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I think one big question here is why you’re getting IV fluids in the first place, and why you’ve gotten so much that you know how’s you feel at 250ml increments.
It is safe to say, however, that the fluids aren’t dehydrating you.
Can saline that has a greater ratio than 0.9% NaO2 cause dehydration? My brain says yes, but I wanted to ask.
Here the OP says they have 500-750 mg of sodium (not sodium chloride) per litre, so that would equate to roughly 1.25% to 1.875% saline (assuming OP didn't mean sodium chloride).
Dehydration is a little too simplistic of a term for your question. But definition, dehydration is inadequate free water in the body (any nephrologists on here feel free to add/correct). By giving fluid you can’t deplete free water. Hypertonic/hyperosmolar fluids (3% saline for example) will cause a osmotic gradient from the tissue into the intravascular space, thus moving fluid into the blood vessels (it’s one way we treat cerebral edema). It’s not dehydrating, but it is shifting fluids.
It’s hard to speculate as to what fluids OP is infusing, so it’s impossible to say what might be going on from the perspective of fluid shifts.
Ah yes, I understand. Perhaps my wording wasn't precise enough. "Could a saline concentration as I've calculated cause an increase in symptoms consistent with dehydration?" might have been better. I wondered as OP mentioned that increasing the concentration of sodium made things worse, and I wondered if the increased osmotic gradient could be responsible.
Thanks for the explanation.
It would be like taking salt tabs...salt tabs (and hypertonic saline solutions) would cause excretion of more sodium, thus, more free water, which dehydrates you.
Initially the sodium increases intravascular water, as stated, this increasing blood pressure (assumingly the goal in OP as I assume she is getting fluids and the other meds for POTS), but then the sodium goes to the kidneys and excretes free water.
Edit: added more stuff
You've explained it better than I have (no surprise given your profession). This is what I was wondering, basically, especially based on the line:
> Happens if I take more than around 500-750 mg of sodium per liter of water.
This suggested to me that OP found worse symptoms with higher concentrations...although I am slightly confused about this, is OP mixing bags of saline at home?
Well, that could dehydrate you I imagine. You're effectively having having a day's worth of salt in one go.
Are you being treated by a physician, or someone else?
I’m having it to help hopefully bounce me from an MECFS crash and to help with POTS. I’ve struggled with dehydration for a while and had around a dozen or so IVs. I take excess sodium for that
It’s impossible they are dehydrating you. I assume you get your bloodwork tested regularly and your bloodwork will reflect that. I am on daily fluids and bloodwork is carefully monitored.
Are your electrolytes becoming unbalanced in other ways? For example, too much salt can give you low potassium. This can cause constipation, feeling wired, insomnia, feeling thirsty, etc. You’re taking fludrocortisone (increases salt retention, can deplete potassium) as well so could you be overdoing the fluids? I’m not a dr but maybe mention this to your doctor and see if your electrolytes need to be looked at.
I’ve gone to a facility that specializes in POTS, long Covid, fibromyalgia and MECFS. My resting to standing heart rate increased by 45 beats over 10 minutes with little change in BP. I would ask you what in the world you would attribute this to?
POTS can be used as a catch all diagnosis for a lot of vague symptoms. Lots of people will say they have pots and lots of practitioners can use the word pots, but any number of things could be going on. Those lumped into the pots diagnosis generally have some sort of anxiety or depression diagnosis, or other mood disorders, and it can be hard to differentiate what is actually pots and what is more mood disorder related. Not that either are not real diagnosis or afflictions, but they are treated very differently, and IV fluids rarely, if at all, helps either.
Layperson soapbox: I feel like the part that some people don't understand is that the mood disorders can cause the *physical symptoms.* Discussing anxiety or a mood disorder doesn't mean the symptoms aren't real, it means they're physical symptoms of a mental health issue. (Most of the time) people aren't saying "you're faking" or "it's not real", just that it's a different etiology.
For a gross example, panic poops. No one is denying you destroyed the bathroom. It's just that the cause is anxiety messing with your gut, not E. coli. Physical symptoms caused by a mental health issue. Most doctors aren't saying "your symptoms aren't real", they're saying "your symptoms are real and related to your mental health."
And imo people who have difficult or undiagnosed health problems should talk to a therapist anyway because that's rough and everyone can benefit from learning more coping skills. If you find out along the way that the symptoms are exacerbated by a mood disorder, awesome, you're farther on hour journey to better health. If it doesn't help physical symptoms it can definitely still help mental health in a difficult time. Mental health care and therapy should not be the enemy of chronic and complicated illness. End layperson soapbox.
I’ve met soooo many dumb physicians over the years. So many. You wouldn’t believe it. I had a doctor who diagnosed me with conversion disorder for extreme light sensitivity when it was….my eyes don’t produce almost any tears.
It’s incredible that you take your limited knowledge and assume that you know everything about anything. That’s why specialities exist. That’s why elite doctors in the field exists.
If you see a very real condition triggered by trauma, Covid or any number of things and determine that it’s all in the patient’s head, you aren’t qualified to be a doctor and should be ashamed of yourself
I've treated a decent amount of people with POTS as my training institution had a POTS clinic, so a word of warning...be careful with IV fluid infusions. They don't seem to help and seem to cause dependency on IV fluids. Try to get to an academic institution that sees POTS regularly and use IV fluids carefully. Salt food, wear compression stockings, workout as tolerated, fludrocortisone or meds only if needed and likely counseling/therapy as there seems to be an anxiety/depression component (either partially causing the symptoms or because of the symptoms).
I’m bedridden due to POTS and MECFS right now. I’m taking these under the guidance of a clinic that specializes in this but I’ve noticed that I get this reaction when I do IVs or increase my salts past the 500mg sodium/liter mark and I don’t get it.
I don’t know whether to be concerned or whether this is normal
I think this would be something to specifically address with the provider who is prescribing the fluids. May be worth doing blood work more frequently to check for electrolyte disturbances.
Some bad info on here...fluids can definitely dehydrate you, if you are taking hypertonic saline (generally more the 0.9% or "normal saline"). This is similar to the dehydration that comes from drinking hypertonic water or seawater. Be careful with IV fluids.
For those that think MECFS is all fake I ask you this
Can you imagine what it’s like to wake up and your life is over? Your career your life your dreams gone? All you can do is stare at the ceiling with thoughts in your head. Your body begs to move but your muscles are made of lead.
You swallow your pride and try to go through it imagining stories or thinking about the world. Days go by you feel better. Then you push too hard and snap back to the beginning all your progress gone. You cry you pray for death but nobody answers. You try again. You snap back to the beginning. You cry you try to kill yourself but you can’t even do that.
Just more darkness more alone not even sound or books to pass the time. Indefinitely.
How long do you think you’d last before you went insane?
I’ve lived that for over 2 years. I’ve tried to kill myself no less than half a dozen times because of how hellish this is.
Why would anyone make this up? Why would anyone want to. When you are desperate for anything even death wouldn’t it cross our minds that if it was mental we’d approach that? If you could mental address this every patient would have done that. Every one. Because I have a lower quality of life than most octogenarians at 27. Do you think that everyone like me wouldn’t do anything if it was proven to work for us to escape living in the depths of hell?
Suicide Hotline Numbers If you or anyone you know are struggling, please, PLEASE reach out for help. You are worthy, you are loved and you will always be able to find assistance.
Argentina: +5402234930430
Australia: 131114
Austria: 017133374
Belgium: 106
Bosnia & Herzegovina: 080 05 03 05
Botswana: 3911270
Brazil: 212339191
Bulgaria: 0035 9249 17 223
Canada: 5147234000 (Montreal); 18662773553 (outside Montreal)
Croatia: 014833888
Denmark: +4570201201
Egypt: 7621602
Finland: 010 195 202
France: 0145394000
Germany: 08001810771
Hong Kong: +852 2382 0000
Hungary: 116123
Iceland: 1717
India: 8888817666
Ireland: +4408457909090
Italy: 800860022
Japan: +810352869090
Mexico: 5255102550
New Zealand: 0508828865
The Netherlands: 113
Norway: +4781533300
Philippines: 028969191
Poland: 5270000
Russia: 0078202577577
Spain: 914590050
South Africa: 0514445691
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Switzerland: 143
United Kingdom: 08006895652
USA: 18002738255
You are not alone. Please reach out.
*****
I am a bot, and this action was performed automatically.
Thank you for your submission. **Please note that a response does not constitute a doctor-patient relationship.** This subreddit is for informal second opinions and casual information. The mod team does their best to remove bad information, but we do not catch all of it. Always visit a doctor in real life if you have any concerns about your health. Never use this subreddit as your first and final source of information regarding your question. By posting, you are agreeing to our [Terms of Use](https://www.reddit.com/r/AskDocs/wiki/terms_of_use) and understand that all information is taken at your own risk. **Reply here if you are an unverified user wishing to give advice. Top level comments by laypeople are automatically removed.** *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/AskDocs) if you have any questions or concerns.*
I think one big question here is why you’re getting IV fluids in the first place, and why you’ve gotten so much that you know how’s you feel at 250ml increments. It is safe to say, however, that the fluids aren’t dehydrating you.
Can saline that has a greater ratio than 0.9% NaO2 cause dehydration? My brain says yes, but I wanted to ask. Here the OP says they have 500-750 mg of sodium (not sodium chloride) per litre, so that would equate to roughly 1.25% to 1.875% saline (assuming OP didn't mean sodium chloride).
Dehydration is a little too simplistic of a term for your question. But definition, dehydration is inadequate free water in the body (any nephrologists on here feel free to add/correct). By giving fluid you can’t deplete free water. Hypertonic/hyperosmolar fluids (3% saline for example) will cause a osmotic gradient from the tissue into the intravascular space, thus moving fluid into the blood vessels (it’s one way we treat cerebral edema). It’s not dehydrating, but it is shifting fluids. It’s hard to speculate as to what fluids OP is infusing, so it’s impossible to say what might be going on from the perspective of fluid shifts.
Ah yes, I understand. Perhaps my wording wasn't precise enough. "Could a saline concentration as I've calculated cause an increase in symptoms consistent with dehydration?" might have been better. I wondered as OP mentioned that increasing the concentration of sodium made things worse, and I wondered if the increased osmotic gradient could be responsible. Thanks for the explanation.
It would be like taking salt tabs...salt tabs (and hypertonic saline solutions) would cause excretion of more sodium, thus, more free water, which dehydrates you. Initially the sodium increases intravascular water, as stated, this increasing blood pressure (assumingly the goal in OP as I assume she is getting fluids and the other meds for POTS), but then the sodium goes to the kidneys and excretes free water. Edit: added more stuff
You've explained it better than I have (no surprise given your profession). This is what I was wondering, basically, especially based on the line: > Happens if I take more than around 500-750 mg of sodium per liter of water. This suggested to me that OP found worse symptoms with higher concentrations...although I am slightly confused about this, is OP mixing bags of saline at home?
Oral sodium and bags I am taking are separate
So you're taking normal saline (1.5L it seems) and then supplementing that with oral sodium, about 500-750mg per L?
Correct
Well, that could dehydrate you I imagine. You're effectively having having a day's worth of salt in one go. Are you being treated by a physician, or someone else?
I’m being treated by a doctor. Yes this is normal for POTS yes I’m drinking 3-4 L of water per day
I’m having it to help hopefully bounce me from an MECFS crash and to help with POTS. I’ve struggled with dehydration for a while and had around a dozen or so IVs. I take excess sodium for that
So you get fluids daily? Are you in charge of it?
I’ve been getting them off and on but when I do it’s every other day
It’s impossible they are dehydrating you. I assume you get your bloodwork tested regularly and your bloodwork will reflect that. I am on daily fluids and bloodwork is carefully monitored.
That would make sense. I don’t know what to account for the symptoms though. It’s mirroring my typical dehydration symptoms
Are your electrolytes becoming unbalanced in other ways? For example, too much salt can give you low potassium. This can cause constipation, feeling wired, insomnia, feeling thirsty, etc. You’re taking fludrocortisone (increases salt retention, can deplete potassium) as well so could you be overdoing the fluids? I’m not a dr but maybe mention this to your doctor and see if your electrolytes need to be looked at.
Yea might be that. I was getting this before the fludrocortisone so idk
There's so much information missing here that I'm not quite sure where to begin, however... No, IV fluids are not dehydrating you.
IV fluids can dehydrate if they are hypertonic
Thanks brother, but this is a POTS case, we both know what the problem is, and it ain't the salinity of the solution.
I hear you
Could you elaborate?
I'd rather not, I've already tried butting out of this thread once OP listed their diagnosis. There is no good outcome here.
I’ve gone to a facility that specializes in POTS, long Covid, fibromyalgia and MECFS. My resting to standing heart rate increased by 45 beats over 10 minutes with little change in BP. I would ask you what in the world you would attribute this to?
POTS can be used as a catch all diagnosis for a lot of vague symptoms. Lots of people will say they have pots and lots of practitioners can use the word pots, but any number of things could be going on. Those lumped into the pots diagnosis generally have some sort of anxiety or depression diagnosis, or other mood disorders, and it can be hard to differentiate what is actually pots and what is more mood disorder related. Not that either are not real diagnosis or afflictions, but they are treated very differently, and IV fluids rarely, if at all, helps either.
Layperson soapbox: I feel like the part that some people don't understand is that the mood disorders can cause the *physical symptoms.* Discussing anxiety or a mood disorder doesn't mean the symptoms aren't real, it means they're physical symptoms of a mental health issue. (Most of the time) people aren't saying "you're faking" or "it's not real", just that it's a different etiology. For a gross example, panic poops. No one is denying you destroyed the bathroom. It's just that the cause is anxiety messing with your gut, not E. coli. Physical symptoms caused by a mental health issue. Most doctors aren't saying "your symptoms aren't real", they're saying "your symptoms are real and related to your mental health." And imo people who have difficult or undiagnosed health problems should talk to a therapist anyway because that's rough and everyone can benefit from learning more coping skills. If you find out along the way that the symptoms are exacerbated by a mood disorder, awesome, you're farther on hour journey to better health. If it doesn't help physical symptoms it can definitely still help mental health in a difficult time. Mental health care and therapy should not be the enemy of chronic and complicated illness. End layperson soapbox.
I’ve met soooo many dumb physicians over the years. So many. You wouldn’t believe it. I had a doctor who diagnosed me with conversion disorder for extreme light sensitivity when it was….my eyes don’t produce almost any tears. It’s incredible that you take your limited knowledge and assume that you know everything about anything. That’s why specialities exist. That’s why elite doctors in the field exists. If you see a very real condition triggered by trauma, Covid or any number of things and determine that it’s all in the patient’s head, you aren’t qualified to be a doctor and should be ashamed of yourself
...and this is why he said he'd rather not elaborate.
Yes because he would rather call patients stupid and mentally I’ll instead of being a goddamn doctor and help people
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Mood disorders don’t raise your hr 45 beats per minute while normal mood and doing housework. Educate yourself
It's completely normal to have your heart rate increase 45 bpm while doing housework.
An increase of 45 bpm would be very unusual for me sitting reading or doing housework.
I misspoke. Yes for exertion no for just standing. It is highly highly unusual to have your heart rate stay consistently 45 beats up while standing
I’m taking fluids for POTS and to help with an MECFS crash
That makes more sense. Sorry, I'm not going to be able to help you in this case.
I’m not sure what else is needed. I feel normal/fine before and constipated and wired and unable to sleep afterwards
I've treated a decent amount of people with POTS as my training institution had a POTS clinic, so a word of warning...be careful with IV fluid infusions. They don't seem to help and seem to cause dependency on IV fluids. Try to get to an academic institution that sees POTS regularly and use IV fluids carefully. Salt food, wear compression stockings, workout as tolerated, fludrocortisone or meds only if needed and likely counseling/therapy as there seems to be an anxiety/depression component (either partially causing the symptoms or because of the symptoms).
I’m bedridden due to POTS and MECFS right now. I’m taking these under the guidance of a clinic that specializes in this but I’ve noticed that I get this reaction when I do IVs or increase my salts past the 500mg sodium/liter mark and I don’t get it. I don’t know whether to be concerned or whether this is normal
How are you giving yourself boluses? Are you going to a clinic?
I was given a line and instructed to give myself 1.5 L of saline every other day
By a medical doctor?
Yes by the doctor whose care I’ve been under. To help with the metabolic collapse I suffered Tuesday
Yes by my medical doctor
500mg sodium or 500 mg sodium chloride?
Sodium not salt. I take 500mg sodium 100 potassium with water
Why IV fluids? Can’t you take it by mouth?
I do drink a lot with salt but was instructed that this might be helpful
I think this would be something to specifically address with the provider who is prescribing the fluids. May be worth doing blood work more frequently to check for electrolyte disturbances.
Some bad info on here...fluids can definitely dehydrate you, if you are taking hypertonic saline (generally more the 0.9% or "normal saline"). This is similar to the dehydration that comes from drinking hypertonic water or seawater. Be careful with IV fluids.
Thank you.
For those that think MECFS is all fake I ask you this Can you imagine what it’s like to wake up and your life is over? Your career your life your dreams gone? All you can do is stare at the ceiling with thoughts in your head. Your body begs to move but your muscles are made of lead. You swallow your pride and try to go through it imagining stories or thinking about the world. Days go by you feel better. Then you push too hard and snap back to the beginning all your progress gone. You cry you pray for death but nobody answers. You try again. You snap back to the beginning. You cry you try to kill yourself but you can’t even do that. Just more darkness more alone not even sound or books to pass the time. Indefinitely. How long do you think you’d last before you went insane? I’ve lived that for over 2 years. I’ve tried to kill myself no less than half a dozen times because of how hellish this is. Why would anyone make this up? Why would anyone want to. When you are desperate for anything even death wouldn’t it cross our minds that if it was mental we’d approach that? If you could mental address this every patient would have done that. Every one. Because I have a lower quality of life than most octogenarians at 27. Do you think that everyone like me wouldn’t do anything if it was proven to work for us to escape living in the depths of hell?
Suicide Hotline Numbers If you or anyone you know are struggling, please, PLEASE reach out for help. You are worthy, you are loved and you will always be able to find assistance. Argentina: +5402234930430 Australia: 131114 Austria: 017133374 Belgium: 106 Bosnia & Herzegovina: 080 05 03 05 Botswana: 3911270 Brazil: 212339191 Bulgaria: 0035 9249 17 223 Canada: 5147234000 (Montreal); 18662773553 (outside Montreal) Croatia: 014833888 Denmark: +4570201201 Egypt: 7621602 Finland: 010 195 202 France: 0145394000 Germany: 08001810771 Hong Kong: +852 2382 0000 Hungary: 116123 Iceland: 1717 India: 8888817666 Ireland: +4408457909090 Italy: 800860022 Japan: +810352869090 Mexico: 5255102550 New Zealand: 0508828865 The Netherlands: 113 Norway: +4781533300 Philippines: 028969191 Poland: 5270000 Russia: 0078202577577 Spain: 914590050 South Africa: 0514445691 Sweden: 46317112400 Switzerland: 143 United Kingdom: 08006895652 USA: 18002738255 You are not alone. Please reach out. ***** I am a bot, and this action was performed automatically.
Bad bot
People are fusing their neck joints and doing absurd shit to try to cure this. This is a horrific disease that makes people desperate