Electrolytes are the minerals in the body that carry an electric charge. These minerals, which are sodium, potassium, magnesium, chloride, calcium, phosphate and bicarbonate, dissolve in the body to create electrically charged ions.

All these minerals have many vital functions in the body like regulating heartbeat, improving bone health and muscle contraction. Electrolyte imbalance in the body can cause symptoms that include muscle aches, anxiety, headaches, and thirst.

Here’s a complete guide on the electrolytes, how they work, their importance and the symptoms of their imbalance.

How do electrolytes work?

The food we eat and the fluids that we drink contain mineral salts. These mineral salts become electrolytes when they dissolve in the body fluids like blood, urine, the liquid inside and around the cells.

Electrolytes are electrically charged, which means they can conduct electrical impulses. When the electrolytes dissolve into water, they separate into positive and negative ions. 

The nerves in the body can signal to each other through chemical exchanges which are dependent on oppositely charged ions.

Our body needs electrical impulses to make muscle cells contract. The cell needs an electrical voltage to be maintained across its membrane to generate these electrical impulses. The difference in electrolyte levels maintains this electrical voltage.

The kidneys perform the critical job of filtering electrolytes from the blood and keeping their levels in the blood constant. Hormones like the antidiuretic hormone, aldosterone, and parathyroid hormone also help to regulate the electrolyte balance.

Our body is continually working to maintain the correct balance of water and electrolyte levels. Whenever the sodium level in the body falls too low, our kidneys produce more urine, and this helps restore the balance.

When the sodium levels grow too high, we develop a thirst and drink more water. The kidneys also produce less urine, which results in dilution of sodium and the restoration of balance.

Electrolytes play many essential roles in the body. These include:

Calcium: Calcium is responsible for building and maintaining strong bones. We also need calcium for muscle contraction and nerve impulse transaction.

Sodium: Sodium regulates the water content in the body. It aids the nerve communication in the nervous system.

Chloride: This electrolyte is found in the blood and the fluid in the outer layers of the cells. It helps control the body’s fluids.

Potassium: Potassium maintains the normal function of cells and muscles. It keeps blood pressure levels stable and regulates heart contractions.

Magnesium: It helps convert blood sugar into energy for the body. It helps in muscle contractions, maintaining heart rhythms, nerve functioning and keeping a stable protein-fluid balance.

Phosphate: Phosphate helps in the absorption of calcium in the bones and regulates the blood’s activity level. 

What causes electrolyte imbalance?

Loss of bodily fluids can cause electrolyte imbalance through vomiting, diarrhea or sweating. Some medications can also lead to electrolyte imbalance. Here are some of the common causes of electrolyte imbalance:

  1. Sickness: When you are sick you may develop symptoms like diarrhea, vomiting, high fever, and sweating. These symptoms can lead to dehydration, which causes electrolyte imbalance.
  2. Digestive issues: If you have trouble absorbing nutrients from your food (malabsorption) it can causes electrolyte imbalance.
  3. Medications: Certain medication for cancer, heart disease, and hormonal disorders can cause electrolyte imbalance.
  4. Chemotherapy: This treatment can cause calcium and potassium deficiency.
  5. Kidney disease: Kidney plays an essential role in regulating chloride, sodium, potassium, and magnesium in the body. When our kidneys do not function properly, it can cause an imbalance.

Recommended intake

Consumption of the correct amount of electrolytes can help correct the imbalance. These are the normal range of some of the electrolytes (1):

  • Calcium: 4.5 to 5.5 mEq/L
  • Chloride: 97 to 107 mEq/L
  • Potassium: 3.5 to 5.3 mEq/L
  • Magnesium: 1.5 to 2.5 mEq/L
  • Sodium: 136 to 145 mEq/L

Signs of electrolyte imbalance

The symptoms of electrolyte imbalance depend on which electrolyte is out of balance and whether its concentration is too high or too low. Some of the common symptoms of electrolyte imbalance include:

  • Muscle spasms
  • Irregular heartbeat
  • Convulsions
  • Weakness
  • Excessive fatigue
  • Bone disorders
  • Twitching
  • Numbness
  • Changes in blood pressure
  • Seizures
  • Confusion
  • Nervous system disorders
  • Thirst
  • Insomnia
  • Digestive cramps
  • Joint pain

Let us discuss some of the more common signs of electrolyte imbalance and their causes:

Slow or irregular heartbeat

Potassium works closely with sodium to maintain healthy muscle contraction and heart function. When the potassium level rises very high (hyperkalemia), it affects the signals sent from the nerves to the muscles.

This results in muscle weakness, muscular spasms, tingling, and numbness. It also impacts the heartbeat and causes rapid rhythms. Hypokalemia (low potassium) can also cause palpitations, slow heart rate and in some cases cardiac arrest.

High levels of calcium in the body also affect the cardiovascular system. Extremely high calcium levels can affect the electrical transmission pathways of the heart and lead to changes in the heartbeat.

Tingling in hands and feet

Calcium is responsible for numerous functions in the body including formation of bones, muscle contraction, blood clotting and maintaining proper heart rhythm.

Too much calcium can cause kidney stones, muscular weakness, depression, fatigue, and constipation. Calcium deficiency can, on the other hand, result in tingling in feet, fingers, tongue, and lips.

Muscle spasms

Muscle spasms are usually the first signs of dehydration. When dehydration occurs, potassium and magnesium levels fall very rapidly. Hypokalemia (low potassium) can cause cramps and constipation.

Hypocalcemia (low calcium) can also lead to cramps, muscle spasms, abdominal pain, and convulsions.

Digestive issues

High levels or low levels of electrolytes in the body can lead to digestive problems like diarrhea, cramping, constipation, and hemorrhoids.

These problems occur because the muscles in the digestive tract are not able to contract properly. Hyponatremia (low sodium) can also lead to nausea.

Excessive itchiness

Excessive itchiness can be one of the symptoms of high phosphorus levels. Hyperphosphatemia can cause severe itchiness, calcification of blood vessels and this can affect the circulatory system and lead to kidney stones.

When phosphorus levels are too low, it can lead to weak respiratory muscles, cardiac arrhythmia, and even death.

Dizziness

High levels of sodium (hypernatremia) can make you dizzy and weak. If the condition worsens, it can also make you delirious and lead to seizures.

Diagnosing an electrolyte imbalance

Several types of tests can be used to diagnose electrolyte imbalance. After your doctor discusses your medical history and your symptoms, he will prescribe a blood test and a urine test for you.

The doctor may also order tests like ultrasound or x-ray to check if your kidneys are working correctly. The doctor may also do additional tests depending on your condition.

He may perform a pinch test to see how severely you are dehydrated. An EKG can check for any irregular heartbeats or heart rhythms.

Treating electrolyte imbalance

Treatment of electrolyte balance involves improving levels that are too low and reducing levels that are too high. The type of treatment also depends on the severity of the imbalance.

While supplements can help in some cases, severe cases require hospitalization and monitoring.

1. Oral rehydration

This treatment is used for people who face dehydration and electrolyte shortage due to severe diarrhea. According to the WHO, the solution to be used in oral rehydration should include 2.6 grams of sodium, 1.5 grams of potassium chloride, 2.9 grams of sodium citrate dissolved in one liter of water.

2. IV fluids

In more severe cases of electrolyte shortage, intravenous fluid like sodium citrate help rehydrate the body. Electrolyte supplements can be added to the IV fluids to correct the deficiencies. A shortage of sodium can be corrected by infusion of sodium lactate.

3. Hemodialysis

Hemodialysis is used when sudden kidney damage causes the electrolyte disorder. This treatment helps remove waste from the blood. The doctors may also use this treatment if the electrolyte imbalance has become life-threatening.

4. Prevention

While electrolyte imbalance caused by medical problems like kidney damage cannot be prevented, a healthy diet can reduce the risk.

A diet that consists of processed foods will be high in sodium but low in other electrolytes like magnesium and potassium. Eat plenty of foods that provide potassium and magnesium.

These include leafy greens, broccoli, cabbage, potato, squash, bananas, and avocados. Water-dense foods like coconut water, celery, watermelon, kiwi and carrots are effective in preventing dehydration.

5. Drink enough water

Electrolyte imbalance can occur if you get dehydrated or overhydrated. Though the standard recommendation is to drink eight glasses of water a day, it can vary according to weather and your daily activities.

Drinking excessive water can also lead to dilution of electrolytes within the blood, and this can lead to low sodium levels.

Final thoughts

An electrolyte imbalance occurs when the levels of electrolytes in the body become too high or too low. This may be due to dehydration, medication, sickness or kidney issues.

Signs of electrolyte imbalance include muscle spasms, irregular heartbeat, weakness, tingling, numbness, and changes in blood pressure.

The treatment for electrolyte imbalance depends on the severity of the condition and can include oral rehydration, IV fluids, and hemodialysis. Eating nutritious food and staying hydrated is the best way to prevent electrolyte imbalance.

Signs of electrolyte imbalance include muscle spasms, irregular heartbeat, weakness, tingling, numbness, and changes in blood pressure.