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Electrolytes

Sodium

Sodium is the main electrolyte outside your cells and, together with water, sets your fluid balance.

What is Sodium?

Sodium is the main salt outside your cells. Together with water it sets your fluid balance, and through that your blood pressure, nerve signalling, and muscle function. Your kidneys and hormones hold the value within a narrow range, regardless of how much salt or water you take in. An abnormal value is therefore almost never about how much salt you eat — it is about your water balance. Low sodium usually comes from retaining too much water or losing too much fluid; high sodium almost always from dehydration.

Why is Sodium relevant?

In healthy people sodium is rarely the marker that demands immediate action, but it adds context in a few situations. People on water pills, with kidney problems, or athletes who drink large volumes of water without replacing salt are at higher risk of a low value. The value becomes more relevant with persistent symptoms such as dizziness, headaches, or confusion, and as part of broader investigation of your kidney, thyroid, or adrenal function. A stubbornly low value is a logical reason for further investigation with a doctor.

Sodium high or low — what it means

Read sodium alongside potassium, creatinine, and eGFR, and in the context of hydration and medication. A single mildly abnormal value without symptoms is usually not a problem — a repeat test under normal conditions gives a more reliable picture. Markedly elevated blood glucose can artificially lower the measured sodium value. A persistent, unexplained deviation warrants investigation into the underlying cause; that is medical territory.

Sodium reference ranges

NormalSerum/plasma sodium in adults135-145 mmol/L
Low (hyponatraemia)Severe below 120 mmol/L< 135 mmol/L
High (hypernatraemia)Almost always due to dehydration> 145 mmol/L

Cut-offs vary slightly by lab and method — always check the reference range on your own report. Markedly elevated blood glucose can lower the measured sodium value.

Educational information only — not medical advice. Consult a healthcare professional for clinical decisions.

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Frequently asked questions

What is a normal sodium level?

In adults, blood sodium normally sits between 135 and 145 mmol/L. The body keeps this value within a narrow range through the kidneys and hormones, regardless of how much salt you eat. The exact reference range can differ slightly between labs, so always check the values on your own report.

What does a low sodium (hyponatraemia) mean?

A sodium below 135 mmol/L is called hyponatraemia. It is almost never about eating too little salt, but about your water balance: retaining too much water or losing too much fluid. Common causes are water pills (diuretics), diarrhoea, heavy sweating, drinking very large amounts of water, or kidney, heart or liver problems. Mild symptoms are fatigue and headache; a rapid or large drop can cause confusion.

What does a high sodium (hypernatraemia) mean?

A sodium above 145 mmol/L is called hypernatraemia and is almost always caused by dehydration — not drinking enough, or losing fluid through sweating, fever or frequent urination. Symptoms include thirst, a dry mouth and restlessness. It usually signals too little water relative to sodium in the body.

When is an abnormal sodium worrying?

A single mildly abnormal value without symptoms is usually not a problem; a repeat test under normal conditions gives a more reliable picture. It becomes more concerning with a markedly abnormal value (for example below 120 mmol/L) or with symptoms such as confusion, severe headache or dizziness. A persistent, unexplained deviation warrants investigation with a doctor into your kidney, thyroid or adrenal function. Always read sodium alongside potassium, creatinine and eGFR.

Sodium is one of the biomarkers in the Optimize blood test. Book a blood draw at any of 238+ partner labs in the Netherlands, or upload your existing results in the app.

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