In 1971 and 1972, beer drinker's hyponatremia (beer potomania) was described in 7 patients with long histories of consuming at least 4 L of beer per day, sodium-deficient diets, low serum sodium values (98107 mmol/L), unconsciousness, and seizures (4).
In 2007, a review of 22 published cases of beer potomania revealed a shared history of excessive beer intake, often long-term, with frequent recent episodes of binge drinking and poor dietary intake (8).
This volume is roughly equivalent to 14 cans of beer (12-oz cans), a level of beer consumption common among patients with beer potomania. Retention of 5 L of free water will produce a serum sodium concentration of 125 mmol/L in a 70-kg man over a 24-h period and a serum sodium concentration of 113 mmol/L on the second day (7).
The case studies involved an ovolactovegetarian with hyponatremia because of a low intake of solute, which limited the patient's ability to excrete water (9), and a recent case of crash-diet potomania in a patient who had a low-calorie diet and consumed 6 L of water per day.
* Severe hyponatremia is caused by an excess of water relative to sodium stores and may be caused by diuretics, vomiting, diarrhea, congestive heart failure, cirrhosis, inappropriate secretion of ADH, and, rarely, beer potomania and excess intake of water alone.
* Beer potomania with biochemical findings of low serum sodium, low serum and urine osmolalities, and low urine sodium values can cause severe hyponatremia.
* If hyponatremia is corrected too rapidly in patients with beer potomania, sodium overcorrection and osmotic demyelination may occur.