In a quiet neighborhood, a medical emergency unfolded, involving 60-year old Maneesh Kumar whose world suddenly tilted toward uncertainty. It all began on a night when his family was attending a joyous marriage ceremony, leaving Maneesh behind. His decision to stay home wasn’t arbitrary; the past few days had weighed on him with an unshakable sense of weakness and lethargy.
When the family returned, their joy turned into panic as they found him unconscious. Rushing him to the emergency room was necessary; it was a race against time. In the sterile and bustling surroundings of the emergency room, the medical team confronted a puzzling scenario. As he lay in a deep coma, unresponsive to any attempt to awaken him, no words escaped his lips, no movement in his limbs. As he had high blood pressure for about 5 years, a heart attack and stroke had to be ruled out first. The ECG was normal, so was the CT scan of the brain. The electrocardiogram (ECG) showed no irregularities, and a CT scan of the brain appeared surprisingly clear.
As the team delved deeper, a crucial detail emerged—Maneesh had been managing his blood pressure with a combination of telmisartan and hydrochlorothiazide. This led them to an alternative diagnosis. Results showed that Maneesh’s blood sodium levels had dropped down to 105, well below the normal range of 135-145. It was a case of severe hyponatremia. Hyponatremia is a condition that occurs when the concentration of sodium is very low in a person’s body.
This case study drew a lot of attention on social media when Dr. Sudhir Kumar, a neurologist who is also invested in public awareness, and busting myths, and giving credible medical information through his social media property shared the story of Maneesh on Twitter. Recently, the late actor Sridevi’s husband Boney Kapoor also made a startling revelation about her sudden death in 2018. Kapoor attributed one of the reasons that could have contributed to her poor health was a low salt/sodium diet. In fact, many celebrities are known to follow a strict low-salt diet for weight purposes.
Dr Sudhir Kumar, Neurologist, Apollo Hospitals Hyderabad
Health on Air caught up with Dr. Sudhir for more clarity on the misunderstandings about sodium intake and its impact on our overall well-being as many people with high blood pressure receive advice to reduce salt intake, a measure believed to prevent potential complications.
Dr. Sudhir clarifies that while salt is crucial for body functions, the emphasis should be on avoiding added salt rather than eliminating it entirely. He states, “People who have no other complications, just plain high blood pressure, should not take added salt. What it means is that when we eat, say peanuts, pickles or chips, we take some extra salt. That should be avoided,” says Dr. Sudhir, who is currently working at Apollo Hospital, Hyderabad, and specializes in neurocritical care, epilepsy, dementia, migraine, and stroke. Failure to maintain normal salt intake can result in hyponatremia (Hypo means low, natremia refers to sodium), causing symptoms like weakness, lethargy, and in severe cases, unconsciousness, coma, and convulsions, he adds.
Understanding the treatment for hyponatremia is paramount in addressing low sodium levels. Saline infusion, according to the individual’s sodium level, is a common approach. In cases where excess fluid dilutes sodium, fluid restriction may be recommended. Additionally, depending on the patient’s condition, medical practitioners may prescribe specific medications as part of the comprehensive treatment plan. The selection of these interventions addresses the unique circumstances of each individual, ensuring a targeted and effective response to hyponatremia.
Alternate lifestyle measures for high blood pressure
Lifestyle plays a very important role in managing blood pressure levels. Dr. Sudhir advises holistic lifestyle measures in managing high blood pressure. Adequate sleep, stress management, and regular exercise are foundational. “The first thing is adequate sleep at night, good sleep will lower the blood pressure. Lack of sleep will increase blood pressure. People should exercise daily and lead a stress-free life, as these factors can fluctuate blood pressure. A daily exercise for 30 minutes is enough. Potassium plays an important role in maintaining BP, so adequate amounts of fruit consumption are necessary. And overall, no smoking or drinking alcohol,” he explains.
Sugar and salt reduction for fitness enthusiasts
Many fitness enthusiasts do reduce their salt and sugar due to many avoidable and unavoidable reasons. While reducing added sugar is advisable, it is always necessary to focus on whole fruits for essential nutrition. The doctor distinguishes between sugars found naturally in foods and the harmful effects of added sugars, cautioning against excessive consumption of soft drinks and packaged fruit juices. “The processed sugar consumption of sugar is never allowed. But reducing even the minimum amount of salt from our diet is never a good option,” he says.
