Low sodium levels

[Matt M.]

Hello,

I’m writing in regards to the results of recent blood work I had done. Almost all levels were normal except for sodium, triglycerides, and VLDL; all of which were mildly low. Specifically, the levels were:
Sodium: 133 mmol/L (normal range 134-145)
Triglycerides: 45mg/dl (normal range 50-150)
VLDL: 9 mg/dl (normal range 10-31)
I am concerned mostly about my sodium level. I have read that low sodium level can be caused by a thyroid issue, but my TSH came back at 1.37ulU/ml (normal range 0.40-4.00). I’ve also read that low sodium can be the result of liver disease, but my liver enzymes all came back normal:
AST : 25 u/l (normal range 5/38)
ALT: 22 u/l (normal range 0-55)
ALK PHOS: 68 u/l (normal range 4—150)
Albumin 4.6 g/dl (normal range 3.5-5.5)
T  Bilirubin 1.1 mg/dl (normal range 0.2-1.2)
BUN 10mg/dl (normal range 8-24)
CREATINE 1.1 mg/dl (normal range 0.7-1.3)
Total Protein 7.4 g/dl (normal range 6.1-8.0)
All of these levels are almost exactly the same as they were when I last had blood work done 2 years ago.  (The exception is Albumin, which was 5.2 g/dl in 2009.)
I have two general questions based on my blood work. The primary question I have is is it likely that a low sodium level could be a sign of liver disease when all other liver markers are in normal range? Second, I’ve suspected that I may have celiac disease for some time now. Can a gluten allergy affect sodium levels? I have an appointment with a gastroenterologist in two weeks. Thank you in advance.

[patient915]

I interpret your lab results as completely normal.  I don't think you have anything to worry about and I don't think that you need to see an Endocrinologist.  Your low numbers don't mean anything as they wern't really low.  If you think you have celiac disease, there is an easy blood test that sometimes picks it up.

[Matt M.]

Thank you very much for the insights. I did drink more water than usual before the blood work as I thought I may need to provide a urine sample. I was also fasting so water was my only option. :-) I'm now concerned that I made the same mistake for a second time. The nurse practitioner that interpreted the initial results to me indicated that dehydration could lower the sodium level. Naturally, I've been drinking plenty of water (probably too much) to stay hydrated in preparation for my second round of bloodwork, which I completed yesterday. I'm now waiting for the results. Of course, I've imagined that I have every symptom of every cause of low sodium - nausea, muscle weakness, lightheadedness, and so on. I'm hoping this all just anxiety over the results. Thank you for the kind response and best wishes to you.

[mammo]

Drinking lots of water, and diarrhea can cause low sodium levels, and if you're not working with an Endocrinologist on the cause....you should be.  There are several causes and an Endo can best determine what the cause is. Diuretics can also cause this along with problems with the adrenal glands which may not be detected in bloodwork. Hope this helps and best wishes!