Hi @Nemina i understand your confusion. I have cut and pasted the following from the internet. It might help if you take this information with you to the doctor and also mention you are worried about bladder problems. Urge incontinence is not uncommon and I’ve had this myself. For the last 7 months I’ve been using ice chips instead of drinking water (I take in far less fluid) and my sodium has risen from 131 to 135 mmol/L. It’s been as low as 126. Fortunately I have not been symptomatic since then. And yes large volumes of urine and urgency can be signs. SSRIs can cause hyponatremia (low blood sodium) even at small, low doses. This is not a dose-dependent side effect, but rather an idiosyncratic reaction caused by Syndrome of Inappropriate Antidiuretic Hormone secretion (SIADH), where the body retains excess water. [1, 2, 3, 4, 5] Why Dose Doesn't Matter The mechanism behind this reaction is serotonin-induced secretion of the antidiuretic hormone (ADH). Because the drug triggers this hormonal response rather than causing direct chemical toxicity, even the lowest starting doses of an SSRI are capable of initiating the condition. [1, 2, 3] Tests to Diagnose SIADH Doctors look for a specific "signature" across blood and urine tests to confirm SIADH. For an accurate diagnosis, you must not be taking diuretics, and your body must be in a euvolaemic state (meaning you show no physical signs of dehydration or fluid overload/swelling). [1, 2] 1. Blood Tests [1] Low Serum Sodium: A standard finding where blood sodium levels fall below 135 mmol/L. [1] Low Plasma Osmolality: Your blood is overly diluted, measuring under 275 mOsm/kg. [, 2] Low BUN and Uric Acid: Blood urea nitrogen (BUN) and uric acid levels are typically unusually low due to the excess water diluting the bloodstream. [1, 2] Hormone Levels: Doctors will check thyroid-stimulating hormone (TSH) and cortisol levels to ensure underactive thyroid or adrenal failure is not causing the low sodium. [1, 2] 2. Urine Tests [1] Inappropriately Concentrated Urine: Even though the blood is diluted, urine osmolality remains abnormally high (usually above 100 mOsm/kg) because the body keeps reabsorbing water. [, 2] High Urine Sodium: Sodium levels in the urine are typically high (usually greater than 20 to 30 mmol/L) despite the low sodium levels in the blood. [, 2] Treatment Options for SIADHThe primary goal of SIADH treatment is to safely raise blood sodium levels while addressing the root cause (such as stopping an offending SSRI medication). First-Line Conservative ManagementFluid Restriction: This is the most crucial step. Intake is typically restricted to 800–1200 mL per 24 hours to stop the further dilution of blood.
