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Current treatment guidelines for severe symptomatic chronic hyponatremia recommend empiric intervention with intravenous 3% NaCl to increase serum sodium levels by 46 mmol/L within the first 24 h 3,4,6,7,8,9

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Patients should be monitored for potential biphasic reactions following initial symptom resolution

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In a randomized, placebo-controlled trial involving 121 subjects with ulcerative colitis, propionyl-L-carnitine , at 1 or 2 grams daily, led to greater remission rates than placebo when added to conventional therapy (Mikhailova 2011)