What Is Beer Potomania? The Symptoms and Causes

Have you ever had a few drinks and gotten a massive craving for a big, salty meal like a burger and fries? Maybe you’ve woken up from a night of heavy drinking and craved a big breakfast or pounded back a few sports drinks because you heard it helps with hangovers. We all know that alcohol can cause us to make some questionable food choices, and research backs this up. Beyond the implications for our diet, alcohol also plays games with our sense of taste and our body’s ability to retain and process nutrients. This is especially true for beer, which is usually ingested in higher volumes than things like liquor.

Alcohol-induced nutrient deficiencies can lead to a number of issues, from malnutrition to a phenomenon known as potomania, or “beer potomania.” So what exactly is potomania and what does it mean for our health? Let’s find out.

What Is Potomania?

Potomania comes from the Latin words poto (“to drink alcohol”) and mania (“with intensity”). It’s a unique version of a common but serious condition known as hyponatremia, in which the blood has low sodium content. Hyponatremia is caused by a number of issues, including excessive water intake, excessive exercise or sweating, liver or kidney disease, heart failure, hypothyroidism, certain medications, or hormonal imbalances. Mild cases have few to no symptoms; severe cases involve confusion, seizures, coma, and death. It can also be a chronic condition, operating in the background and causing slow damage to vital organs over the course of years.

Potomania, colloquially known as “beer potomania,” is when hyponatremia is specifically caused by excessive alcohol intake. Since alcohol is low in sodium and known to cause electrolyte imbalance, it presents a particular danger for developing hyponatremia and other electrolyte imbalances. Beer is singled out because it’s often consumed in large volumes, making it incredibly effective at inducing potomania.

Electrolytes: Superconductors of Life

You may recognize the term “electrolytes” from ads for your favorite sports drink. Electrolytes are commonly talked about in the context of exercise but also in binge-drinking culture. These essential nutrients are necessary for our bodies to function — they regulate chemical reactions in the body, carry signals from our nerves to our muscles, maintain fluid balance in our cells, and help maintain our body’s pH levels.

The body has several essential electrolytes: sodium, potassium, calcium, magnesium, chloride, phosphate, and bicarbonate. Each one serves an important function, and they all work together to keep us alive. When we are dehydrated for any reason, drinking water is not enough. Water alone does not have enough electrolytes to restore the balance of sodium necessary for our body to function. So, is there sodium in beer? Not much, and the sodium in beer is roughly equivalent to the sodium content in water. This is why many binge drinkers reach for the same sports drinks that athletes use to recover from their overindulgence.

Why Does Potomania Happen?

While any electrolyte imbalance is unhealthy, sodium imbalance is the most common due to the prevalence of medications, lifestyle choices, and medical conditions that deplete sodium. Alcohol works in synergy with these to deplete sodium, but the hyponatremia alcohol causes is preventable.

Beer is often consumed in higher quantities than other alcoholic drinks because it’s low in alcohol — a single serving of beer is 12 ounces (that would be eight servings of liquor!). Throwing back a few beers provides no more sodium than throwing back a few glasses of water. Drinkers often pair alcohol with water, thinking this will balance out alcohol intake and prevent dehydration or hangovers. However, when this isn’t paired with adequate electrolyte intake, the result is a sodium imbalance.

Psychosocial factors also lead to excessive beer consumption. It’s common to “get together and have a few beers” with our friends. Happy hours at bars encourage rapid beer intake. Many common drinking games also involve drinking beer. Since beer is low-alcohol, it’s often seen as safe for drinking in high quantities over long periods of time, and we don’t notice how much we’re drinking since it doesn’t get us as intoxicated as stronger drinks.

So just how much sodium is in beer? Again, the sodium in beer is about equal to the sodium in water — beer contains about 14 mg per 12-ounce serving, and water contains 12 mg. Some people will try to make up for this by salting their beer, but this doesn’t balance sodium depletion because fluid intake is not the only thing that causes potomania.

Alcohol depletes sodium by stressing the body and creating a larger demand for its function. It increases our heart rate and causes tissue damage that requires our body to divert energy for repairs. Alcohol is also a diuretic, so it makes us pee more. Urine is high in sodium, which exacerbates depletion of blood sodium levels when paired with high fluid intake, like when we are drinking beer.

In a more abstract way, potomania is linked to poor diet. Since beer is high in calories, many beer drinkers restrict calories to maintain their weight and avoid beer belly. Alcohol is also linked with overeating and poor food choices, which means we may not get the right balance of nutrients to maintain our health. In fact, in many cultures, alcohol is used as an aperitif to stimulate appetite before meals. Alcohol activates the same response in our body as starvation — beer potomania is closely linked to “starvation potomania,” wherein heavy drinkers severely restrict calorie intake to budget for alcohol.

Symptoms of Potomania

Craving salt after a night of drinking is the body’s way of preventing potomania, which results from the severe and chronic response to continued sodium depletion. But how do we know if we have potomania?

Potomania may not have any symptoms, or it may have subclinical symptoms (symptoms that are easily missed, misdiagnosed, or written off) such as clumsiness, attention deficit, poor judgment, brain fog, headaches, nausea, fatigue, irritability, or low appetite. These can fester for weeks, months, or even years before becoming serious.

There may also be acute life-threatening symptoms of potomania, especially if sodium intake is dramatically low or chronic symptoms are missed or ignored. These can include severe cramps, excessive vomiting, dizziness and poor coordination that leads to injury, cerebral edema, pulmonary edema, brain herniation, respiratory arrest, seizures, coma, and death. 

Health Issues of Potomania

Over time, the mild symptoms of potomania worsen, leading to more serious symptoms. It can even cause chronic diseases such as osteoporosis, kidney disease, liver disease, and permanent brain damage from increased pressure in the brain. This brain damage can present as things like difficulty walking, slow reaction time, and issues with attention and memory.

These symptoms are compounded by the effects of ethanol itself. Beyond hyponatremia, alcohol interferes with many of our bodily functions, including blood sugar regulation, cognition, heart function, and digestion. Over time, this can cause chronic conditions.

How To Treat Potomania

Many remedies for hangovers are focused on replenishment of electrolytes. In fact, many of us have heard some strange ones. For instance, have you ever wondered, “Why do people put salt in beer?” This is an old practice used to enhance the flavor of beer, but it is also a folk remedy that is said to prevent or treat many hangover symptoms.

It may seem logical that we can treat potomania with hangover prevention and recovery methods, but it’s not that simple. Potomania is a serious medical condition that requires careful medical care. Simply consuming a massive dose of sodium will not bring the body back to homeostasis. In fact, it could lead to acute hypernatremia, or excessive salt in the blood. Rapid salt infusion can also cause a condition known as osmotic demyelination syndrome, which can permanently damage our nervous system.

Depending on its severity, beer potomania treatment is administered in a medical setting over the course of several hours or days, and it requires close monitoring for quite a while after. It typically involves a period of intentional dehydration, followed by the slow administration of intravenous saline solution.

The medical conditions that arise from potomania may compound, putting us at a higher risk of developing it again. For that reason, the best beer potomania treatment is prevention.

Tips for Preventing Potomania

• Understand your limits. Pay close attention to how much and what type of alcohol you’re drinking. Beer may seem like a “safer” choice than liquor, but when used chronically it can put you at a higher risk for potomania. With Reframe, you can track your drinks to stay mindful of your intake. And remember — there is no “safe” alcohol.
• Eat a balanced diet. Proper nutrition is important for all aspects of our health, particularly when we include alcohol as part of our lifestyle. Make sure you’re consuming adequate electrolytes, especially sodium.
• Consult with a professional. If a balanced diet is difficult for you to manage, or if you eat a sodium-restricted diet due to heart conditions or hypertension, alcohol may not be a good choice for you. Consult with a dietician to make sure you are consuming proper amounts of essential nutrients.
• Seek support for alcohol dependence. If you fear you may have potomania or that you may be at risk of developing it, reach out to a medical or mental health professional. Reframe offers resources like support groups, lifestyle education, and professional coaching to help you along this path.
• Get regular health checkups. Regular visits to your primary care physician or general practitioner are very important for maintaining health and identifying medical conditions before they get serious. This is especially true if you consume alcohol or other intoxicating substances. Don’t lie to your doctor about your use — it may protect you from perceived judgment, but it does not benefit you. Physical exams, neurological exams, and blood tests can catch potomania before it gets serious.
• Educate yourself and others. Spread awareness about potomania and its risks. By reading this article, you have already taken an important step in protecting yourself from potomania!

Prevention Is Key

Beer potomania is a serious medical condition, but it’s entirely preventable. Maintaining health is about being honest with ourselves and advocating for ourselves in medical settings — but we must also curb our most harmful impulses. Problematic and self-destructive behaviors take many forms, but by staying balanced and being mindful, we can give ourselves the gift of health. Potomania is entirely preventable when we pay close attention to our bodies and follow basic advice about nutrition, alcohol moderation, and lifestyle.