Sodium, Serum (Natrium)

Optimal Result: 134 - 144 mmol/L.

What is a Sodium test?

This test measures the levels of sodium in your blood and is usually done as part of an electrolyte or basic metabolic panel blood test.

The sodium test may also be ordered separately if you have:

  • eaten large amounts of salt
  • not eaten enough or had enough water
  • a serious illness, or gone through surgery
  • received intravenous fluids

You may also receive this test to monitor medications that affect your sodium levels. These include diuretics and certain hormones.

Elevated or decreased amounts of sodium in your body can have many adverse health effects ranging from as minor as thirst to as serious as a coma in incredibly severe cases. Monitoring the healthy level of this essential mineral is incredibly important to your overall health.

A sodium blood test is used to detect an abnormal sodium level, including low sodium (hyponatremia) and high sodium (hypernatremia). It is often used as part of an electrolyte panel or basic metabolic panel for a routine health exam.

A blood sodium test may also be used to:

  • Help detect, evaluate, and monitor electrolyte imbalances and/or acid-base (pH) imbalances (acidosis or alkalosis)
  • Detect the cause and help monitor the treatment if you have dehydration or excess fluid buildup (edema)
  • Help evaluate and monitor a variety of chronic or acute illnesses involving the brain, lungs, liver, heart, kidney, thyroid, or adrenal glands
  • Monitor if you are taking medications that can affect sodium levels, such as diuretics

Urine sodium levels may be tested if you have abnormal blood sodium levels to help determine whether an imbalance is due to, for example, consuming too much or losing too much of the mineral. Also, if you have abnormal kidney test results, urine sodium testing may help your health practitioner determine the cause of kidney disease and help guide treatment.

As the meals we eat on a given day affect our sodium levels, a 24-hour urine sodium test can be helpful to your health practitioner to reduce the impact of a single meal on the urine sodium result.

As mentioned above, the sodium blood test is often part of a basic metabolic panel. This is a group of related tests. The basic metabolic panel includes tests for: calcium, bicarbonate, chloride, creatinine, glucose, potassium, sodium and blood urea nitrogen. Blood sodium can also be part of an electrolyte panel. Electrolytes are substances that carry an electrical charge. Potassium and chloride are other electrolytes.

What is Sodium & what are the main functions of Sodium?

Sodium is an electrolyte in all body fluids that is vital to normal body function, including nerve and muscle function. Sodium is a substance your body's cells need to work normally. Sodium helps make sure that your nerves and muscles can work as they should. Sodium is also important because it helps maintain the right balance of fluids in your body. The kidneys help keep sodium at a healthy level. 

Sodium is particularly important for nerve and muscle function. Your body keeps sodium in balance through a variety of mechanisms. Sodium gets into your blood through food and drink. It leaves the blood through urine, stool, and sweat. Having the right amount of sodium is important for your health. Too much sodium can raise your blood pressure.

Balancing Sodium in your body:

Too much sodium in the blood is called hypernatremia. Too little sodium in the blood is called hyponatremia

Hypernatremia can occur when you lose too many fluids. This can happen from sweating too much, vomiting, or diarrhea. 

Hyponatremia can occur when you drink large amounts of water or if you have problems with your kidneys that affect your ability to urinate. 

We get sodium in our diet from table salt (sodium chloride or NaCl) and, to some degree, from most foods we eat. Most people have an adequate intake of sodium. The body uses what it requires, and the kidneys eliminate the rest in the urine. The body tries to keep the blood sodium within a very narrow range. It does this by:

  • Producing hormones that can increase (natriuretic peptides) or decrease (aldosterone) the amount of sodium eliminated in urine
  • Producing a hormone that prevents water losses, known as antidiuretic hormone (ADH) and, sometimes called vasopressin
  • Controlling thirst; even a 1% increase in blood sodium will make you thirsty and cause you to drink water, returning the sodium level to normal

When the level of sodium in the blood changes, the water content in the body also changes. These shifts can be associated with too little fluid (=dehydration) or too much fluid (=edema), often resulting in leg swelling.

What are electrolytes?

Electrolytes are minerals that carry a charge and exist in your body fluids. Sodium and other electrolytes such as potassium, chloride, and bicarbonate (or total CO2) help cells function normally and regulate the body’s fluid. While sodium is present in all body fluids, it is found in the highest concentration in the blood and the fluid outside of the body’s cells. This extracellular sodium, as well as all body water, is regulated by the kidneys.

Normal Sodium levels:

Normal results for the sodium test are usually 135 - 145 mEq/L (milliequivalents per liter).. But different laboratories use different values for “normal.

Sources:

Sodium - labtestsonline.org/understanding/analytes/sodium/tab/test/

Lewis, J. L. (n.d.). Hypernatremia (High level of sodium in the blood)

merckmanuals.com/home/hormonal-and-metabolic-disorders/electrolyte-balance/hypernatremia-high-level-of-sodium-in-the-blood

Takahashi, P. (2014, July 8). Why is low blood sodium a health concern for older adults? How is it treated? Retrieved from

mayoclinic.com/health/low-blood-sodium/AN00621

References:

Al-Awqati Q. Disorders of sodium and water. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 108.

Oh MS, Briefel G, Pincus MR. Evaluation of renal function, water, electrolytes, and acid-base balance. In: McPherson RA, Pincus MR, eds. Henry's Clinical Diagnosis and Management by Laboratory Methods. 24th ed. Philadelphia, PA: Elsevier; 2022:chap 15

What does it mean if your Sodium, Serum (Natrium) result is too high?

Elevated Sodium levels:

Hypernatremia means high levels of sodium in the blood. It’s defined as levels that exceed 145 mEq/L

Symptoms of hypernatremia include:

  • thirst
  • fatigue
  • swelling in hands and feet
  • weakness
  • insomnia
  • rapid heartbeat
  • coma

Hypernatremia is most often a problem in older adults, infants, and people who are bedridden. 

Causes of hypernatremia include:

  • not drinking enough water
  • drinking salty water
  • eating too much salt
  • excessive sweating
  • diarrhea
  • low levels of hormones such as vasopressin
  • high levels of aldosterone
  • Cushing’s syndrome, caused by excessive cortisol

Certain medications can also potentially cause hypernatremia. These include:

  • birth control pills
  • corticosteroids
  • laxatives
  • lithium
  • nonsteroidal anti-inflammatory pain medications

What does it mean if your Sodium, Serum (Natrium) result is too low?

A lack of sodium can cause symptoms such as:

  • nausea
  • vomiting
  • exhaustion
  • dizziness

Abnormally low levels:

A blood sodium level lower than 135 mEq/L is called hyponatremia

Symptoms of hyponatremia include:

  • fatigue
  • nausea and vomiting
  • headache
  • loss of appetite
  • confusion or disorientation
  • hallucinations
  • loss of consciousness or coma

Hyponatremia can cause damage to cells. It makes them swell up with too much water. This may be particularly dangerous in areas such as the brain.

Hyponatremia is more often a problem in older adults. It can be caused by:

  • diuretics
  • antidepressants
  • certain pain medications
  • large burns on the skin
  • kidney disease
  • liver disease or cirrhosis
  • severe diarrhea or vomiting
  • heart failure
  • high levels of certain hormones, such as antidiuretic hormone or vasopressin
  • drinking too much water
  • not urinating enough
  • excessive sweating
  • ketones in the blood, known as ketonuria
  • underactive thyroid, or hypothyroidism
  • Addison’s disease, which is low hormone production in the adrenal gland

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