Electrolyte Imbalance

Electrolytes play a vital role in maintaining homeostasis within the body. They help to regulate heart and neurological function, fluid balance, oxygen delivery, acid–base balance and much more. Electrolyte imbalances can develop by the following mechanisms: excessive ingestion; diminished elimination of an electrolyte; diminished ingestion or excessive elimination of an electrolyte.

The most serious electrolyte disturbances involve abnormalities in the levels of sodium, potassium or calcium. Other electrolyte imbalances are less common, and often occur in conjunction with major electrolyte changes. Chronic laxative abuse or severe diarrhea or vomiting (gastroenteritis) can lead to electrolyte disturbances along with dehydration. People suffering from bulimia or anorexia nervosa are at especially high risk for an electrolyte imbalance.

General function

Electrolytes are important, because they are what cells (especially nerve, heart and muscle cells) use to maintain voltages across their cell membranes and to carry electrical impulses (nerve impulses, muscle contractions) across themselves and to other cells. Kidneys work to keep the electrolyte concentrations in blood constant despite changes in the body. For example, during heavy exercise, electrolytes are lost in sweat, particularly in the form of sodium and potassium. These electrolytes must be replaced to keep the electrolyte concentrations of the body fluids constant.

Some of the major roles that electrolytes have within the body include:

  • Calcium: helping with muscle contractions, nerve signaling, blood clotting, cell division, and forming/maintaining bones and teeth
  • Potassium: helping keep blood pressure levels stable, regulating heart contractions, helping with muscle functions
  • Magnesium: needed for muscle contractions, proper heart rhythms, nerve functioning, bone-building and strength, reducing anxiety, digestion, and keeping a stable protein-fluid balance
  • Sodium: helps maintain fluid balance, needed for muscle contractions, and helps with nerve signaling
  • Chloride: maintains fluid balance

Electrolytes, or ions, are the charged particles in body fluids that help transmit electrical impulses for proper nerve, heart, and muscle function.1,2 The number of positive ions, called cations, and negative ions, called anions, is supposed to be equal. Anything that upsets this balance can have life-threatening consequences.


Signs and Symptoms of an Electrolyte Imbalance

There’s a long list of conditions that lead to electrolyte imbalances, including dehydration, diabetic ketoacidosis, cancer, and even head injury. But renal disease is at the top of the list.  It’s the kidneys’ job to control fluid, electrolyte, and acid-base balance.

Because too much or too little of any one of the electrolytes quickly becomes a major problem of its own, doing everything possible to maintain the proper balance is a vital component of health. 

  • Muscle aches, spasms, twitches and weakness
  • Restlessness
  • Anxiety
  • Frequent headaches
  • Feeling very thirsty
  • Insomnia
  • Fever
  • Heart palpitations or irregular heartbeats
  • Digestive issues like cramps, constipation or diarrhea
  • Confusion and trouble concentrating
  • Bone disorders
  • Joint pain
  • Blood pressure changes
  • Changes in appetite or body weight
  • Fatigue (including chronic fatigue syndrome)
  • Numbness and pain in joints
  • Dizziness, especially when standing up suddenly

To diagnose an electrolyte imbalance, your doctor can perform a few different tests to determine your electrolyte levels. Most likely your health care provider will discuss your medical history with you, any reoccurring symptoms you experience, and take a urine and blood test to identify any abnormalities.

It’s also sometimes necessary to have an EKG test, ultrasound or X-rays of your kidneys in order to look for severe electrolyte imbalances that can put you at risk for heart complications.

Your doctor will look for any noticeable changes in optimal electrolyte levels, including very high or low potassium, magnesium or sodium levels. These are usually fairly easy to spot since the body works very hard to keep electrolyte concentrations within a narrow range. Levels are measured per liter of blood, and an electrolyte imbalance is diagnosed when you either have a value higher or lower than the normal ranges below:

  • Calcium: 5–5.5 mEq/L
  • Chloride: 97–107 mEq/L
  • Potassium: 5–5.3 mEq/L
  • Magnesium: 1.5-2.5 mEq/L
  • Sodium: 136–145 mEq/L

How do you know when it’s time to speak with a doctor about whether or not you might have an electrolyte imbalance? If you can identify with the descriptions of electrolyte imbalance symptoms below, it’s best to talk visit a health care provider to talk about how to reverse the problem and prevent it from happening again.

Here are some of the common signs of experiencing an electrolyte balance and a bit more about what can cause each one:

Changes in Heartbeat

When potassium rises to very high levels, a condition called hyperkalemia develops. This interferes with the normal signals sent from nerves to muscles, which can result in muscles becoming weak, tingly or numb. At the same time, high potassium can impact your heartbeat and cause rapid rhythms that make you feel anxious. Also, one of the main effects of high calcium levels is on the cardiovascular system and electrical transmission pathways of the heart, so very high calcium levels are another common cause of heartbeat changes.

Anxiety and Trouble Sleeping

Most of us know how hard it is to fall and stay asleep when we have muscle spasms, a fast heartbeat or night sweats. Despite feeling like you’re always tired, low magnesium levels and high potassium can cause trouble getting good rest because of ongoing pains and mental disturbances.

Muscle Spasms

When dehydration occurs or potassium and magnesium levels fall abruptly, muscle weakness and spasms are usually some of the first signs. Very low potassium levels (hypokalemia) can also cause cramps and constipation. Low calcium levels (hypocalcemia) also causes muscle spasms, cramps, abdominal muscle pain and convulsions.

Digestive Issues

The muscles within your digestive tract need to contract properly in order to help you go to the bathroom. So, either high or low levels of electrolytes can result in diarrhea, constipation, cramping or hemorrhoids. Nausea is also sometimes caused by very low sodium levels (called hyponatremia). This same condition can be followed by headaches, disorientation and respiratory problems when it’s left unresolved.

Bone Pains

Very high calcium levels (called hypercalcemia) can result in bone fractures, painful kidney stones, vomiting and constipation. The same condition can also make you feel tired and weak, with trouble concentrating. Confusion, Dizziness and Irritability:

When your sodium levels rise too drastically (called hypernatremia), you can become dizzy and weak. When this worsens, it’s possible to become even more delirious and even experience a seizure or coma.

How to Solve an Electrolyte Imbalance

1. Adjust Your Diet

The first step to correcting an electrolyte imbalance is to identify how it developed in the first place. For many people, a poor diet that’s high in processed foods containing lots of sodium, but low in other electrolytes like magnesium or potassium, paves the way for a dangerous imbalance. In many cases, a minor electrolyte imbalance can be corrected by simply making dietary changes and cutting way back on junk foods, takeout and restaurant foods, while instead cooking more fresh foods at home.

Focus your diet around a Whole Food Plant-Based diet.  Remove packaged foods and pre-cooked / fast foods from your diet.  This link will provide you with more information on what to remove from your diet.   Make sure that your diet is made up of plenty of vegetables and fruits that provide potassium and magnesium. Some of the best include leafy greens, cruciferous veggies like broccoli or cabbage, starchy vegetables like sweet potatoes or squash, bananas, and avocados. A diet that’s rich in magnesium or potassium likely can be enough to solve problems like low potassium levels that can lead to blood pressure problems or magnesium deficiency that can contribute to anxiety, restlessness and muscle cramps.

To prevent dehydration and restore electrolytes, focus on these foods — which are some of the most hydrating due to being very water-dense:

  • Coconut water
  • Celery
  • Watermelon
  •  Cucumber
  • Kiwi
  • Bell peppers
  • Citrus fruit
  • Carrots
  • Cultured dairy – goat or sheep (kefir/yogurt)
  • Pineapple

Another thing to consider is whether you’re consuming enough calcium – it is possible to get calcium from leafy greens, other veggies, beans and legumes. Follow this link for more information on obtaining sufficient calcium in your diet.

2. Monitor Your Sodium Intake

If your diet is packed with processed and pre-packaged foods rather than whole foods, its important to check your sodium levels.  Your doctor can do this for you.  Sodium plays an important role in the body’s ability to release or hold on to water.  If the food you are eating is full of sodium (junk and processed foods), more water will be excreted by the kidneys which can cause problems in the body trying to balance your electrolytes.  

Although sodium is often blamed for being the cause of high blood pressure, it does play several essential roles in the body – so it is NEEDED.  Sodium regulates the function of muscles and nerves as well as controls blood pressure, but many people consume far too much sodium through in improper diet.

3. Drink Enough Water 

Electrolyte imbalances can develop when the amount of water in your body changes, either causing dehydration (not enough water compared to certain elevated electrolytes) or overhydration (too much water).  Drinking enough water, without over-diluting your cells, helps stop levels of sodium and potassium from rising too high or too low.

Eight Glasses A Day is the usual standard recommendation, but one needs to take into account various factors such as age, diet, physical activity, body size and of course your diet.  These factors determine how much water your body needs.  A good rule of thumb is to drink enough so you urinate at least every three to four hours, which for most people is around eight to 10 eight-ounce glasses daily.  This link will give you some valuable water tips and read here about hydration and dehydration.

4. Check Your Medications

Antibiotics, diuretics, hormonal pills, blood pressure medications and cancer treatments can all impact electrolyte levels. The most serious forms of electrolyte imbalances are usually seen in cancer patients receiving chemotherapy. Their symptoms can be very serious when not properly managed and include high blood calcium levels or other imbalances that develop when cancer cells die off.

If you’ve started a new medication or supplement and notice changes in your mood, energy, heartbeat and sleep, talk to your doctor about possibly changing your dose to minimize electrolyte imbalance risks.

5. Refuel After Exercise

You don’t need to gulp down litres of water after a workout, but do make sure you eat a balanced meal after your workout and that you have some water throughout the rest of the day. If you notice yourself feeling dizzy or heavily cramping up, try drinking lots of fluids immediately and consuming electrolytes until you feel better. Both water and sodium need to be replaced after workouts to re-establish “normal” body water levels.

A quick way to replenish electrolytes is to make your OWN electrolyte drinks.  The simplest of which is a squeeze of lime or lime in some clean spring water with a pinch of salt.  Do not buy pre-made electrolyte drinks as they are usually PACKED with sugar.  On average, one cup of lemon juice provides 55 mg of calcium, 293 mg of potassium, 17 mg of magnesium and only a trace of sodium.