All About Electrolyte Disorders

What are electrolyte disorders?

An electrolyte disorder occurs when the levels of electrolytes in your body are either too high or too low. Electrolytes are naturally occurring elements and compounds in the body. They control important physiologic functions.

Examples of electrolytes include:

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

These substances are present in your blood, bodily fluids, and urine. They’re also ingested with food, drinks, and supplements.
Electrolytes need to be maintained in an even balance for your body to function properly. Otherwise, vital body systems can be affected. Severe electrolyte imbalances can cause serious problems like coma, seizures, and cardiac arrest.

Symptoms

Symptoms of electrolyte disorders

Mild forms of electrolyte disorders may not cause any symptoms. Such disorders can go undetected until they are 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
• fatigue
• lethargy
• convulsions or seizures
• nausea
• vomiting
• diarrhea or constipation
• abdominal cramping
• muscle weakness
• muscle cramping
• irritability
• confusion
• headaches
• 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.

Causes

Causes of electrolyte disorders

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 are to blame.
The exact cause may vary depending on the specific type of electrolyte disorder.

Types of electrolyte disorders

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.
Hypercalcemia is when you have too much calcium in the blood. This usually happens due to:

• hyperparathyroidism
• kidney disease
• thyroid disorders
• 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 like lithium, theophylline, or certain water pills

Hypocalcemia is a lack of adequate calcium in the bloodstream. Causes can include:

• kidney failure
• hypoparathyroidism
• vitamin D deficiency
• pancreatitis
• prostate cancer
• malabsorption
• certain medications, including heparin, osteoporosis medicine, and antiepileptic drugs

Chloride

Chloride is necessary for maintaining the proper balance of bodily fluids.
Hyperchloremia occurs when there is too much chloride in the body. This can happen as a result of:

• severe dehydration
• kidney failure
• dialysis

Hypochloremia develops when there is too little chloride in the body. This is often caused by sodium or potassium problems, as discussed below. Other causes can include:

• cystic fibrosis
• eating disorders, such as anorexia
• scorpion stings
• acute kidney injury

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. This is a disorder that primarily affects people with Addison’s disease and end-stage kidney disease.
Hypomagnesemia means having too little magnesium in the body. Common causes include:

• alcohol use disorder
• malnutrition
• malabsorption
• chronic diarrhea
• excessive sweating
• heart failure
• certain medications, including some diuretics and antibiotics

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 often happens as a result of:

• eating disorders
• severe vomiting or diarrhea
• dehydration
• certain medications, including laxatives, diuretics, and corticosteroids

Sodium

Sodium is needed in the body to maintain fluid balance and is critical for normal body function. It also helps to regulate nerve function and muscle contraction.
Hypernatremia happens when there is too much sodium in the blood. Abnormally high levels of sodium may occur due to:

• 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 is 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
• overhydration
• 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)

Phosphate

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 result of cancer treatment
• excessive use of phosphate-containing laxatives

Low levels of phosphate, or hypophosphatemia, can be seen in:

• acute alcohol abuse
• severe burns
• starvation
• vitamin D deficiency
• overactive parathyroid glands
• certain medication use, such as intravenous (IV) iron treatment, niacin, and some antacids

Diagnosis

Diagnosing electrolyte disorders

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 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 (EKG), an electrical tracing of your heart, may also be useful to check for any irregular heartbeats, rhythms, or EKG changes brought on by electrolyte problems.

Treatment

Treating electrolyte disorders

Treatment varies depending on the type of electrolyte disorder and on the underlying condition.
In general, certain treatments are used to restore the proper balance of minerals in the body. These include:

IV fluids

IV fluids, typically sodium chloride, can help rehydrate the body. This treatment is commonly used in cases of dehydration from vomiting or diarrhea. Electrolyte supplements can be added to IV fluids to correct deficiencies.

Certain IV medications

These can help your body restore electrolyte balance quickly. They can also protect from negative effects while you’re being treated by another method.

Oral medications

Oral medications are often used to correct mineral abnormalities in the body that are chronic. This occurs especially in people with ongoing kidney disease. Common oral medications treat electrolyte imbalances, like high potassium, calcium, or phosphate.

Hemodialysis

This 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 a 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.

Supplements

Supplements can help replace depleted electrolytes on a short- or long-term basis, depending on the cause.
Once the imbalance has been corrected, your doctor will treat the underlying cause.

Advertisement

Risk factors

Risk factors for electrolyte disorders

Anyone can develop an electrolyte disorder. Certain people are more at risk because of their medical history. Conditions that increase risk for an electrolyte disorder include:

• alcohol use disorder
• cirrhosis
• congestive heart failure
• kidney disease
• eating disorders, such as anorexia and bulimia
• trauma, such as severe burns or broken bones
• thyroid and parathyroid disorders
• adrenal gland disorders

Prevention

Preventing electrolyte disorders

Tips

1. Visit a doctor if you’re experiencing common symptoms of an electrolyte disorder.
2. 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.
3. Stay hydrated if you’re experiencing prolonged vomiting, diarrhea, or sweating