Most athletes are well versed in the importance of electrolytes for the proper functioning of the nerves and muscles and maintaining fluid balance, but many people are unfamiliar with the specific signs of electrolyte imbalances and how to balance electrolytes in cases where an electrolyte balance does occur.
Key electrolytes in the body, such as sodium, potassium, magnesium, and calcium, must be maintained within certain parameters individually and in certain ratios compared to one another in order to support all of the many functions they perform.
So, what are electrolyte imbalance symptoms? Are the low electrolyte symptoms different from those when your electrolyte levels are too high?
In this article, we will discuss signs of an electrolyte imbalance, how to diagnose and treat electrolyte imbalances, and how to balance electrolytes to prevent an imbalance in the first place.
We will cover:
- What Are Electrolytes?
- What Is an Electrolyte Imbalance?
- Signs You May Have an Electrolyte Imbalance
- How to Diagnose and Treat an Electrolyte Imbalance
- How to Balance Electrolytes
Let’s jump in!
What Are Electrolytes?
Electrolytes are minerals that have an electrical charge (termed ions) when they dissolve in body fluids like blood and urine.
The primary electrolytes in the human body are sodium, potassium, magnesium, calcium, chloride, phosphate, and bicarbonate.
There are numerous physiological functions of electrolytes in the body. Here are some of the primary functions of each of the main electrolytes in the human body:
- Sodium helps manage proper fluid balance in the body and is vital for nerve conduction and muscle contraction.
- Potassium supports the functions of the heart, nerves, and muscles and helps shuttle nutrients into cells and waste out of cells. It also is involved in cellular respiration, the pathways that produce ATP, which is cellular energy.
- Calcium plays numerous physiological roles, such as aiding muscle contraction, the contraction of the smooth muscle in blood vessels, stabilizing blood pressure, conducting nerve impulses, aiding hormone secretion, creating enzymes, and supporting bone health.
- Magnesium aids nerve conduction and muscle contraction and supports bones, teeth, and healthy sleep.
- Chloride helps maintain the optimal fluid balance in the body to regulate blood pressure.
- Phosphate is also involved in nerve and muscle function and is crucial for bones and teeth.
- Bicarbonate plays a pivotal role in maintaining the proper acid/base balance in the body (pH) and helps remove excess carbon dioxide in circulation.
What Is an Electrolyte Imbalance?
We often hear about having depleted electrolytes after exercise or perhaps after becoming ill with a stomach virus that involves a lot of vomiting and diarrhea or other sorts of causes of significant dehydration.
In these types of cases, it may be that all of the major electrolytes in the body are simultaneously at low levels. This isn’t necessarily an “imbalance“ per se, as much as it is an instance of electrolyte depletion or simply insufficient electrolytes.
An electrolyte imbalance can also occur in instances where one or more of the major electrolytes are present in sufficient quantities in the body, whereas one or more is notably low.
An electrolyte imbalance can also occur when you have too much of one electrolyte in your body above normal healthy levels.
| Electrolyte | Electrolyte Imbalance With an Excessive Level | Electrolyte Imbalance With an Insufficient Level |
| Sodium | Hypernatremia | Hyponatremia |
| Potassium | Hyperkalemia | Hypokalemia |
| Calcium | Hypercalcemia | Hypocalcemia |
| Chloride | Hyperchloremia | Hypochloremia |
| Magnesium | Hypermagnesemia | Hypomagnesemia |
| Phosphate | Hyperphosphatemia | Hypophosphatemia |
| Bicarbonate | Alkalosis (low alkaline base) | Acidosis (high acid levels) |
Signs You May Have an Electrolyte Imbalance
Overall, signs that you have an electrolyte imbalance will depend on the particular electrolyte or electrolytes that are either abnormally low or high and the severity of the electrolyte imbalance.
For example, low electrolyte symptoms will usually differ from high electrolyte signs.
A mild electrolyte imbalance may not manifest in noticeable symptoms. On the other end of the spectrum, a severe electrolyte imbalance can cause a host of concerning symptoms, and certain electrolyte imbalances—such as hyponatremia (low sodium) can result in comas, seizures, cardiac arrest, permanent neurological damage, and can even potentially be lethal.
According to the Cleveland Clinic, some of the most common electrolyte imbalance symptoms and signs include:
- Confusion
- Irritability
- A rapid or slow heartbeat (tachycardia and bradycardia, respectively)
- Abnormal heartbeat (arrhythmia)
- Nausea
- Vomiting
- Headaches
- Numbness and tingling in your limbs and extremities
- Fatigue
- Diarrhea
- Constipation
- Coordination issues
- Muscle cramps, muscle spasms, muscle weakness
How to Diagnose and Treat an Electrolyte Imbalance
It may be possible for you to self-diagnose an electrolyte balance, particularly if you are noting the common signs and have reason to believe that your electrolytes levels might be off for one reason or another (for example, after a hard workout, stomach virus, or consuming too much sodium or magnesium too quickly).
Electrolyte imbalances can also be detected via a blood test, such as a basal metabolic panel (BMP) or comprehensive metabolic panel (CMP).
Your healthcare provider will usually order one of these two tests during a routine annual physical exam, but they may also be ordered if you are hospitalized, are experiencing concerning signs of an electrolyte imbalance or other disease state, or have certain health conditions that require frequent blood work, such as type 2 diabetes.
Treatment for electrolyte imbalances will depend on the type and severity of electrolyte imbalance you are experiencing.
Rehydrating and consuming a well-balanced diet or an electrolyte-based oral rehydration solution (ORS) is often sufficient to correct mild to moderate electrolyte imbalances.
However, more aggressive treatment may be necessary for severe electrolyte imbalances. This might include IV fluids with sodium chloride to rehydrate your body, IV medications that help restore the proper electrolyte balance, and/or hemodialysis in cases where the electrolyte imbalances are caused by kidney failure or severe kidney damage.
How to Balance Electrolytes
As with most health-related conditions, preventing an electrolyte imbalance is ideal.
This can be accomplished by ensuring you are eating a well-balanced diet, hydrating properly, and replacing electrolytes lost in sweat, particularly when your workouts are longer than 60 minutes.
The National Athletic Trainers’ Association Position Statement states that plain water should be sufficient before, during, and after workouts lasting an hour or less, provided you have a well-balanced diet, an average sweat rate, and didn’t have an extremely intense workout.
However, beyond an hour or so, you should make sure you are replacing electrolytes lost in sweat. Additionally, there is a large body of evidence to suggest that hydrating beverages that combine carbohydrates (particularly glucose and fructose) with electrolytes can increase the absorption of water and electrolytes and improve hydration.
According to the American College of Sports Medicine’s (ACSM) position stand on Exercise and Fluid Replacement, the electrolyte needs of athletes depend on their sweat rate and specific sweat concentration, and there aren’t specific recommendations.
With that said, if you are looking for how to balance your electrolytes to prevent electrolyte imbalances, the recommendations for each electrolyte for general health include the following:
- Sodium: Given the association of sodium and hypertension, rather than a recommended minimum, there’s a recommended maximum of 1,500 mg of sodium per day (ideally), with a firm maximum of 2,300 mg.
- Potassium: The recommended intake is 3,400 milligrams (mg) for adult males and 2,600 mg for adult females per day.
- Calcium: The recommended intake is 1,000 mg for all adults aged 19–50 and males aged 51–70, while females aged 51 or over and males aged 71 and over should strive for 1,200 mg per day.
- Magnesium: The recommended intake is 400 mg for males aged 19–30 and 420 mg for males aged 31 and over. It is 310 mg for females aged 19–30 and 320 mg for females aged 31 and over.
- Phosphorus: The recommended intake is 700 mg for adults over the age of 18.
- Chloride: Because nearly all dietary sources of chloride come from table salt (sodium chloride), the recommended intake for chloride is the same as sodium.
Consuming a well-balanced diet with foods from all the major food groups (whole grains, vegetables, fruits, seeds and nuts, legumes, dairy, meat and fish, and healthy fats) can usually provide all the electrolytes you need for optimal health and athletic performance.
For example, many nuts and whole grains are great sources of magnesium, and fruits (such as avocados and bananas) and dairy products provide potassium. Dairy products and green vegetables provide calcium, while phosphorus is found in most meat, fish, seeds, and legumes.
However, if you are concerned about meeting your electrolyte needs, or incurring specific electrolyte imbalances, work with your doctor or a nutritionist, and inquire if taking an electrolyte supplement is a good idea.
To ensure you get enough electrolytes through your diet, check out our guide on 50 Great Sources Of Natural Electrolytes.
