What is the treatment for SIADH when sodium levels are below 120 mEq/L and the patient shows no symptoms?

Fluid restriction is a key treatment approach for managing SIADH (Syndrome of Inappropriate Antidiuretic Hormone secretion), especially when sodium levels are below 120 mEq/L and the patient is asymptomatic. This strategy aims to limit the amount of fluid intake to help correct the hyponatremia caused by excess water retention due to inappropriate levels of antidiuretic hormone.

When sodium levels dip significantly, even without symptoms, excessive water retention can lead to serious neurological complications if not managed properly. By restricting fluid intake, it encourages the body's natural processes to begin excreting excess water, thus stabilizing sodium levels over time.

In cases where symptoms are present, more immediate interventions, such as administering hypertonic saline, might be considered to rapidly correct sodium levels. However, for asymptomatic patients with severely low sodium levels, fluid restriction is often the initial and preferred strategy because it is less aggressive and reduces the risk of rapid shifts in sodium levels, which could induce osmotic demyelination syndrome. Other treatment options, like diuretics or DDAVP, would not be indicated for asymptomatic patients either, as diuretics would further promote water loss without addressing the underlying issue, and DDAVP would exacer