Diabetes Insipidus and Hypernatremia

One of the most common effects of diabetes insipidus on the human body is the development of hypernatremia. This is a medical term that is used to describe the presence of elevated sodium levels within the blood because of an electrolyte imbalance. Hypernatremia is defined by having sodium serum levels measured at 145 mEq/L or above.

In addition to the symptoms of diabetes insipidus, people who have hypernatremia may experience a feeling of weakness in their muscles, irritability, fever, and general restlessness. In some instances, migraine headaches may be triggered, seizures may occur, and there may be severe changes to an individual’s blood sugar levels.

What Is the Danger of Hypernatremia?

When people are suffering from diabetes insipidus, it means their bodies are unable to respond to commands to concentrate urine to preserve hydration. The kidneys begin to pull out all consumable fluids and prepare them to be expelled from the body. Without proper fluid intake, the end result is dehydration because the body is losing more water than what is being consumed.

The danger of hypernatremia is that in up to half of all cases that occur because of diabetes insipidus, a condition called adipsia occurs. This is because the hypothalamus is responsible for the thirst mechanisms and if it is malfunctioning already by not producing the necessary levels of anti-diuretic hormone, it may also fool people into thinking that they aren’t thirsty when they really are.

This means that an individual may not feel thirsty, be expelling up to 20 liters of urine per day, and wind up with severe dehydration. Many cases of diabetes insipidus involve polydipsia, which means excessive thirst, but when sodium levels are increased, the opposite effect may occur.

This generally occurs with central diabetes insipidus only. It is most commonly associated with cases that involve tumors of the hypothalamus.

What Is the Telltale Sign of Hypernatremia?

The most common symptom that is experienced with hypernatremia which is caused by diabetes insipidus is a severe headache. The significance of this headache cannot be overstated. It is one of the body’s last efforts to communicate to someone that it needs water, even if that individual is not feeling thirsty.

The feeling of the headache is similar to a headache receive while exercising for a prolonged period of time if there isn’t enough fluids being introduced into the body. It’s a headache band that throbs along both temples. Although there may not be a thirst urge present, the throat will feel dry and the mouth will feel like cotton. There may also be hard residue that forms on the teeth as saliva production diminishes.

How Is Adipsia with Hypernatremia Treated?

The most common method of treatment for adipsia and huypernatremia is to attempt higher levels of fluid intake. If a routine can be established during a flare-up of diabetes insipidus that allows people to maintain proper fluid levels, then the adipsia has the potential of being temporary.

The goal is often to treat the diabetes insipidus as the next step because it is the cause of the adipsia and hypernatremia. By adding synthetic hormones, hormone therapy, or treating the condition with other medications, the adipsia may be able to go into remission.

In severe cases that involve cysts, tumors, or hematomas, surgery may be the only available option to restore an individual’s thirst functionality.

What Is the Outlook of Hypernatremia?

If the only issue involved with an individual’s diabetes insipidus is hypernatremia, then the outlook is generally quite positive. With increased fluids, the excessive salt levels will begin to decrease. Because diabetes insipidus will generally resolve over time on its own or with hormone therapies, the excessive salt levels will also begin to reduce.

When hypernatremia is accompanied by adipsia, however, then medical complications may arise. The damage to the hypothalamus that causes the change in the thirst mechanism is not usually reversible. This means the goal of care is often to teach people how to manage their fluid intake levels properly since they no longer feel an urge of being thirsty when they need something to drink. Adipsia may even continue to happen after diabetes insipidus issues have been resolved.

There are no medications that can reverse adipsia. In some cases, adipsia becomes psychogenic instead of because of a physical injury, so behavioral therapies are often introduced and these have varying levels of success.

Coping with diabetes insipidus and hypernatremia can be difficult. With help maintaining fluid levels, however, this disorder can be overcome.