Electrolytes

What are electrolytes?

Electrolytes are substances that have a natural positive or negative electrical charge when dissolved in water. An adult’s body is about 60% water, which means nearly every fluid and cell in your body contains electrolytes. They help your body regulate chemical reactions, maintain the balance between fluids inside and outside your cells, and more.

Your body gets electrolytes or their components from what you eat and drink. Your kidneys filter excess electrolytes out of your body and into your urine. You also lose electrolytes when you sweat.

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Key terms to know:

• Hyper-: A condition that starts with “hyper” means it involves too much of something.
• Hypo-: A condition that starts with “hypo” means it involves too little of something.
• Ion: An atom that has an electrical charge.
• Cations: Ions with a positive charge.
• Anions: Ions with a negative charge.
• pH: A scale that measures whether a liquid is an acid or base. Your body’s natural blood pH is between 7.36 and 7.44.
• Acidic: Has a pH of less than 7.
• Neutral: Has a pH of 7.
• Basic: Has a pH of more than 7 (basic is also known as “alkaline”).

What do electrolytes do?

Your cells use electrolytes to conduct electrical charges, which is how your muscles contract. Those same electrical charges also help with chemical reactions, especially when it comes to hydration and the balance of fluids inside and outside of cells.

The key principle that electrolytes rely on is that certain chemical elements can naturally hold a positive or a negative electrical charge. When those elements are dissolved in a liquid, that liquid can then conduct electricity.

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An example of this is salt water, which conducts electricity easily. Salt consists of sodium (positively charged) and chlorine (negatively charged), and when combined, their charges balance each other out. Atoms with an electrical charge are called ions (positive ions are called cations, while negative ions are called anions).

Dissolving salt in water splits the sodium and chlorine atoms apart, which means they go back to being positively and negatively charged. Electricity jumps between the sodium and chlorine ions — not the water molecules — because they have opposite electrical charges.

At the most basic chemical level, electrolytes help your body maintain balance. Just like electricity uses ions to travel from place to place in salt water, your body uses ions to transport chemical compounds in and out of cells.

What are the key electrolyte components?

There are several key elements that your body needs to maintain normal electrolyte levels. The following section includes the major elements, marked as positive (+) or negative (-), and what happens when there’s too much or too little of that element.

Sodium (+)

Sodium plays a critical role in helping your cells maintain the right balance of fluid. It’s also used to help cells absorb nutrients. It’s the most abundant electrolyte ion found in the body.

• Hypernatremia (too much sodium): Can cause confusion or behavior changes, unusually strong reflexes and loss of muscle control, seizures and coma.
• Hyponatremia (not enough sodium): Confusion, irritability, weakened reflexes, nausea and vomiting, seizures and coma.

Magnesium (+)

Magnesium helps your cells as they turn nutrients into energy. Your brain and muscles rely heavily on magnesium to do their job.

• Hypermagnesemia (too much magnesium): Heart rhythm changes and arrhythmias, weakened reflexes, decreased ability to breathe and cardiac arrest (your heart stops).
• Hypomagnesemia (not enough magnesium): Muscle weakness, twitching and loss of control, heart arrhythmias. This commonly happens in connection with calcium and potassium deficiencies.

Potassium (+)

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Your cells use potassium alongside sodium. When a sodium ion enters a cell, a potassium ion leaves, and vice versa. Potassium is also especially critical to your heart function. Too much or too little can cause serious heart problems.

• Hyperkalemia (too much potassium): Weakness, inability to move muscles, confusion, irregular heart rhythms (arrhythmias).
• Hypokalemia (not enough potassium): Muscle weakness and cramps, feeling unusually thirsty and needing to pee frequently, dizziness or passing out when standing up too quickly. At higher levels, muscle tissue begins to break down (a condition called rhabdomyolysis, which can severely damage your kidneys) and heart arrhythmias become a serious threat.

Calcium (+)

Calcium is a key element in your body, but it does more than just build strong bones and teeth. It’s also used to control your muscles, transmit signals in your nerves, manage your heart rhythm and more. Having too much or too little calcium in your blood can cause a wide range of symptoms across different systems in your body.

Hypercalcemia (too much calcium)

• Brain: Headache, fatigue, apathy and confusion.
• Digestive tract: Constipation, abdominal pain and vomiting.
• Kidneys: Frequent need to pee, kidney stones and kidney failure.
• Heart: Arrhythmias, some of which can be severe.
• Skeletal: Pain in the bones and joints.

Hypocalcemia (not enough calcium)

• Brain: Confusion and behavior changes.
• Muscles: Unusually strong reflexes and loss of muscle control, muscle twitching, spasms in the throat muscles making it hard to speak or breathe.

Chloride (-)

Chloride (the name for a chlorine ion) is the second-most abundant ion in the body. It’s also a key part of how your cells maintain their internal and external balance of fluid. It also plays a role in maintaining the body’s natural pH balance.

Hyperchloremia (too much chloride)

This can cause acidosis, which is when your blood’s acidity is too high. It results in nausea, vomiting and fatigue, as well as rapid, deeper breathing and confusion. This usually happens in connection with too much or too little potassium.

• When related to hyperkalemia: When associated with too much potassium, it can cause severe kidney problems or kidney failure.
• When related to hypokalemia: When connected with too little potassium, it can cause diarrhea, fluid leakage from the pancreas, and other serious urinary tract problems.

Hypochloremia (not enough chloride)

• This causes your blood to become more alkaline, a condition called alkalosis. It usually happens with hyponatremia or vomiting. Symptoms of alkalosis are apathy, confusion, arrhythmias and muscle twitching or loss of control.

Phosphate (-)

Phosphate is a phosphorous-based molecule that’s a key part of transporting chemical compounds and molecules outside your cells. It helps your cells metabolize nutrients, and it’s also a key part of molecules called nucleotides, which are the building blocks that make up your DNA.

• Hyperphosphatemia (too much phosphate): This typically causes you to experience hypocalcemia because your body tries to use calcium as a substitute for phosphorus. It usually doesn’t cause symptoms until it becomes severe, and symptoms of hypocalcemia also often happen with this. It can also be associated with excessive itching.
• Hypophosphatemia (not enough phosphate): The early symptom of this condition is usually muscle weakness. As it gets worse, more severe symptoms occur. They include rhabdomyolysis (breakdown of muscle tissue, which can cause severe kidney damage), seizures, reduced heart function and trouble breathing (caused by muscle weakness).

Bicarbonate (-)

Not all the carbon dioxide that your body makes gets sent to your lungs for you to breathe it out. Instead, some gets recycled into bicarbonate, which your body uses to keep your blood pH levels normal.

• Acidosis. Too little bicarbonate causes acidosis, where your blood is too acidic. This causes fatigue, nausea and vomiting, and you will breathe faster and deeper. It can also cause confusion.
• Alkalosis. Too much bicarbonate causes alkalosis, where your blood becomes too alkaline. Symptoms include confusion, apathy, arrhythmias and muscle twitching.

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