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What Does Light-headedness And Increased Sodium Level In Urine Test Indicate?
Question: I have constant 24/7 lightheadedness and a sodium level of 49 from a 24 hour urine test. My cortisol and aldosterone was apparently normal. Does this mean there's nothing wrong with my adrenals?
Brief Answer:
Following probable causes to constant lightheadedness...
Detailed Answer:
Hi,
I am sorry for the situation you are in.
Having a sodium level of 49 from a 24 hour urine test falls within the normal range. However, it will depend on reference range of the lab where you did the testing for the evaluation of sodium level.
Next, your cortisol and aldosterone level were apparently normal. Can you please upload the full test report, so I can analyze them my self?
There are various factors causing lightheadedness apart electroly imbalance including:
- anemia: a complete blood count will rule it out
- oscillations in blood pressure: monitoring of bp is needed
- hypoglycemia: measure your blood sugar levels at the time when you feel lightheadeded
- spondyloarthrosis: x-ray of the vertebral spine of neck are is advised to rule it out
Next, I need to know:
- when you feel lightheadedness: is it worse when you get up? wake up? lay down? after having your meal?
- are you taking any medication on regular basis?
- any other illness you might be suffering?
Hope it was of help!
Dr.Sejdini
Following probable causes to constant lightheadedness...
Detailed Answer:
Hi,
I am sorry for the situation you are in.
Having a sodium level of 49 from a 24 hour urine test falls within the normal range. However, it will depend on reference range of the lab where you did the testing for the evaluation of sodium level.
Next, your cortisol and aldosterone level were apparently normal. Can you please upload the full test report, so I can analyze them my self?
There are various factors causing lightheadedness apart electroly imbalance including:
- anemia: a complete blood count will rule it out
- oscillations in blood pressure: monitoring of bp is needed
- hypoglycemia: measure your blood sugar levels at the time when you feel lightheadeded
- spondyloarthrosis: x-ray of the vertebral spine of neck are is advised to rule it out
Next, I need to know:
- when you feel lightheadedness: is it worse when you get up? wake up? lay down? after having your meal?
- are you taking any medication on regular basis?
- any other illness you might be suffering?
Hope it was of help!
Dr.Sejdini
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
thank you for getting back to me.
The first time I took the urine test it was 107 under sodium,Ur/volume and then 49 the second time, The other one says 171 under Sodium, Ur/24Hr then the second time it was 103. they told me it was low and to eat a high sodium diet
I'm not sure how to upload my labs so I will try and interpret them:
Acth-24 Serum
Cortisol-15.8
TSH (GMC) 1.607 (range .36-3.7)
T4 Free (GMC)- 1.04 (range .76-1.46)
Cortisol Untimed 25.1 (it says range 1-23ug/dL)
Aldosterone-Serum (that's all it says)
I feel lightheaded ALL THE TIME. it is CONSTANT. I get a headrush type feeling when I stand up but then it doesn't go away. They told me that my blood pressure will drop when I stand up but no one has told me why. The only medication is hydroxyzine for allergies.
The first time I took the urine test it was 107 under sodium,Ur/volume and then 49 the second time, The other one says 171 under Sodium, Ur/24Hr then the second time it was 103. they told me it was low and to eat a high sodium diet
I'm not sure how to upload my labs so I will try and interpret them:
Acth-24 Serum
Cortisol-15.8
TSH (GMC) 1.607 (range .36-3.7)
T4 Free (GMC)- 1.04 (range .76-1.46)
Cortisol Untimed 25.1 (it says range 1-23ug/dL)
Aldosterone-Serum (that's all it says)
I feel lightheaded ALL THE TIME. it is CONSTANT. I get a headrush type feeling when I stand up but then it doesn't go away. They told me that my blood pressure will drop when I stand up but no one has told me why. The only medication is hydroxyzine for allergies.
Brief Answer:
Orthostatic hypotension explained as following.....
Detailed Answer:
Hi back,
From the reports you are proving, it seems that your urine sodium level seems to be borderline reduced. As per the hormones, they were within the normal range.
1. If sodium level is low, your blood pressure (bp) is low too. That's why you feel lightheaded. Once you increase salt intake in your diet, your bp will be elevated too, improving the lightheadedness.
2. If the lightheadedness is aggravated when you stand up, it is called "orthostatic hypotension". When standing up, gravity will cause your blood to pool in your legs. Consequently, less blood is circulating back to your heart to pump again, thus, bp will be quickly dropped.
Normally, the baroreceptors located in your heart and brain will put all the mechanisms into action in order to bring the bp back to normal again.
There are various factors breaking this balance, resulting in reduction of bp and related symptoms.
3. Some of these factor include :
- dehydration: in your case, low sodium level is caused dehydration and consequently orthostatic hypotension.
- heart issues: if I was your caring doctor would advise to run cardiac tests like ECG, holter monitoring, stress test.
- your doctor has already checked your hormones level to exclude endocrine issues like Addison's disease. However, hypoglycemia is to rule out through measuring blood sugar levels
I advise to:
- increase salt intake as recommended by your doctor
- increase fluids intake
- have your meals regularly
- keep monitoring your bp and blood sugar levels
Hope it was of help!
Dr.Sejdini
Orthostatic hypotension explained as following.....
Detailed Answer:
Hi back,
From the reports you are proving, it seems that your urine sodium level seems to be borderline reduced. As per the hormones, they were within the normal range.
1. If sodium level is low, your blood pressure (bp) is low too. That's why you feel lightheaded. Once you increase salt intake in your diet, your bp will be elevated too, improving the lightheadedness.
2. If the lightheadedness is aggravated when you stand up, it is called "orthostatic hypotension". When standing up, gravity will cause your blood to pool in your legs. Consequently, less blood is circulating back to your heart to pump again, thus, bp will be quickly dropped.
Normally, the baroreceptors located in your heart and brain will put all the mechanisms into action in order to bring the bp back to normal again.
There are various factors breaking this balance, resulting in reduction of bp and related symptoms.
3. Some of these factor include :
- dehydration: in your case, low sodium level is caused dehydration and consequently orthostatic hypotension.
- heart issues: if I was your caring doctor would advise to run cardiac tests like ECG, holter monitoring, stress test.
- your doctor has already checked your hormones level to exclude endocrine issues like Addison's disease. However, hypoglycemia is to rule out through measuring blood sugar levels
I advise to:
- increase salt intake as recommended by your doctor
- increase fluids intake
- have your meals regularly
- keep monitoring your bp and blood sugar levels
Hope it was of help!
Dr.Sejdini
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
hello-thanks for getting back to me.
I already was salt loading from the first test to the second test. I was on about 5000 mg/day and it didn't help. I am also hydrating about 100 fl oz a day. Still no help.
I am aware that I have orthostatic hyptenstion but besides salt loading no one has given me any reasoning as to why or what I can do to help it...also-it doesn't explain why I am lightheaded all the time. its not positional.
I have already had numerous heart tests, nothing abnormal
No one has mentioned blood sugar levels. If I am reading your last post correctly my doc has already tested for that. Is that correct?
Basically I have tried everything and nothing seems to be working.
I was recently told I had a Nystagmus but I don't think there is anything I can do about it. I also have headaches but I don't believe the headache is causing the dizziness, I think the headache is a result of the dizziness but everyone seems to want it to be migraine associated vertigo, regardless of what I am telling them.
Thank you for your response but I'm thinking that no one can figure this out.
I already was salt loading from the first test to the second test. I was on about 5000 mg/day and it didn't help. I am also hydrating about 100 fl oz a day. Still no help.
I am aware that I have orthostatic hyptenstion but besides salt loading no one has given me any reasoning as to why or what I can do to help it...also-it doesn't explain why I am lightheaded all the time. its not positional.
I have already had numerous heart tests, nothing abnormal
No one has mentioned blood sugar levels. If I am reading your last post correctly my doc has already tested for that. Is that correct?
Basically I have tried everything and nothing seems to be working.
I was recently told I had a Nystagmus but I don't think there is anything I can do about it. I also have headaches but I don't believe the headache is causing the dizziness, I think the headache is a result of the dizziness but everyone seems to want it to be migraine associated vertigo, regardless of what I am telling them.
Thank you for your response but I'm thinking that no one can figure this out.
Brief Answer:
Following advice....patience is required....
Detailed Answer:
Hi back my dear,
1. Sodium loading is one part of your history.
2. As long as no heart problem is being detected, then, Echo doppler of the blood vessels especially of the legs and carotid arteries is advised to evaluate their function.
3. As per blood sugar levels (bsl), I did not notice any report regarding your bsl. You can take a random testing at your local pharmacy or after fasting.
4. You are right; headache is the result of dizziness.
5. Eyes and ENT examinations are needed to rule out related problems.
6. You should be patient because, all these tests are necessary to identify your true problem and try to get it resolved.
If you have not done such examinations so far, can discuss with your doctor about my suggestions. You can also disccuss to run Ct-scan of your brain to rule out related issues too.
Improvement might need time to be visible. You should be consistent and patient.
All the best!
Dr.Sejdini
Following advice....patience is required....
Detailed Answer:
Hi back my dear,
1. Sodium loading is one part of your history.
2. As long as no heart problem is being detected, then, Echo doppler of the blood vessels especially of the legs and carotid arteries is advised to evaluate their function.
3. As per blood sugar levels (bsl), I did not notice any report regarding your bsl. You can take a random testing at your local pharmacy or after fasting.
4. You are right; headache is the result of dizziness.
5. Eyes and ENT examinations are needed to rule out related problems.
6. You should be patient because, all these tests are necessary to identify your true problem and try to get it resolved.
If you have not done such examinations so far, can discuss with your doctor about my suggestions. You can also disccuss to run Ct-scan of your brain to rule out related issues too.
Improvement might need time to be visible. You should be consistent and patient.
All the best!
Dr.Sejdini
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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