Beer Potomania: A Literature Review of an Underrecognized Cause of Severe Hyponatremia

Abstract

Beer potomania is a rare but significant cause of severe hyponatremia, often misdiagnosed as syndrome of inappropriate antidiuretic hormone secretion (SIADH). It is characterized by excessive beer consumption and insufficient dietary solute intake, leading to impaired renal water excretion and dilutional hyponatremia. The pathophysiology involves reduced osmotic load, altered antidiuretic hormone (ADH) regulation, and compromised renal handling of free water. The clinical overlap with SIADH presents diagnostic challenges, necessitating a thorough dietary and biochemical evaluation. This review discusses the mechanisms, differential diagnosis, and management strategies for beer potomania, emphasizing the need for gradual sodium correction to prevent osmotic demyelination syndrome (ODS) and addressing
underlying alcohol use disorder to reduce recurrence.