President's Message

Good Morning Friends,

This month's message will be a bit different than normal. I am a big fan of learning from others so heed my error. A few weeks ago I found myself in the hospital thinking I was having a heart attack. Fortunately, no heart attack and I’m doing great. After arriving at the ER and a plethora of tests, the ER doctor said my sodium chloride was dangerously low, and they need to admit me until it’s at acceptable levels.

For those who know me, you know I eat a ton of quality sea salt, so how did this happen? To compound the low sodium issue I was also severely dehydrated. Below you will find symptoms and preventative measures for low sodium chloride and dehydration. These findings are AI generated and it did reference WebMD and other medical websites.

Low sodium in the blood is called hyponatremia. It means the sodium concentration is below the normal range—typically below about 135 mmol/L (mine was 128). Sodium is important for nerve function, muscle function, and maintaining the body’s fluid balance.

Why low sodium can be dangerous

The biggest concern is the brain. When blood sodium becomes too low, water can move into cells and cause them to swell. Brain swelling can lead to neurological symptoms and, when severe or rapid, can become life-threatening.

Symptoms can include:

• Headache
• Nausea or vomiting
• Fatigue or unusual drowsiness
• Weakness or muscle cramps
• Confusion, irritability, or restlessness
• Muscle twitching
• Seizures
• Loss of consciousness or coma in severe cases

A rapid drop is particularly dangerous. Acute hyponatremia can cause significant brain swelling, while sodium that falls gradually may produce fewer or milder symptoms.

What causes it?

Interestingly, low blood sodium isn’t usually simply from “not eating enough salt.” Causes can include drinking excessive amounts of water, vomiting/diarrhea, heavy sweating, certain medications, kidney/heart/liver problems, hormonal problems, and SIADH, among others.

Treatment depends heavily on why the sodium is low. In some cases doctors restrict fluids; in others, IV fluids or medications may be needed. Sodium generally needs to be corrected carefully because raising it too quickly can also cause serious neurological injury.

If someone with known or suspected low sodium develops confusion, repeated vomiting, a seizure, severe drowsiness, or loses consciousness, that’s an emergency and they should receive immediate medical attention.

Dehydration happens when your body loses more fluid than it takes in. It can range from mild to life-threatening, especially if it becomes severe or happens quickly.

What dehydration can cause

• Thirst, dry mouth, and dark urine
• Headache, dizziness, and weakness
• Fatigue and difficulty concentrating
• Muscle cramps
• Fast heartbeat or breathing
• Low blood pressure, which can cause fainting
• Kidney problems, including kidney injury if severe
• Electrolyte abnormalities, including changes in sodium and potassium that can affect muscles, nerves, and the heart
• In severe cases, confusion, extreme weakness, shock, loss of consciousness, or organ damage

When it’s an emergency

Seek urgent medical help if someone who may be dehydrated has confusion, fainting, inability to keep fluids down, very little/no urination, severe weakness, rapid breathing/heartbeat, or significant worsening symptoms.

Dehydration and low sodium can sometimes occur together, but they don’t always. Drinking excessive amounts of plain water while dehydrated can actually make blood sodium dangerously low in some circumstances.

My input on dehydration; if you tongue is sticky/dry you are dehydrated to the point you need an IV. Pinch the back of your hand, if it snaps back you are good. If it is slow to get to normal you are dehydrated.

Low sodium (hyponatremia) and dehydration occurring together can be particularly concerning because they affect the body’s fluid balance, blood pressure, brain function, kidneys, and electrolytes.

Why the combination is dangerous

With dehydration, you lose water and often sodium and other electrolytes. If sodium falls significantly at the same time, the body can struggle to maintain adequate circulation while the brain is affected by the abnormal sodium concentration.

Possible complications include:

• Severe dizziness or fainting from low blood volume and blood pressure
• Confusion, unusual sleepiness, or difficulty thinking
• Severe headache, nausea, or vomiting
• Muscle weakness, cramps, or twitching
• Rapid heartbeat
• Kidney injury from inadequate blood flow to the kidneys
• Seizures or loss of consciousness when sodium becomes severely low, particularly if it falls rapidly
• In extreme cases, brain swelling, shock, organ damage, or death

An important complication

It can be tempting to treat dehydration by drinking large amounts of plain water. If the person’s sodium is already low, excessive plain water can dilute the sodium further and make hyponatremia worse. On the other hand, simply consuming a lot of salt isn’t necessarily the right treatment either. The appropriate treatment depends on the cause and severity.

Also, sodium must be corrected carefully. Raising it too quickly after significant hyponatremia can cause a serious neurological condition called osmotic demyelination syndrome.

When to get emergency help

If someone has known or suspected low sodium plus dehydration and develops confusion, severe drowsiness, fainting, seizure, severe weakness, repeated vomiting, inability to drink/keep fluids down, or very little/no urine, they should receive emergency medical evaluation.

When dehydration and low blood sodium (hyponatremia) occur together, symptoms can overlap, and the combination can become serious.

Common signs

• Strong thirst or dry mouth
• Dark yellow urine or urinating less often
• Dizziness, especially when standing
• Headache
• Weakness or unusual tiredness
• Nausea or vomiting
• Muscle cramps or weakness
• Fast heartbeat
• Feeling lightheaded or faint
• Difficulty concentrating or feeling mentally “foggy”

Warning signs of worsening hyponatremia

These are more concerning:

• Increasing confusion or disorientation
• Unusual sleepiness or difficulty staying awake
• Severe headache
• Significant muscle weakness
• Repeated vomiting
• Problems walking or coordinating movements
• Seizure
• Loss of consciousness

Confusion, seizure, loss of consciousness, or severe difficulty staying awake is an emergency—call 911.

Because dehydration can also cause low blood pressure and electrolyte abnormalities, symptoms alone can’t reliably tell you how low the sodium is. A blood electrolyte panel is usually needed.

Please feel free to forward this to you crews or anyone else you think may need this information.

Your humble President,

BRION YANCY, PSM

Previous 2026 Messages
January 2026
February 2026
March 2026
April 2026
May 2026
June 2026
July/August 2026