What Are the Symptoms of Electrolyte Imbalance and How Do You Balance Them?

Electrolytes are small molecules with huge impacts on the body. There are several different kinds of electrolytes and each plays a critical role in maintaining normal bodily functions. 

Electrolyte levels in the body can become unbalanced and cause serious symptoms. However, balancing electrolytes doesn't have to be difficult, and electrolyte imbalances can be prevented through a healthy diet and good hydration.

Electrolytes are molecules that carry an electrical charge when dissolved in water. Since these molecules carry a positive or negative charge, they can conduct electricity. This conduction is essential for many bodily functions, like contracting muscles or activating nerve cells.

There are several different types of electrolytes in the body that play overlapping but distinct roles. These electrolytes include:

• Sodium. Sodium helps cells regulate their water content and take up necessary nutrients. Sodium also regulates the electrical charge found across cell membranes. 
• Potassium. Potassium is a critical regulator of the heart. Along with sodium, it’s also an important component of nervous system communication. 
• Calcium. Calcium is important for bone health, muscle movement, and hormone regulation. Like sodium and potassium, it also plays an important role in the nervous system. 
• Magnesium. Magnesium is another important molecule in the nervous system. It also plays a key role in breaking down nutrients for energy within cells. 
• Chloride. Chloride, like sodium, helps regulate the amount of water within cells. Unlike sodium, chloride carries a negative charge instead of a positive one. 
• Phosphate. Like magnesium, phosphate is an electrolyte that is critical for nutrient metabolism. It’s also a key component of nucleotides, which are the molecules that make up DNA. 
• Bicarbonate. Bicarbonate is essential for regulating blood pH. This electrolyte helps ensure that blood stays at a neutral pH and doesn’t become too acidic or too basic. 

All of these electrolytes are required to maintain normal bodily functions but the body can’t produce electrolytes on its own. Most people can get all of the electrolytes they need by consuming a nutritious and varied diet. However, electrolyte levels can become unbalanced based on a number of factors. 

An electrolyte imbalance happens when the body either has too much or too little of a type of electrolyte. Either too much or too little of an electrolyte can lead to various symptoms and complications. 

Electrolyte imbalances can be caused by numerous factors. A poor diet that does not contain enough nutrients can cause low electrolyte levels. Low electrolyte levels can also be caused by a sudden loss of fluids, such as through vomiting, diarrhea, or sweating. 

Certain medications and medical treatments may also cause an electrolyte imbalance. Antibiotics, chemotherapy drugs, and immunosuppressants may affect the levels of electrolytes in the body. Other medications, like those that improve water retention, may also cause an electrolyte imbalance. 

The symptoms of an electrolyte imbalance can vary depending on which electrolyte is affected. Too much of an electrolyte (indicated by the prefix hyper-) can also have different symptoms than having too little of an electrolyte (indicated by the prefix hypo-). 

Hypernatremia. Increased sodium levels typically cause neurological symptoms. These can be very serious and include changes to behavior, confusion, seizures, and even coma. 

Hyperkalemia. Excessive potassium can cause heart issues, such as irregular heart rhythms. It may also cause muscle weakness. 

Hypercalcemia. High levels of calcium can cause numerous issues, including neurological symptoms such as headache and confusion, digestive symptoms like constipation and vomiting, heart issues such as arrhythmias, and skeletal issues like joint pain. 

Hypermagnesemia. Similar to hyperkalemia, high levels of magnesium can cause heart issues such as arrhythmias. Hypermagnesemia may also cause breathing problems. 

Hyperchloremia. Excessive chloride can cause digestive issues such as vomiting and nausea. It may also cause rapid breathing. 

Hyperphosphatemia. High phosphate levels are typically asymptomatic until the imbalance becomes severe. Having too much phosphate impacts calcium levels, and causes similar symptoms to hypercalcemia. 

Alkalosis. Alkalosis occurs when bicarbonate levels are too high. This changes the pH of the blood and causes it to become too basic. Alkalosis can cause symptoms such as confusion and muscle twitching. 

Hyponatremia. Hyponatremia, which happens when sodium levels are too low, is the most common electrolyte imbalance. Low sodium levels may cause sleep disruptions and restlessness. 

Hypokalemia. Low levels of potassium can cause fatigue and twitching. Hypokalemia may also cause dizziness, excessive urination, and unusual thirst. 

Hypocalcemia. Not having enough calcium causes neurological and muscular symptoms, including confusion, unusually strong muscle reflexes, and throat spasms. 

Hypomagnesemia. Low levels of magnesium cause muscle and heart issues, including muscle weakness and arrhythmias. Hypomagnesemia is often seen in cases of alcohol use disorder. 

Hypochloremia. Hypochloremia occurs when chloride levels get too low. It can cause digestive issues like vomiting. 

Hypophosphatemia. Hypophosphatemia, in which phosphate levels are too low, initially has mild symptoms such as slight muscle weakness. Eventually, as the imbalance becomes more severe, muscle tissue begins to break down and leads to issues such as difficulty breathing and reduced heart function. 

Acidosis. When bicarbonate levels are low, the blood becomes too acidic. Acidosis can cause fatigue and gastrointestinal issues like nausea and vomiting. 

Electrolyte imbalances can be diagnosed by a blood test. Typically, these blood tests include either a basic or comprehensive metabolic panel. Your doctor may also order an additional electrolyte panel to further narrow down any issues. 

Blood test results include the level of electrolytes measured in your blood and compare your levels to a reference range. This reference range is an important indicator of what levels are considered normal. 

Different electrolytes have different normal ranges:

• Normal sodium range — 135 to 145 millimoles per liter. 
• Normal potassium range — 3.6 to 5.5 millimoles per liter. 
• Normal calcium range — 8.8 to 10.7 milligrams per deciliter.
• Normal magnesium range — 1.46 to 2.68 milligrams per deciliter.
• Normal bicarbonate range — 23 to 30 millimoles per liter.
• Normal phosphate range — 3.4 to 4.5 milligrams per deciliter. 

If your electrolyte levels lie above or below the normal range, talk with your physician about possible causes and potential treatments. 

Mild electrolyte imbalances can often be treated by adding different foods to your diet. For example, low potassium levels can be supplemented by eating potassium-rich foods such as bananas, strawberries, and prunes. Low magnesium levels can be helped by eating more broccoli, spinach, and yogurt.

If you’re experiencing severe symptoms of an electrolyte imbalance, it’s important to seek medical attention right away. Extreme cases may require hospitalization and intravenous delivery of electrolytes. 

A balanced and nutritious diet is the first line of defense against electrolyte imbalances. Since we mainly get electrolytes through the food we eat, it’s important to consume a variety of whole grains, fruits, vegetables, and lean meats. 

Although a balanced diet is important, sometimes losing electrolytes is unavoidable. A bad illness that causes vomiting or diarrhea or a hot day that causes excessive sweating can lead to unexpected electrolyte loss. In these cases, try to stay hydrated with water or drinks supplemented with electrolytes and consume electrolyte-rich foods if you can. 

A night of heavy drinking may also cause electrolyte imbalances. Alcohol is a diuretic that causes increased urination and fluid loss, which can lead to an electrolyte imbalance and a tough hangover. Drinking water during a night out or supplementing with electrolyte-replacement drinks can help maintain appropriate electrolyte levels. 

Many electrolyte drinks are advertised as essential for maintaining hydration during exercise. However, in most cases, plain water does the trick.

Athletes who are exercising intensely for several hours a day and people working out in hot weather can benefit from sports drinks that replace electrolytes. However, electrolyte replacement isn’t typically necessary for short periods of light exercise. 

Electrolytes are critical molecules that help our bodies function properly. Electrolyte imbalances, where the body has too much or too little of a certain electrolyte, can cause serious complications. 

Sports drinks can help replace electrolytes during intense exercise or after significant fluid loss but are typically not necessary. Instead, since we get most of the electrolytes we need through what we eat, it’s important to maintain a balanced and nutritious diet to prevent electrolyte imbalances.