Potomania, also known as beer potomania and beer drinkers hyponatremia, is a
Potomania, also known as beer potomania and beer drinkers hyponatremia, is a

specific hypo-osmolality syndrome related to massive consumption of beer,
specific hypo-osmolality syndrome related to massive consumption of beer,

which is poor in solutes and electrolytes. With little food or other
which is poor in solutes and electrolytes. With little food or other

sources of electrolytes, consumption of large amounts of beer or other dilute
sources of electrolytes, consumption of large amounts of beer or other dilute

alcoholic drinks leads to electrolyte disturbances. The symptoms of potomania
alcoholic drinks leads to electrolyte disturbances. The symptoms of potomania

are similar to other causes of hyponatremia and include dizziness,
are similar to other causes of hyponatremia and include dizziness,

muscular weakness, neurological impairment and seizures, all related to
muscular weakness, neurological impairment and seizures, all related to

hyponatraemia and hypokalaemia. While the symptoms of potamania are similar to
hyponatraemia and hypokalaemia. While the symptoms of potamania are similar to

other causes of hyponatremia and acute water intoxication, it should be
other causes of hyponatremia and acute water intoxication, it should be

considered an independent clinical entity due to the often chronic nature
considered an independent clinical entity due to the often chronic nature

of onset, pathophysiology, and presentation of symptoms.
of onset, pathophysiology, and presentation of symptoms.

Pathophysiology The normal human kidney, through
Pathophysiology The normal human kidney, through

suppression of anti-diuretic hormone, is normally able to excrete vast amounts of
suppression of anti-diuretic hormone, is normally able to excrete vast amounts of

dilute urine. Thus a normal adult can drink up to 20 liters per day of water
dilute urine. Thus a normal adult can drink up to 20 liters per day of water

without becoming hyponatremic. However, the intake of solutes is also necessary
without becoming hyponatremic. However, the intake of solutes is also necessary

to excrete free water. Under normal circumstances, this is clinically
to excrete free water. Under normal circumstances, this is clinically

irrelevant. In the lack of proper solute intake, the amount of free water
irrelevant. In the lack of proper solute intake, the amount of free water

excretion can be severely limited. Without adequate solute intake, the
excretion can be severely limited. Without adequate solute intake, the

normal functioning electrolyte gradient that pulls water into urine will be
normal functioning electrolyte gradient that pulls water into urine will be

effectively destroyed. Briefly, to excrete free water from
effectively destroyed. Briefly, to excrete free water from

urine, the urine flow will equal the rate of solute excretion divided by the
urine, the urine flow will equal the rate of solute excretion divided by the

urine osmolality. With a diet of only solute poor beer, only about 200-300
urine osmolality. With a diet of only solute poor beer, only about 200-300

mOSM of solute will be excreted per day, capping the amount of free water
mOSM of solute will be excreted per day, capping the amount of free water

excretion at four liters. Any intake above 4 liters would lead to a dilution
excretion at four liters. Any intake above 4 liters would lead to a dilution

of the serum sodium concentration and thus hyponatremia.
of the serum sodium concentration and thus hyponatremia.

Any vomiting or GI absorptive problems due to alcohol intoxication can also
Any vomiting or GI absorptive problems due to alcohol intoxication can also

compound the effect of potomania due to additional electrolyte and acid-base
compound the effect of potomania due to additional electrolyte and acid-base

disturbances. Treatment
disturbances. Treatment

As with all cases of hyponatremia, extreme caution must be taken to avoid
As with all cases of hyponatremia, extreme caution must be taken to avoid

the fatal consequences of rapidly correcting electrolytes. Special
the fatal consequences of rapidly correcting electrolytes. Special

considerations with the treatment of potomania are needed. Because this could
considerations with the treatment of potomania are needed. Because this could

be a chronic condition, low sodium may be normal for the patient, so an
be a chronic condition, low sodium may be normal for the patient, so an

especially careful correction is warranted. It is also very important to
especially careful correction is warranted. It is also very important to

note that due to the normal kidney function, and lack of other intrinsic or
note that due to the normal kidney function, and lack of other intrinsic or

toxic cause of the electrolyte disturbance, restoration of dietary
toxic cause of the electrolyte disturbance, restoration of dietary

solutes will correct the electrolytes to normal serum levels. This again must be
solutes will correct the electrolytes to normal serum levels. This again must be

done with caution. References
done with caution. References

Hilden, T; Svendsen, T. L.. "ELECTROLYTE DISTURBANCES IN BEER DRINKERS a Specific
Hilden, T; Svendsen, T. L.. "ELECTROLYTE DISTURBANCES IN BEER DRINKERS a Specific

'Hypo-osmolality Syndrome'". The Lancet 306: 245–6.
'Hypo-osmolality Syndrome'". The Lancet 306: 245–6.

doi:10.1016/S0140-6736(75)90961-7. PMID 49796. )*Harrow, A. S.. "Beer potomania
doi:10.1016/S0140-6736(75)90961-7. PMID 49796. )*Harrow, A. S.. "Beer potomania

syndrome in an alcoholic". Virginia medical 116: 270–1. PMID 2763635.
syndrome in an alcoholic". Virginia medical 116: 270–1. PMID 2763635.

ellow.blogspot.com03/beer-potomania.html Berl, T.. "Impact of Solute Intake on
ellow.blogspot.com03/beer-potomania.html Berl, T.. "Impact of Solute Intake on

Urine Flow and Water Excretion". Journal of the American Society of Nephrology
Urine Flow and Water Excretion". Journal of the American Society of Nephrology

19: 1076–8. doi:10.1681/ASN.2007091042. PMID 18337482.
19: 1076–8. doi:10.1681/ASN.2007091042. PMID 18337482.