What Are Electrolytes?

What
Causes Electrolyte
Imbalance?
Last updated Tue 24 May 2016
By Christian Nordqvist
930

An electrolyte is a substance that produces an electrically conducting

solution when dissolved in water. Electrolytes carry a charge and are
essential for life. All higher forms of life need electrolytes to survive.

In our bodies, electrolytes include sodium (Na ), potassium (K ), calcium (Ca ),

+ + 2+

bicarbonate (HCO ), magnesium (Mg ), chloride (C1 ), and hydrogen

3
- 2+ -

phosphate (HPO ). 4
2-

Contents of this article:

Symptoms and causes of electrolyte imbalance

Effects of calcium, potassium and sodium imbalances

Fast facts on electrolytes

Here are some key points about electrolytes. More detail and supporting
information is in the main article.

Electrolytes are vital for the normal functioning of the human body

Fruit and vegetables are good sources of electrolytes

 Electrolytes include sodium, potassium, calcium and bicarbonate

The symptoms of electrolyte imbalance can include twitching, weakness

and, if unchecked, seizures

Elderly people are particularly susceptible to electrolyte imbalance

Hypercalcemia - too much calcium - is common in cancer patients

Kidney disease and severe dehydration can cause electrolyte imbalance

Patients with diabetes or heart failure have an increased risk of low sodium
levels.

What are electrolytes?

Electrolytes regulate our nerve and muscle function, our body's hydration,
blood pH, blood pressure, and the rebuilding of damaged tissue. Various
mechanisms exist in our body that keep the concentrations of electrolytes
under strict control.

Fresh fruits and vegetables are rich in electrolytes.

Our muscles and neurons are sometimes referred to as the "electric tissues"
of the body. They are reliant on electrolyte movement between extracellular,
interstitial and intracellular fluid (fluid inside, outside or between cells).

A muscle contraction needs calcium (Ca ), sodium (Na ) and potassium (K ) to

2+ + +

be present. Wrong electrolyte levels can lead to either weak muscles, or

muscles that contract too severely.

Our heart, muscle and nerve cells use electrolytes to maintain voltages across
their cell membranes and to carry electrical impulses to other cells.
The level of an electrolyte in the blood can become too high or too low. Body
electrolyte levels tend to alter when water levels in the body change - when
our level of hydration goes up or down.

Electrolyte levels are kept constant by our kidneys and several

hormones. When we exercise we sweat and lose electrolytes, mainly sodium
and potassium.

To maintain constant electrolyte concentrations in our body fluids, these

electrolytes must be replaced. Fresh fruits and vegetables are good sources
of sodium and potassium and replace lost electrolytes. Excess electrolyte
levels in our blood are filtered out by our kidneys.

If we do not consume the necessary levels of electrolytes there can be health

consequences. The most common imbalances are hypernatremia and
hyponatremia (too much or too little sodium), and hyperkalemia and
hypokalemia, (excessive and insufficient levels of potassium).

Doctors refer to a low electrolyte level with the prefix hypo- and to a high level
with the prefix hyper-.

Elderly people and electrolyte levels

As older people are more susceptible to dehydration and over-hydration, they
are also more prone to abnormal electrolyte levels. This is because our
kidneys do not work as efficiently when we become elderly.

Some seniors who have mobility problems, and do not have daily access to
help, may experience fluctuating levels of food and fluid intake - these two
factors can have an impact on their levels of electrolytes.

Symptoms of electrolyte imbalance

 Electrolyte imbalance can cause bone disorders.

An electrolyte imbalance can be manifested in several ways. The symptoms

will depend on which electrolyte is out of balance, and whether that level is too
high or too low.

An altered level of magnesium, sodium, potassium,or calcium may produce

one or more of the following symptoms:

Irregular heartbeat

Weakness

Bone disorders

Twitching

Blood pressure changes

Confusion

Seizures

Numbness

Nervous system disorders

Fatigue, lethargy

Convulsions

Muscle spasm.

Hypercalcemia is a common disorder among cancer patients, especially

those with breast cancer, lung cancer and multiple myeloma. It often results
from the destruction of bone due to bone metastases.
 Signs and symptoms may include: frequent urination, irregular heart beat,
lethargy, fatigue, moodiness and irritability, nausea, stomach pain, vomiting,
extreme muscle weakness, being very thirsty, dry mouth or throat, total loss of
appetite, coma, confusion and constipation.

As these symptoms may also be the result of the cancer itself or cancer
treatment, it is sometimes difficult for hypercalcemia to be identified straight
away.

Causes of electrolyte imbalance

Kidney disease

Vomiting for prolonged periods

Severe dehydration

Heatwaves - A report found that the number of cases of electrolyte

imbalances increases significantly during heatwaves 1

Acid/base (pH) imbalance (acid and alkaline balance in the body is

disproportionate)

Congestive heart failure

Cancer treatment

Some drugs, such as diuretics or ACE inhibitors. A study revealed that 20%
of patients taking diuretics commonly prescribed for high blood pressure or
heart conditions end up with reduced sodium and potassium levels 2

Bulimia

Severe and persistent vomiting and nausea during pregnancy. 3

Electrolytes: Calcium,
Potassium and Sodium
Last updated Tue 24 May 2016

By Christian Nordqvist

930

(Continued from page 1...)

Calcium, potassium and sodium levels

Low sodium levels (hyponatremia)

Hyponatremia may result from not eating enough foods containing sodium, too much
sweating and urinating, or being over-hydrated.

When large amounts of fluids which do not contain sodium are given intravenously,
the patient may develop hyponatremia. Diuretics cause the kidneys to expel excess
sodium and water quicker - sometimes the excretion of sodium can be faster than the
excretion of water.

When sodium levels are low, our bodies can produce too much of an antidiuretic
hormone which tells our kidneys to retain water - this commonly happens in patients
who have pneumonia, strokeand those taking certain medications, such as
anticonvulsants and some SSRI (selective serotoninreuptake
inhibitor) antidepressants.

Patients with diabetes, heart failure, liver failure and kidney disorders have a higher
risk of experiencing low sodium levels.
Symptoms of hyponatremia - people suffering from hyponatremia may experience,
confusion, headache, irritability, loss of appetite, muscle weakness, nausea, vomiting,
fatigue, decreased consciousness, hallucinations, and even coma.

The Clinical Journal of Sport Medicine says that athletes who drink excessive
amounts of fluids during prolonged exercise - particularly novice marathon runners -
can develop dangerously low sodium levels.

High sodium levels (hypernatremia)

This is usually caused by water loss (dehydration) or the use of diuretics. Diuretics
can cause both hyponatremia and hypernatremia. The first symptom of hypernatremia
is thirst. Typically, patients with hypernatremia feel weak and sluggish.

When sodium levels are too high, people can suffer from confusion, paralysis,
seizures and eventually coma. The best treatment is to increase water intake -
sometimes this has to be done intravenously.

Low potassium levels (hypokalemia)

Some electrolyte imbalances can cause changes in heart rhythm.

Hypokalemia is often caused by using diuretics. Diuretics tend to make the kidneys
excrete more potassium and water in urine.

Diarrhea and vomiting can also cause hypokalemia. If potassium levels drop slightly,
there will usually be no symptoms. Prolonged slightly low potassium levels may lead
to lower insulin production, resulting in an increase in blood sugar levels.

Symptoms of hypokalemia - if potassium levels drop too low the patient will suffer
from fatigue, confusion, muscle weakness and cramps. If levels fall even lower, the
person can become paralyzed, and have arrhythmias (unusual heart rhythms).
Patients with heart failure who take digoxin and have moderately low potassium
levels are likely to develop abnormal heart rhythms. An interesting article published
by The Cochrane Library looked at the benefits of diuretics for heart failure patients,
while others wonder whether the changes in electrolyte levels might not outweigh the
benefits.
8

Low potassium is treated with potassium supplements by mouth - this can be either in
tablet or liquid forms.

Patients can also raise their potassium levels by changing their diet.

Hypokalemia caused by diuretics can sometimes be resolved by switching to a

potassium-sparing diuretic.

Researchers at Yale University School of Medicine explained why cystic

fibrosis patients may be prone to low potassium levels.

High potassium levels (hyperkalemia)

This is much more serious than hypokalemia. Hyperkalemia is usually caused by
either kidney failure or medications that lower the amount of potassium excreted by
the kidneys, such as the diuretic spironolactone, and angiotensin-converting enzyme
(ACE) inhibitors that are used for hypertension (high blood pressure).

Patients taking these medications combined with potassium supplements or food high
in potassium tend to have rapidly increasing potassium levels because their kidneys
cannot get rid of it fast enough. They should stop taking the potassium supplements
and change their diets. In some cases drugs that speed up the excretion of potassium
are needed. Individuals with abnormal heart rhythms may be given calcium
intravenously.

Researchers at the University of Texas Southwestern Medical Center in Dallas

reported that heart drugs can cause a dangerous build up of potassium.
Low calcium levels (hypocalcemia)

Individuals with hypocalcemia might experience numb hands or feet

This can happen as a result of a sudden widespread blood infection, as well as

infections in other tissues. If the body produces less parathyroid hormone, calcium
levels can also drop - this might occur after the removal of the parathyroid glands
during neck surgery.

People with vitamin D deficiency are more prone to hypocalcemia. The main reasons
for low vitamin D are not enough exposure to sunlight and poor diet.

Other reasons for hypocalcemia include anticonvulsant medications, such as

phenytoin and phenobarbital, or an underactive thyroid gland.

Symptoms of hypocalcemia - people with hypocalcemia may experience numbness

in the hands and/or feet, confusion, and even seizures. Treatment includes taking oral
calcium supplements, and treating the disorder that caused it.

High calcium levels (hypercalcemia)

This can happen if a bone is broken down and calcium is released into the
bloodstream. When cancer spreads to the bone there may be calcium release into the
bloodstream. In severe cases of Paget's disease hypercalcemia can become very
debilitating.

If levels of parathyroid hormone are too high hypercalcemia is much more likely - this
is usually the result of a tumor in the parathyroid gland. Some cancers can cause
parathyroid hormone levels to rise above normal levels. If thyroid hormone levels are
abnormally high, calcium levels can rise excessively.

Symptoms of hypercalcemia - if calcium levels increase slightly most people do not

have any symptoms. If levels are higher, the patient will experience dehydration
because the kidneys automatically excrete more water. When levels are very high, the
patient will experience nausea, loss of appetite, vomiting and confusion. There is also
a risk of coma and death.

Very high levels of calcium need to be treated immediately.

What is an electrolyte panel?

The test is used to screen for any electrolyte or acid-base imbalances (the body's
balance between acidity and alkalinity) and to check the effect of treatment on a
known imbalance that is disrupting the proper bodily function of an organ.

An electrolyte panel is sometimes included as part of a routine physical. It can be

done as a standalone test or as part of a basic metabolic panel or comprehensive
metabolic panel.

The electrolyte panel is often used with hospitalized patients or those who are brought
to the emergency room because acid-base and electrolyte imbalances are frequently
part of acute and chronic illnesses.

If a single electrolyte is found to be either too high or too low, the doctor will keep
testing for that imbalance until levels are back to normal. If an acid-base imbalance is
found, blood gas tests may be done. These measure the pH, oxygen and carbon
dioxide levels in an arterial blood sample to determine how severe the imbalance is
and see how the patient responds to treatment.

Electrolytes may also be tested if the patient is prescribed certain drugs, especially
diuretics or ACE inhibitors.

Video - Electrolytes

Recent developments on electrolytes from MNT news

Increasing calcium intake 'does not improve bone health of seniors'

The bone density and fracture risk of older individuals do not improve with increased
calcium intake. This is the finding of two new studies recently published in The BMJ.

Potassium-rich diets could protect diabetic patients' kidneys

Diabetes patients are at risk for a wide variety of negative health outcomes during the
progression of their disease. One such area of concern is kidney function. New
research hopes to spark further investigation into ways to tackle these disorders with
dietary potassium.