirstnameLastname-pe5ib
      @FirstnameLastname-pe5ib 16 дней назад +1

      @@jac1161 Yup, that was my line of logic as well. They kept drilling this misinformation that salt is the cause of high bp that I believed it as a kid. Whole family would regurgitate the same thing etc. But I took it a step further. I strained all of my food, so there was 0 sodium in it. Compounded by probably 20 waters a day, it didn't take long to deplete it all

    • @celestialstar124
      @celestialstar124 15 дней назад

      Isn't almost all food is loaded with the sodium in this era? 0 sodium is impossible even when we die.
      I have especially avoid all added sodium for a decade and never have i once end up with low sodium. My doctor say that's because i didn't over drink water.

  • @jimatsydney
    @jimatsydney 17 дней назад +13

    Finally someone talking about the danger of low sodium. I’m a whole plant based older athlete. It is common for health conscious people to be also low salt (as I was once). I was struggling with low performance, brain fog, dizziness thinking that extra training was the answer. It was only when I understood that salt wasn’t a poison to be avoided but an essential nutrient that should be consumed to the RDI did my symptoms disappear. It is doubly scary hearing this, that catching viral gastro whilst on a low salt diet could be life threatening or cause brain damage.

    • @carl13579
      @carl13579 17 дней назад +3

      I'm also an older plant-based athlete and have wondered about whether I need to add electrolytes during longer periods of exercise outdoors when it is hot and humid. Some of the plant-based doctors say no, but now I'm not sure.

    • @Medcram
      @Medcram  17 дней назад +3

      It’s rare for somebody on a low sodium diet to have low sodium in their blood. This is because sodium regulation is tied very closely to water regulation.

    • @stavokg
      @stavokg 17 дней назад +2

      @@Medcramthank you for this clarification. The video frightened me as well, as I eat so little salt.

    • @jimatsydney
      @jimatsydney 16 дней назад +1

      @@Medcram However as your example given clearly shows in the case of viral gastrointestinal a person with low sodium reserves has little wriggle room. If they don’t keep hydrated correctly it might result in a trip to the ED. I have been in endurances races where significant number of people have been hospitalised because they have depleted their salt reserves by sweating and only rehydrating with water. This seems to rarely happen to people who maintain their salt levels to the RDI either through food or beverages. I hydrate only with water and don’t have a problem because I ensure my food contains enough salt.

    • @jimatsydney
      @jimatsydney 16 дней назад

      @@Medcram As a health educator do you recommend people stick to the published RDI for salt? Or do you feel these recommended levels are wrong?

  • @HanzShaoPing
    @HanzShaoPing 17 дней назад +13

    That's more complicated than I would have thought just to increase someone's sodium levels.

    • @Medcram
      @Medcram  17 дней назад +14

      It seems the medicine is always more complicated. Likely because the body is complicated. Sigh.

    • @garylancaster2031
      @garylancaster2031 15 дней назад

      Excellent presentation….Even I understood this process! Thanks Doc👍

  • @DW-ry7sy
    @DW-ry7sy 17 дней назад +22

    I appreciate you putting this out, my aunt has dementia and is on Lithium. She's constantly thirsty and can't remember when she's drank water last. Because of this she sometimes she drinks too much water and ends up in the hospital with Hyponatremia. My mom is her primary caregiver and has had to really educate some folks at the emergency room as they'll try to increase her sodium too quickly.

    • @tuvoca825
      @tuvoca825 17 дней назад +2

      Ask your healthcare professional.
      Most people can probably have Gatorade with half water instead, assuming their kidneys and everything else work okay and they don't already have electrolyte imbalances.
      Again, ask your doctor.

    • @martinklawinski2933
      @martinklawinski2933 17 дней назад +2

      I don't know a lot of medicin and i don't know what type of demtia she has but if it where a member of my family i would put her an a ketogenic diet and a lot of vitamin d3, coemzyme Q10 at least if she is on statins and watch every video from Dr. Ben Bikman and all the videos from Low Carb Down Under.

    • @jamesalles139
      @jamesalles139 12 дней назад

      @@tuvoca825 the sugar is not beneficial for anyone.

    • @jamesalles139
      @jamesalles139 12 дней назад +1

      Will she drink water from a container? add the equivalent of 1/8 teaspoon table salt to 8-12 ounces of water to a quart dispenser. It will taste slightly sweet, not salty.

  • @chuck3441
    @chuck3441 17 дней назад +8

    It just amazes me on the knowledge that Dr's have, I've been a mechanic for nearly 50 years and feel like I don't know much after presentations like this.

    • @twelvesmylimit
      @twelvesmylimit 4 дня назад

      I find the more you learn, the more you realise you don't know!

  • @arleenm7367
    @arleenm7367 17 дней назад +8

    Thanks for this. This is definitely a problem in many long-distance runners (marathons, ultramarathons) who are told to drink drink drink to keep hydrated.

    • @Medcram
      @Medcram  17 дней назад +1

      Well said!

  • @corinnenovotny9900
    @corinnenovotny9900 17 дней назад +11

    I was hospitalized due to low sodium. It made no sense to me, or my family, as I’ve always craved salt, and as a result have always consumed a lot of salt!! While I still consume a lot of salt on my food, as well as eating salty snacks, I now add electrolytes to my water.

    • @jima3345
      @jima3345 17 дней назад +2

      Smart!😊 I've been there too.

    • @jac1161
      @jac1161 17 дней назад +3

      Careful with the 'snacks' as processed foods don't a healthy salt. On the plus side, you likely have great iodine levels which are not discussed but so important.

    • @carl13579
      @carl13579 17 дней назад +2

      @@jac1161 Depends where she is. In the UK, for example, salt is not iodized.

  • @buckbenelli8
    @buckbenelli8 17 дней назад +8

    After 43 years, now I understand. But I’ll keep watching and learning after I retire. Health care by corporations is horrible, they try to save pennies by hiring highly paid administrators. Then they blame us for everything.

    • @jac1161
      @jac1161 17 дней назад +2

      healthcare is the most corrupt business of them all -- I became quite sick from them as a patient, and a nurse.

  • @JR-kk6ce
    @JR-kk6ce 17 дней назад +7

    I have gone on several expeditions to explore the deep Amazon jungle. It is incredibly hot and humid in the jungle and one becomes quickly drenched in sweat. The more a person sweats, the more they drink water. Soon the terrible headache hits, the dizziness, cramps, and the person becomes disoriented. It gets worse and worse, becoming dangerous. So, you always take plenty of salt and put it in your water when exploring the jungle.

  • @jima3345
    @jima3345 17 дней назад +5

    An alarm bell for me is if I'm craving potato chips (salt), that's when I hit the electrolytes.

  • @catb4918
    @catb4918 17 дней назад +5

    It's difficult for most ppl to understand that hydration is not about drinking water, it's the electrolytes. There are a lot of 0 cal 0 carb 0 sugar flavored & unflavored electrolyte mixes that if you consume one or 2 packets mixed in water a day you will feel so much better. I hike ALOT & carry salt, electrolytes all the time. You have no idea how many ppl I have saved on hikes because they're cramping or just feel horrible. Always they say 'my Dr tells me not to eat salt...'. I tell them them you are doing an altitude marathon. You need salt! & get a new Dr! 😂

  • @rise4329
    @rise4329 17 дней назад +7

    Awesome! More like this please! (Common clinical pathways for some of the most common disorders/Dx that come through the Emergency Dept.) Thank you!

  • @biodivers5294
    @biodivers5294 17 дней назад +1

    The body knows things that we hardly understand. Beautiful!

  • @orion9k
    @orion9k 17 дней назад +10

    Too complicated for the average Joe to even take into consideration on a daily water/sodium consumption.
    Few years ago I went complete cold turkey on salts and from one day to another, I stopped adding salts into my diet, because Dr. Gabor Maté said something about stopped consuming salts because it was unhealthy. At the time I had burn out from stress and my health was far from optimal, so I was desperate to try anything to improve my health, and I remember how the first week going no salts, I could barely bend my joins and my muscles became completely stiff. After a month with heart palpitations and constantly feeling dreadful and dizzy, I went back to salts and my heart and muscles slowly got better again.

    • @Medcram
      @Medcram  17 дней назад +11

      Again this video has little to do with salt intake and more to do with the management in the hospital.

    • @noelbrown6771
      @noelbrown6771 17 дней назад +2

      I have similar concern about the perceived conflicts with sodium in the diet. I've actually been increasing my sodium intake in order to combat low blood pressure.

    • @AlphaGeekgirl
      @AlphaGeekgirl 17 дней назад +1

      1:36 it’s not complicated at all. You just need to pay attention.

    • @mesomebody5017
      @mesomebody5017 17 дней назад

      @@Medcram
      Yes==but you can’t always trust hospital management with short staffing, staff from training outside the US, and just stupid doctors….some training hospitals might touch on this very lightly and some might do better job
      This can happen to someone IN the hospital for other factors--I think this happened to my senior sister-in-law whose dr was always restricting her fluids-she got dehydrated-had to go to hospital-and think they probably didn’t watch her sodium levels very well-if they gave her Dextrose that would hurt vs help her….and she did have issues with her thinking/organizational skills after that time that were not apparent before that episode.

    • @jac1161
      @jac1161 17 дней назад

      Gabor is good but not in everything. Like every one. No one has it all, and there are some flaming contradictions, that's for sure, with medical advice. Stress depletes SO much. Been there - decades of abuse I shouldn't have taken, working in healthcare is a version of that to boot, etc.

  • @juergenzhang9133
    @juergenzhang9133 17 дней назад +6

    Thank you so much, for the great explaination.
    I have diabetes insipidus using Dessmopressin for many years and sometimes fell into Hyponatremia. No doctor could explain the connection between the complex control loop.
    This video was a real enlightening!!!

    • @Medcram
      @Medcram  17 дней назад +3

      Wow. Excellent.

    • @jac1161
      @jac1161 17 дней назад +1

      they explain very little - I learned this as a nurse and a patient. Hot mess.

  • @vibolyong
    @vibolyong 17 дней назад +4

    That's a very clear explanation! Thanks Dr. Sehult!

  • @Melodie007
    @Melodie007 17 дней назад +9

    You have a great channel. You are a wonderful teacher. I listened to you back when and I am the only one I know who didn’t get . . . V

  • @briangriffiths114
    @briangriffiths114 17 дней назад +1

    Well explained whilst also reminding me of how difficult it must be to be a doctor making such complex balancing decisions. Enjoyed the video, thank you!

  • @sapelesteve
    @sapelesteve 17 дней назад +2

    That was an excellent synopsis of ODS Doc! Yet another Med Cram video that I have to send off to my cousin (M.D.) for viewing. Thanks and I hope that all is well with you & your family!

  • @Just_forfun9140
    @Just_forfun9140 17 дней назад +3

    I thought all you need is a glass of water with salt in it, to raise sodium level. I could have never guessed this much complication. Who knew drinking too much water could cause this problem.

  • @nian60
    @nian60 17 дней назад

    Thank you for the video. Very interesting.

  • @ThomasAT86
    @ThomasAT86 16 дней назад +1

    It's fascinating and probably true for a lot of fields that the "experts" or let's say "professionals", know WAY more about a topic than you'll usually ever get to know, as opposed to some scammers and quacks who know very little and yet still claim to know more than the professionals. When I did my strength coach and nutrition coach certification I learned a lot of stuff that I'll usually never get to tell a client, but that knowledge is crucial for the coach to be able to make proper decisions, digest and filter new information and explain things in an easier but still at least mostly accurate way. I'm sometimes picturing a sketch of a head and what comes out through the mouth is like a small opening and on the back of it is an exponentially wide funnel with all the information necessary.

  • @rhyothemisprinceps1617
    @rhyothemisprinceps1617 13 дней назад +1

    I had symptoms of hyponatremia when I did my colonoscopy prep (nausea, vomiting, headache - I also felt really cold, tho I don't see that listed as a symptom). I reported it to my gastro, and he completely ignored it. I'm glad I managed to recover without any help, so I guess it wasn't that bad.

  • @bjornbaron5940
    @bjornbaron5940 16 дней назад

    Love your drawings, makes following very easy.

  • @joyfisher8008
    @joyfisher8008 17 дней назад +4

    No background in medical fiekd but you explain things so well i can get about 85% of this. BTW I remember "D5W" from an old TV show "Emergency"; seemed to be the 1st thing the doc ordered everytime

  • @jaggeranand6408
    @jaggeranand6408 15 дней назад

    Perfect thank you Dr

  • @ItsSakuraKeiIRL
    @ItsSakuraKeiIRL 17 дней назад +1

    Very interesting. 😮

  • @southerncomfortuk
    @southerncomfortuk 17 дней назад +3

    Fascinating video. It would be great if guidance was available on how much fluid / sodium intake is best. NHS advises 8 glasses a day which is fine in cooler weather but how much is too much when the temperature is high.

  • @DJSouthwest162
    @DJSouthwest162 17 дней назад +3

    Thanks 🙂 as always u and ur staff do an excellent RUclips influencer opinion video presentation 🤔 helping the 🤕 not so well get back to normal, so to speak 🙃

  • @DavisonVideo
    @DavisonVideo 17 дней назад +1

    Ur nice, Roger. ☺️

  • @rnw4468
    @rnw4468 17 дней назад

    Great to have you breaking down the mechanism. Would love to have your work/interpretation on salt wasting syndrome in icu pt with brain damage. Thank you 🙏🏻

    • @Medcram
      @Medcram  17 дней назад

      Yes! Now that’s a complicated one. And therefore a good suggestion.

  • @Just_forfun9140
    @Just_forfun9140 17 дней назад +2

    I would like to know who is the architect of this body, for that matter even a Cell. I thought Eye is a very complicated organ, the Biochemistry of it, now I see how complicated with Na level balance in neurons. It never ceases to amaze me. What is most amazing to me is, we function fine, how is it possible with so much complexity happening all the time everywhere in the body.

  • @yasmine4754
    @yasmine4754 11 дней назад

    Dr Seheult, could you please make a video about Gabapentin toxicity.

  • @iceangel587
    @iceangel587 17 дней назад +6

    Myelin sheath Just like the plastic in a wire

  • @jakeaurod
    @jakeaurod 17 дней назад +1

    I always learn something useful in these videos, that help me understand something that's happened or could happen so I feel like I understand what's going on with my health or those around me. Unfortunately, post-covid fatigue and brainfog made my mom choose someone else to be her medical PoA when she went in for a procedure that should be simple and low-risk and next thing I know she has a hole in her heart, a balloon in her aorta, her liver and kidneys are failing, she's being flown to a second hospital, then a third hospital out of state, and by the time I get there I'm expected to make an informed decision on when to pull the plug. I still have no idea what happened. We haven't even gotten the death certificate or her ashes back yet.

    • @Medcram
      @Medcram  17 дней назад +2

      Sorry to hear this….

  • @hollylorn131
    @hollylorn131 15 дней назад

    How much salt should we add to our diet daily along with how many ounces of water daily should we take in? You explained everything very well so that the average person could understand these medical topics, thank you!

  • @lynpolkabla4088
    @lynpolkabla4088 17 дней назад +1

    Thanks! Am post massive stroke (almost all cognition & aphasia recall & fluency) and don't trust most docs to keep current with research. My huge intellectual reserve means I can ask for help when I notice symptoms. Good info to know if/when I get dehydrated: dilute electrolyte better choice for me as sodium usually tests low side normal. Ya got some of us who're biochem 'groupies' or should I say nerds LOL! Thanks again for this one esp.

  • @sheila7814
    @sheila7814 15 дней назад +1

    If you eat a healthy diet ( non processed foods), your sodium might be lower (at least mine was). I found I needed to start salting some of my food.

  • @jamesalles139
    @jamesalles139 12 дней назад

    As a 'normal' adult human I add 1/8 teaspoon of table salt to 10 ounces of water for my break-fast drink in the morning. It will taste slightly sweet, not salty.
    It is all about the osmolality!

  • @jumpnsmashbadminton3948
    @jumpnsmashbadminton3948 17 дней назад

    Just now got back mother from hospital for low sodium, they increased slowly only,

  • @currentconditions962
    @currentconditions962 17 дней назад

    Wow! This is really great information. I am always worried about my sugar levels because I don’t want to develop diabetes, but now I also have to check my salt intake. How does someone keep a well balanced salt diet? Is that’s why sometimes the body craves salt once in a while?

    • @Medcram
      @Medcram  17 дней назад +1

      This has little to do with dietary sodium intake. It has more to do with acute illnesses, that cause loss of sodium with the replenishment of just water.

  • @tafarihowe3277
    @tafarihowe3277 17 дней назад +2

    I come here to watch videos so I can the smartest respiratory therapist at my job lol

    • @jac1161
      @jac1161 17 дней назад

      How about "so I can help save and optimize lives under my care, by God's grace and my thirst for wisdom to apply it to others".. ?.."lol"

    • @tafarihowe3277
      @tafarihowe3277 17 дней назад +1

      @@jac1161 the joke went right over your head. As a side note lol usually means it’s a light hearted joke. Find someone else to play with. Thanks

    • @nian60
      @nian60 16 дней назад

      @@jac1161 Maybe the OP is not a religious fundamentalist?

  • @fs3579
    @fs3579 17 дней назад

    Do you recommend any Cardiac EP well experienced in PFA ablation? In any location. Thank you!

  • @yossarianmnichols9641
    @yossarianmnichols9641 17 дней назад +2

    Very interesting, I wonder how often this occurs in the population and can it occur under circumstances not related to an illness such as outdoor exercise in very hot weather. I have read of people dying of heat stroke with water in their water bottle.

    • @shakeyj4523
      @shakeyj4523 17 дней назад

      If the water is hot enough, you can die of heat stroke while submersed in water. Water alone does not prevent heat stroke.

    • @megeek727
      @megeek727 11 дней назад

      I can not imagine this happening in the U.S. There is so much salt in our diet. Folks who are rehydrating after extreme dehydration like marathon runners may be the few that need be concerned.

    • @shakeyj4523
      @shakeyj4523 11 дней назад

      @@megeek727 Not all of us eat highly processed foods. If you don't it's actually fairly easy to be low on salt.

  • @nian60
    @nian60 17 дней назад +1

    I wonder if the increase in hyponatremia is partly due to more people doing intermittent fasting and OMAD*. I started intermittent fasting a few months ago, and I got headaches that were cured by taking salt with the water. When you only drink tap water (or poor quality bottled water) for a long time, it can give you salt and electrolyte deficiencies. Some fasts last for several days. So it's important to eat some salt and electrolytes then. *OMAD = one meal a day.

  • @Ockv74
    @Ockv74 17 дней назад +1

    ❤❤❤

  • @sanbetski
    @sanbetski 13 дней назад +1

    7:03 this is INaccurate. multiple studies suggest it is safe to administer 3%NaCl in peripheral vein to treat severe symptomatic hyponatremia

    • @Medcram
      @Medcram  13 дней назад

      Sure if delay will cause harm but then use risk benefit.

  • @deborahd.7281
    @deborahd.7281 17 дней назад +4

    I was looking at the ingredients for Pedialyte and sports drinks and they have about 25g or maybe more of sugar per liter, that seems to be an awful of sugar if taken at once, could that lead to reactive hypoglycemia in sensitive people?

    • @tuvoca825
      @tuvoca825 17 дней назад

      Sugar is sugar... if they would get it otherwise, maybe. And in dissolved form... faster absorption and it hits harder than in food.

  • @bethra.flowers
    @bethra.flowers 16 дней назад +1

  • @sylviawelsh9518
    @sylviawelsh9518 10 дней назад +1

    Been advised to limit salt and givin LASIK to eliminate fluid but also messes with my electrolytes, any recommendations.🤔

    • @marianbaldwin1832
      @marianbaldwin1832 9 дней назад +1

      Do be careful! Dr. changed my diuretic to Chlorthalidone 25MG. After approx. 5 days, noticed that I was not urinating much. Sixth or seventh day, it was like a dam broke! So I thought the "worst" was over, and continued to take the medicine. However, my body kept saying that "something was wrong", so I quit taking any diuretic after taking it for 5-6 weeks. About 2-3 weeks later, came down with Vertigo. Horrid! It then affected my eye (as eyes will roll around), and I was to learn that I had early AMD. Three months later, the Vertigo is still with me (considered a vestibular problem by Drs.), and the eye has problems not experienced before the meds+vertigo 6 months ago. Good luck in finding the right balance!

  • @sheila7814
    @sheila7814 15 дней назад

    Does anastrazole cause a problem with sodium? Just curious. Every since I have started it, my sodium is borderline 135.

  • @bobthrasher8226
    @bobthrasher8226 17 дней назад +1

    What about the K? How did that get restored? What about using a balanced electrolyte IV?

    • @Medcram
      @Medcram  17 дней назад +2

      Yes, the potassium was replaced successfully. We really didn’t need to use balance fluids in this case because it only took a small amount of fluid to restore the volume that was enough to shut down ADH secretion.

  • @fingerdreck2328
    @fingerdreck2328 17 дней назад

    So i had a patient with hyponatremia of 120 mmol/l without any synptoms. Consequently we could diagnose SIADH, the origin was ovarian carcinoma. After this we tried to create an overview about the diagnostic algorithm of hyponatremia becauae it is so complicated. What are the most important first steps in hyponatremia?

    • @Medcram
      @Medcram  17 дней назад

      We go over this in our video on our website, but basically it’s the first determine whether or not the patient is hypotonic, hypotonic, or isotonic.
      Most of the time the patient is hypotonic.
      Then the next step is to determine whether the patient is hypovolemic, hypervolemic, or isovolemic.
      SIADH is isovolemic and this patient was hypovolemic.

  • @littlevoice_11
    @littlevoice_11 17 дней назад +2

    Are you seeing an increase in this?
    I wonder if it is anything to do with the trend in carrying giant water bottles and constantly drinking from their bottle?

    • @Medcram
      @Medcram  17 дней назад +3

      Not really an increase, but a constant drip. No pun intended.

  • @joemoya9743
    @joemoya9743 17 дней назад

    Good Example. But, it would also be an interesting discussion to use an example where someone becomes hyponatremic as a result of excessive consumption of water during an ultra-endurance sporting event (such as an Ironman). And/Or, where the cause may be the onset of the kidney's failure to function properly may be a contributory cause as a result of long term abuse of NSAIDS (...such as may be the case of an Ironman athlete or women who use NSAIDS for mensural cramps).

    • @Medcram
      @Medcram  17 дней назад +1

      Yes. That is a different story. If it happens in less than 72 hours, it’s considered acute and the real danger there is the opposite. It’s brain swelling and you want to get the sodium up and the brain swelling down.
      In this case, it was six days which is much longer than 72 hours. And you want to correct things more slowly.

    • @joemoya9743
      @joemoya9743 17 дней назад +1

      @Medcram Yep... different story. But, it is a story where many EMT's confuse hyponatremia with dehydration in the case of ulra endurance events. Thus, complicating the problem by applying dehydration treatments to a hyponatremic situation. And, where the symptoms are similar and the environment points the wrong direction for proper treatment. My rule of thumb is... if there is vomiting involved in what appears to be dehydration, it may be best to test for hyponatremia rather than assume dehydration, especially in the case of an ultra endurance event. Btw. very informative video.

  • @pearlneidlinger391
    @pearlneidlinger391 17 дней назад +2

    Thank you this is interesting to me. My left kidney died it's still in my body and I've been concerned that I don't eat enough skat. I don't eat processed foods so I'll be asking about this blood test. Also have you ever heard of the mouth salivating profusely and it tastes like salt coming out of the saliva. It usually lasts five minutes or so and its very odd. Im embarrassed to ask but this video piqued my curiosity about this salty run off.This has happened to me over my lifetime quite a few times. I've asked my doctor what it could be and he didn't understand what it is. Im very curious about it, it hasn't happened in over a year but its very strange. Any information would be appreciated.

    • @Medcram
      @Medcram  17 дней назад +2

      I have not heard that before. Interesting

    • @honorburza9110
      @honorburza9110 16 дней назад

      Could it be coming from your sinuses?
      Only because after I do a nasal irrigation with salt water, I suddenly get salty water in my mouth for a couple of hours later as it seems to flow from sinus cavities I guess. Although this doesn’t feel like excessive salivating as you’re describing. My partner tells me he gets excessive salivating , or almost bubbling saliva, if he’s about to be sick/vomit.

    • @pearlneidlinger391
      @pearlneidlinger391 6 дней назад +1

      @@honorburza9110 No its really like my mouth is over watering but its strong salt, and awful when it happens. But I'm so curious about what it's doing to my body. I don't use salt and I dont eat processed foods, I don't use nasal sprays uts so weird. I do feel exhausted and slightly nauseous after. I really am wondering has this happened to anyone else?

  • @AE-yt4lx
    @AE-yt4lx 17 дней назад +1

    I know someone who had cancer and it was undiagnosed and she was so low on sodium, she could have died, right away.

  • @thaominhtruong6038
    @thaominhtruong6038 17 дней назад

    You neglect to mention SIADH in patients with history of brain or lung diseases, such as stroke and COPD, which are quite common.

    • @Medcram
      @Medcram  17 дней назад +2

      SIADH happens but those patients are not hypovolemic. We discuss treatment for that in our series on medcram.com

  • @Rene-uz3eb
    @Rene-uz3eb 17 дней назад

    Maybe a point should be made about ace inhibitors causing hyponatremia, because they prevent more sodium reabsorption, which is then compensated with vasopressin which only absorbs water without sodium.
    13:51 it seems these patients are mainly hyponatremic, not hypovolemic. So by giving them fluid you make them fluid overloaded, which would seem to be the main reason why the body is dumping tons of water so fast.

    • @Medcram
      @Medcram  17 дней назад

      Actually they are both hypovolemic and hyponatremic. The mechanism is explained.

    • @Rene-uz3eb
      @Rene-uz3eb 17 дней назад

      ⁠it seems easier to diagnose hyponatremia than hypovolemia. I'm not saying it's impossible that the body would suddenly try to start concentrating sodium now that it has more fluid, and get back into a hypovolemic state for benefit of correcting sodium balance. Since the body prioritizes maintaining volume over sodium concentration though, if these patients were truly hyponatremic hypovolemic (GI losses, diuretics, dying of thirst), then fluid resuscitation would bring them back to normal without rapid urine production and sodium increase. Vs a patient who just drank too much water.
      Thanks for the video though and the danger of increasing sodium too fast

    • @Rene-uz3eb
      @Rene-uz3eb 20 часов назад

      I think an even bigger problem is IV fluid induced pulmonary edema, which has high mortality. I really don't see why people are doing iv fluid at all, it seems all it does is cause extreme danger.

  • @RobMcGinley81
    @RobMcGinley81 17 дней назад +1

    Does anybody know why 3% "Super Salt" shouldn't be given peripherally? Because that's how we do it in my ED

    • @Medcram
      @Medcram  17 дней назад +3

      It’s not an adequate access for 3%. Usually that needs to go through central line because of the hypertonicity.

  • @Momofukudoodoowindu
    @Momofukudoodoowindu 16 дней назад +1

    Is it ok to drink a serving of electrolytes after a 30-45 minute stint in the sauna?

    • @Medcram
      @Medcram  15 дней назад +1

      Generally yes.

    • @Momofukudoodoowindu
      @Momofukudoodoowindu 15 дней назад +1

      @@Medcram Doctor, may I make a video topic request? I have attempted to find YT doctors to discuss this topic to no avail. I take spironolactone for PCOS. Is it unproductive to drink electrolytes if the drug is a diuretic? I don't understand that drug factored in to the salt-and-water relationship. How do I properly hydrate on this drug? Thank you so much. 🙏🏼

  • @honorburza9110
    @honorburza9110 16 дней назад

    Could the patient have prevented this if she’d been drinking rehydration salts instead of just water please?

    • @Medcram
      @Medcram  16 дней назад

      It’s possible. She was also on a chronic diuretic which may have exacerbated the issue so it’s hard to tell.

  • @barleyhops38
    @barleyhops38 17 дней назад +1

    Question: I don't drink water. I drink probably 2 PowerAdes a day (similar to Gatorade) Is that bad for too much electrolytes etc?

    • @infinitelo_op
      @infinitelo_op 17 дней назад

      Powerade is 96% water

    • @barleyhops38
      @barleyhops38 17 дней назад

      @@infinitelo_op Understood it's water mostly. My question is perhaps too much electrolytes. Is it harmful to heart etc.

    • @StofStuiver
      @StofStuiver 17 дней назад +3

      Im not a medic and i dont think youll get medical advice here from an md. So
      I checked its contents and seems ok to me. According to my online source it is water with
      carbohydrates (ie sugars), saline (NaCl), citric acid, sodiumcitrate, Mg and Ca chlorides, B12, C, potassiumphosphate, etc.
      Seems to be (what it was developed for) a sports drink without any stimulants (as cafeine and so). I see no harm there.
      Generally, your body will ask what it needs by creating that particular appetite for something. If its needs water, you will be thirsty. If it needs sodium, youll crave something salty. You can be 'hungry' for lack of all sorts of nutrients, but youll have a specific craving for things as your body needs that. Biggest things there are sugars, protein and fat. But specific foods may indicate something in there that your body needs (same as pregnancy will cause specific cravings)
      I often find myself craving for something. I can stack up on sugars (potato chips or something) but craving stays. Ive learnt by now that i shouldnt just put anything in my mouth. If i really really want meat, but fill up on sugars, i can keep eating but the craving for meat will not go. So when you feel like eating something, first thing of what sort of thing you would really like. Thats an indication of what your body needs and if you are going to eat anything, it should be that.
      As for the powerade, i see no harm in it. Salt concentration , according to this source says 150mg for a 12 oz, which is alledgedly 6 % of max total intake of salt. So 2 would be 12%.
      Also, dont confuse salt concentration with IV salt concentration.
      Its 'isotonic', so should follow normal gradient of salt in intestines. Also your body can deal with quite a bit wrt that and regulate salt conc, starting with intake. If youd take too high conc of salt, which would negatively affect osmosis in intestines, you are most likely going to throw up. Which is your body saying this is no good.
      As with all things; moderation and variation is wise. Two seems fine to me.

    • @shakeyj4523
      @shakeyj4523 17 дней назад

      Look up how much sodium and potassium you are supposed to have in a day. Calculate how much you are getting in your food and drinks. Do the same for sugar. If you already have too much sugar and salt in your diet, and then you add a sugary drink to that, yes, it is harmful to your entire body. You could look for a drink that does't have so much sugar. Or you could make sure the rest of your diet Plus the drink is not over daily recommendations. You can get the information from the American Heart Association Website.

    • @jonmoceri
      @jonmoceri 17 дней назад

      It's bad because of all the sugar in it.

  • @AdAstra870
    @AdAstra870 14 дней назад

    Is osmotic demyelination brain damage permanent?

    • @Medcram
      @Medcram  13 дней назад +1

      There have been reports of some improvement overtime, but generally yes

  • @martinklawinski2933
    @martinklawinski2933 17 дней назад

    The normal value is what? 135 pears or apples or kg/l?

  • @nattyfatty6.0
    @nattyfatty6.0 17 дней назад

    Just don't drink a gallon of water at once. Unless you weigh 370lb like me and eat a ton of salt, then you should be alright even with two gallons

  • @sylviawelsh9518
    @sylviawelsh9518 10 дней назад +1

    Most MDs don’t understand Diet or electrolyte imbalances just keep writing those scripts.🤨😵‍💫😡

  • @littlevoice_11
    @littlevoice_11 17 дней назад

    😉 This video is sponsored by LMNT 😉

    • @Medcram
      @Medcram  17 дней назад +3

      Not really. Because again this situation has very little to do with the salt or lack of in our diet. It has more to do with the pathological conditions where salt is lost (vomiting for example) and the human being replaces with just free water.