Do low salt levels slow down stroke recovery? DR MARTIN SCURR answers your health questions 

My father is now coming into his thirteenth week in hospital after a suspected stroke. In 2017 he was instructed he had low ranges of sodium and now this seems to be hindering his restoration, because it means he’s on a restricted fluid consumption and ‘sluggish’ sodium tablets which depart him weak, drained and confused.

Jackie Stanbury, by way of e-mail.

We hear a lot about the necessity to minimize our salt consumption to keep away from hypertension however, in reality, all of us want some salt — within the type of sodium — because it’s utilized by the physique for wholesome muscle and nerve perform.

Nonetheless, it could simply be depleted, often because of remoted incidents corresponding to vomiting or diarrhoea.

However often it’s a side-effect of a drugs corresponding to diuretics (water tablets) used to cut back hypertension —which is why older persons are extra liable to it.

Low sodium ranges are additionally linked to circumstances corresponding to kidney failure, or extreme launch of the hormone vasopressin, the so-called anti-diuretic hormone (ADH).

We hear a lot about the necessity to minimize our salt consumption to keep away from hypertension however, in reality, all of us want some salt — within the type of sodium — because it’s utilized by the physique for wholesome muscle and nerve perform

In your longer letter you say that your father’s sodium stage went all the way down to 118mEq/L — something under 120 is considered extreme.

It’s not clear what induced this however it’s potential that, reasonably than a stroke, your father had some type of seizure as a consequence of swelling of the mind, which is a recognised complication of low sodium ranges. (Your father would have had mind scans in hospital and I assume that no agency analysis was reached about him having had a stroke, or the trigger.)

Nonetheless, the one approach to decide if it was a seizure is that if somebody noticed this occur.

The same old therapy for low sodium is fluid restriction to cut back the quantity of sodium flushed out within the urine.

Your father has additionally been placed on ‘sluggish’ sodium tablets, the place the mineral is sealed in a manner in order that it’s progressively leached out because it passes via the gut, and never dumped in a single large hit, guaranteeing the sodium is best absorbed. 

Often it’s a side-effect of a drugs corresponding to diuretics (water tablets) used to cut back hypertension —which is why older persons are extra liable to it [File photo]

That is the usual therapy for extreme ranges of ADH, and the truth that he’s been prescribed this means to me that is the reason for your father’s low sodium ranges.

I additionally assume that the signs you describe, corresponding to confusion, are linked to the low sodium and to not the therapy he’s having — which might be serving to his restoration, by elevating his sodium ranges, reasonably than hindering it.

In case your father does, certainly, have an excessive amount of ADH, what’s unclear is whether or not the staff treating him has additionally prompt an ADH receptor antagonist. These medicine assist the physique produce extra water with out lowering sodium ranges and provide the perfect probability of him not having a relapse as soon as his sodium tablets are stopped.

I like to recommend you communicate to the advisor caring to your father on the ward, and ask them in regards to the subsequent steps for therapy — presumably together with ADH receptor antagonist medicine.

Write to Dr Scurr  

Write to Dr Scurr at Good Well being, Day by day Mail, 2 Derry Avenue, London W8 5TT or e-mail: drmartin@dailymail.co.uk — embrace contact particulars. Dr Scurr can not enter into private correspondence. Replies must be taken in a normal context. Seek the advice of your individual GP with any well being worries.

For my part: Each residence wants a blood stress monitor

Some new findings will be so astonishing you realise that, as docs, we should always have been treating sufferers utterly in another way.

Most lately the analysis which impressed such an epiphany was about diabetes, which is now more and more widespread, principally attributed to the rising ranges of weight problems.

A examine printed in The Lancet in November means that for each 20mmHg enhance in blood stress above a wholesome studying (140/90 mmHg), there’s a 77 per cent enhance within the threat of sort 2 diabetes.

What this implies is screening everyone for raised blood stress is extra vital than ever, as treating it might assist stop diabetes. We already know that these with diabetes and hypertension are more likely to have heart problems, placing them liable to life‑threatening occasions corresponding to coronary heart assaults and stroke.

I wish to see everyone who’s most liable to raised blood stress, particularly these of center age and past, utilizing their very own easy blood stress machine at residence to maintain a daily test on their blood stress stage.

These don’t price a lot — round £20 out of your native chemist.

For my part these are as important a bit of family gear as a washer, a toaster or kettle.

Proudly owning and utilizing one could properly save your life.