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You have not mentioned why are you taking losartan.
The ARB losartan + bystolic -- a new type of beta blocker -- for hypertension.
.79% of the patients on losartan developed hyponatremia which is eerily similar to the .89% who developed the condition from lisinopril. ARBs and ACEs accomplish the same thing via different routes; so it's reasonable to suggest that a person who is sensitive to one would be sensitive to the other.
I'm going to mention this to the medico after seeing the results of the caffeine restriction. Thanks for the heads-up.
ACE inhibitors can cause Syndrome of Inappropriate Antidiuretic Hormone secretion (SIADH) with water retention. This means that every time you consume a lot of water (either from beverages or foods), the body retains some water, which automatically causes the drop of blood sodium levels.
When the cause of SIADH cannot be removed (for example, no appropriate substitute for losartan), water restriction (amount to be discussed with a doctor) can help to correct hyponatremia.
So, the thing in coffee that could contribute to hyponatremia is - water.
If caffeine withdrawal happens to increase your sodium levels, i would appreciate if you can report it here.
Caffeine was withdrawn to a measly 40 mg. a day but hyponatremia is still alive-and-well. In addition, this disorder has provided the impetus to markedly cut back on alcohol, from 24 drinks per week a year ago, to 16 drinks a week six months ago, and now 8 drinks a week. None of this reduction has had any effect on the sodium levels.
In addition, during the past three months, potassium has become elevated (hypernatremia). So I have low sodium and high potassium. Crazy electrolyte syndrome, ain't it.
Now it's back to the drawing board with an appt. in four weeks with a nephrologist.
I'm still suspicious of the Losartan (ARB) I take for hypertension. A yr. ago the primary replaced Lisinopril (ACE inhibitor) with Losartan in the belief that Lisinopril was causing the problem. But search engine research revealed that the risk factors for low sodium for both drugs is about the same. Furthermore, 2% of Losartan users develop elevated potassium. That's a relatively high percentage.
The hormone aldosterone stimulates sodium retention and potassium excretion in the kidneys. So, when the activity of the hormone aldosterone is lowered, more sodium is excreted and more potassium re-absorbed, which results in hyponatremia and hyperkalemia. The disorder can be in the adrenal gland, which secretes aldosterone (adrenal insufficiency), in the kidney, which does not respond to aldosterone action, or in medications that block aldosterone action, including ACE-inhibitors. So, yes, it can be losartan...I don't know, what is your underlying disorder, which by itself could cause electrolyte disturbances.
Saying, by a doctor, that SIADH has been ruled out is a big word; SIADH has many causes, including various types of stress (pain, anxiety, severe physical exertion...), various drugs, many pulmonary disorders, including tuberculosis and lung cancer (this one can be small, not detectable on MRI in early stages and completely without symptoms), various brain disorders, cancers (a combination of various weird symptoms and lab values associated with cancer is called paraneoplastic syndrome) and, of course, there is an idiopathic SIADH with no known cause.
Still, trying another drug that does not mess with sodium, might be the next step before other investigations, but a doctor should tell.
The hormone aldosterone stimulates sodium retention and potassium excretion in the kidneys. So, when the activity of the hormone aldosterone is lowered, more sodium is excreted and more potassium re-absorbed, which results in hyponatremia and hyperkalemia. The disorder can be in the adrenal gland, which secretes aldosterone (adrenal insufficiency), in the kidney, which does not respond to aldosterone action, or in medications that block aldosterone action, including ACE-inhibitors. So, yes, it can be losartan...I don't know, what is your underlying disorder, which by itself could cause electrolyte disturbances.
Saying, by a doctor, that SIADH has been ruled out is a big word; SIADH has many causes, including various types of stress (pain, anxiety, severe physical exertion...), various drugs, many pulmonary disorders, including tuberculosis and lung cancer (this one can be small, not detectable on MRI in early stages and completely without symptoms), various brain disorders, cancers (a combination of various weird symptoms and lab values associated with cancer is called paraneoplastic syndrome) and, of course, there is an idiopathic SIADH with no known cause.
Still, trying another drug that does not mess with sodium, might be the next step before other investigations, but a doctor should tell.
Yeah, I wouldn't dismiss lung ca even though recent X-ray was negative. Formerly a heavy smoker. Regarding SIADH, it's my understanding that the hormone is produced excessively. In my case, there is excessive urination, especially nocturia, often six times at night, voiding up to 90 ozs. This suggests that the hormone is under-secreted.
My sister has issues with hyponatremia but the symptoms aren't bad until she gets down to 125 or below - and you're right that a gradual change causes fewer symptoms. She has kidney issues, mild (so far) congestive heart failure and some related issues. She's actually told to use a lot of salt but that can be a catch 22 as that increases fluid retention which exacerbates her heart failure problem - then she's told to limit fluid intake to 24 oz. a day. So quite a tightrope!
Good luck in your journey - the good thing is that you don't have any other apparent issues related to kidney or heart!
I am an epileptic since childhood, Im 58 y/o. surgery on hold-sodium level of 129..??
Yeah, the normal ref. range is like 135-144 so 129 may be a contraindication to surgery.
Some people are hospitalized when it drops to certain levels but if the correction is too rapid, there's a risk of central pontine myelinolysis which can cause severe brain damage. They really need to watch you carefully when they decide to use this therapy.
In my case which is believed caused by losartan potassium which is an angiotensin II receptor antagonist for high blood pressure and which tends to lower sodium while raising potassium, a renal specialist added a small dosage of furosemide (Lasix) a water pill which does the opposite. My sodium is now usually in the normal range and the potassium is at the higher limits of normal or slightly above normal.
I don't worry about caffeine at all now. In fact I love it for the buzz.
I use a lot of caffeine, mostly in the form of tea and iced tea, and I also drink water every day. Two years ago, a blood test showed i had mild hyponatremia. Again yesterday, a blood test came back with the same results: Low blood sodium and also the chloride was low. I was also given several other tests for my kidneys and a CAT scan. Obviously, caffeine is the cause because it is a diuretic. Also, I consume more liquid overall, because I drink caffeinated beverages when I am not really thirsty, just for enjoyment.
Everyone's body is different, even a small amount of caffeine can cause hyponatremia in some people.
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