Potomania is a word that literally means drinking (poto) alcohol excessively (mania). In medicine, beer potomania refers to a condition in which the level of sodium in your bloodstream drops too low due to excessive beer consumption.
Unlike most other things we consume in our diet, beer contains a lot of water and only a little bit of sodium. It’s this lopsided water-to-salt ratio that causes potomania in high-risk individuals, especially when one’s intake of sodium and protein-rich foods is also low.
Beer potomania is sometimes called beer drinker’s hyponatremia. Hyponatremia is the medical term for an abnormally low sodium level in the blood. Hyponatremia can be caused by a number of different conditions, including excessive water consumption. This can cause something doctors call water intoxication, where neuropsychiatric issues occur from hyponatremia because the body has more water than it can handle.
What are the symptoms?
Symptoms of beer potomania, which often follow an episode of binge drinking and poor nutritional intake, may include:
- acutely altered mental state
- muscle weakness, spasms, or cramps
- loss of energy or fatigue
- trouble walking
- irritability or restlessness
- nausea or vomiting
- inability to wake (coma)
What causes this?
Potomania causes a dangerously low sodium level in your blood, called hyponatremia. There are many different conditions that can cause low sodium levels. In potomania, it’s typically a combination of malnourishment and binge drinking over time.
Sodium is an important nutrient that helps regulate the balance of water in your body. Most people get enough sodium from their diet. However, when someone stops eating, the levels of sodium in their blood can drop — especially when combined with excessive intake of fluids low in sodium. This is common among people who misuse alcohol, some of whom get most of their calories from drinking beer and other alcoholic beverages.
Baseline serum sodium levels can also drop due to a recent illness affecting electrolyte levels, particularly when there’s vomiting or diarrhea.
To work properly, your kidneys require a certain amount of sodium. Without it, they can’t clear excess fluids from your body. That excess fluid builds up in your blood and causes your cells to swell. Swelling in the brain causes the neurological symptoms of potomania.
Normally, when someone stops eating, their body breaks down fat and muscle to use as energy. This provides the body with enough sodium to keep the kidneys working. Drinking excessive quantities of water or beer, however, will dilute this sodium, making it ineffective. Learn about other effects of alcohol on your body.
Effects on solutes and electrolytes
Beer doesn’t contain much in the way of solutes. (Solute in this instance refers to an electrolyte or protein that is dissolved in beer’s water content.)
Beer drinking causes potomania because it has a high water content and a low sodium content. Sodium is an important electrolyte. When someone with chronically low sodium levels routinely binges on beer or other alcoholic beverages, especially when they also have poor overall nutrition, the kidneys can become dysfunctional.
Fluid builds up in the cells because there isn’t enough sodium in the body. This is made worse by all the water in beer. The sodium in the bloodstream becomes diluted by the extra water and can rapidly drop to a severely low level.
Treating beer potomania can be tricky and requires a delicate approach. While giving someone sodium may seem like the obvious treatment, this can actually be dangerous.
Rapid reversal of sodium levels can lead to neurological problems, including a condition known as osmotic demyelination syndrome (ODS). The symptoms of ODS can include serious neurological problems, including spasms, severe mental impairment, and coma.
In a review of 22 cases of beer potomania, 18 percent of people developed ODS.
If you have beer potomania, you are at greater risk of ODS than people with other types of hyponatremia (low sodium). This is because your state of hyponatremia is likely severe and has developed over time due to sustained alcohol intake, making it more complex to treat.
The risk of ODS is directly correlated with the speed of sodium replacement. Therefore, doctors now recommend a slow and careful administration of sodium over the course of 48 hours.
If you’re not symptomatic due to hyponatremia, doctors may decide not to give IV fluid with sodium in it. Instead, they may put you on a liquid-restricted diet for at least 24 hours. Sometimes this is enough for the body to expel extra fluids and build up sodium concentration.
Are there complications?
Left untreated, potomania can be life-threatening. When too much fluid builds up inside your cells, they begin to expand. This causes swelling in your body’s tissues. In cases where sodium levels drop quickly or to a very low level, the brain can swell up in a matter of hours. Swelling in the brain can lead to seizures, coma, and death, so it’s very important to get treatment.
What’s the outlook?
Potomania is a serious condition that can be avoided by eating a sufficient amount of healthy nutrients and reducing your alcohol intake.
If you’re unable to eat due to illness, try using a meal-replacement drink. Be sure to talk to your doctor honestly about your drinking habits. Your doctor may have advice about reducing your risk of complications.
If you haven’t been eating a regular and healthy diet, avoid bingeing on beer or other alcoholic beverages. (It’s a good rule of thumb to avoid binge drinking in general.) If you’re planning to drink several beers in one sitting, also have a salty and protein-rich snack, like beef jerky or nuts.