Hypochloremia: What Is It and How Is It Treated?

Medically reviewed by Suzanne Falck, MD on September 19, 2017Written by Jill Seladi-Schulman, PhD on September 19, 2017

What is it?

Hypochloremia is an electrolyte imbalance that occurs when there’s a low amount of chloride in your body.

Chloride is an electrolyte. It functions with other electrolytes in your system, such as sodium and potassium, to regulate the amount of fluid and the pH balance in your body. Chloride is most commonly consumed as table salt (sodium chloride).

Continue reading to learn the symptoms of hypochloremia as well as what causes it and how it’s diagnosed and treated.

What are the symptoms of hypochloremia?

You often won’t notice symptoms of hypochloremia. Instead, you may have symptoms of other electrolyte imbalances or from a condition that’s causing hypochloremia.

Symptoms include:

  • fluid loss
  • dehydration
  • weakness or fatigue
  • difficulty breathing
  • diarrhea or vomiting, caused by fluid loss

Hypochloremia can also frequently accompany hyponatremia, a low amount of sodium in the blood.

What causes hypochloremia?

Since the levels of electrolytes in your blood are regulated by your kidneys, an electrolyte imbalance such as hypochloremia may be caused by a problem with your kidneys. Learn the basics of kidney health and kidney disease.

Hypochloremia can also be caused by any of the following conditions:

Certain types of drugs, such as laxatives, diuretics, corticosteroids, and bicarbonates, can also cause hypochloremia.

Hypochloremia and chemotherapy

Hypochloremia, along with other electrolyte imbalances, can be caused by chemotherapy treatment.

The side effects of chemotherapy can include:

  • prolonged vomiting or diarrhea
  • sweating
  • fever

These side effects can contribute to a loss of fluids. Fluid loss through vomiting and diarrhea can lead to an electrolyte imbalance.

How is hypochloremia diagnosed?

Your doctor can diagnose hypochloremia by performing a blood test to check your chloride level. Typically, blood chloride isn’t the only factor tested. It’ll be included as part of an electrolyte or metabolic panel.

The amount of chloride in your blood is measured as a concentration — the amount of chloride in milliequivalents (mEq) per liter (L). The normal reference ranges for blood chloride are below. Values below the appropriate reference range may indicate hypochloremia:

  • adults: 98–106 mEq/L
  • children: 90–110 mEq/L
  • newborn babies: 96–106 mEq/L
  • premature babies: 95–110 mEq/L

If your doctor suspects metabolic alkalosis, they may order a urine chloride test and urine sodium test. This will help your doctor determine what type of acid-base imbalance is present.

Like the blood chloride test, results for the urine test are also given in mEq/L. Normal urine chloride results range from 25 to 40 mEq/L. If the level of chloride in your urine is below 25 mEq/L, then you may be losing chloride through your gastrointestinal tract or cystic fibrosis.

Treatment of hypochloremia

If your doctor detects an electrolyte imbalance such as hypochloremia, they’ll investigate whether a condition, disease, or medication you’re taking is causing the imbalance to occur. Your doctor will work with you to treat the underlying problem that’s causing the electrolyte imbalance.

If your hypochloremia is due to a medication or drug that you’re taking, then your doctor may adjust the dosage, if possible. If your hypochloremia is due to problems with your kidneys or an endocrine disorder, your doctor may refer you to a specialist.

You may receive intravenous (IV) fluids, such as normal saline solution, to restore electrolytes to normal levels.

Your doctor may also request that you have your electrolyte levels tested regularly for monitoring purposes.

If your hypochloremia is mild, then it can sometimes be corrected by an adjustment to your diet. This could be as simple as consuming more sodium chloride (salt). Here’s what you need to know about daily salt intake.

Can it be prevented?

You can take the following measures to avoid hypochloremia:

  • Make sure that your doctor is aware of your medical history — especially if you have kidney disease, heart disease, liver disease, or diabetes.
  • Make sure that your doctor is aware of all medications that you’re taking.
  • Stay hydrated. In addition to water, these 19 foods can also help you stay well-hydrated.
  • Try to avoid both caffeine and alcohol. Both can contribute to dehydration.

The takeaway

Hypochloremia occurs when there’s a low level of chloride in your body. It can be caused by fluid loss through nausea or vomiting or by existing conditions, diseases, or medications.

Your doctor may use a blood test to confirm hypochloremia. In mild cases, replenishing the chloride in your body can treat hypochloremia. This can be accomplished either by consuming more salt or through receiving IV fluids.

If your low chloride levels are due to a medication or an existing condition, your doctor may adjust the dosage of your medication or refer you to the appropriate specialist.

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