Understanding electrolyte disorders
Electrolytes are elements and compounds that occur naturally in the body. They control important physiologic functions.
Examples of electrolytes include:
These substances are present in your blood, bodily fluids, and urine. They’re also ingested with food, drinks, and supplements.
An electrolyte disorder occurs when the levels of electrolytes in your body are either too high or too low. Electrolytes need to be maintained in an even balance for your body to function properly. Otherwise, vital body systems can be affected.
Mild forms of electrolyte disorders may not cause any symptoms. Such disorders can go undetected until they’re discovered during a routine blood test. Symptoms usually start to appear once a particular disorder becomes more severe.
Not all electrolyte imbalances cause the same symptoms, but many share similar symptoms.
Common symptoms of an electrolyte disorder include:
- irregular heartbeat
- fast heart rate
- convulsions or seizures
- diarrhea or constipation
- abdominal cramping
- muscle cramping
- muscle weakness
- numbness and tingling
Call your doctor right away if you’re experiencing any of these symptoms and suspect you might have an electrolyte disorder. Electrolyte disturbances can become life-threatening if left untreated.
Electrolyte disorders are most often caused by a loss of bodily fluids through prolonged vomiting, diarrhea, or sweating. They may also develop due to fluid loss related to burns.
Certain medications can cause electrolyte disorders as well. In some cases, underlying diseases, such as acute or chronic kidney disease, are to blame.
The exact cause may vary depending on the specific type of electrolyte disorder.
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
Hypercalcemia occurs when you have too much calcium in the blood. This is usually caused by:
- kidney disease
- thyroid disorders, including 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 occurs due to a lack of adequate calcium in the bloodstream. Causes can include:
- kidney failure
- vitamin D deficiency
- prostate cancer
- certain medications, including heparin, osteoporosis drugs, and antiepileptic drugs
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:
Hypochloremia develops when there’s too little chloride in the body. It’s often caused by sodium or potassium problems.
Other causes can include:
Magnesium is a critical mineral that regulates many important functions, such as:
- muscle contraction
- heart rhythm
- nerve function
Hypomagnesemia means having too little magnesium in the body. Common causes include:
- alcohol use disorder
- chronic diarrhea
- excessive sweating
- heart failure
- certain medications, including some diuretics and antibiotics
The kidneys, bones, and intestines work to balance phosphate levels in the body. Phosphate is necessary for a wide variety of functions and interacts closely with calcium.
Hyperphosphatemia can occur due to:
- low calcium levels
- 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
- vitamin D deficiency
- overactive parathyroid glands
- certain medications, such as intravenous (IV) iron treatment, niacin (Niacor, Niaspan), and some antacids
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 often happens as a result of:
- eating disorders
- severe vomiting or diarrhea
- certain medications, including laxatives, diuretics, and corticosteroids
Sodium is necessary for the body to maintain fluid balance and is critical for normal body function. It also helps to regulate nerve function and muscle contraction.
Hypernatremia occurs when there’s too much sodium in the blood. Abnormally high levels of sodium may be caused by:
- inadequate water consumption
- severe dehydration
- excessive loss of bodily fluids as a result of prolonged vomiting, diarrhea, sweating, or respiratory illness
- certain medications, including corticosteroids
Hyponatremia develops when there’s too little sodium. Common causes of low sodium levels include:
- excessive fluid loss through the skin from sweating or burns
- vomiting or diarrhea
- poor nutrition
- alcohol use disorder
- thyroid, hypothalamic, or adrenal disorders
- liver, heart, or kidney failure
- certain medications, including diuretics and seizure medications
- syndrome of inappropriate secretion of antidiuretic hormone (SIADH)
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 disorder. These additional tests will vary depending on the condition in question.
For example, hypernatremia (too much sodium) can cause loss of elasticity in the skin due to significant dehydration. Your doctor can perform a pinch test to determine whether dehydration is affecting you.
They may also test your reflexes, as both increased and depleted levels of some electrolytes can affect reflexes.
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.
Treatment varies depending on the type of electrolyte disorder and on the underlying condition that’s causing it.
In general, certain treatments are used to restore the proper balance of minerals in the body. These include:
Intravenous (IV) fluids
Intravenous (IV) fluids, typically 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 you’re being treated by another method.
The medication you receive will depend on the electrolyte disorder you have. Medications that may be administered include calcium gluconate, magnesium chloride, 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 in if you’ve been diagnosed with ongoing kidney disease.
Depending on your electrolyte disorder, 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
They can help replace depleted electrolytes on a short- or long-term basis, depending on the underlying cause of your disorder. Once the imbalance has been corrected, your doctor will treat the underlying cause.
Although some of the supplements can be purchased over the counter, most people with electrolyte disorders get a prescription for supplements from their doctor.
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 will allow 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 when an electrolyte disorder is caused by sudden kidney damage and other treatments aren’t working. Your doctor may also decide on hemodialysis treatment if the electrolyte problem has become life-threatening.
Anyone can develop an electrolyte disorder. Certain people are at an increased risk because of their medical history. Conditions that increase your risk for an electrolyte disorder include:
Follow this advice to help prevent electrolyte disorders:
- stay hydrated if you’re experiencing prolonged vomiting, diarrhea, or sweating
- visit your doctor if you’re experiencing common symptoms of an electrolyte disorder
If the electrolyte disorder is caused by medications or underlying conditions, your doctor will adjust your medication and treat the cause. This will help prevent future electrolyte imbalances.