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Here are all the mnemonics you ever wanted on Hyponatremia. These mnemonics covers all aspects of the disease/health condition 

Causes of Hyponatremia


S – SIADH (Syndrome of Inappropriate Antidiuretic Hormone)

A – Addison’s disease

L – Loss of sodium (renal or non-renal)

T – Thiazide diuretics

Y – HypothYroidism

P – Polydipsia (excessive drinking)

E – Excessive water intake

N – Nephropathy

G – GI losses (vomiting, diarrhea)

U – Uremia

I – Inadequate sodium intake

N – Neurological disorders (head injury, meningitis)


Triggers for Hyponatremia


W – Water overload

A – Antipsychotics

T – Trauma (head)

E – Excessive IV fluids

R – Renal failure

S – Surgery (postoperative)

L – Low solute intake

I – Infections (CNS)

D – Diuretic overuse

E – Endocrine disorders


Risk Factors For Hyponatremia


H – Heart failure

Y – Young age/elderly

P – Psychiatric illness

O – Oncology patients (cancer)

N – Nausea

A – Alcoholism

T – Tuberculosis

S – Sepsis

E – Eating disorders



Warning Signs of Hyponatremia

Mnemonic: SALTLESS

S – Seizures

A – Altered mental status

L – Lethargy

T – Tendon reflexes diminished

L – Loss of appetite

E – Emesis (vomiting)

S – Stomach cramps

S – Sodium below 135 mEq/L


Predisposing Factors of Hyponatremia

Mnemonic: LOW SALT

L – Liver cirrhosis

O – Overhydration

W – Women (esp. post-menopausal)

S – Syndrome of inappropriate ADH secretion

A – Advanced age

L – Low dietary sodium

T – Thiazide diuretics


Signs & Symptoms of Hyponatremia

Mnemonic: SODIUM LOW

S – Stupor

O – Oedema

D – Dizziness

I – Irritability

U – Unsteady gait

M – Muscle cramps

L – Lethargy

O – Orientation disturbed

W – Weakness


Characteristic Findings In Hyponatremia

Mnemonic: WATER LOG

W – Weight gain (fluid retention)

A – Anorexia

T – Tremors

E – Encephalopathy

R – Reflexes, hyperactive

L – Low urine output

O – Osmolality increased in urine

G – Gastrointestinal symptoms (nausea)


What Should Be Avoided In Hyponatremia

Mnemonic: DRY SAND

D – Diuretics (especially thiazides)

R – Rapid correction of sodium

Y – Yoghurt and other high protein diets

S – Salt tablets

A – Alcohol


D – Dehydration


Drugs Used To Treat Hyponatremia

Mnemonic: SALT FIX

S – Saline hypertonic

A – ADH antagonists (Vaptans)

L – Loop diuretics

T – Tolvaptan

F – Fluid restriction

I – IV sodium chloride

X – eXamination of underlying cause


Drugs To Avoid In Hyponatremia

Mnemonic: NO SAD PILL


O – Opiates


A – Antipsychotics

D – Diuretics (especially thiazides)

P – PPIs (Proton Pump Inhibitors)

I – Insulin (excessive)

L – Lithium

L – Laxatives


Radiological Features of Hyponatremia

Mnemonic: BRAIN SALT

B – Brain edema

R – Reduced ventricular size

A – Absence of hemorrhage

I – Intracranial pressure increased

N – Normal structural findings

S – Sulcal effacement

A – Attenuated blood flow

L – Lack of focal lesions

T – Transependymal flow


Diagnostic Tests for Hyponatremia

Mnemonic: TEST SALT

T – Total body water calculation

E – Electrolytes serum

S – Serum osmolality

T – Thyroid function tests

S – Sodium urine

A – ADH levels

L – Lipid profile

T – Tonicity assessment


Laboratory Findings In Hyponatremia

Mnemonic: SALT LAB

S – Sodium decreased

A – ADH increased (in SIADH)

L – Lipase (pancreatitis workup)

T – Triglycerides (rule out pseudohyponatremia)

L – Low serum osmolality

A – Aldosterone levels (if adrenal insufficiency suspected)

B – Blood urea nitrogen (to assess renal function)


Indications for Treatment in Hyponatremia

Mnemonic: SALTY NEED

S – Symptoms severe (seizures, coma)

A – Acute hyponatremia

L – Low serum sodium (<120 mEq/L)

T – Thiazide-induced hyponatremia

Y – Young patients (more resilient to treatment)

N – Neurological symptoms

E – Elderly (careful correction)

E – Euvolemic hyponatremia

D – Diabetes insipidus (central)



Clinical Features of Hyponatremia:

Mnemonic: “FISH TANK”

F – Fatigue

I – Irritability

S – Seizures


T – Tiredness

A – Anorexia (or Appetite loss)

N – Nausea

K – Kinesia abnormalities (like ataxia)


Complications of Hyponatremia:

Mnemonic: “CLOUDS”

C – Cerebral edema

L – Lethargy

O – Osmotic demyelination syndrome

U – Unconsciousness

D – Death (in severe cases)

S – Seizures


Differential Diagnosis of Hyponatremia:

Mnemonic: “SALTY SEA”

S – SIADH (Syndrome of Inappropriate Antidiuretic Hormone secretion)

A – Adrenal insufficiency

L – Loss of sodium (renal or non-renal)

T – Thyroid dysfunction (hypothyroidism)

Y – Young’s syndrome

S – Salt-wasting nephropathy

E – Excess water intake (psychogenic polydipsia)

A – Acid-base disturbances



Dr. Arin Nandi

Passionate About Medical Science & Helping Future Doctors Achieve Top Ranks In Medical Exams. He is professionally a dentist as well as a public health expert from JIPMER (1), (2)working in health department