Understanding Cerebral Salt Wasting

 There are numerous conditions that require patients to increase their consumption of salt and sodium, including dysautonomia and cystic fibrosis. One of the least known conditions that also require changes in the amount of salt a person consumes is a condition known as cerebral salt wasting.


What is Cerebral Salt Wasting?

Also known as renal salt wasting (RSW) and simply salt wasting, cerebral salt wasting (CSW) is a condition in which that body cannot absorb and reabsorb sodium in the way a healthy person can. Some practitioners may confuse this condition with another syndrome, known as the syndrome of inappropriate antidiuretic hormone secretion (SIADH). 

Like CSW, SIADH also results in difficulties in sodium absorption and can also be identified by testing for higher than normal sodium levels in a person’s urine. However, patients with CSW also show lower blood volume than healthy patients. This is where the difficulty in diagnosis comes in – there is no standard of how low blood volume should be before someone can be diagnosed with CSW, and it is often left up to the diagnosing physician.

Usually, diagnosis depends on what type of doctor you visit – neurologists are more likely to diagnose CSW, while nephrologists tend to diagnose SIADH. Luckily, the treatment plan is generally the same (increase dietary salt intake), so many doctors aren’t overly concerned with this issue.

Symptoms of CSW include excessive urination and excess sodium in urine, excessive thirst and salt cravings, low blood volume, and dehydration. In some patients, it can also cause dysautonomia. If the condition is not treated, further symptoms can include muscle cramps, dizziness and light-headedness, changes in heart rate and blood pressure, and postural hypotension, which can cause fainting.


Causes of Cerebral Salt Wasting

The causes for CSW are not yet fully understood. However, patients with neurological injuries, especially aneurysmal subarachnoid hemorrhages, tend to be the most at risk.

It’s important to remember that this is not the only cause of CSW. Patients without neurological injuries can also develop this condition, though it is far less common. Furthermore, patients can also develop CSW after several illnesses, including meningitis and carcinoma, and after brain surgery (even after successful surgeries).

Some theories behind the causes of salt-wasting include:

  • Hormonal irregularities: Patients with CSW often present with inappropriate secretion of the hormones aldosterone (which regulates salt and water levels in the body) and vasopressin, also known as antidiuretic hormone (which helps control blood pressure, kidney function, and water levels in the body).
  • Interruption of neural signals to the kidneys. CSW is most commonly seen in patients with brain or CNS damage. Due to this, researchers have theorized that the neural signals that send messages from the brain to the kidneys and ensure that they work efficiently have been damaged or interrupted in some way. This, in turn, affects the kidneys’ ability to reabsorb sodium into the bloodstream. Additionally, some CNS conditions also result in interruptions to the hormonal system that regulates the balance of electrolytes in the body, which further affects sodium levels.
  • Higher than normal levels of natriuretic peptides. These are proteins that cause a process known as natriuresis, which allows kidneys to excrete sodium. This, in turn, helps regulate your blood pressure. Patients with CSW often present with high levels of natriuretic peptides, which increase sodium excretion. The reason for this increase is unknown, though one theory is that brain releases these peptides when injured, and they are released into the bloodstream due to a damaged barrier between the blood and the brain.

As mentioned above, cerebral salt wasting usually develops post brain damage or brain surgery. It is a relatively rare complication, and most patients who develop symptoms see them spontaneously resolved quickly, within 2 to 4 weeks. That said, in rare cases, symptoms can persist for months or even years. 


Treating Cerebral Salt Wasting

There is no permanent treatment for CSW. However, there are treatment and management options available.

One common treatment for low sodium levels caused by cerebral salt wasting is the prescription medication fludrocortisone. This corticosteroid helps improve sodium reabsorption in the kidneys.

Patients often self-medicate by increasing salt and fluid consumption. While this is inarguably beneficial, it’s important to see a physician as soon as you develop symptoms. 

A doctor will be able to provide you with the exact amount of salt you need to consume. Depending on the severity of your condition, your physician may recommend consuming up to 12 grams of salt daily!

Furthermore, your doctor may want to monitor your condition over the long term and determine how your illness is progressing. With a physician keeping track of your illness, you will be alerted immediately if your condition has resolved, so you aren’t changing your diet unnecessarily.

There are numerous ways to increase your dietary salt intake, including by increasing the amount of salt you add to your food and consuming salty snacks like chips, jerkies, broths, and popcorn. Alternatively, you can increase your intake of electrolyte drinks, especially as you will also need to increase your fluid intake to manage cerebral salt wasting.

That said, if you are on an extremely high salt diet, getting enough sodium can pose a challenge. Additionally, you may need to further increase sodium intake on hot days and before exercise (your doctor will be able to guide you on these specifics).

One of the best ways to overcome this challenge is to use salt tablets and other supplements like Klaralyte. These tablets make it easy to get the amount of sodium you need without worrying about making significant changes to your diet. 

Klaralyte has been formulated to ensure you get a balance of both sodium and potassium to prevent any electrolyte imbalance in your body. Each tablet contains 250mg of sodium and 50mg of potassium, ensuring that you’ll be able to get the additional salt you need easily. Furthermore, you can easily carry it with you, allowing you to quickly boost your sodium levels if you feel them coming down when you’re out of the house.


Other Sources:

You will not be disappointed!

Additional Information

*Not Evaluated by FDA: These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, cure, or prevent any disease. Klaralyte LLC manufactures dietary supplements and medical food products that should be used under the direct supervision of a licensed healthcare practitioner.

Designated Medical Food: Klaralyte Salt Capsules are classified as a medical food under 21 U.S.C. 360ee(b)(3), and are intended for specific dietary management based on recognized scientific principles, as evaluated by a physician.

Comparative Advertising: Klaralyte is a registered trademark of Klaralyte LLC. Registered trademarks, brand names, images, or any information that could refer to another brand are used solely for lawful comparative advertising. This follows FTC-defined criteria for objectively comparing brands based on attributes or price, while clearly identifying the alternative brand.