How Can I Raise My Serum Sodium To Frem 127 To 134 In Two Days?

Posted on Sat, 18 Jul 2020

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Sat, 18 Jul 2020 Answered on

Tue, 12 Aug 2025 Last reviewed on

Question : I have necessary spinal surgery in two days. My serum sodium is 127. It must be 134 to procede in 36 hours.. How can increase my sodium in two days. I have had diarrhea, due to taking cathartics for opiate induced diarrhea. I wak 2 miles per day to prepare from months from inactivit for months The heat index of 110 degrees F in S florida.

I re-hydrate with 2 liters of dilute Gatorade per walk How can I raise my serum sodium to frem 127 to 134 in two days? please help.
No diuretics, no thyroid disease. Response is urgent.

Answered by Dr. Rakesh Madhyastha (1 hour later)

Brief Answer:
Low sodium due to loss of electrolytes

Detailed Answer:
Hello Beshapiro

Thank you for reaching out to Healthcaremagic.com. I understand that you will need to normalise your sodium before you undergo spinal surgery. From the history you have provided it looks like your sodium is low due to loss of it from diarrhoea and sweating. I am assuming that the sodium level was checked today. However, to be sure I would like you to answer the following questions

1. Do you have any ongoing kidney problems?
2. Are you still having diarrhoea? If not, when did it stop?
3. How much plain water do you drink per day? Apart from Gatorade.
4. Do you have any symptoms like giddiness, vomiting or difficulty in concentration ?

If you do not have any history of kidney problems then sodium gets corrected on its own because kidneys have the capacity to retain/absorb sodium. Consuming a slightly higher salt in food also naturally brings up the sodium levels. Please consume water to your thirst and not in excess. Drinking 2 litres of Gatorade is not something I would recommend to my patients.

Please get back to me, I am awaiting your reply.

Thank you
Warm regards

Above answer was peer-reviewed by : Dr. Kampana

Answered by Dr. Rakesh Madhyastha (1 hour later)

Brief Answer:
Follow up

Detailed Answer:
Dear Dr XXXXXXX

Thank you for getting back to me and giving me the list of all your medications.

As you are otherwise fit and well with no co morbidities that could cause hyponatremia like the ones you have mentioned like thyroid disorders, kidney disorders and congestive heart failure it is very likely that your sodium will to correct to normal in the next 2 days. I understand how important it is for your sodium to correct.
As suggested in my earlier post, consuming a bit more salt in your diet. i.e adding a pinch more to your regular meal will certainly help.

I would not work you up for SIADH right away with a single reading low sodium and you have history of diarrhoea and dehydration as well. Water restriction is again something I would not recommend without a proper investigated diagnosis, drinking to your thirst is the most optimal thing to do at the moment

Please fell free to get back to me with any further queries.

Warm regards
Rakesh

Above answer was peer-reviewed by : Dr. Kampana

Follow up: Dr. Rakesh Madhyastha (12 hours later)

Are there any other electrolyte, or biochemical levels that would suggest that something other than Water and fluid management be needed?
Do either of the medications: 1. oxcarbazepine or 2. lamotrigine have the side effect of causing hyponatremia?, If so, how long would it take to correct once these medications are stopped?

Answered by Dr. Rakesh Madhyastha (36 hours later)

Brief Answer:
Follow up

Detailed Answer:
Hello

Thanks for getting back to me.

Both the medications you have mentioned could cause hyponatremia. Oxcarbazepine causes hyponatremia in a dose-dependent manner and Lamotrigine causes retention of water leading to low sodium in blood mimicking a hormone called Antidiuretic hormone. I would not recommend stopping this medication before speaking to your doctor. Correction of hyponatremia should happen within 2 days of stopping this drug if this is the cause as this medication has a short half-life.

Today is your operation, please do let me know what the outcome was.

I wish you a speedy recovery
Warm regards
Rakesh

Note: For further queries related to kidney problems and comprehensive renal care, talk to a Nephrologist. Click here to Book a Consultation.

Above answer was peer-reviewed by : Dr. Nagamani Ng