Electrolyte Imbalance: Causes, Symptoms & Treatment

Electrolytes such as sodium and magnesium perform important functions in the body’s cells. An electrolyte disorder is said to occur when the electrolytes found in a blood analysis are elevated or decreased. The consequences can vary depending on the exact disorder, as can treatment and therapeutic prospects.

What is an electrolyte disorder?

The electrolytes present in the body are bicarbonate, calcium, chloride, potassium, magnesium, sodium, and phosphate. The normal level of each electrolyte varies. For example, sodium is balanced at about 100g in a normal weight person and magnsium is found at about 25g in a healthy person. Calcium, which is responsible for building bones and teeth and is an important component of them, is present in the human body at approximately 1.1kg. The naming of the present electrolyte disorder is as follows: The name begins with the prefix hyper or hypo as a definition of increased or decreased level. The name of the electryolyte is found in the root word, and the suffix is always -emia, meaning blood. -emia is appended because the disorder is diagnosed by blood analysis, but the disease always manifests throughout the body. So examples of the correct term are hypernatremia and hyponatremia and hypercalcemia and hypocalcemia, respectively, the most common electrolyte disorders.

Causes

The causes of electrolyte deficiencies vary, but usually, if the amount is too low, it can first be assumed that there is an insufficient intake of the corresponding electrolyte. The reasons for this may be an incorrect or one-sided diet, a manifest eating disorder, and inadequate fulfillment of an increased requirement due to stress, exercise, or pregnancy. Other possible causes are chronic intestinal diseases, alcohol and drug consumption that confuse electrolyte metabolism, kidney diseases and metabolic diseases. Rarely, cancer is found to be the cause. The causes of an over-supply of electrolytes are also varied and depend on the specific electrolyte disorder. The underlying cause is always a disturbed metabolism of the electrolyte in question, as can occur, for example, in tumors, familial predisposition, organ damage or electrolyte overdose. Determining the exact cause is important in order to initiate adequate therapy.

Symptoms, complaints, and signs

In any case, an electrolyte disorder has a negative effect on the health of the affected person and can lead to various complaints and complications in the process. As a rule, however, the symptoms and complaints are very much dependent on the exact deficiency symptom, so that here no general prediction can be made. However, those affected often suffer from sensory disturbances or paralysis. Pain and cramps in the muscles can also occur and make everyday life much more difficult for the affected person. There are also twitches in the muscles and often an increased irritability of the patient. Likewise, general weakness and fatigue may result from the electrolyte disturbance, so that the affected person appears fatigued and no longer actively participates in everyday life. Furthermore, the patient’s heart can also suffer from these complaints, so that disturbances of the heart rhythm occur, which in the worst case can also lead to the death of the patient. In some cases, the electrolyte disturbance also has a negative effect on sensory perception, resulting in disturbances of smell or taste. This also significantly reduces the patient’s quality of life.

Diagnosis and course

The diagnosis of an electrolyte disorder first requires a detailed medical history in which the patient and the attending physician discuss the presenting symptoms. The symptoms described in the presence of an insufficiency are clear and provide the physician with important clues to the presence of an electrolyte disorder. It can be problematic that in the case of an oversupply, diffuse symptoms occur, including poor performance, fatigue and rapid physical exhaustion. In order to verify the suspicion of electrolyte disturbance, to be able to name the disturbance concretely and to initiate an adequate treatment, the physician must take a blood sample. In the laboratory, with a simple blood draw, all electrolyte levels can be determined and compared with the level defined as the norm.For example, magnesium levels should be 0.7 to 1 mmol per liter, calcium levels 2 to 2.8 mmol/l, and sodium levels 130 to 150 mmol/l. A mild form of electrolyte imbalance is harmless, but as the disease progresses, severe symptoms, edema, and death may result if treatment continues to fail.

When should you see a doctor?

In most cases, an electrolyte imbalance is not something that requires urgent treatment. It often progresses without symptoms, especially in the case of a mild deficiency, and is discovered at most by an incidental finding. Harmless cases can often be treated by a balanced diet or the temporary use of over-the-counter dietary supplements from pharmacies, drugstores or health food stores, without the need for a visit to the doctor. Nevertheless, there are cases in which medical advice is important. For example, if a deficiency of potassium leads to cardiac arrhythmias, the doctor must record the current potassium level in order to ensure that the substitution is in line with requirements. This is necessary because an overdose of potassium can be dangerous to the patient. A visit to the doctor is also often helpful in the case of iron deficiency, for example, in order to find out and treat a cause that requires gynecological treatment or bleeding in the area of the stomach or intestines as the reason. Also the control of the iron level or if necessary necessary infusions are only possible with a doctor. Chronic diarrhea or other intestinal problems are often the cause of an electrolyte disorder. Here, too, the doctor can help. In principle, it is better to treat the cause than to keep taking magnesium or other minerals to treat the symptoms. In this context, it is also important that older people and pregnant patients better consult the doctor before taking electrolytes on their own due to their special life situation.

Treatment and therapy

The treatment of electrolyte disorder depends on the specific disorder on the one hand, of course, and on the severity and cause on the other hand. In the case of a mild electrolyte disorder, a change in diet and, if necessary, the intake of chemical electrolytes for a certain period of time are the right choice. On the other hand, in the case of causative underlying diseases, these must be treated primarily in order to be able to regulate the under- or oversupply permanently. As an example, the treatment options for sodium and calcium disorders are presented below. The treatment of choice for hypernatremia is oral or intravenous increase of fluid intake under controlled conditions. Hyponatremia, on the other hand, is treated with slow and controlled fluid deprivation and/or increased intake of saline via food or infusion. Supportive vitamin D is given for hypocalcemia in long-term treatment. Symptomatic treatment may help attenuate acute symptoms.

Outlook and prognosis

In mild electrolyte imbalance, the prognosis is usually good. Dietary changes can easily compensate for an existing deficiency or excess supply of electrolytes. Medical treatment is not mandatory in these patients. If the food intake is consistently adhered to, the symptoms will be alleviated after only a few days. If the change in food is not sufficient, an artificial supply of electrolytes will help if a deficiency is detected. These can be easily purchased in pharmacies and used regularly. Within a short time, freedom from symptoms is achieved in most cases. Subsequently, regular monitoring should take place, as the electrolyte disorder can recur at any time. In the case of a severe electrolyte disorder, medical treatment is necessary. A large number of patients suffer from an underlying disease that must be diagnosed and treated. In these patients, the electrolyte disturbance is a symptom of another disease. The prognosis of the underlying disease must be assessed individually. If a cure of the underlying cause is achieved, the electrolyte disturbance disappears at the same time. Thus, complete recovery takes place in these patients. If the underlying disease cannot be cured, long-term therapy must be expected. Without medical care, the patient with a severe electrolyte deficiency faces an early demise.

Prevention

Electrolyte imbalance caused by disease cannot be counteracted.Prevention of nutritional insufficiency or oversupply, on the other hand, is possible with a balanced diet.

Follow-up

In most cases of electrolyte imbalance, the options for follow-up care are very limited. First and foremost, a comprehensive examination with subsequent treatment must be performed to prevent further complications. The earlier the electrolyte disorder is detected, the better the further course of this disease usually is. In most cases, the underlying disease must be treated first in the case of an electrolyte disorder. For this reason, aftercare is mainly aimed at preventing the recurrence of the underlying disease. In many cases, those affected also depend on taking medications and other drugs or vitamins to completely alleviate the symptoms of the electrolyte imbalance. When taking medications, the affected person should always make sure to take the medications regularly and correctly in order to completely relieve the symptoms. Furthermore, the support and help of friends and family can be very helpful in the case of electrolyte imbalance and support the affected person in his daily life. Changing the diet can also be very helpful and contribute to an improvement of the symptoms. In many cases, it is also worthwhile to contact other sufferers of this disease, as this can lead to an exchange of information.

What you can do yourself

Electrolyte balance disorders mean that there is too little or too much of a particular electrolyte or electrolytes in the body. The disordered electrolyte balance may be due to a metabolic disorder, abnormally high consumption, such as during severe fluid loss and prolonged stressful situations, or a very unbalanced diet. As a rule, it is a relative deficiency of a certain electrolyte, which manifests itself by non-specific, but also by specific symptoms. Self-help measures consist in ensuring a balance of the corresponding electrolyte in case of electrolyte deficiency. For example, it is a matter of recognizing situations from the outset that are associated with increased electrolyte consumption or an increased rate of excretion due to continuous physical activity at high outside temperatures and prophylactically ensuring an appropriate balance of fluids including electrolytes. Since it is not possible to check the concentration of individual electrolytes everywhere during everyday life, it is helpful to pay attention to specific symptoms. Calcium deficiency is manifested by cramps, sensory disturbances and increased irritability. Muscle cramps, cardiac arrhythmias and states of weakness are typical of a potassium deficiency. Extraordinary sweating and cramps and muscle twitching typically indicate magnesium deficiency, and zinc deficiency can cause olfactory and gustatory disturbances as well as acne and nail discoloration. If deficiencies of a particular electrolyte develop despite a normal diet and for no other apparent reason, it is essential to investigate the causes so that they can be specifically treated.