Confusion and Nausea? Why Your Sodium Is Low (Hyponatremia) & Medical Next Steps

If you're feeling confused, nauseated, unusually tired, or just "not yourself," low sodium levels in your blood—called hyponatremia—could be a possible cause.

Hyponatremia is a common but sometimes serious medical condition. It happens when the level of sodium in your blood falls below normal. Sodium is an essential electrolyte that helps regulate:

• Fluid balance in and around your cells
• Blood pressure
• Nerve and muscle function
• Brain activity

When sodium levels drop too low, your body—especially your brain—can't function properly. Understanding why this happens and what to do next can help you stay safe and get appropriate care.

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What Is Hyponatremia?

Hyponatremia occurs when blood sodium levels fall below 135 mEq/L. It can range from mild to severe:

• Mild: 130–134 mEq/L
• Moderate: 125–129 mEq/L
• Severe: Below 125 mEq/L

The more rapidly sodium levels fall, the more dangerous the situation can be. A slow decline may cause subtle symptoms. A sudden drop can become life-threatening.

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Why Low Sodium Causes Confusion and Nausea

Sodium plays a key role in balancing fluids inside and outside your cells. When sodium levels fall:

1. Water moves into cells.
2. Cells begin to swell.
3. Brain cells are especially sensitive to swelling.

Because your skull limits space, brain swelling can lead to symptoms such as:

• Confusion
• Headache
• Nausea and vomiting
• Drowsiness
• Difficulty concentrating
• Irritability

In more severe cases, hyponatremia can cause:

• Muscle cramps or weakness
• Seizures
• Loss of consciousness
• Coma

This is why confusion combined with nausea should never be ignored—especially in older adults.

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Common Causes of Hyponatremia

Hyponatremia usually develops because of an imbalance between water and sodium—not simply from "not eating enough salt."

Here are the most common causes:

1. Drinking Too Much Water

Excessive water intake can dilute sodium levels. This sometimes occurs in:

• Endurance athletes
• People with psychiatric conditions affecting water intake
• Individuals following extreme "detox" routines

2. Medications

Certain medications increase the risk of hyponatremia, including:

• Diuretics (water pills)
• Some antidepressants (SSRIs)
• Anti-seizure medications
• Certain pain medications

Older adults are especially vulnerable.

3. Hormonal Conditions

Problems with hormone regulation can affect sodium balance:

• Adrenal insufficiency
• Hypothyroidism
• Syndrome of inappropriate antidiuretic hormone (SIADH)

4. Heart, Liver, or Kidney Disease

Chronic medical conditions can disrupt fluid regulation and cause dilutional hyponatremia.

5. Vomiting or Diarrhea

Prolonged gastrointestinal illness can lead to sodium loss and dehydration.

6. Post-Surgery or Severe Illness

Hospitalized patients are at higher risk due to IV fluids, medications, or stress-related hormone changes.

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Who Is Most at Risk?

Certain groups are more likely to develop hyponatremia:

• Adults over age 65
• People taking diuretics
• Endurance athletes
• Individuals with heart, liver, or kidney disease
• Hospitalized patients
• People with chronic alcoholism

If you fall into one of these categories and develop confusion or nausea, medical evaluation is especially important.

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When Is Hyponatremia an Emergency?

Mild hyponatremia may cause only subtle symptoms. However, severe or rapidly developing hyponatremia is a medical emergency.

Seek immediate medical care if someone experiences:

• Sudden confusion
• Seizures
• Severe headache
• Persistent vomiting
• Loss of consciousness
• Difficulty staying awake

Do not wait to "see if it gets better." Rapid sodium shifts can be life-threatening.

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How Doctors Diagnose Hyponatremia

Diagnosis is straightforward with a blood test measuring sodium levels. However, identifying the cause requires additional evaluation.

Your doctor may order:

• Blood electrolyte panel
• Urine sodium and osmolality tests
• Kidney function tests
• Thyroid and adrenal hormone testing
• Review of medications

Because treatment depends entirely on the underlying cause, accurate diagnosis is critical.

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Treatment for Hyponatremia

Treatment varies depending on:

• How low sodium levels are
• How quickly levels dropped
• The underlying cause
• Your overall health

Mild Cases

If symptoms are minimal, treatment may include:

• Fluid restriction
• Adjusting medications
• Monitoring sodium levels

Moderate Cases

Doctors may:

• Administer IV fluids carefully
• Address hormonal imbalances
• Treat underlying conditions

Severe Cases

Severe hyponatremia requires hospital care. Treatment may include:

• Hypertonic saline (carefully controlled IV sodium solution)
• Intensive monitoring
• Seizure management

It's important to note: Sodium must be corrected slowly. Raising levels too quickly can cause a serious neurological condition called osmotic demyelination syndrome. That's why medical supervision is essential.

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Can You Treat Hyponatremia at Home?

You should not attempt to self-treat hyponatremia with salt tablets or sports drinks without medical guidance.

While mild cases may only require fluid adjustments, the wrong approach can make the problem worse—especially if the cause involves fluid retention rather than sodium loss.

If you're experiencing symptoms like confusion, nausea, or unexplained fatigue and want to understand whether Hyponatremia could be the cause, a quick assessment may help you determine if you need to seek medical care right away.

However, an online tool is not a substitute for professional evaluation.

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Preventing Hyponatremia

Prevention depends on managing underlying risks.

General tips include:

• Avoid excessive water intake unless medically advised
• Follow your doctor's instructions if you take diuretics
• Replace fluids appropriately during prolonged exercise
• Monitor chronic conditions carefully
• Report new confusion or nausea promptly

Older adults should be especially cautious, as symptoms may be mistaken for normal aging or dementia.

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Why You Shouldn't Ignore Confusion

Confusion is never "normal." Even mild disorientation can signal a serious imbalance like hyponatremia.

In older adults, hyponatremia may present as:

• Falls
• Memory issues
• Personality changes
• Fatigue
• Poor appetite

Because these symptoms overlap with other conditions, blood testing is often needed to identify the cause.

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The Bottom Line

Hyponatremia is a potentially serious condition caused by low sodium levels in the blood. It can lead to confusion, nausea, headache, and in severe cases, seizures or coma.

The key points to remember:

• Sodium is essential for brain and body function.
• Symptoms often involve confusion and nausea.
• Rapid drops in sodium are dangerous.
• Treatment depends on the underlying cause.
• Severe cases require emergency care.

If you are experiencing confusion, vomiting, severe headache, seizures, or extreme drowsiness, seek emergency medical attention immediately.

Even if symptoms seem mild, it's wise to speak to a doctor about persistent nausea, mental changes, or unusual fatigue—especially if you have risk factors for hyponatremia.

Low sodium is treatable. The most important step is recognizing the symptoms early and getting appropriate medical care.