|Year : 2020 | Volume
| Issue : 3 | Page : 242-243
Hyponatremia and hypothyroidism
Department of Community Medicine, Dr DY Patil University, Pune, Maharashtra, India; Department of Medical Science, Faculty of Medicine, University of Nis, Nis, Serbia; Department of Biological Science Joseph Ayobabalola University, Ikeji- Arakeji, Osun State, Nigeria; Departement of Laboratory Medicine, Chulalongkorn University, Bangkok, Thailand
|Date of Submission||28-May-2019|
|Date of Decision||15-Oct-2019|
|Date of Acceptance||15-Oct-2019|
|Date of Web Publication||3-Jun-2020|
Chulalongkorn University, Bangkok
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Wiwanitkit V. Hyponatremia and hypothyroidism. Med J DY Patil Vidyapeeth 2020;13:242-3
Hypothyroidism is an important endocrine disorder. In clinical practice, this condition is a significant thyroid disease. There are many metabolic complications in patients with hypothyroidism. An electrolyte imbalance is a possible clinical challenge. In a publication in the journal, decreased serum sodium is observable. In fact, abnormal serum sodium is an important but little mentioned metabolic alteration seen in patients with hypothyroidism.,, Low serum sodium is observable, and the type of hyponatremia is euvolemic. The main pathomechanism is the decreased capacity of free water excretion due to hypothyroidism-related, cardiac output-induced increased antidiuretic hormone levels. The incidence of this problem is about 4%. Nevertheless, there are often additional nonthyroid-related factors causing hyponatremia. Some researchers propose that hyponatremia is only a coincidence in a patient with hypothyroidism., It is suggested that blood sodium investigation should be done in any patient with hypothyroidism., On the other hand, the investigation for thyroid function test should be done in any patient presenting with hyponatremia. In a recent report from Japan, 1.3% of patients with hyponatremia had hypothyroidism. Additionally, hyponatremia might co-occur with hypercreatinemia in patients with hypothyroidism. Nevertheless, hypercreatinemia is more common than hyponatremia in patients with hypothyroidism. Hypothyroidism-related hyponatremia can be seen in any group of patients, ranging from infants to elderly people. Pediatric patients might develop a clinical complex of massive myxedema, hyponatremia, and hypothermia. Hyponatremia can be managed and returned to normal if there is an appropriate management of hypothyroidism by thyroid hormone therapy. Finally, there should also be an investigation for other possible additional endocrine disorder that might cause hyponatremia. Another important endocrine problem that can induce hyponatremia is hypoadrenalism. There is a possibility that a patient might have both central hypothyroidism and central hypoadrenalism. More complex conditions such as Sheehan's syndrome  and Schmidt's syndrome  should also be added in the differential diagnostic list. In conclusion, severe hypothyroidism may be the cause of hyponatremia. Patients with chronic hypothyroidism should be evaluated for hyponatremia. It is an uncommon condition that probably occurs in severe hypothyroidism or myxedema. All hypothyroid patients with low serum sodium levels should be evaluated for other causes and superimposed factors of hyponatremia and treated accordingly. Physicians should not forget to look for electrolyte imbalance in hypothyroid patients.
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