Low chloride level and symptoms
A reduced chloride level in the blood is more common than an increase, but causes similar complaints. Again, minimally reduced chloride levels do not cause any symptoms and it is only when low chloride levels persist for a long time that the first symptoms appear. Here too, nausea and vomiting are very common as well as headaches, dizziness, malaise and heart stumbling.
Isolated chloride deficiency is often rare. Much more common is a lack of all electrolytes. Very often, after frequent and strong vomiting, there is a lack of chloride in the blood.
The reason is that important electrolytes such as sodium and chloride leave the body through vomiting and cannot be replenished as quickly by eating or drinking. Many patients who have a severe gastrointestinal infection must be treated with the help of infusions so that they do not lose too many nutrients and electrolytes. A hormone-related chloride deficiency is caused by hyperaldosteronism, in which the body produces too much aldosterone.
In Cushing’s disease, too much cortisone is released into the body, which can also lead to a reduced chloride level in blood serum. Rather less frequent are so-called ACTH-forming tumours, which can also lead to a chloride deficiency via complex hormone control processes. All substances that have flushing properties can lead to a chloride deficiency when administered medicinally.
The furosemide or torasemide prescribed as a water tablet can cause chloride, sodium and potassium deficiency via increased water excretion via the kidneys. Patients who are lying in intensive care, for example, and are fed through a stomach tube, may also have a very low chloride level if they lie in bed for a long time. The most common cause of a chloride deficiency in blood serum is heavy sweating and reduced drinking.
In principle, the first step is to find out where this reduced value comes from. The triggering causes must then be switched off or reduced. Afterwards, if there is a slight to moderate chloride deficiency, it should be checked whether the chloride value will stabilise and increase again on its own.
If this is not possible, chloride should be added additionally. This is usually done by administering saline tablets (NaCl). If this is not sufficient, an infusion can also ensure that chloride is supplied to the body for a foreseeable period of time.
