Difference Between SIADH and Cerebral Salt Wasting
SIADH vs Cerebral Salt Wasting
Certain illnesses can be quite scary and harmful in the long term especially when they provoke unwanted signs and symptoms.
SIADH and cerebral salt wasting are two diseases that can be life threatening. These two diseases can also be interchanged because they possess the same signs and symptoms in the patients involved.
SIADH means “symptom of inappropriate anti-diuretic hormone hypersecretion.” The “ADH” or “antidiuretic hormone” keeps the release of water in the kidneys. Thus, it retains the water in the body. When there is too much water in the body, the sodium in the body becomes diluted. Thus, the number one manifestation is hyponatremia or a low amount of sodium circulating in the blood. If there is low sodium circulating in the body, there will be a profound effect in consciousness. Thus, there will be dizziness, headache, confusion, and comatose. Nausea and vomiting also occurs.
Cerebral salt wasting, on the other hand, isn’t a common endocrine disease that manifests dehydration and hyponatremia. This is caused by brain trauma, tumors, injury, or even hematoma that’s surrounding the brain. The manifestation is also the same as those of SIADH with dehydration, too much urination and urine output which is about 2.5 liters for 24 hours, extreme thirst, and an extreme craving for salty food.
For the physician to diagnose SIADH, sodium will be tested in the blood. If the values are low, then there is hyponatremia. Then additional findings, such as low BUN, low uric acid, low albumin and normal serum creatinine can confirm SIADH. The cause of SIADH is different from cerebral salt wasting. The cause can be infections, such as pneumonia, meningitis; cancers, such as lung cancer; hypothyroidism, and certain medicines, such as Carbamazepine and Clofibrate.
Since the cause of cerebral salt wasting is mainly from the brain, it can be differentiated from SIADH via the urine concentration. In cerebral salt wasting, sodium urine concentration is lower than 100 meq/liters while SIADH has a greater value.
Treatment of SIADH is by fluid restriction, intravenous saline, and certain medications. Treatment of cerebral salt wasting is through frequent hydration to prevent dehydration plus medications.
Summary:
1.SIADH is caused by infections and cancers while cerebral salt wasting is caused by brain trauma, injury, hematoma, and tumors all occurring in the brain.
2.SIADH has a greater sodium urine concentration than cerebral salt wasting.
3.Management of SIADH is by fluid restriction while cerebral wasting is by frequent hydration.
4.Both manifest hyponatremia.
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I suffer from SIADH with my initial hospitalization in 2003 when my blood sodium dropped to 106, as measured in the hospital. That morning I awoke unable to give my name and address but could, otherwise, talk to my wife. With difficult questions (she asked me, i.e., my name, address, etc.) I mostly giggled like a 5 year old. She rushed me to my doctor who rushed me to the hospital where I remained for a week on IV solutions until my blood sodium level reached 128, at which point I was discharged. Once again in 2005, I suffered blood sodium levels below hospital admission levels and was released too early, again at 128; a week later, I was readmitted and released too early at 128 (same hospital).
With this history, I began an indepth study of SIADH (Intenet) and located an Endocrinologist who worked with me for a year or so, but who also believed “older people do not need to live with the normally accepted blood sodium levels of 135-145). Today, I refuse to work with a doctor (md) who lives by textbook “crap” rather than good medical knowledge. In other words, I need to be in at least the 130s to be feel normal. I strive for higher levels and and discovered (through a doctor who practices medicine “outside of the box”) that most medications do nothing for one with SIADH. Water restriction does not not help me one iota; old fashion salt tablets work wonderfully (available only at selected drug stores (not CVS or Walgreens, etc) can order it. I am currently taking two 1000mg tables per day (doctors orders) and the tables are non RX – my cost is about $16.00 per 100 tablets. My blood sodium levels are now usually in the 130s and have been as nigh as 138 when the salt tables were initially administered to me while a patient a different hospital. Hope this helps.