As with everyone I like to try to piece together some of the patterns of this lovely disease that apply to me, to help better target the treatment. I’ve got my vitamin D deficiency squared away as likely related, and a serum uric acid coming up a bit high (thanks for the help wth that one tntlamb), but cant find anything on chronic mild sodium deficiency. Has anyone else had this experience or heard of it? It is not enough for my rhuemy to have raised it as an issue with me, but it is certainly anomalous and associated with poor long term outcomes (between about 130 - 136, at worst 128). I am very conscious of my diet, and this issue is definitely not related to inadequate intake of salt, or excessive water consumption.
Aside from drinking too much water, the only three things I know cause low sodium (In order)
1. Drinking too much Beer (really)
2. A recent course of predi (or other steroid) it can take several months to recover.
3. And heres the bad one.... Arthritis. Apparently arthrits can effect the adrenal glands which sets off a chain reaction which ultimatley reduces sodium. OR the arthrits effects the kdneys which effects the Adrenals (they live on top)
A 128 isn't bad some labs call 130 normal. I'd ask your rheumy but unless you having symptoms (and who know if you are they are the same as PsA except muscle spasms are worse. I wouldn't worry about it. Now if you live near Scott and have been getting into his swill (he calls it Blue Moon) it could be a really easy fix. I'm betting on #2 though. (There is actually a fourth which is asthma medicine but its really the same as 2 - steroids)
Thanks for the info guys (sorry about the slow response).
My lab uses 136 - 144 as normal, pretty consistent with most sources that say 135 - 130 is mild, and 130 - 125 is moderate, both of which can be chronic but almost a symptomatic.
Not beer - at least not anymore Damn MTX
Still on steroids - low dose at 5mg maintenance and up to 12 - 15 on flares, which are pretty regular. Couldn’t find much to indicate why pred would lower sodium (though I could see why it’s withdrawal would), any references you can point me in the direction of lamb?
Arthritis - yep, also the effects on IL 6, though I would have thought I’d have to be in worse shape than I am (dodgy, but no canes or wheelchairs yet, and still working) before the IL 6 would have a big impact on sodium.
Oddly enough, it’s just that the salt cravings are driving me to distraction - literally, particularly at work. It also makes me want to eat, and I really don’t need to add extra weight to my joints. I’m also thirsty all the time, but then that’s probably to be expected with so much salt intake!
Anyway, it’s been going on for ages and I never think to mention it to my Rhuemy, so I’ll make a concerted effort this time
Its one of those catch 22's...... The use of predi causes fluid retention. More water in the body dilutes everything so blood levels are lower. Going off Predi changes your metabolism so less is retained. Its mostly a dietary thing. Anyway the condition is called: hyponatremia Researching that will give you more detail. Here a Site I use for a lot of stuff:
Heres the other funny thing Predi can cause the OPPOSITE to. Kigh sodium
You might also if you want to go wild check about MTX and low sodium. There is a link there also, but near as I can tell its in the higher Chemo doses.
Damn MTX