Sodium 146 mEq/L

It is just above the usual 135–145 mEq/L range, most often from being a bit short on fluids when your blood was drawn. A repeat test after normal drinking and eating often comes back normal.

Usually not by itself — 146 mEq/L most often reflects mild dehydration or lab variation. It becomes concerning mainly if it persists or climbs on repeat testing.

Low sodium almost always means too much water relative to sodium, not too little salt in the diet. Common causes include thiazide diuretics (water pills), antidepressants such as SSRIs, drinking large amounts of water, vomiting or diarrhea, SIADH (excess antidiuretic hormone from lung, brain, or medication causes), and heart, liver, kidney, thyroid, or adrenal conditions. Very high blood glucose can also dilute the measured sodium. Your clinician uses urine tests and your fluid status to sort out which applies to you.

Yes. Drinking water faster than your kidneys can excrete it dilutes your blood sodium — this is water intoxication. It is a known risk during endurance events when people drink heavily without eating, in people who drink very large volumes habitually, and when illness or medications limit how much water the kidneys can release. For most healthy people, drinking to thirst is the safest guide; there is no need to force extreme volumes of water.

Usually not. A salty diet makes you thirsty and makes your body hold water, which raises blood pressure and causes puffiness — but the blood sodium concentration typically stays normal because thirst and the kidneys rebalance it. High blood sodium (hypernatremia) is almost always a shortage of water rather than an excess of dietary salt. That said, a lower-salt diet is still worthwhile for blood pressure and heart health, which is a separate issue from this test result.

No, not for 146 mEq/L alone. Rehydrate normally and follow up with your clinician soon; seek care promptly if you become confused, stop urinating, or cannot keep fluids down.

Because blood sodium is a concentration, not a measure of salt intake. Low sodium nearly always means your body is holding on to extra water that dilutes the sodium — from medications, hormones like ADH, drinking large volumes, or conditions such as heart, liver, or kidney disease. Adding more salt to your food rarely fixes it and can be harmful in some of these conditions, so the right move is finding the cause with your clinician rather than changing your diet on your own.