Electrolyte Imbalance

What is an electrolyte imbalance?

An electrolyte imbalance occurs when you have too much or not enough of certain minerals in your body. This imbalance may be a sign of a problem like kidney disease.

Electrolytes are minerals that give off an electrical charge when they dissolve in fluids like blood and urine. Your body makes electrolytes. You also get these minerals from foods, drinks and supplements. Electrolytes in blood, tissue, urine and other body fluids play a critical role in balancing body fluids, regulating your heart rhythm and supporting nerve and muscle function.

What do electrolytes do?

Electrolytes perform different functions in your body:

• Sodium controls fluid levels and aids nerve and muscle function.
• Potassium supports heart, nerve and muscle functions. It also moves nutrients into cells and waste products out of them while supporting your metabolism.
• Calcium helps blood vessels contract and expand to stabilize blood pressure. It also secretes hormones and enzymes (proteins) that help the nervous system send messages.
• Chloride helps maintain healthy blood levels, blood pressure and body fluids.
• Magnesium aids nerve and muscle function. It also promotes the growth of healthy bones and teeth.
• Phosphate supports the skeletal system, as well as nerve and muscle function.
• Bicarbonate helps balance acids and basic alkaline compounds (bases) in blood (pH balance). Bicarbonate also helps move carbon dioxide (a waste product) through your bloodstream.

What are the types of high electrolyte imbalances?

High electrolyte imbalances include:

• Sodium: Hypernatremia.
• Potassium: Hyperkalemia.
• Calcium: Hypercalcemia.
• Chloride: Hyperchloremia.
• Magnesium: Hypermagnesemia.
• Phosphate: Hyperphosphatemia.
• Bicarbonate: Alkalosis (low alkaline base).

What are the types of low electrolytes or electrolyte deficiencies?

Low electrolytes or electrolyte deficiencies include:

• Sodium: Hyponatremia.
• Potassium: Hypokalemia.
• Calcium: Hypocalcemia.
• Chloride: Hypochloremia.
• Magnesium: Hypomagnesemia.
• Phosphate: Hypophosphatemia.
• Bicarbonate: Acidosis (high acid levels).

What causes an 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. Your kidneys and liver, as well as other organs and tissue, continually move electrolytes in and out of cells to adjust fluid levels within the compartments.

Certain health conditions can affect your body’s ability to move and balance electrolytes. When fluid compartments have too many or too few electrolytes, you have an electrolyte imbalance.

What are the risk factors for an electrolyte imbalance?

Infants, young children and older adults are more prone to changes in electrolyte levels, but an imbalance can happen to anyone.

Certain conditions can also throw off your body’s electrolyte levels. You may be more likely to develop an electrolyte imbalance if you have:

• Burns.
• Cancer.
• Cardiovascular disease, heart failure or 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).
• Eating disorders.
• Kidney disease.
• Liver disease like cirrhosis.
• Substance use disorder.

Certain medications can also affect electrolyte levels. These include:

• Antibiotics.
• Chemotherapy drugs.
• Corticosteroids.
• Diuretics and laxatives.

What are electrolyte imbalance symptoms?

Symptoms of an electrolyte imbalance vary depending on the severity and electrolyte type. A slight electrolyte imbalance may not cause noticeable changes.

When problems occur, you may experience:

• Confusion and irritability.
• Diarrhea or constipation.
• Fatigue.
• Headaches.
• Irregular or fast heart rate (arrhythmia).
• Muscle cramps, muscle spasms or weakness.
• Nausea and vomiting.
• Numbness or tingling in limbs, fingers and toes.

How is an electrolyte imbalance diagnosed?

An electrolyte panel is a blood test that measures electrolyte levels. Healthcare providers often order an electrolyte panel if you:

• Need blood tests for a routine physical exam.
• Are in the hospital.
• Have certain health conditions.
• Experience disease symptoms.

Your provider may also order a basic metabolic panel or comprehensive metabolic panel. These blood tests check for electrolytes, as well as other substances in blood.

How are electrolyte imbalances managed or treated?

Treatment depends on the specific electrolyte imbalance and cause. Some imbalances will correct without treatment.

To treat dehydration, your provider may recommend rehydrating with electrolyte drinks or an oral rehydration salt (ORS) solution. Your provider can tell you the correct amount of sugar, salt and water to make this solution at home. Or you can buy ORS packets at a drugstore.

Medical treatments for electrolyte imbalances include:

• IV fluids like sodium chloride to rehydrate your body.
• IV medicines to restore a healthy electrolyte balance.
• Medications or supplements to replace lost electrolytes.
• Hemodialysis to correct electrolyte imbalances caused by kidney failure or severe kidney damage.

What are the complications of an electrolyte imbalance?

A significant electrolyte imbalance (either too high or too low) can cause serious, life-threatening problems. These complications include:

• Coma.
• Seizures.
• Sudden cardiac death (sudden cardiac arrest).

How can I prevent an electrolyte imbalance?

Proper hydration can help your body maintain a healthy level of electrolytes. It’s especially important to drink enough fluids if you experience prolonged diarrhea, vomiting or sweating.

When should I call the doctor?

You should call your healthcare provider if you experience:

• Changes in heart rate.
• Extreme fatigue.
• A prolonged bout of diarrhea or vomiting.
• Signs of dehydration.
• Unexplained confusion, muscle cramps, numbness or tingling.

What questions should I ask my doctor?

You may want to ask your healthcare provider:

• What type of electrolyte imbalance do I have?
• What caused the electrolyte imbalance?
• What is the most appropriate treatment?
• What are the treatment side effects?
• How can I lower my chances of developing an electrolyte imbalance?
• Should I look out for complications?

A note from Cleveland Clinic

Electrolytes like potassium, sodium, magnesium and calcium help your body regulate fluids. Certain health conditions can affect electrolyte levels in blood, urine and tissues, causing an electrolyte imbalance. An electrolyte panel as part of a routine blood test may detect this imbalance. Or you may have symptoms that indicate a problem with electrolyte levels.