Understanding electrolyte imbalance and disorders

Electrolytes are present in your blood, bodily fluids, and urine. You also ingest them through food, drinks, and supplements.

Examples of electrolytes include:

• calcium
• chloride
• magnesium
• phosphate
• potassium
• sodium

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

Types 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.

when you have too much calcium in the blood. This is usually caused by the following:

• 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

Due to a lack of adequate calcium in the bloodstream. Causes can include:

• kidney failure
• hypoparathyroidism
• vitamin D deficiency
• pancreatitis
• prostate cancer
• malabsorption
• certain medications, includingTrusted Source 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 means excess amounts of magnesium. It primarily affects people with acute or chronic kidney disease. Addison’s disease and hypothyroidism are also risk factors for hypermagnesemia because these conditions increase the absorption of magnesium into the bloodstream.for hypermagnesemia because these conditions increase the absorption of magnesium into the bloodstream. Hypomagnesemia means having too little magnesium in the body. Common causes include:. Common causes include:

• 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 can occur due to the following:

• 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, can be seen in:

• 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 may develop due to high levels of potassium. This condition can be fatal if left undiagnosed and untreated. It’s typically triggered by:

• 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 occurs when potassium levels are too low. This happens as a result of the following:

• Vomiting or diarrhea
• Poor nutrition
• Alcohol use disorder
• Overactive
• Thyroid or adrenal disorders
• Liver, heart, or kidney failure
• Certain medications, including diuretics and seizure medications
• Syndrome of inappropriate secretion of antidiuretic hormone (SIADH)

Symptoms of electrolyte imbalance

There are different types of electrolyte imbalance, depending on the compound that’s out of balance. 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. Possible 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.

Treating electrolyte imbalance

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. a larger amount of blood to flow through your body during hemodialysis treatment. This means more blood can be filtered and purified. 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.

Diagnosing electrolyte imbalance

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.

Risk factors for electrolyte disorders

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