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Electrolyte Imbalance: Types, Symptoms, Causes, Treatment & More

HealthcareOnTime Team 2024-04-15 2024-04-16 3 Min Read
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  • Electrolyte Imbalance: Types, Symptoms, Causes, Treatment & More

    Electrolytes power many body functions, and an imbalance or disturbance in these electrolytes can disrupt health. Let's explore the different types, symptoms, causes, and treatments for electrolyte imbalance.

    What are Electrolytes in the Body? 

    Electrolytes are minerals found in one's body that impact how the body functions.1 They may influence hydration, blood acidity, and nerve and muscle function.They also carry an electrical charge responsible for the dissolution of blood and other fluids and their proper circulation. Electrolytes perform different functions in your body: 

    • Calcium: It helps regulate blood pressure through the contraction and expansion of blood vessels. Calcium also releases proteins for the functioning of your nervous system. 
    • Bicarbonate: It maintains the acidic and alkaline balance in the body and enables carbon dioxide excretion from the body.
    • Chloride: This electrolyte takes care of a healthy blood level and maintains blood pressure. 
    • Potassium: It is responsible for maintaining the metabolism of your body. This electrolyte ensures the proper circulation of nutrients in the body and waste product removal. 
    • Magnesium: It promotes the healthy functioning of bones and muscles. 
    • Sodium: Sodium ensures proper fluid balance in your body and enables the smooth functioning of your muscles and nerves. 2 

    You can detect electrolyte imbalances in the body through a full-body test or a serum electrolyte test to diagnose any underlying issues. 

    What is an Electrolyte Imbalance? 

    Before you learn how to balance electrolytes, let's first talk about what an electrolyte imbalance is.

    The excess or deficit of different types of electrolytes in the body is termed an electrolyte imbalance or electrolyte disturbance. It might happen due to the loss of excessive fluids from the body. In other cases, an electrolyte abnormality might signify any other underlying disease. The following are the electrolyte imbalance causes: 

    • Severe vomiting or diarrhoea can lead to the loss of essential fluids from the body.
    • Lifestyle disorders, which include drinking too much or very little water, along with consumption of fast foods
    • Genetic disorders that run in the family or are transmitted from parents
    • Diseases like diabetes can affect the kidneys and lead to improper waste removal from the body in the form of urine or faeces.3

    Did you know: 

    • An adult human body consists of approximately 60% water, indicating that electrolytes are present in almost all cells and fluids throughout the body. 4
    • 18.4% of individuals diagnosed with electrolyte imbalance have some form of eating disorder. 5
    • Hyponatremia, occurring in 32% of cases, emerges as the predominant electrolyte abnormality, exhibiting a statistically significant variance across various stroke types. 6

    Types of High Electrolyte Imbalances

    High electrolyte imbalance is a condition where the salts are in excess in the body, which can lead to several serious complications. Here are some of the different types of electrolyte abnormalities:

    • Sodium: Too much sodium in the body is also termed hypernatremia
    • Magnesium: This condition is also called hypermagnesemia 
    • Calcium: A high level of calcium in your body can cause a condition called hypercalcemia
    • Potassium: Also known as hyperkalemia,  this condition signifies high potassium levels
    • Chloride: Also known as hyperchloremia or an excess of chloride in the body
    • Phosphate: Hyperphosphatemia or excess phosphate in the body 7

    Types of Low Electrolyte Imbalances

    The following are the types of high electrolyte imbalances: 

    • Sodium: This condition is also called hyponatremia and is one of the most common electrolyte diseases. Liver or kidney disease, hormonal changes, or certain medications are the common causes. 8
    • Potassium: It is also called hypokalemia. The common causes include an individual losing fluids or failing to get enough potassium from their diet. This situation can also arise in patients with diabetes, chronic kidney disease, and excessive alcohol use. You can detect your potassium levels through a potassium test (K+ blood test). 9
    • Chloride: It is also called hypochloremia. Some causes of low chloride levels include excessive sweating, kidney problems, diarrhoea, and vomiting. It has a similar cause as hyponatremia, and it generally signifies the body's inability to produce enough chloride compounds. If you have any of the symptoms of chloride imbalance, you must take a chloride blood test to detect any underlying condition. 10
    • Calcium: Hypocalcemia, or low blood calcium levels, stems from issues with parathyroid hormone (PTH) production or vitamin D deficiency, crucial for calcium regulation. Common causes include hypoparathyroidism due to insufficient PTH production, vitamin D deficiency from a lack of sunlight or intake, and kidney failure, which disrupts calcium and phosphorus balance. 11
    • Magnesium: Also known as hypomagnesemia, this condition generally occurs due to insufficient dietary magnesium intake, excessive magnesium loss via the kidneys or gastrointestinal tract, or the redistribution of magnesium into less accessible body compartments. 12
    • Phosphate: Also known as hypophosphatemia, this condition is characterised by a low level of phosphate in the blood. It can occur due to alcohol use disorder, severe burns, or refeeding syndrome. The condition can be chronic due to conditions like hyperparathyroidism, vitamin D deficiency, malnutrition, or the long-term use of certain medications and phosphate binders. 13

    Complications and Risks of Electrolyte Imbalance

    Electrolyte imbalances or electrolyte disturbance in body can result in several complications. Below is a list of risks a person might be prone to from various electrolyte abnormalities. 

    • Sodium: A sodium imbalance can cause severe complications, including muscle seizures and nervous imbalances. 14 A critical sodium imbalance could also lead a patient to slip into a coma. Take a sodium blood test to detect this.
    • Magnesium: Magnesium disbalance, detected through a magnesium blood test, could lead to heart problems, including cardiac arrest. People suffering from hypermagnesemia can also experience breathing problems 15 or stunted reflexes. 
    • Calcium: This can lead to several disorders affecting different parts of the body. It could lead to headaches or intense confusion, 16 affecting brain functioning. The condition can also cause digestive and kidney issues. It is connected to kidney stones or failure. Hypercalcemia can also cause a weakened skeletal system, resulting in joint pain.
    • Potassium: Potassium imbalance can affect your nervous system, leading to confusion. These excess electrolyte symptoms can even change your heartbeat rhythm, causing arrhythmias. 17
    • Chloride: Excess chloride in the body can lead to several disorders, like excessive vomiting and kidney disease. 18 Beyond the typical electrolyte tests, you can take a kidney function or a kidney profile test to check the condition of your kidneys when you have a chloride imbalance.
    • Phosphate: Phosphate imbalances can lead to severe health risks, including coma and death from extreme hypophosphatemia 19. Chronic low phosphate levels result in symptoms like bone pain, fractures, and rickets in children while inducing hypocalcemia, which increases the risks of seizures and bone disease. Conversely, high phosphate levels, especially in kidney disease patients, significantly raise mortality risks due to cardiovascular complications. 20

    Electrolyte Imbalance Causes

    While electrolyte imbalances can occur from an imbalance of specific acids, bases, or salts, here are some of the other general causes of electrolyte imbalance and its symptoms:

    • Vomiting and nausea
    • Diarrhoea or severe food poisoning
    • Lack of fluids in the body
    • Malnourishment 
    • Sweating
    • certain medications, such as laxatives and diuretics
    • Kidney or liver diseases
    • Chemotherapy 
    • Heart problems and congestion 21

    What Happens Inside Your Body When Electrolytes Are Out of Balance


    • High Sodium (Hypernatremia) Hypernatremia often results from dehydration due to inadequate fluid intake or excessive losses from vomiting, diarrhoea, or fever. It can also occur with kidney disease, uncontrolled diabetes, dementia, and conditions like diabetes insipidus that disrupt water balance.  22
    • Low Sodium (Hyponatremia)

    Hyponatremia occurs when sodium levels drop below 135 mEq/L. Excessive water intake or conditions that promote water retention and sodium loss cause hyponatremia. These include the use of certain medications, heart, kidney, or liver diseases, SIADH, hormonal imbalances, and recreational drug use. 23


    • High Magnesium (Hypermagnesemia): 

    Hypermagnesemia typically occurs in individuals with kidney failure or severe liver disease, as they cannot excrete excess magnesium. Contributing factors include:

    • Chronic kidney disease treatments.
    • Malnourishment and alcoholism.
    • Magnesium-containing drugs like laxatives and antacids.
    • Conditions such as lithium therapy, hypothyroidism, and Addison's disease. 24
    • Low Magnesium (Hypomagnesemia): 

    Hypomagnesemia can result from:

    • Inadequate dietary intake or IV nutrition in critically ill patients
    • Poor absorption due to gastrointestinal disorders or surgeries
    • Excessive magnesium loss through the kidneys or gastrointestinal tract is exacerbated by conditions like diabetes, diuretic use, or chemotherapy.
    • Redistribution of magnesium into less accessible body compartments, 25 as seen in acute pancreatitis


    • High Calcium (Hypercalcemia)

    Hypercalcemia often results from overactive parathyroid glands, which produce excessive parathyroid hormone, affecting blood calcium levels. Additionally, a significant number of cancers, including lung, breast, and various blood cancers, can rapidly increase calcium levels. Other contributing factors include:

    • Excessive intake of calcium supplements or vitamins D and A.
    • Use of certain medications, like thiazide diuretics and lithium.
    • Less common causes include lung diseases like sarcoidosis, kidney failure, and prolonged immobilisation. 26
    • Low Calcium (Hypocalcemia)

    Hypocalcemia is frequently linked to inadequate parathyroid hormone levels or vitamin D deficiency, which are essential for maintaining stable blood calcium levels. Common causes include:

    • Hypoparathyroidism, possibly due to genetic disorders or surgical removal of parathyroid glands
    • Chronic kidney failure, leading to disruptions in vitamin D production and phosphorus accumulation
    • Medications such as bisphosphonates and corticosteroids
    • Conditions like pancreatitis, pseudohypoparathyroidism, and certain rare genetic disorders also contribute to low calcium levels. 27


    • High Potassium (Hyperkalemia)

    Hyperkalemia primarily occurs when the kidneys fail to excrete potassium effectively, a common issue in advanced kidney disease. Contributing factors for high potassium levels include:

    • Diets rich in potassium, particularly in individuals with kidney impairment
    • Certain medications that limit potassium excretion by the kidneys
    • Additional causes are less common but can include excessive intake of potassium through supplements, Addison's disease, severe burns or injuries that release potassium into the bloodstream, and poorly controlled diabetes affecting kidney function. 28
    • Low Potassium (Hypokalemia) 

    Hypokalemia arises from a potassium deficiency, which is crucial for cell function regulated by the kidneys. The top causes of low potassium include:

    • Medications such as diuretics and certain antibiotics
    • Conditions causing excessive potassium loss, like diarrhoea, vomiting, or heavy sweating
    • Chronic issues such as eating disorders, laxative overuse, hyperaldosteronism, and chronic kidney disease
    • Low magnesium levels and genetic disorders like hypokalemic periodic paralysis and Bartter syndrome also contribute to hypokalemia. 29


    • High Chloride (Hyperchloremia)

    Hyperchloremia occurs when there is an excess of chloride in the blood, primarily regulated by the kidneys. Factors leading to high chloride levels include:

    • High intake of saline solutions during medical treatments like surgeries
    • Severe diarrhoea or ingestion of high amounts of dietary salt or salt water
    • Conditions such as acute or chronic kidney disease affect the kidneys' ability to maintain electrolyte balance.
    • Respiratory alkalosis, where carbon dioxide levels drop too low due to hyperventilation and metabolic or renal acidosis, causing increased acidity in the body
    • Long-term use of carbonic anhydrase inhibitors used in treating glaucoma.30
    • Low Chloride (Hypochloremia)

    Although rare, hypochloremia can occur due to conditions that decrease chloride levels. Causes include:

    • Excessive loss of body fluids through diarrhoea, vomiting, or sweating.
    • Kidney disorders that disrupt chloride balance.
    • Respiratory acidosis: when the body retains too much carbon dioxide
    • Syndrome of inappropriate antidiuretic hormone secretion (SIADH), leading to water retention and chloride dilution
    • Metabolic alkalosis, which makes the body too alkaline.
    • Use of certain medications like corticosteroids, diuretics, laxatives, and bicarbonates.
    • Chemotherapy treatments can cause long-term electrolyte imbalances, including low chloride due to kidney damage. 31
    • Phosphate:High Phosphate (Hyperphosphatemia)

    Hyperphosphatemia typically arises when the kidneys fail to properly eliminate phosphate, commonly due to advanced chronic kidney disease. Other factors include:

    • Hypoparathyroidism, which affects calcium and phosphate balance
    • Respiratory and metabolic acidosis are conditions where blood pH drops due to excessive acids.
    • Less common causes are diabetes-related ketoacidosis, muscle damage (rhabdomyolysis), severe infections (sepsis), crush injuries, and pseudohypoparathyroidism.
    • Excessive dietary intake of phosphate or through medical treatments like enemas 32
    • Low Phosphate (Hypophosphatemia)

    Hypophosphatemia can occur suddenly or develop over time. It appears in the following situations: 33

    • Recovery from diabetes-related ketoacidosis.
    • Alcohol use disorder and withdrawal.
    • Conditions causing significant shifts in bodily fluids, like severe burns and refeeding syndrome after starvation.
    • Respiratory alkalosis occurs from a carbon dioxide deficiency.

    Chronic causes include:

    • Hormonal imbalances such as increased parathyroid hormone levels and Cushing's syndrome.
    • Vitamin D deficiency and conditions leading to malabsorption.
    • Electrolyte imbalances from low magnesium or potassium levels.
    • Long-term effects from IV iron infusions, use of certain diuretics, and frequent use of phosphate-binding antacids.
    • Theophylline intoxication

    Phosphate imbalances (high and low) are closely linked with kidney function, dietary intake, and hormonal regulation and can affect overall health.

    Electrolyte Imbalance Symptoms

    Recognising electrolyte imbalances is crucial for maintaining health. The following sections will explore the symptoms of low and excess electrolytes.

    Symptoms of Low Electrolytes

    What happens when your body suffers from electrolyte deficiency? The following are a few electrolyte deficiency symptoms:

    • Hypokalemia: Hypokalemia or potassium deficiency can cause an irregular heartbeat called arrhythmia. Patients with electrolyte imbalance symptoms feel weak and have intense muscle cramps.
      • Hyponatremia: Hyponatremia occurs when the sodium levels in the body are too low. It can result from various diseases, such as drinking too much water, which dilutes the sodium concentration in the body. It can lead to nausea and vomiting, headaches, fatigue, muscle spasms or seizures, and even coma.
    • Hypocalcemia: Hypocalcemia patients are mostly asymptomatic. However, it can result in hospitalisation in advanced cases. Symptoms of unbalanced electrolytes, in this case, can lead to several critical disorders, like neuromuscular problems, muscle seizures or spasms, cramps, and also personality disturbances. 34
    • Hypomagnesemia: Initially, hypomagnesemia can result in anorexia, vomiting, or nausea. Though the patients are initially asymptomatic, it can result in very severe impacts in advanced stages. These electrolyte imbalance symptoms can include changes in personality and twitching of facial muscles, also known as the Chvostek sign. 35 
    • Hyperchloremia: The lack of bicarbonates in the body is also known as acidosis. It can lead to nausea, loss of appetite, headaches, and confusion. Other unbalanced electrolyte signs include a rapid heartbeat, breathing distress, and weakness. You can detect such a condition through a bicarbonate test. 36
    • Hypophosphatemia: The lack of phosphates or hypophosphatemia causes neuromuscular disorders, spasms, cramps, anorexia, and weakness.
    • Hypochloremia: Hypochloremia is generally asymptomatic in the initial stages. However, it can trigger excessive fluid loss through vomiting and dehydration and results in weakness, tiredness, and shortness of breath. 37

    Symptoms of High Electrolytes

    The following are the symptoms of excess electrolytes: 

    • Hyperkalemia: Hypokalemia, or the increase of potassium, can cause palpitations in your heart, chest pain, shortness of breath, and even vomiting and nausea. In extreme cases, hyperkalemia can be fatal.
      • Hypernatremia: Hyponatremia occurs when the sodium levels in your body are too high. It can result from various diseases, including restlessness, confusion, feeling lethargic, or even falling unconscious. It could also lead to constant thirst, irritability, and muscle seizures.
    • Hypercalcemia: Hypercalcemia affects different body parts and induces various symptoms in the patient. It can lead to digestive problems like loss of appetite and nausea. It could also make you feel constantly thirsty due to changes or any underlying condition of your kidney. You can detect this through a kidney function test. Too much calcium can impact your bones and brain, leading to changes in personality or confusion.
    • Hypermagnesemia: Mild hypermagnesemia can cause lethargy, nausea, or dizziness. Slightly higher levels of magnesium can result in headaches, confusion, bladder problems like bladder paralysis, and constipation. At the very advanced stages of hypermagnesemia, it can result in muscle paralysis, a reduced heart rate or breathing pace, and also blockades in your blood vessels. 38
    • Alkalosis: The excess of bicarbonates in the body is called alkalosis. It can lead to bloating, stomach pain, nausea, and other digestive issues. Extreme cases of alkalosis can also cause frequent vomiting. You can detect whether you have alkalosis through a bicarbonate blood test.
    • Hyperphosphatemia: High phosphate levels, also known as hyperphosphatemia, can result in memory problems like short-term memory loss, muscle cramps, dry skin, and seizures
    • Hyperchloremia: Hypochloremia is generally asymptomatic in the initial stages. However, its causes include excessive fluid loss through vomiting and dehydration. It leads to weakness, tiredness, and shortness of breath.

    Diagnosis of Electrolyte Imbalance

    You must be thinking about how to balance electrolytes. For that, diagnosis is the first step. Diagnosing symptoms of electrolyte deficiency involves a systematic approach that integrates clinical assessment, vital tests like the Blood checkup, electrolyte imbalance test, HCO3- Blood Test,  and consideration of the patient's medical history and risk factors. 

    Initial evaluation typically includes a thorough physical examination to assess for signs and symptoms of electrolyte disturbance, such as weakness, fatigue, muscle cramps, cardiac arrhythmias, or changes in mental status. It is what happens when your body is low on electrolytes. Laboratory testing, including serum electrolyte levels obtained through blood tests, is essential for confirming the diagnosis and determining the different types of electrolytes affected. 

    In addition, other tests, such as urine electrolyte analysis or imaging studies, can help assess electrolyte imbalance underlying causes or other diseases such as renal dysfunction or adrenal insufficiency. Electrolyte level interpretation should consider factors such as hydration status, medications, and concurrent medical conditions. 

    A comprehensive approach that combines clinical judgment with laboratory findings is essential for accurately diagnosing and effectively managing electrolyte deficiency or imbalance. With that, we hope you understand how to lower the chances of developing an electrolyte imbalance.

    How to Treat Electrolyte Imbalance

    Electrolyte deficiency represents a spectrum of conditions, and managing and treating electrolyte disturbance requires a comprehensive approach that addresses the underlying cause and the specific electrolyte affected. 

    The first step in managing electrolyte abnormalities is to identify the underlying cause. Electrolyte disturbances can arise from a wide range of factors, including dehydration, kidney dysfunction, hormonal imbalances, gastrointestinal losses (such as vomiting or diarrhoea), medication side effects, and certain medical conditions like diabetes or heart failure. Understanding the root cause is essential for developing an effective treatment plan tailored to the patient’s electrolyte imbalance. 

    For instance, if dehydration causes electrolyte disturbances, rehydration therapy may be necessary, either orally or intravenously. In cases where kidney dysfunction is the cause, optimising kidney function and managing any underlying renal disease are essential treatment components. You can check the condition of your kidneys through a kidney profile test.

    Once the underlying cause is known, taking care of the patient with fluid and electrolyte imbalances is an immediate priority. It often involves electrolyte replacement through oral or intravenous administration, and regular blood tests are crucial for assessing the patient's response to treatment. The choice of electrolyte replacement therapy depends on several factors, including the severity of the imbalance, the specific electrolyte disturbance, and the presence of any coexisting medical conditions. Depending on these factors, frequent monitoring may be necessary to ensure electrolyte levels are within the target range.

    Now that you've come this far, we're sure you know how to lower your chances of developing an electrolyte imbalance. Remember, managing and treating electrolyte abnormalities requires a multifaceted approach that addresses the underlying cause and the specific electrolyte affected. By identifying the root cause, replacing electrolytes as needed, and implementing preventive measures, healthcare providers can detect and treat the condition.


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