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What Are the Symptoms of Hypernatremia?

By A. Gamm
Updated May 17, 2024
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Hypernatremia is one of many electrolyte disorders that affects the central nervous system in which sodium levels in the blood are elevated, usually due to dehydration or unreplaced water loss. The signs and symptoms of hypernatremia are not always obvious because most people who suffer from the condition also have other underlying neurological problems. While it is usually easy to treat, it is important for a person to seek medical assistance if hypernatremia is suspected. The symptoms of hypernatremia tend to vary at each stage for different age groups. Generally speaking, however, the symptoms of hypernatremia are twitching, feeling malaise, lethargy and weakness, and irritability.

Most people begin to feel lethargic and weak, having a general feeling of malaise in the initial stages of hypernatremia. Some people may become so nauseated that vomiting occurs. It is not uncommon for people with the beginning signs of hypernatremia to also become irritable. After prolonged hypernatremia, a person may experience some fluid retention and subsequent weight gain as the body tries to compensate for the loss fluid and the sodium imbalance. Other symptoms include increased thirst, increased heart rate, and a noticeable change in blood pressure when standing.

More extreme symptoms usually do not occur until sodium levels are above 158 meq/L, which stands for meilliEquivalents/liter. At this stage, symptoms of hypernatremia include general twitching and occasionally chorea, which are uncontrolled jerky movements of the face, hips, and shoulders. Many patients also experience hyperreflexia, or overactive reflexes. Seizures may occur at this phase as well.

When hypernatremia becomes advanced, there is a risk that a person may fall into a coma. When blood sodium levels go above 180 meg/L, the chances of the condition becoming fatal increase dramatically. It is not common for sodium levels to reach this high level.

Infants will show several symptoms of hypernatremia, which are relatively easy to spot. The most common and recognizable symptoms are weakened muscles, reduced movement, restlessness and insomnia, usually coupled with high pitched crying. In extreme cases, the infant may fall into a coma.

In most cases, the symptoms of hypernatremia are more difficult to spot in adults and the elderly. This is largely because in most people, a neurological problem is already present. Doctors know this is true for most patients because many neurological problems within patients hinder the brain’s ability to recognize thirst. Finding symptoms in elderly people can be even more challenging as many of these symptoms are already present within the elderly due to age.

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