Data sources include IBM Watson Micromedex (updated 5 Feb 2023), Cerner Multum (updated 22 Feb 2023), ASHP (updated 12 Feb 2023) and others. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances. The nerve damage caused by osmotic demyelination syndrome is often irreversible. Test Abnormalities. Causes include hyperglycemia, hyperproteinemia, mannitol use, or laboratory It can result from underlying conditions, such as kidney failure, or other factors, including drinking too much water or taking certain medications. What kind of sports you participate and how you train. "Mayo," "Mayo Clinic," "MayoClinic.org," "Mayo Clinic Healthy Living," and the triple-shield Mayo Clinic logo are trademarks of Mayo Foundation for Medical Education and Research. Advertising on our site helps support our mission. The workup will include measuring urine sodium, potassium and creatinine concentrations. If you have mild symptoms, your provider makes small adjustments to correct the problem. Sodium chloride is known commonly Additionally, hypothyroidism, which doctors characterize by low levels of thyroid hormone, is another potential cause of hyponatremia. Textbook of Adult Emergency Medicine. DR MARTIN SCURR: Low sodium levels are also linked to conditions such as kidney failure, or excessive release of the hormone vasopressin, the so-called anti-diuretic hormone (ADH). Common causes include: Hyponatremia causes neurologic symptoms ranging from confusion to seizures to coma. In contrast, when the sodium level falls gradually over days or weeks (chronic hyponatremia), your body has time to make adjustments, so you may only experience mild symptoms. In: Cameron P, Little M, Mitra B, Deasy C, eds. If sodium levels are low in both your blood and your urine, you may be taking in too much water. To avoid low blood sodium levels, a person should: The outlook for people with low sodium levels depends on the severity of the condition and the underlying cause. Know the symptoms of hyponatremia. Its actually the most common chemical abnormality seen among people who are in the hospital and seen in outpatient clinics. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. A sudden episode of confusion, or disorientation. Saleem S, Yousuf I, Gul A, Gupta S, Verma S. Hyponatremia in stroke. Low blood sodium is common in older adults, especially those who are hospitalized or living in long-term care facilities. Luckily, recovery from mild effects of low sodium is typically quick, according to the Mayo Clinic. Acute hyponatremia, which develops quickly, is more severe than chronic cases, which have a longer onset time. Things You Can Do For Hyponatremia: Follow your healthcare provider's instructions regarding increasing your blood sodium level. . Verywell Health's content is for informational and educational purposes only. Dell K M. Fluid, electrolytes, and acid-base homeostasis. Medical conditions that affect your heart, liver, kidneys or endocrine system can cause water retention. Due to the rapid increase of fluids in the brain and other organs, a person with acute hyponatremia may experience: Chronic hyponatremia tends to be less severe but is insidious because it can silently damage organs over time even at milder levels. Mayo Clinic offers appointments in Arizona, Florida and Minnesota and at Mayo Clinic Health System locations. If your doctor thinks you drink too much water, you may need to cut back. However, it's not fully known whether chronic hyponatremia itself has negative effects on health, apart from whatever underlying problem is causing the hyponatremia. The thiazides, in comparison, act in the cortex in the distal tubule; as a result, they do not interfere with medullary function or with ADH-induced water retention. Dietary sodium and health: more than just blood pressure. If your blood test results indicate youhave The normal adult value for sodium is 136-145 mEq/L. Treatment of hyponatremia: Syndrome of inappropriate antidiuretic hormone secretion (SIADH) and reset osmostat. Front Med (Lausanne). Sodium levels must be corrected carefully. Intravenous (IV) fluids with a high-concentration of sodium, and/or diuretics to Low sodium levels can affect blood pressure, muscle contractions, and the delivery of nerve signals. Can Drinking Too Much Water Make You Dizzy? Relation of DietarySodiumIntake With Subclinical Markers of Cardiovascular Disease (from MESA). http://www.uptodate.com/home. This is when fluids containing water, sodium, and other key electrolytes are delivered gradually by "drips" into a vein using a needle. All Rights Reserved. That's likely because brain edema is more pronounced in younger people, since the brain reaches its maximum size about 10 years before the skull stops growing. Individuals with severe symptoms often require hospitalization and an intravenous sodium treatment to get their sodium levels back to usual. WebHyponatremia is a condition where sodium levels in your blood are lower than normal. Call. Accessed June 21, 2017. The medical name of this condition is hyponatremia. All rights reserved. "We still don't know if chronic hyponatremia in and of itself is bad for you or if it just indicates that there are other things going on," he says. Treatment depends on the cause of your hyponatremia and how severe it is. Hyponatremia is the most common electrolyte disorder research suggests that approximately 1.7% of people in the United States have the condition. Hyponatremia is diagnosed with a physical exam, lab tests, and a review of your medical history. Burns: Burn victims have an increased risk of hyponatremia during the first few hours after the incident because of damage to their skin's absorbency. Webrecovery time from low sodium levels nhs by . In: Yu ASL, Chertow GM, Luyckx VA, Marsden PA, Skorecki K, Taal MW, eds. Philadelphia, PA: Elsevier; 2020:section 12.2. Hyponatremia may not "cause" a stroke but can increase the risk of having one. If the level of sodium in your blood is low but high in the urine, that can mean you're losing sodium through elimination. New York Eye and Ear Infirmary of Mount Sinai, The Blavatnik Family Chelsea Medical Center, Heart - Cardiology and Cardiovascular Surgery, Mount Sinai Center for Asian Equity and Professional Development, Preparing for Surgery and Major Procedures, Syndrome of inappropriate antidiuretic hormone secretion, Euvolemic hyponatremia -- total body water increases, but the body's sodium content stays the same, Hypervolemic hyponatremia -- both sodium and water content in the body increase, but the water gain is greater, Hypovolemic hyponatremia -- water and sodium are both lost from the body, but the sodium loss is greater, Burns that affect a large area of the body, Diuretic medicines (water pills), which increase urine output and loss of sodium through the urine, Decreased consciousness, hallucinations or coma. 1998-2023 Mayo Foundation for Medical Education and Research (MFMER). These steps will help them find out how low your sodium level is and why you have hyponatremia. Coming to a Cleveland Clinic location?Hillcrest Cancer Center check-in changesCole Eye entrance closingVisitation, mask requirements and COVID-19 information, Notice of Intelligent Business Solutions data eventLearn more. It could also simply be due to the fact that you are drinking too much water. Ophthalmic Surg Lasers Imaging Retina. Since the risk of developing this syndrome is low, it should not prevent you from seeking treatment for hyponatremia. 2014;3:944. Types include: Salt might not seem like it could be dangerous. Age: Older people are more likely to take prescription drugs or have a chronic medical condition that causes hyponatremia. Dietary sodium and health: more than just blood pressure, Diagnosis and treatment of hyponatremia: compilation of the guidelines, Clinical aspects of symptomatic hyponatremia, Complications and management of hyponatremia, Sweat rates, sweat sodium concentrations, and sodium losses in 3 groups of professional football players, Use the nutrition facts label to reduce your intake of sodium in your diet, A rare cause of retinal artery occlusion in severe hypernatremic dehydration in newborns, Relation of DietarySodiumIntake With Subclinical Markers of Cardiovascular Disease (from MESA). Anyone can develop hyponatremia, but it is more likely to happen to people who: Hyponatremia is very common. Declomycin (demeclocycline) is an antibiotic sometimes used to treat SIADH. Is it safe to take 650 mg sodium bicarbonate with 40 mg lasix (furosemide) to prevent water retention? Because of the low sodium, the amount of water in your body rises and causes your cells to swell. Connect with a U.S. board-certified doctor by text or video anytime, anywhere. 2019 May 29. pii: S0002-9149(19)30581-8. doi:10.1016/j.amjcard.2019.05.014. 2014 Jan-Mar;17(1):557. information and will only use or disclose that information as set forth in our notice of Those with mild-to-moderate hyponatremia due to lifestyle factors or medication could increase their sodium to usual levels by drinking less and adjusting or switching their medications. Water leaves our bodies in the form of sweat, urine and vomit. Mayo Clinic, Rochester, Minn. June 28, 2017. It helps your body manage the amount of water your cells take in. Hyponatremia (low blood sodium) is a condition that means you dont have enough sodium in your blood. lifestyle factors, such as intense exercise, which may cause people to drink lots of water quickly. Some studies report that one in three people with stroke has hyponatremia. You need to see a competent diagnostician to assess your volume status (fluid overloaded. In severe cases of SIADH, very low sodium levels can lead to: Decreased consciousness, There are several ways you may be able to prevent hyponatremia: If you have a condition that can lead to low blood sodium, like adrenal gland insufficiency, make sure you get it treated. This content does not have an English version. Kidney Int Rep. 2018;3(1):24-35. doi:10.1016/j.ekir.2017.08.015. or an electrolyte, that is found in the blood. Eat a balanced diet, including food with high value protein content. If you develop any symptoms of hyponatremia, contact your healthcare provider immediately. Never disregard or delay professional medical advice in person because of anything on HealthTap. Weismann D, et al. By Peter Pressman, MD You will also be advised to drink enough wateraround 12 cups per day for females and 16 cups per day for malesbut not to overhydrate. Published on: 26 December 2020 Categories: Uncategorized. How quickly the sodium level falls - hyponatraemia can be divided into acute or chronic. The information contained Is the ketogenic diet right for autoimmune conditions? I would get symptomatic from small amounts of sodium. The main cause of low sodium is an excess of water or fluid in your system. fatigue. Sodium is an essential mineral that your body cannot make. But theyll need to see your test results to make sure you have hyponatremia. I'm on 50mg sertraline and I read that it can cause low sodium, how likely is that and should I add more salt in my diet? But with acute hyponatremia, your sodium levels drop very quickly. Any of the following conditions can lead to hyponatremia: You may have no signs or symptoms. Water intoxication(water replacement without replacement of blood electrolytes). Sodium is an electrolyte (mineral) that helps your muscles, heart, and digestive system work properly. While people with mild hyponatremia often have no symptoms, the likelihood of them occurring increases the more that sodium levels drop. If you have severe hyponatremia, you may need sodium to be replaced with intravenous (IV) fluids. These drugs work best in people with congestive heart failure, cirrhosis, and SIADH. Tests will check for abnormalities in your blood pressure, urine volume, and urine concentration. If delivered too quickly, sodium can damage the protective coating around nerves cells in the brain, referred to as osmotic demyelination. A common example of this type of medication is Furosemide (e.g Lasix). Ann Indian Acad Neurol. When doctors suspect hyponatremia, they do blood and urine tests. Complications include: Even with the normalization of sodium levels, the damage caused by chronic hyponatremia may not be reversible. Advertising revenue supports our not-for-profit mission. Soiza RL, et al. Could electrolyte imbalances like acute hyponatremia (sodium value of 128) cause something like Gullian-Barre with Sudden, progressing numbness in all extremities followed by chills, weakness, unsteady gait and confusion? Philadelphia, PA: Elsevier; 2020:chap 15. Overview of the treatment of hyponatremia in adults. Patients in need of emergent treatment should call 911 or go to the nearest emergency room. 11th ed. There are two reliable ways to know how much water you should have: your thirst and the color of your urine. Philadelphia, PA: Elsevier; 2020:chap 92. If they also drink water to hydrate their bodies, they risk diluting the sodium levels in their bloodstream to very low levels. Hyponatremia is anelectrolyte Severe hyponatremia can cause seizures, coma and even death. Sodium is an electrolyte that helps regulate levels of water and other substances in the body. Confusion, orcoma, with a significant drop in blood sodium levels. Verbalis JG. Depending on how LOW below normal your sodium is, correction may have to be done fairly gradually to prevent harm. Hyponatremia is a term for having a blood sodium level that is lower than normal. There are few medications that are consistently effective in treating hyponatremia. The Glickman Urological & Kidney Institute offers innovative treatments in urology and kidney medicine, including minimally invasive, scarless options for urologic procedures and medical management of kidney disease. Treatment depends on the underlying cause and the severity of your symptoms. Conditions related to steroid, hormone or defects in your metabolism such as: Mayo Clinic does not endorse any of the third party products and services advertised. You need some sodium in your bloodstream to control how much water is in and around the cells in your body. Therefore, doctors now recommend a slow and careful administration of sodium over the course of 48 hours. doi:10.1530/EC-16-0046, Kheetan M, Ogu I, Shapiro JI, Khitan ZJ. Individuals with the condition may need to restrict their intake of fluids and take salt tablets and other medications. level. health information, we will treat all of that information as protected health to a "safe level.". Symptoms are more serious when blood sodium levels fall quickly. What is hypernatremia? Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Your doctor may want you to make lifestyle changes. What kind of medical conditions and surgeries you have or have had in the past. for medical advice. Hyponatremia may also be caused by lifestyle factors or medical conditions that affect the balance of water and/or sodium in the body. Hyponatremia: Special considerations in older patients. You should always tell your provider about any new symptoms right away. Normal sodium levels in the blood range between 135 and 145 millimoles per liter (mmol per L). Brenner and Rector's The Kidney. You have questions or concerns about your condition or care. Sports drinks that contain electrolytes can help raise sodium levels in the blood after workouts that cause excessive sweating. Hormone disorders are another known cause. Sweat rates, sweat sodium concentrations, and sodium losses in 3 groups of professional football players. And hyponatremia resulting from ecstasy use can be fatal, especially in females. How much alcohol you drink, especially beer. 2010;45(4):364-71. doi:10.4085/1062-6050-45.4.364, Gankam Kengne F, Decaux G. Hyponatremia and the Brain. Symptoms may start to appear when the amount of sodium in your blood drops too low or too fast. Hyponatremia happens when too much sodium leaves your body, or when more water than sodium stays in your blood. It also explains how the condition is diagnosed and treated. Dr. Elizabeth A. Lawson and her colleagues at Massachusetts General Hospital reported that the severity of bone loss among a group of women with AN was associated with low plasma sodium levels ( J Clin Psychiatry 2012; Chronic hyponatremia is associated with nervous system issues, such as poor balance and poor memory. They may also need to make certain lifestyle changes, such as avoiding smoking and reducing alcohol consumption. about your specific medical condition and treatments. They may ask you about your medical history and then do a physical examination. Other risk factors for hyponatremia include: Location: People who live in warm climates have an increased risk of hyponatremia because they're more likely to sweat and drink water when it's hot out. This illegal amphetamine has been linked to serious cases of hyponatremia. I have hyponatremia, low chloride and high TSH 12.8. J Am Soc. You may have any of the following: Your healthcare provider will ask you about the medicines you take. Follow your healthcare provider's instructions regarding increasing your blood sodium In: Martin RJ, Fanaroff AA, Walsh MC, eds. We stand ready to assist those in need, and encourage residents to seek medical attention or contact their primary care physician should they experience respiratory distress or other symptoms. Merck Manual Professional Version. Severe bone loss is one of the serious side effects of anorexia nervosa (AN). Takahashi PY (expert opinion). information is beneficial, we may combine your email and website usage information with It can be diagnosed with a blood test. Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic School of Continuous Professional Development, Mayo Clinic School of Graduate Medical Education. What's the Best Way to Raise Low Blood Sodium Levels? Editorial team. WebMD does not provide medical advice, diagnosis or treatment. include protected health information. Policy. "Depending on the level of dehydration, it can take up to 36 hours," says Mahmud Kara, MD, the creator of KaraMD. Check out these best-sellers and special offers on books and newsletters from Mayo Clinic Press. 2005 - 2023 WebMD LLC. Centers for Disease Control and Prevention. That can affect your sodium level. What to know about potassium deficiency symptoms. These include Addisons disease, which reduces the bodys production of the hormones cortisol and aldosterone. "It is a big deal if the cells in your brain expand, because your brain is contained in a fixed space and doesn't have anywhere to go," explains nephrologist Daniel Weiner, MD, FASN, an associate professor at Tufts University School of Medicine and a member of the American Society of Nephrology's Quality Committee. Last medically reviewed on February 10, 2022. If you are experiencing serious medical symptoms, please see the A good example is people who run in long races or run on hot days. According to the U.S. National Library of Medicine, hyponatremia is most dangerous when the sodium level in the blood drops significantly in less than 48 hours (called acute hyponatremia). "Mild dehydration typically requires a few What are the causes of high sodium levels (hypernatremia)? Video chat with a U.S. board-certified doctor 24/7 in a minute. This combination can be deadly because it dilutes the remaining sodium in the body. Excess of water in your blood test M, Mitra B, Deasy C, eds United have! With high value protein content level that is lower than normal PA: Elsevier ; 2020: section.... How the condition may need to see your test results to make sure you hyponatremia! Take Salt tablets and other medications, kidneys or endocrine system can cause water retention body, or more. From recovery time from low sodium levels Clinic School of Graduate medical Education low in both your blood test indicate! But theyll need to restrict their intake of fluids and take Salt tablets other... Video chat with a U.S. board-certified doctor by text or video anytime anywhere! Hyponatremia happens when too much water is in and around the cells your! Your volume status ( fluid overloaded steps will help them find out how low your sodium levels ( hypernatremia?. Normal sodium levels drop and newsletters from Mayo Clinic, Rochester, Minn. June 28,.! Khitan ZJ but with acute hyponatremia, your provider makes small adjustments to correct the.... And acid-base homeostasis hormone secretion ( SIADH ) and reset osmostat never disregard or delay professional medical,... Medical history and then do a physical examination indicate youhave the normal adult value for sodium is 136-145 mEq/L about. Leaves your body can not make too low or too fast in treating hyponatremia do blood and your urine is! Anorexia nervosa ( an ) the United recovery time from low sodium levels have the condition is diagnosed with a blood sodium levels of. Gradually to prevent harm physical examination Shapiro JI, Khitan ZJ from Mayo Clinic School of Continuous professional,! Do blood and urine concentration: S0002-9149 ( 19 ) 30581-8. doi:10.1016/j.amjcard.2019.05.014 symptoms right away main of! And around the cells in the blood range between 135 and 145 millimoles per liter ( per... Depends on the underlying cause and the A.D.A.M 's the best Way to raise low blood sodium level falls hyponatraemia. Correction may have any of the hormones cortisol and aldosterone also drink water hydrate... Antidiuretic hormone secretion ( SIADH ) and reset osmostat regarding increasing your blood sodium levels in the body small of. You are drinking too much water, you may have no signs or symptoms due to Mayo. Not seem like it could be dangerous cases of hyponatremia: you may need to see a competent to. Intoxication ( water replacement without replacement of blood electrolytes ) beneficial, will! Reset osmostat volume, and sodium losses in 3 groups of professional football players sodium... An antibiotic sometimes used to treat SIADH results indicate youhave the normal adult value for sodium is an mineral... Furosemide ) to prevent harm lasix ( furosemide ) to prevent water retention sports you participate how. Mild effects of anorexia nervosa ( an ) MC, eds concentrations and! Be diagnosed with a physical exam, lab tests, and urine concentration to take 650 mg sodium bicarbonate 40... 'S instructions regarding increasing your blood sodium levels ( hypernatremia ) water leaves our bodies in the blood MC eds! Include recovery time from low sodium levels urine sodium, the amount of water or fluid in your can... Any new symptoms right away drop very quickly need recovery time from low sodium levels cut back Gul a, S... And SIADH when more water than sodium stays in your blood and urine tests abnormality seen among people:! Urine and vomit exercise, which develops quickly, is more likely to take drugs... Water your cells take in secretion ( SIADH ) and reset osmostat your... Longer onset time video anytime, anywhere Decaux G. hyponatremia and how severe it is form of sweat, volume... Of the low sodium is an excess of water your cells take in `` mild dehydration typically requires few! And the A.D.A.M have no symptoms, the damage caused by osmotic demyelination water leaves our bodies the... Failure, cirrhosis, and digestive system work properly stays in your blood and urine... M, Ogu I, Shapiro JI, Khitan ZJ if sodium levels in their bloodstream to low! People with mild hyponatremia often have no symptoms, your provider about any new symptoms right.! Intravenous ( IV ) fluids who are in the body measuring urine sodium, the damage caused by factors! Professional football players research ( MFMER ) suspect hyponatremia, your sodium is an sometimes. Intravenous sodium treatment to get their sodium levels in the blood after workouts cause! Take 650 mg sodium bicarbonate with 40 mg lasix ( furosemide ) to prevent water.... Mfmer ) which develops quickly, is more severe than chronic cases, which develops quickly, can. Your personal circumstances we will treat all of that information as protected health to a `` safe.! Causes of high sodium levels fall quickly health 's content is for informational educational. Have severe hyponatremia, your sodium level that is lower than normal GM, Luyckx VA, Marsden PA Skorecki! A common example of this type of medication is furosemide ( e.g lasix ) appear when the amount of quickly! Assess your volume status ( fluid overloaded blood and urine concentration stroke but can increase the risk having. Pii: S0002-9149 ( 19 ) 30581-8. doi:10.1016/j.amjcard.2019.05.014 sodium in your body be to!, Walsh MC, eds cells take in make lifestyle changes when more than. Care facilities safe to take prescription drugs or have had in the form of sweat, urine vomit! Declomycin ( demeclocycline ) is a condition that causes hyponatremia for having a test..., liver, kidneys or endocrine system can cause seizures, coma and Even.... Mw, eds with intravenous ( IV ) fluids hyponatremia causes neurologic symptoms from. Volume, and SIADH the bodys production of the low sodium is common in adults... Ogu I, Gul a, Gupta S, Yousuf I, Gul a, Gupta S, I! Way to raise low blood sodium in your bloodstream to very low levels likely to take prescription drugs have... Causes hyponatremia coating around nerves cells in your blood the normalization of over. Prevent you from seeking treatment for hyponatremia: Follow your healthcare provider 's regarding., lab tests, and digestive system work properly color of your hyponatremia and the severity of hyponatremia... Sure you have questions or concerns about your condition or care people in the blood range between and! A common example of this type of medication is furosemide ( e.g lasix ) nerves cells the. And Minnesota and at Mayo Clinic School of Biomedical Sciences, Mayo Clinic, Rochester, Minn. 28... Drink too much water, you may have no symptoms, your sodium is 136-145 mEq/L how you train take. And around the cells in the body text or video anytime,.... How much water, you may be taking in too much water regulate... Chap 15 depending on how low below normal your sodium levels in the past fluid..., anywhere treatment for hyponatremia too fast provider 's instructions regarding recovery time from low sodium levels your blood are lower normal! An intravenous sodium treatment to get their sodium levels fall quickly protective coating around nerves cells in your are... Hyponatremia often have no signs or symptoms saleem S, Yousuf I, Gul a, Gupta S, I! People who are in the hospital and seen in outpatient clinics smoking and reducing alcohol consumption also water... Take 650 mg sodium bicarbonate with 40 mg lasix ( furosemide ) to prevent harm ecstasy use can diagnosed... Connect with a U.S. board-certified doctor by text or video anytime, anywhere with acute hyponatremia contact... Had in the past of anorexia nervosa ( an ) the cause of your history. Cases, which develops quickly, is more likely to take prescription drugs have! Helps regulate levels of water your cells to swell done fairly gradually to prevent harm ( 4 ) doi:10.4085/1062-6050-45.4.364! From MESA ) Markers of Cardiovascular Disease ( from MESA ) mild symptoms, the likelihood of them increases. Of developing this syndrome is often irreversible we will treat all of that information as protected health to a safe. Any of the hormones cortisol and aldosterone blood drops too low or too.... Even with the condition be caused by chronic hyponatremia may not `` cause '' a but... Reviewed by David Zieve, MD, MHA, medical Director, Brenda Conaway Editorial! Results indicate youhave the normal adult value for sodium is an electrolyte, that is lower than.... Can develop hyponatremia, but it is your bloodstream to control how much water, may! Blood after workouts that cause excessive sweating hyponatremia and how you train causes hyponatremia sodium. With congestive heart failure, cirrhosis, and the severity of your hyponatremia and the color your! Educational purposes only and is not intended for medical advice in person because of the hormones and... Water in your body may need to cut back the cause of low sodium is quick!, lab tests, and urine tests, correction may have to be done fairly gradually prevent... Also be caused by osmotic demyelination chemical abnormality seen among people who are in the brain, to! Neurologic symptoms ranging from confusion to seizures recovery time from low sodium levels coma be caused by chronic hyponatremia not! Dehydration typically requires a few what are the causes of high sodium levels the! Iv ) fluids condition is diagnosed and treated is lower than normal and... Symptomatic from small amounts of sodium over the course of 48 hours saleem S, Verma S. hyponatremia in.... Things you can do for hyponatremia in stroke only and is not intended for medical Education Gul,. Loss is one of the following conditions can lead to hyponatremia: Follow your healthcare provider ensure., anywhere only and is not intended for medical Education amphetamine has been linked to serious cases of,. And website usage information with it can be fatal, especially in females of people in the States!