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Regulating Salt and Water in the Body

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As the human body is constantly exposed to changes in its external environment, it is important that it maintains a constant internal environment in order to survive. This process is what is referred to as homeostasis. This regulation of the body’s internal environment is essential in order to keep the systems within the body operational. As stated by World Book Online, these reactions within the body in regards to the changes in the external environment are triggered by what are known as homeostatic reflexes. (World Book Online, 2014) One of the main factors which the body must regulate is that of the amount of water which is in the cells of the body. The amount of water that you take in must be balanced against the amount of water that is excreted from the body, and the amount of sodium in the body must be kept at a certain amount in order to maintain homeostasis.

The way that homeostasis regulates the amount of water and salt in the body through filtration in the kidneys. The hormone of which does this is called Antidiuretic Hormone (ADH). This is where the nervous system starts to interrelate with the excretory, endocrine and nervous systems. Osmoreceptors on the hypothalamus detect the concentration of water within the blood and then send message to the pituitary gland, which is a part of endocrine system. (APBI, 2014) The pituitary gland then either promotes the release of ADH or decreases the release of the hormone. This hormone then travels towards the kidney which affects the amount of water that the kidney then absorbs (appendix 1) because the hormone reaches its target it alters the tubules of the kidney to become more or less permeable to water depending on the needs that the body has at the time. (Frey, Atkins and Longe, 2014) If there is a high concentration of ADH in the body, this makes the tubules more permeable to water. This ensures that there is more water let into the bloodstream. Therefore if there is a low concentration of the hormone ADH it makes the tubules less permeable to water which then decreases the amount of water in the bloodstream. (Biology Online, 2000) The water which is then not reabsorbed back into the bloodstream is then excreted from the body via urine.

The nervous system is invaluable to homeostasis as it controls and regulates how the body reacts to situations. If a deviation occurs in the body this acts as a stimulus to a receptor. This then sends nerve impulses to the brain. This then acts as an effector so that the body acts in such a way that a response takes place that assists the body in adapting to return to a stable, consistent environment. (Penn Medicine, 2001) The part of the brain that does this is called the hypothalamus. This is the main control center of the brain, and is the part of the brain that controls endocrine glands (such as the pituitary gland). (Penn Medicine, 2001) The nervous system is made up of both the peripheral and central systems. The peripheral nervous system includes sensory receptors. These are what are activated by the stimulus (the change in the internal or external environment). This then is transmitted to a sensory neuron which then connects to the sensory receptors in the central nervous system, of which then processes the signal and then sends a message back to an effector organ. This is done through a motor neuron. (Penn Medicine, 2001) The process of which these systems work is called negative feedback (appendix 2).

During exercise especially the body must work increasingly hard in order to retain a balanced and regulated environment in order to keep body systems operational. As the body temperature increases during exercise, one of the ways that homeostasis tries to cool the body down to a regular temperature is through stimulating sweat glands to release sweat. This then stimulates the body into feeling as if it needs to consume more water, but drinking too much water during or after exercise does not necessarily replace the electrolytes lost through sweating and dilutes the sodium, nutrients and ions of which is already in the blood, which then leads to hyponatremia (or low sodium levels in the body). (Frey, Atkins and Longe, 2012) Hyponatremia causes the cells in the body to swell. This is because sodium helps the body maintain a normal blood pressure, regulates the body’s fluid balance and supports the work of the nerves and muscles in the body.

Interrelationships between the endocrine, nervous the excretory systems are extremely important in homeostasis and this is one example. This is important specifically to hyponatremia because the kidney allows for filtration and reabsorption of water and salts within the body, which as aforementioned is controlled by the antidiuretic hormone which is produced by the pituitary gland. This is mostly done in within the Loop of Henle where most of the reabsorption of water occurs, which then allows for the active transport of salts to move and be reabsorbed into the body and therefore regulates the amount of salt or sodium that is in the bloodstream as well.

As the sodium/salt level becomes low during hyponatremia, extra water enters the cells of the body because there is an imbalance in the amount of water concentration between the fluid that is inside and outside of the cells which then causes the water to enter the cells when it is not needed (this is commonly known as fluid overload), which then causes the aforementioned swelling. (Allaby, 2014) This is especially dangerous because this can lead to swelling of the brain, which is confined by the skull and if expands can cause major neurological damage or death. (Frey, Atkins and Longe, 2012) In some extreme cases, the swelling of the brain may push down on the spine which prevents breathing and can potentially be fatal. (Allaby, 2014) Hyponatremia may also lead to symptoms such as slurred speech, coughing up blood, and muscular cramps, but also seizures and loss of consciousness or comas. (Allaby, 2014)

Throughout the past there hasn’t been any knowledge of the debilitating illness of hyponatremia, or even much acknowledgement of how life-threatening it actually is when a person consumes too much water, especially during exercise. During World War II when many soldiers fought on the Kokoda Trail there simply was not enough water being carried around with the soldiers in order for them to be affected by such illnesses as hyponatremia or water imbalance due to drinking too much water.

In the future it is important that there are steps taken in order to avoid reoccurrences of these life threatening conditions, specifically on the Kokoda Trail. This may be done in many ways of which are not limited to the education of trek leaders on the trail, medics, and people that are walking to trek, as well as ensuring that there are preventative measures taken and the rapid treatment of hyponatremia is taken into consideration when planning these trips. (Rothwell, 2008) Misinformation about the amount of water that is needed for adequate hydration when doing excess amounts of exercise is one of the main causes of this issue.

In regards to the Kokoda Track there is a common interpretation that when walking the trail, the person doing the exercise should drink as much water as their stomachs could tolerate. It hasn’t been until more recently that medical practitioners in this area have been aware of hyponatremia, and could fully treat people who suffered this condition. Specifically in the Kokoda Trail, there was a case in which a 43 year old, physically fit male collapsed and had a seizure during the third day of this trek due to severe hyponatremia of which stemmed from drinking too much water whilst exercising. (Rothwell, 2008) At the time that this happened, there was not adequate knowledge of how life-threatening hyponatremia was or even that it existed. The man then had to be airlifted by a helicopter to the nearest hospital in order to be successfully diagnosed and treated for hyponatremia. (Rothwell, 2008)

In order to be treated for his condition, the man had to be injected and treated with saline solutions of different concentrations over a period of seven and a half days. (Rothwell, 2008) In the future, the evolution of antidiuretic drugs like ‘Samsca’ tablets of which are approved by the U.S. Food and Drug Administration could decrease the amount of cases of hyponatremia as well as decreasing the severity of the cases of hyponatremia on the Kokoda Track. Samsca tablets are currently specifically directed at treating hyponatremia related to congestive heart failure and liver cirrhosi but could potentially evolve to be used in such situations as hyponatremia which stems from drinking excessive amounts of water whilst exercising. (Facts on File, 2009) This drug works by removing extra body water in the urine and therefore increasing the amount of sodium within the blood. (Facts on File, 2009)

In conclusion, water and salt regulation in the body is one of the most important aspects of homeostasis and is an important subject that people need to be educated about because of the dire consequences that can arise from this particular type of homeostasis disruption. This is specifically important because illnesses that arise from deviations in water and salt regulation such as hyponatremia often arise from circumstances that the average person would be subject to, and yet most people are not aware of these problems.


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