Electrolytes are minerals that control important physiologic functions of the body. An electrolyte imbalance occurs when your body’s mineral levels are too high or too low. This can negatively affect vital body systems.
Electrolytes must be evenly balanced for your body to function properly. Severe electrolyte imbalances can cause serious problems such as coma, seizures, and cardiac arrest.
Electrolytes are present in your blood, bodily fluids, and urine. You also ingest them through food, drinks, and supplements.
Examples of electrolytes include:
A loss of bodily fluids most often causes an electrolyte imbalance. This can happen after prolonged vomiting, diarrhea, or sweating, due to an illness, for example. It can also be caused by:
- fluid loss related to burns.
- certain medications, such as diuretics
- diseases such as acute or chronic kidney disease, heart problems, lung disorders, and more
The exact cause may vary depending on the specific type of electrolyte imbalance
Elevated levels of an electrolyte are indicated with the prefix “hyper-.” Depleted levels of an electrolyte are indicated with “hypo-.”
Conditions caused by electrolyte level imbalances include:
- Calcium: hypercalcemia and hypocalcemia
- Chloride: hyperchloremia and hypochloremia
- Magnesium: hypermagnesemia and hypomagnesemia
- Phosphate: hyperphosphatemia or hypophosphatemia
- Potassium: hyperkalemia and hypokalemia
- Sodium: hypernatremia and hyponatremia
Calcium
Calcium is a vital mineral that your body uses to stabilize blood pressure and control skeletal muscle contraction. It’s also used to build strong bones and teeth.
Hypercalcemia
- kidney disease
- hyperparathyroidism
- lung diseases, such as tuberculosis or sarcoidosis
- certain types of cancer, including lung and breast cancers
- excessive use of antacids and calcium or vitamin D supplements
- medications such as lithium, theophylline, or certain water pills
Hypocalcemia
- kidney failure
- hypoparathyroidism
- vitamin D deficiency
- pancreatitis
- prostate cancer
- malabsorption
- certain medications,
including chemotherapy drugs, osteoporosis drugs, and certain diuretic and anti-convulsant drugs
Chloride
Chloride is necessary for maintaining the proper balance of bodily fluids.
Hyperchloremia occurs when there’s too much chloride in the body. It can happen as a result of the following:
- severe dehydration
- kidney failure
- metabolic acidosis
Hypochloremia develops when there’s too little chloride in the body. Causes include:
Other causes can include:
- metabolic alkalosis
- diuretics
- chronic respiratory acidosis
- extreme fluid loss such as from vomiting or diarrhea
Magnesium
Magnesium is a critical mineral that regulates many important functions, such as:
- muscle contraction
- heart rhythm
- nerve function
Hypermagnesemia
Hypomagnesemia means having
- alcohol use disorder
- malnutrition
- malabsorption
- diarrhea
- certain medications, including some diuretics and antibiotics
Phosphate
The kidneys, bones, and intestines balance phosphate levels in the body. Phosphate is necessary for various functions and interacts closely with calcium.
Hyperphosphatemia
- chronic kidney disease
- severe breathing difficulties
- underactive parathyroid glands
- severe muscle injury
- tumor lysis syndrome, a complication of cancer treatment
- excessive use of phosphate-containing laxatives
Low levels of phosphate, or hypophosphatemia,
- acute alcohol abuse
- severe burns
- refeeding syndrome
- vitamin D deficiency
- overactive parathyroid glands
- certain medications, such as some antacids
Potassium
Potassium is particularly important for regulating heart function. It also helps maintain healthy nerves and muscles.
Hyperkalemia
- severe dehydration
- kidney failure
- severe acidosis, including diabetic ketoacidosis
- certain medications, including some blood pressure medications and diuretics
- adrenal insufficiency, which is when your cortisol levels are too low
Hypokalemia
- eating disorders
- severe vomiting or diarrhea
- certain medications, including laxatives, diuretics, and corticosteroids
Sodium
Sodium is necessary for the body to maintain fluid balance and is critical for appropriate body function. It also helps to regulate nerve function and muscle contraction.
Hypernatremia
- inadequate water consumption
- excessive loss of bodily fluids as a result of prolonged vomiting, diarrhea, or sweating
Hyponatremia develops when there’s
- vomiting or diarrhea
- poor nutrition
- alcohol use disorder
- overhydration
- thyroid or adrenal disorders
- liver, heart, or kidney failure
- certain medications, including diuretics and seizure medications
- syndrome of inappropriate secretion of antidiuretic hormone (SIADH)
There are different types of electrolyte imbalance,
Mild electrolyte imbalance may not cause any symptoms. This can go undetected until discovered during a routine blood test. Symptoms usually start to appear once a particular imbalance becomes more severe.
Not all electrolyte imbalances cause the same symptoms, but many share similar symptoms.
symptoms of an electrolyte imbalance include:
- agitation
- dry mouth and thirst
- restlessness
- confusion or difficulty with cognition
- muscle weakness or spasms
- numbness or tingling
- fatigue
- heart palpitations
- constipation
- nausea or vomiting
- slow or irregular heart rate
- difficulty breathing
- low or high blood pressure
- itching
Call your doctor immediately if you’re experiencing any of these symptoms. Electrolyte disturbances can become life threatening if left untreated.
Treatment varies depending on the type of electrolyte imbalance and the underlying condition causing it.
Certain treatments are generally used to restore the proper balance of minerals in the body. These include:
Intravenous (IV) fluids
Intravenous (IV) fluids, typically containing sodium chloride, can help rehydrate the body. This treatment is commonly used in cases of dehydration resulting from vomiting or diarrhea. Electrolyte supplements can be added to IV fluids to correct deficiencies.
Certain IV medications
IV medications can help your body restore electrolyte balance quickly. They can also protect you from negative effects while being treated by another method.
The medication you receive will depend on the electrolyte imbalance you have. Medications that may be administered include calcium gluconate, magnesium sulfate, and potassium chloride.
Oral medications and supplements
Oral medications and supplements are often used to correct chronic mineral abnormalities in your body. This is more common if you’ve been diagnosed with ongoing kidney disease.
Depending on your electrolyte imbalance, you may receive medications or supplements such as:
- calcium (gluconate, carbonate, citrate, or lactate)
- magnesium oxide
- potassium chloride
- phosphate binders, which include sevelamer hydrochloride (Renagel), lanthanum (Fosrenol), and calcium-based treatments such as calcium carbonate
These can help replace depleted electrolytes on a short- or long-term basis, depending on the underlying cause of your disorder. To correct the imbalance, your doctor will usually treat the underlying cause.
Hemodialysis
Hemodialysis is a type of dialysis that uses a machine to remove waste from your blood.
One way to get the blood to flow to this artificial kidney is for your doctor to surgically create a vascular access, or an entrance point, into your blood vessels.
This entrance point
Hemodialysis can be used to treat an electrolyte imbalance. Your doctor may also decide on hemodialysis treatment if the electrolyte problem has become life threatening.
A simple blood test can measure the levels of electrolytes in your body. A blood test that looks at your kidney function is important as well.
Your doctor may want to perform a physical exam or order extra tests to confirm a suspected electrolyte imbalance. These additional tests will vary depending on the condition in question.
For example, hypernatremia (too much sodium) can cause skin elasticity loss due to significant dehydration. Your doctor can perform a pinch test to determine whether dehydration affects you.
An electrocardiogram (ECG or EKG), an electrical tracing of your heart, may also be useful to check for any irregular heartbeats, rhythms, or ECG or EKG changes brought on by electrolyte problems.
Anyone can develop an electrolyte imbalance. Certain people are at an increased risk because of their medical history. Conditions that increase your risk for an electrolyte imbalance include:
- alcohol use disorder
- cirrhosis
- congestive heart failure
- kidney disease
- eating disorders such as anorexia and bulimia
- physical trauma such as severe burns or broken bones
- thyroid disorders
- adrenal gland disorders
An electrolyte imbalance happens when there’s too much or not enough of one or more important minerals in your body. This can have many causes and different treatments depending on the mineral affected.
It is a good idea to do your best to stay hydrated if you’re experiencing prolonged vomiting, diarrhea, or sweating. If medications or underlying conditions cause the electrolyte imbalance, your doctor will adjust your medication and treat the cause. This will help prevent future electrolyte imbalances.
But not every electrolyte imbalance can be easily prevented, and it could be caused by a serious condition. Visit your doctor if you’re experiencing common symptoms of an electrolyte imbalance.