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Hyponatremia & dehydration
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Hello all,

Hoping someone might be able to chime in.

I've been struggling performance wise since 2011. I've had multiple tests since July 2012. Negative for Celiac, Crohn's and Small Intestinal Bacterial Overgrowth. Two allergy tests were positive for gluten, soy and some nuts and seeds. I eliminated those foods, found no relief, so, added them back. I've tried many of the usual supplements for GI issues, but received no benefit. Had candida overgrowth from Feb 2017 labs. One GI doc in July 2012 concluded IBS. My intuition tells me it's not the food, and, IBS is just a symptom. Seeing my 13th specialist who also believes IBS is just a symptom. Currently, my chief symptoms are chronic fatigue(no matter how much I sleep), bloated pot belly, stubborn weight gain that diet and exercise will not affect, overall thicker body composition, change in urine and bowel habits, blurry vision, chronic muscle soreness, and gut swelling like a pregnant woman when I drink water, eat and exercise.

Some history:

In Sept 2010, I finished Branson 70.3. I was in the best shape of my life at that time. During the run, my "wheels" fell off. That year, the temps were in the upper 90s. During the run, I got nauseous, bloated belly, water was sloshing around in my gut, felt sore all over and lost my appetite. I went to the medical tent after the race. The EMT gave me an IV of two bags of a saline solution (I assume sodium chloride). My blood pressure was about 60 over 40. EMT said I had diluted sodium levels (hyponatremia). It made sense because I didn't take enough electrolytes, but kept drinking only water. Had some electrolytes on the run, but, the EMT concluded it was too late. I needed the IV because my digestion was compromised. Within an hour of the IV, I felt reborn. All my previous symptoms disappeared. I wasn't even sore. My appetite returned, so, got something to eat. The next morning, I felt great, so, did an hour easy bike ride. Returned to WA a few days later still feeling great.

Fast forward to March 2011. I began to feel something off in my gut. Physical exercise was harder. By October 2011, something was definitely not right in my gut. My weight had gradually increased by 15 pounds since Branson (I've been between 150-155 from 95-2010). Overall body composition was puffier. I noticed no matter what exercises I did and what I ate (been vegan since 95), my body was not leaning out like before. By 2012, my urine and bowel habits changed.

As of today, my symptoms have worsened. One thing I've noticed is when I drink water (up to a gallon a day, with some electrolytes), I don't have to urinate for two hours. When I do go, it's not clear and the volume is low. When I was well from 95-2010, I would drink a quart of water, and have to urinate really bad within 30 minutes. When I'd go, it was mostly clear (unless taking a multi-vitamin) and heavy volume. When I drink water now, it feels like it's sitting in my stomach, but finally evacuates after several hours. It also causes my belly to inflate like a woman four to six months pregnant. My body weight is also heavier. It's now 25 pounds more since 2010. There's also a fat roll around the belly that's impossible to lose. Physical exercise (like SBR) makes my belly bloat more so.

Currently, I'm drinking between 170-190oz of water (with electrolytes) each day. My urine becomes clear and heavy volume only after consuming 90 oz of water. I drink that before I eat breakfast. However, I still have the chief symptoms I cited above in the first paragraph. I thought I've been chronically dehydrated since 2011, but, my symptoms are not improving after increasing my water and electrolyte intake.

I had a specialist draw blood last week (waiting for results) He's checking for lyme among other things.

Hoping someone might have experienced similar issues and found the root cause. Thanks for your input.

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Re: Hyponatremia & dehydration [Recoverie] [ In reply to ]
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Are you a veteran? Reason I ask is because there is the whole gulf war syndrome which is a plethora of things, chronic fatigue being one.
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Re: Hyponatremia & dehydration [Recoverie] [ In reply to ]
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Have you tried an elimination diet? Get rid of all processed foods, nuts, soy, dairy etc. Sounds like you are not digesting. Some recent research shows IBS may be food intolerance which is different from allergy. I have a soy intolerance and had a lot of the same issues as you. I found a very good naturopath (I saw a few physicians with no answers) who had me do an elimination diet and take betaine HCL tablets. An intolerance can pretty much shut down digestion, as a result, bloating, full feeling for hours and body thinks it is starving so hangs on to every last calorie yet does a poor job of nutrient absorption at the same time‚Äč. This can lead to fatigue. Intolerance can cause leaky gut (inflammation) which then triggers system wide inflammation. Had we not figured this out, I was told I very likely would have ended up with autoimmune issues. Since eliminating soy my allergies are minimal and energy is great. I went round and round for years. Yes, it can be as simple as food causing symptoms similar to asthma, autoimmune etc. Betaine HCL tabs dosed appropriately with no processed food, eliminating common culprits and it was amazing how I felt in less than two weeks. Slowly added things back till we had an answer. I did have soy unknowingly some time later and my reaction was almost immediate so it was confirmed.
I wouldn't rule out food so quickly. The physicians I saw were quick to throw drugs at me which only serves as a bandaid and didn't resolve the underlying cause.
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Re: Hyponatremia & dehydration [Recoverie] [ In reply to ]
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Have you considered a test of dropping the veganism? The fact that we have evolved with canine teeth suggests that we might not be designed for veganism. Those teeth aren't made for ruminating on leaves and legumes.

http://www.popsci.com/...why-vegan-diets-suck

Extreme endurance events really test our body chemistry. If you go into them with an imbalance at the starting line, it can end badly. For example, I've known a couple of vegan (former) folks who had low-t problems. No meat and lots of tofu. Not good, unless your name is Lola. Lots of other problems: B vitamins, calcium, iron.....

But I'm just a random guy on the Internet. So see a doctor or two, or three. I mean real ones -- not homeopaths or any other kind of *path.
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Re: Hyponatremia & dehydration [jens] [ In reply to ]
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The naturopath I saw recommended Paleo. Not all naturopath are equal just as all physicians are not equal. What constitutes food these days is anything but, go figure. The gut is a huge part of your immune system. I wouldn't toss all "paths" in the same bucket. Just because symptoms are complex doesn't mean the answer can't be fairly simple and in my case it took going through a few specialists before it was time to try something else. My naturopath is an athlete and is highly regarded and knowledgeable. My ex-physician was an IM athlete and was highly regarded, jumped to conclusions and prescribed unecessary drugs. I agree when you start pushing your limits, one little thing off is magnified which is exactly what I found. First Ironman after a couple of years in tri, no problem, second IM pushing the limits brought to light that one little thing shining a floodlight on it.
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Re: Hyponatremia & dehydration [madonebug] [ In reply to ]
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madonebug wrote:
The naturopath I saw recommended Paleo. Not all naturopath are equal just as all physicians are not equal...


The difference is that the basis of modern medicine is science- and evidence- based practice. That is not the case for naturopathy:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3182944/


As for homeopathy, it is based on early 19th century German chemistry, which is only a little better than alchemy.

I agree that you might find a scientific naturopath or an un-scientific M.D. You may also find a zebra when you hear hoof-beats. But it ain't the most likely outcome.
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Re: Hyponatremia & dehydration [jens] [ In reply to ]
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jens wrote:
Have you considered a test of dropping the veganism? The fact that we have evolved with canine teeth suggests that we might not be designed for veganism. Those teeth aren't made for ruminating on leaves and legumes.

http://www.popsci.com/...why-vegan-diets-suck

Extreme endurance events really test our body chemistry. If you go into them with an imbalance at the starting line, it can end badly. For example, I've known a couple of vegan (former) folks who had low-t problems. No meat and lots of tofu. Not good, unless your name is Lola. Lots of other problems: B vitamins, calcium, iron.....

But I'm just a random guy on the Internet. So see a doctor or two, or three. I mean real ones -- not homeopaths or any other kind of *path.

You couldn't be more wrong on the canine teeth. Using 4 out of 32 teeth to support an argument is crazy. Go look in your dogs mouth. Hell, go look in a cats mouth.

Not even comparable.

But like you said, you're just a random guy on the internet.

I just love when people spout off about things they know nothing about.
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Re: Hyponatremia & dehydration [T.Skelton] [ In reply to ]
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T.Skelton wrote:

You couldn't be more wrong on the canine teeth. Using 4 out of 32 teeth to support an argument is crazy. Go look in your dogs mouth. Hell, go look in a cats mouth. Not even comparable.


They are also not comparable to any ruminant. Exactly when do you think humans' 12 front teeth (canines and incisors) became vestigial? Maybe a look at the oldest known human drawing will give you a starting point:





That takes us back 30,000 years or so. There is clear evidence of Oldowan homins hunting antelope 2 million years ago.


T.Skelton wrote:
I just love when people spout off about things they know nothing about.


indeed
Last edited by: jens: Jul 8, 17 6:57
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Re: Hyponatremia & dehydration [jens] [ In reply to ]
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jens wrote:
T.Skelton wrote:

You couldn't be more wrong on the canine teeth. Using 4 out of 32 teeth to support an argument is crazy. Go look in your dogs mouth. Hell, go look in a cats mouth. Not even comparable.


They are also not comparable to any ruminant. Exactly when do you think humans' 12 front teeth (canines and incisors) became vestigial? Maybe a look at the oldest known human drawing will give you a starting point:





That takes us back 30,000 years or so. There is clear evidence of Oldowan homins hunting antelope 2 million years ago.


T.Skelton wrote:
I just love when people spout off about things they know nothing about.


indeed

Another random guy on the internet here. I think both sides of the vegan discussion have valid points.

Yes, there is evidence of ancient man hunting wild beasts. I'm willing to bet they also ate much more fresh fruit and raw vegetables than our current general population.

Not everything is as it seems -Mr. Miagi
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Re: Hyponatremia & dehydration [Recoverie] [ In reply to ]
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It sounds to me like you have been focusing just on the GI system. If that is the case you may also want to look into problems that could be caused by other body systems such as your kidneys, liver and endocrine systems. Those can also affect your body in the ways you describe. Take a look at any medications that you may be taking, PPI's, Statins can really mess you up. If your taking a lot of "natural" supplements consider those as well. Just because they are "natural" doesn't mean they are good for you.

The problem today is that most so called doctors just want you in and out so they can get the billing done and it's quicker and easier to write a script then it is to work towards a diagnoses. It's really difficult to find a Physician who will look at all the body systems and how they work together. Maybe look for a internal medicine doctor. I've had my best luck with them as they seem to know more then most general practitioners and typically are more interested in exploring all avenues.

In some ways it seems like you are tackling this problem with extreme measures, such as your water intake. I have a history of kidney stones and try to drink 100-128 oz of water or tea a day. Nothing special added. Unless you are exercising and sweating there is no reason for you to constantly drink as much fluid as you are. With the electrolyte intake it's possible that your body is all screwed up. As far as eating and drinking, try just doing normal things like drinking mostly plain water with no electrolytes and not such an excessive amount. If your kidneys are functioning properly they will regulate your electrolyte balance. Don't eliminate food groups but rather cook your own food as much as possible and avoid heavily processed foods.

Good luck.
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Re: Hyponatremia & dehydration [mike s] [ In reply to ]
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Thanks for your input. Yes I am. However, I wasn't involved in the Gulf War.
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Re: Hyponatremia & dehydration [madonebug] [ In reply to ]
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Thanks for your input. Yes, I tried multiple elimination diets. It didn't lessen or eliminate my symptoms. I experience issues with everything I eat. Even drinking water (apart from food) causes my abdomen to swell. It feels like the water is just sitting there.

I agree about the drugs. I've tried some in the past. I know enough that in an emergency situation, they may be needed. For chronic issues, they don't address the root cause. They just create more problems. So, for my situation, I won't take them.
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Re: Hyponatremia & dehydration [jens] [ In reply to ]
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Thanks for your input. Two food panel tests came back positive for eggs and dairy, but negative for beef, chicken, turkey and fish. So, I tried dropping the veganism. It didn't lessen or eliminate my symptoms.

I'm seeing yet another doctor (not a naturopath). The thing is, I've seen "real doctors." Some said everything looks pretty normal. Others just prescribed drugs as a band-aid. For me, these will not address the root cause. So, I'm seeking input from more specialists.
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Re: Hyponatremia & dehydration [Daydreamer] [ In reply to ]
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Thanks for your input. I'm being tested for kidney and thyroid issues and lyme as we speak. Waiting to hear of the results next week.

I took Nystatin (Rx from an IBS naturopath) for a yeast overgrowth from Feb to May. It didn't lessen or eliminate my symptoms. So, I stopped taking it.

I agree about seeing someone who looks at all the body systems. The person I'm seeing now believes strongly that "IBS" is just a symptom. I liked hearing that because that's what I believe. So, he's taking my chart notes from other docs I've seen and my symptoms since 2011 and focused on looking at the bigger picture.

Yes, I've been using extreme measures. Since adding more water last week, my symptoms have not improved. So, I'm backing off. I agree my body is screwed up. It feels that way. So, backing off on the supplements. Honestly, I don't feel better off by taking them.
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Re: Hyponatremia & dehydration [Recoverie] [ In reply to ]
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If eggs and dairy were a problem, and you've eliminated them, it may still take awhile before your body bounces back.

Have any of your docs done more detailed GI investigation (endoscopy, etc?). It seems pretty clear your digestion sometimes just stops. Seems like the next logical step is to take a look.
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Re: Hyponatremia & dehydration [Recoverie] [ In reply to ]
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The thing with elimination diets,they do take time and if your stomach lining is leaky, inflamed, you may be a ways off from producing enough acid to digest. This is why I was started on the hcl. It was the combination of limiting the food types and adding acid that works, it can take a month or more. Even pain meds tend to shut me down or the wrong drink and I am starting all over again. Drinking lots of fluids may be diluting out what little you have. Hence the bloat. Hcl will be key to getting your food digested while your stomach has a chance to heal. What you have eliminated may have helped, but the inflammation may take much longer to heal.
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Re: Hyponatremia & dehydration [madonebug] [ In reply to ]
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madonebug wrote:
The thing with elimination diets,they do take time and if your stomach lining is leaky, inflamed, you may be a ways off from producing enough acid to digest. This is why I was started on the hcl. It was the combination of limiting the food types and adding acid that works, it can take a month or more. Even pain meds tend to shut me down or the wrong drink and I am starting all over again. Drinking lots of fluids may be diluting out what little you have. Hence the bloat. Hcl will be key to getting your food digested while your stomach has a chance to heal. What you have eliminated may have helped, but the inflammation may take much longer to heal.
Probably obvious but if the stomach lining has inflammation, in addition to any food allergies, also cut out alcohol, spicy food and coffee (yeah yeah I know, all the fun stuff). And just drink water when you're thirsty.. If you overdo it, you're just stretching your stomach which continues the vicious cycle.
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Re: Hyponatremia & dehydration [spudone] [ In reply to ]
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I felt worse when I did consume eggs and dairy.

A GI doc in did an endoscopy and colonoscopy March 2013. She said "everything looks normal."
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Re: Hyponatremia & dehydration [spudone] [ In reply to ]
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I don't drink alcohol or coffee nor eat spicy foods. Back to drinking water only when thirsty.
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Re: Hyponatremia & dehydration [Recoverie] [ In reply to ]
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Honestly, sounds like you have conflated several issues here and then somehow related them back to your hard race. Maybe that wasn't your intention but it's how I'm reading your post. Sounds like the physical exhaustion, weight gain, and maybe blurry vision/muscle soreness are issue one. That reads like an endocrine issue to me (think thyroid, testosterone, etc). You say you are awaiting those tests now so there's a path ahead with that. Plan on seeing an endocrinologist to get a full workup.

Issue two sounds like a GI issue but isn't quite as clear. Not sure why you are stuffing down a 1.5 gallon of water per day, especially given your bodies preference to hold onto water. You haven't mentioned your age which could be a contributing factor as bowel slow down isn't unheard of as we grow older. Frankly, I don't see only having to urinate 120 minutes after drinking vs 30 minutes to be a huge problem. If your body wants to hold onto the water then just drink a little less. Not sure about the "IBS" issue. Adult onset of IBS is pretty rare, so again this depends on your age.

Lastly, I don't see how any of this relates to your race. Maybe you just added that as a reference point and not a causation claim? But 7 months post race is a little difficult to trace the lines back to as being the source.
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Re: Hyponatremia & dehydration [Recoverie] [ In reply to ]
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I am not a doctor, but I've had sevral (non-triathlete) friends/family with some similar issues. One thing to consider is diverticulosis. The water retention thing could be a number of things, but congestive heart failure jumps to the front of my mind. It's not impossible in athletes.
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Re: Hyponatremia & dehydration [Recoverie] [ In reply to ]
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Recoverie wrote:
Hello all,

Hoping someone might be able to chime in.

I've been struggling performance wise since 2011. I've had multiple tests since July 2012. Negative for Celiac, Crohn's and Small Intestinal Bacterial Overgrowth. Two allergy tests were positive for gluten, soy and some nuts and seeds. I eliminated those foods, found no relief, so, added them back. I've tried many of the usual supplements for GI issues, but received no benefit. Had candida overgrowth from Feb 2017 labs. One GI doc in July 2012 concluded IBS. My intuition tells me it's not the food, and, IBS is just a symptom. Seeing my 13th specialist who also believes IBS is just a symptom. Currently, my chief symptoms are chronic fatigue(no matter how much I sleep), bloated pot belly, stubborn weight gain that diet and exercise will not affect, overall thicker body composition, change in urine and bowel habits, blurry vision, chronic muscle soreness, and gut swelling like a pregnant woman when I drink water, eat and exercise.

Some history:

In Sept 2010, I finished Branson 70.3. I was in the best shape of my life at that time. During the run, my "wheels" fell off. That year, the temps were in the upper 90s. During the run, I got nauseous, bloated belly, water was sloshing around in my gut, felt sore all over and lost my appetite. I went to the medical tent after the race. The EMT gave me an IV of two bags of a saline solution (I assume sodium chloride). My blood pressure was about 60 over 40. EMT said I had diluted sodium levels (hyponatremia). It made sense because I didn't take enough electrolytes, but kept drinking only water. Had some electrolytes on the run, but, the EMT concluded it was too late. I needed the IV because my digestion was compromised. Within an hour of the IV, I felt reborn. All my previous symptoms disappeared. I wasn't even sore. My appetite returned, so, got something to eat. The next morning, I felt great, so, did an hour easy bike ride. Returned to WA a few days later still feeling great.

Fast forward to March 2011. I began to feel something off in my gut. Physical exercise was harder. By October 2011, something was definitely not right in my gut. My weight had gradually increased by 15 pounds since Branson (I've been between 150-155 from 95-2010). Overall body composition was puffier. I noticed no matter what exercises I did and what I ate (been vegan since 95), my body was not leaning out like before. By 2012, my urine and bowel habits changed.

As of today, my symptoms have worsened. One thing I've noticed is when I drink water (up to a gallon a day, with some electrolytes), I don't have to urinate for two hours. When I do go, it's not clear and the volume is low. When I was well from 95-2010, I would drink a quart of water, and have to urinate really bad within 30 minutes. When I'd go, it was mostly clear (unless taking a multi-vitamin) and heavy volume. When I drink water now, it feels like it's sitting in my stomach, but finally evacuates after several hours. It also causes my belly to inflate like a woman four to six months pregnant. My body weight is also heavier. It's now 25 pounds more since 2010. There's also a fat roll around the belly that's impossible to lose. Physical exercise (like SBR) makes my belly bloat more so.

Currently, I'm drinking between 170-190oz of water (with electrolytes) each day. My urine becomes clear and heavy volume only after consuming 90 oz of water. I drink that before I eat breakfast. However, I still have the chief symptoms I cited above in the first paragraph. I thought I've been chronically dehydrated since 2011, but, my symptoms are not improving after increasing my water and electrolyte intake.

I had a specialist draw blood last week (waiting for results) He's checking for lyme among other things.

Hoping someone might have experienced similar issues and found the root cause. Thanks for your input.

I went through something similar and after 7 doctors and 21 months I was diagnosed with a tapeworm infection that damaged my pancreas causing EPI (exocrine pancreatic insufficiency). I definitely can understand your frustration and am sorry you are going through this. Have your pancreatic enzymes levels been checked? Also, have you been checked for delayed gastric emptying? I certainly hope you find answers soon. My IM training was greatly disrupted when I was sick and even now, 2 1/2 years later, I'm a lot better but still nowhere near 100%
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Re: Hyponatremia & dehydration [T.Skelton] [ In reply to ]
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Tskeleton, you seem to enjoy telling people they are wrong in a kind of mean-spirited fashion. Sadly your post offered no positive information to assist the OP.
If he is vegan now maybe a change would help. It was a suggestion with intent to help. Too bad yours seemed only to belittle.
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Re: Hyponatremia & dehydration [Pat0] [ In reply to ]
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Ok
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Re: Hyponatremia & dehydration [Recoverie] [ In reply to ]
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How old are you? Male/Female?

I'm guessing at least one of those 13 specialists has tested you for thyroid issues(?).
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