Hyponatremia Associated with Excessive Tea Consumption

Pathophysiology and Vulnerable Populations

• The elderly are particularly vulnerable to hyponatremia due to inadequate solute intake combined with excessive fluid consumption, which blunts thirst sensation and impairs primary urine concentration by the kidneys 1, 2
• Elderly individuals with memory problems, social isolation, or fear of incontinence who voluntarily reduce food intake while maintaining high tea consumption are at risk of developing hyponatremia 1

Hydration Potential of Tea

• High-quality RCT evidence demonstrates that tea has hydration potential similar to water and does not cause dehydration, according to the Clinical Nutrition journal 3, 4
• The ESPEN Geriatrics Guidelines recommend that tea should be encouraged as part of adequate fluid intake in older adults 3, 4

Cardiovascular Benefits of Green Tea

• Green tea consumption of 3-4 cups daily is associated with cardiovascular benefits, including a 5% reduction in cardiovascular mortality per cup, as reported by Praxis Medical Insights 5

Dietary Modification and Treatment

• Increasing dietary solute intake through adequate protein (0.8-1.2 g/kg/day) and appropriate salt consumption is recommended, according to the Proceedings of the Nutrition Society 6
• Fluid restriction (1-1.5 L/day) is indicated only if serum sodium is below 120-125 mmol/L with neurologic symptoms, as stated in the Clinical and Molecular Hepatology journal 7

Monitoring and Screening

• All older adults should be screened for low-intake dehydration when contacting healthcare, as they are at universal risk, according to the Clinical Nutrition journal 1
• Directly measured serum osmolality or calculated osmolarity should be used to identify low-intake dehydration, with an action threshold of >300 mOsm/kg or >295 mmol/L, respectively 1, 8