Ayurvedic Treatment of Hyponatremia

Abstract

Adequate amount of fluid & electrolyte balance plays a key role in maintaining homeostasis in the body, and it also plays a beneficial role in protecting the normal cellular functions, acid-base balance and tissue perfusion. Electrolytes are one of the major components of the body that helps in sustaining the body’s blood chemistry, muscle action and other processes in normal state. One of such electrically charged minerals is sodium. Sodium has a very beneficial role in maintaining blood pressure, supporting the functions of tissues, muscles & nerves. The main function of sodium is regulating the fluids in and around the cells to maintain the adequate osmotic balance i.e. fluid & electrolyte balance within & outside the cells of the whole body. But when the concentration of blood sodium is lower than the normal value then the condition that arises is hyponatremia. In this article we’re going to discuss hyponatremia in general including its clinical manifestation, causes and its treatment on the basis of Ayurvedic principles.

Introduction

Hyponatremia is the condition of electrolyte imbalance in which sodium level drops down than the normal amount present in the blood. Under normal conditions, the human body is well designed to maintain the blood sodium level within the normal range of 135–145 mEq/l (milliequivalent/liter) despite a wide range of fluctuations in fluid intake by the person. The hyponatremic condition arises when the kidney’s functions are disturbed by some systemic disease or other cause and these altered functions result in impairment of the kidney’s functions to excrete free water and thus the plasma sodium level falls down below 130 mEqL.

Causes

Various lifestyles or associated systemic diseases are considered as the causative/risk factor for the hyponatremic condition:

• Excessive Fluid Intake: Drinking water in excess amounts can lead to hyponatremia. The main excretion of sodium is through urine and sweating, so drinking plenty of fluids can lead to the decreased concentration of sodium in serum.
• Inadequate Salt Intake: Some people prefer a less salty diet which leads to the sodium deficiency. As salt is the richest source of sodium in our daily diet regimen.
• Hormonal Changes: Some diseases such as hypothyroidism and Addison’s disease affect the ability of thyroid and adrenal gland to produce hormones (thyroxine and aldosterone respectively) which plays a key role in maintaining the bodily balance of water & electrolyte.
• Other Systemic Diseases: Cardiac issues: Heart failure and other cardiac disorders affect the normal functioning of the liver and kidneys can result in the accumulation of fluid in the body which brings down the sodium level in blood.
• Severe vomiting and chronic diarrhea: These conditions are the prime cause of losing the electrolytes quickly. Also, it increases the ADH levels, Antidiuretic hormone controls the amount of water stored by the kidneys.
• Use of Certain Medications: Few medications that alter the hormonal processes and kidney functions and that help in keeping the sodium concentrations within the normal range, leading to reduction in sodium concentration. These include antidepressants, diuretics and analgesics. Intravenous injections of glucose can also interfere with the sodium concentration in blood.

Other Causes Include

1. Loss of gastrointestinal secretions
2. Severe burns
3. Excessive sweating
4. Cholera

Classification

Hyponatraemia is easily classified according to volume status:

1. Hypervolemia Hyponatraemia is the condition when the level of both fluid & sodium is high but the level of water is more as compared to the level of sodium.
2. Euvolemic Hyponatremia is when the level of water is too much but the sodium level remains the same
3. Hypovolaemic Hyponatraemia is when there is a drop in the levels of both water & sodium levels but the loss of sodium is more than water.

Sign & Symptoms

Hyponatremia can be sometimes present as an asymptomatic condition. The common clinical features of symptomatic hyponatremia include:

• Headache or confusion
• Nausea with vomiting
• Irritability and restlessness
• Fatigue
• Generalized weakness
• Cramps or spasms in muscles
• Dizziness & drowsiness
• Loss of energy
• Restlessness and irritability
• Spasms and seizures
• Coma

Diagnosis

The diagnosis of hyponatremia can be made on the basis of:

1. Patient’s history
2. Clinical features
3. Lab Investigations: Low serum sodium levels can be monitored by doing blood & urine examinations.

Ayurvedic View

The concept of fluid & electrolyte imbalance (hyponatremia) in Ayurveda can be best explained with udakvaha sroto dushti. Acharya Sushruta had mentioned that taalu & klom are the basic seats of udaka vaha srotas.

(Reference Sushruta sharir sthana 9/12)

Here in this case, udaka vaha stotras are the microchannels associated with the taalu (palate) and klom (adrenal glands & pancreas). As mentioned earlier, these glands are responsible for hormone secretions that determine the proper functioning of fluid and electrolyte balance in the body & also sodium balance in the plasma.

The disturbances in these microchannels due to the following causes mentioned by Acharya Charka:

(Reference- Charka Viman sthan 5/11)

Due to excessive intake of hot articles and warm lifestyle (as due to excessive heat inside or outside body will facilitate the passage of sweating and thus aiding in sodium excretion resulting in low serum sodium), ama dosha (endotoxins formed as a result of weak digestive power), fear, excessive water or alcohol intake (already mentioned) and suppressing the urge of thirst for a longer duration will lead to the vitiation of udaka vaha srotas dushti.

This udakvaha sroto dushti is responsible for various symptoms like dehydration, restlessness, irritability, sunken eyes, dry tongue & palate, low blood pressure, concentrated yellowish coloured & scanty micturition, lassitude etc.

Treatment

The major aim for treating the hyponatremia in Ayurveda is focused on

• Treating the mandagni (weak digestive fire) leading to ama (endotoxins) that are the basic cause of the disease.
• Also using the herbs & minerals rich in micronutrients to cope up with serum sodium deficiency.
• Nidana Parivarjana: Avoidance of causative factors or treating responsible disease for causing the condition.
• Use of herbal diuretics to decrease the excess fluid resulting in swellings.
• Use of nervine tonics to boost up brain functions to enhance proper secretion & efficient working of the body’s endocrine system (hormones).
• Diet & lifestyle modifications (pathya apathya aahar vihar)

Herbal Remedies for Hyponatremia by Planet Ayurveda

Planet Ayurveda is a manufacturing hub that produces herbal formulations. These products are processed & made under the strict guidance of our expert team of ayurvedic physicians. The formulations are 100% natural and are manufactured in adherence with the ayurvedic texts and are made with ancient time-tested formulas.

Herbal Remedies Suggested by Planet Ayurveda’s Experts for Hyponatremia:

1. Chitrakadi vati
2. Lavan Bhaskar Churna
3. Brahmi Capsules
4. Neuro Plan Syrup

Product Description

1. Chitrakadi Vati

Chitrakadi vati is an amazing classical combination of herbs available in tablet form. The composition of this vati includes combinations of herbs having multiple actions that are beneficial in hyponatremia. These ingredients are ushna dravya (herbs having hot potency) like shunti (Zingiber officinalis) maricha (black pepper), pippali (Piper longum), chavya (Piper retrofractum), pippali mool (root of Piper longum) and chitraka (Plumbago zeylanica) along with Hing (ferula assa-foetida) due to their deepan action facilitate in better digestion of ama (endotoxins) and also aids in blood purification which in turn prevent the extracellular accumulation of fluids and thus help in reducing the swelling. The other ingredients include five types of lavan (salts) i.e. sauvarchala (sochal salt), saindhava (rock salt), vida (vida salt), samudra (common salt) and audbhida salt which are rich sources of sodium and will help in maintaining the electrolyte balance, two kshar i.e. yava kshara-alkaline extract of Barley (Hordeum vulgare) and swarjika kshara (alkaline extract) will help in lekhan karma i.e. due to their scraping action these extracts supports the fast excretion of the extra fluid accumulated in hyponatremic cases.

Dosage: Two tablets twice a day with plain water after meals.

2. Lavan Bhaskar Churna

This is also a classical formulation in powder form having the mixture of four types salts as the main ingredients along with other herbs such as twak (Cinnamomum zeylanica), badi elachi (Amomum subulatum), amlavetasa (Garcinia pedunculata) and talis patra (Abies webbiana) etc. These herbs along with the salt helps is the very efficient source of essential micronutrients that helps in enhancing the electrolyte content in blood. Also the powdered form will also allow the formulation to reach upto the cellular level & normalize the altered metabolism of the cells due to swelling up of cells in hyponatremia. This formulation also promotes digestion & acts as an appetizer, thus proving a great role in managing the associated symptoms like nausea, vomiting in hyponatremia.

Dosage: 1 teaspoonful two times in a day with plain water after meals.

3. Brahmi capsule

Brahmi capsules are single herb formulations made from the standardized extract of Bacopa monnieri available in capsule form. These formulations are made from the extracts of the best nervine tonics that are mentioned in ancient Ayurvedic texts. These herbal medicines will help in maintaining the proper balance in hormones, particularly antidiuretic hormone that is secreted from the pituitary gland located in the hypothalamus of the brain.

Dosage: 1 capsule twice daily with plain water, after meals.

4. Neuro Plan Syrup

It is the polyherbal formulation formed by seven medhya dravyas (nervine boosters) including Sankhpushpi (Convolvulus pluricaulis), Madhuyashti (Glycyrrhiza glabra), Mandukaparni (Centella asiatica) and other such drugs along with trikatu (combination of three hot potency drugs) and honey. Also, these drugs support in preventing or treating the after effects of the hyponatremic condition such as drowsiness, restlessness, irritability etc.

Dosage: 2 teaspoons twice daily, after meals.

Diet & Lifestyle Modifications

1. Restrict the excessive intake of water. Instead, they can take coconut water and lemon water with salt.
2. Introduction of sodium rich foods in dietary items such as spinach, carrots, beans and sweet potato etc.
3. Pranayam (breathing exercises) for strengthening the nervous system and yogasana for better physical exercise.
4. The patients must include daily salt intake of minimum 2-3 grams.

Conclusion

The consequences of hyponatremia can range from being a normal lifestyle disorder which may be asymptomatic to the dangerous life-threatening conditions such as seizures, coma etc. So, it’s necessary to include these herbal formulations for treating hyponatremia conditions along with dietary & lifestyle changes as advised.