Learn more about your low levels of electrolytes

Dear Dr. Gott: Last month, I passed out at home and ended up in the intensive-care unit for two days. Primary diagnosis: syncope and hyponatremia.

I believe this means fainting, dizziness and low electrolytes. I don’t understand what all this means, why it happened, and how to prevent it from happening again.

I’ve asked three doctors and don’t seem to get an answer to my questions. I’ve enclosed my reports from my hospital stay.

If you could help me understand what happened and why, I’d appreciate it. I worry about this every day.

Thank you for your help. I’m 63 years old.

Dear Reader: You have analyzed your problem quite correctly: faintness secondary to low electrolytes. The issue, as I see it, is why were your electrolytes low?

The term electrolytes refers to many substances, including sodium, potassium and other minerals, that are vital for normal metabolism.

If a person is deficient in one or more, the heart rate can be affected, leading to lightheadedness and other symptoms. Electrolyte depletion is a well-recognized consequence of chronic therapy with diuretic (water-eliminating) drugs.

In addition to my concern about why your electrolytes dropped, I am uncomfortable about your doctors’ failure to explain why this imbalance occurred and what can be done to prevent future problems.

As a patient, you are entitled to an understandable explanation of what happened and why, even though the answer to such questions may be “I don’t know.” This should be followed rapidly by, “But I will refer you to a specialist to find out.”

In reviewing the lab work you supplied, I was struck by the fact that you not only had a low potassium level (3.4) but a low sodium level (119) as well.

While you’re awaiting a follow-up appointment with your primary care physician, consider drinking one V8 juice cocktail a day unless you are already receiving prescription electrolyte supplements. Insist on a review of your health issues and let me know how this turns out.

Dear Dr. Gott: About two years ago, my aunt, who is 70 years old, developed heart problems. A stent was inserted, and she was placed on Zocor, aspirin, hydrochlorothiazide and atenolol.

She will be adding Zetia to her daily regimen shortly.

Since all of this started, my aunt has suffered nonstop itching all over her body. She has talked to her doctor, and he prescribed Allegra, which only made her feel drugged.

Now the doctor is thinking this may be psychosomatic. Can you think of anything that may be causing the itching? She isn’t getting much sleep.

Dear Reader: Until disproved by allergy testing, your aunt may be suffering a reaction to one of her medications. In my view, psychological causes are at the bottom of the list.

Were I her physician, I’d request an immediate consultation with an allergist.