Electrolyte imbalance occurs when certain mineral levels in our blood are too high or too low. Electrolytes are minerals that give off an electrical charge when they dissolve in fluids like blood and urine. These are made by our body and also obtained from foods, drinks and supplements. Electrolytes in blood, tissue, urine and other body fluids play a critical role in balancing body fluids, in metabolism and in regulating heart, kidney, nerve, and muscle function.
Important Electrolytes and their Imbalances in our Body
These include:
- Sodium – It controls water/fluid levels and is required for nerve and muscle function. A high level of sodium in the blood is called hypernatremia while a low level in the blood is called hyponatremia.
- Potassium – It supports heart, nerve, and muscle functions. It also moves nutrients into cells and waste products out of them thereby supporting metabolism. A high level of potassium in the blood is called hyperkalemia while a low level in the blood is called hypokalemia.
- Calcium – It helps in the formation of the bone matrix and is vital for the strength and health of bones and teeth. Calcium also helps in the contraction of muscles, stabilizing blood pressure, nerve conduction, and clotting. A high level of calcium in the blood is called hypercalcemia while a low level in the blood is called hypocalcemia.
- Chloride – It helps maintain healthy blood pressure and body fluid levels. A high level of chlorine in the blood is called hyperchloremia while a low level in the blood is called hypochloremia.
- Magnesium – It helps in nerve and muscle function, and along with calcium promotes the growth of healthy bones and teeth. A high level of magnesium in the blood is called hypermagnesemia while a low level in the blood is called hypomagnesemia.
- Phosphate – It supports the formation of the bone matrix, as well as aids nerve and muscle function along with calcium. A high level of phosphate in the blood is called hyperphosphatemia while a low level in the blood is called hypophosphatemia.
- Bicarbonate – It helps balance acids and alkaline compounds (bases) in the blood (pH balance). Bicarbonate also helps move carbon dioxide (a waste product) out through the bloodstream. A high level of bicarbonate in the blood is called alkalosis while a low level in the blood is called acidosis.
Causes of Electrolyte Imbalance
Water makes up more than half of your body’s weight. Blood and fluid in and around cells (called fluid compartments) hold most of this water. Our kidneys and liver, as well as other organ tissues, continually move electrolytes in and out of cells to adjust fluid levels within these compartments. When fluid compartments have too many or too few electrolytes, there is an electrolyte imbalance. While young children and elderly adults are more prone to changes in electrolyte levels, such an imbalance can happen to anyone.
Certain health conditions can affect our body’s ability to move and balance electrolytes.
These include:
- Kidney Disease
- Cardiovascular disease (CVD), or heart failure
- High blood pressure.
- Dehydration due to not drinking enough liquids or from excessive vomiting, diarrhea, sweating (hyperhidrosis) or fever.
- Overhydration or water intoxication (drinking too much water).
- Hormonal imbalance as in pituitary, thyroid, parathyroid or adrenal disorders
- Burns
- Eating disorders.
- Liver disease like cirrhosis.
- Alcoholism and Substance use disorder.
- Cancer
- Certain medicines – Diuretics, Laxatives, Steroids and some antibiotics or anticancer drugs
Symptoms and Signs of Electrolyte Imbalance
Symptoms vary depending on the severity and type of electrolyte imbalance. A slight electrolyte imbalance may not cause noticeable changes.
Electrolyte levels can be assessed by a blood test.
General symptoms of electrolyte imbalance include:
- Weakness and fatigue
- Nausea-vomiting
- Diarrhea or constipation
- Headache or body ache
- Muscle weakness, cramps or spasms
- Irregular or fast heart rate (arrhythmia)
- Tingling or numbness in limbs, fingers and toes
- Mental confusion and irritability
It is important to look for signs of dehydration like thirst, dry mouth, lips and tongue, headache, dizziness especially on standing up, and a reduced amount and dark color of urine.
One should immediately seek medical consultation if the above symptoms or signs are present.
Rarely a significant electrolyte imbalance can present with severe complications like seizures, coma and cardiac arrest.
Diagnosis of Electrolyte Imbalance
An electrolyte panel is a blood test that measures electrolyte levels individually. This may be done as part of a routine health checkup, if mentioned risk factors or associated health conditions are present, pre-operatively if due for surgery, or if the mentioned signs and symptoms of electrolyte imbalance are present. The report mentions the actual level of each of these electrolytes in the person’s blood along with the expected normal range.
Apart from this BP check, an ECG/2-D Echo, and other blood tests like kidney/liver function, complete blood counts (CBC), thyroid function, and protein levels, will also be ordered to understand the associated medical condition and treat that as well.
Management of Electrolyte Imbalance
Treatment depends on the specific electrolyte imbalance and cause. Some imbalances get corrected in routine course without treatment. Dietary modification may be suggested for potassium and sodium chloride imbalances like inclusion/exclusion of high potassium foods (fruits- avocados, apples, oranges and bananas, vegetables: leafy greens such as spinach, tomatoes, carrots, cucumbers, zucchini, brinjal and pumpkin) or modifying common salt in the diet. Supplements may be given for calcium or magnesium deficiency, usually along with vitamin D. Phosphate binding medicines are also available.
The most important thing is to manage dehydration timely. For this rehydrating solutions and electrolyte drinks like ORS (oral rehydration salt) are prescribed that have the correct amount of sugar, and salt to be mixed with the right amount of water to make the solution at home. In severe cases of acute dehydration, hospitalization and intravenous fluids with sodium chloride or other specific electrolytes needed, are given. In some severe cases, hemodialysis to correct electrolyte imbalances due to affected kidney function is required.
Proper hydration and a balanced nutritious diet help the body maintain a healthy level of electrolytes, and prevent or reduce the risk of electrolyte imbalances.
Also read:
Chronic Kidney Disease (CKD) – 5 Key Points of Understanding