Electrolyte Imbalance: Symptoms, Causes and When to Seek Care

Urgent signs first

Get urgent help (in the US, call 911) for confusion, a seizure, fainting or loss of consciousness, a very irregular or racing heartbeat, or severe weakness, especially after vomiting, diarrhea, heavy sweating, or in someone with kidney or heart disease. MedlinePlus says low blood sodium and low magnesium can each become a life-threatening emergency, and that a large drop in blood potassium may cause abnormal heart rhythms. [1][2][3] For dehydration, MedlinePlus advises calling 911 or the local emergency number if the person loses consciousness, shows a change in alertness such as confusion or seizures, or does not improve despite treatment. [4] Do not try to sort out the cause yourself first.

What an electrolyte imbalance is

An imbalance means the level of one or more electrolytes in the body is too low or too high. [5] It can happen when the amount of water in the body changes. [5] The main electrolytes are described on What electrolytes do.

Common causes

MedlinePlus lists these common reasons for an imbalance: certain medicines, severe vomiting or diarrhea, heavy sweating, heart, liver or kidney problems, not drinking enough fluids during intense exercise or very hot weather, and drinking too much water. [5] Specific pages add detail:

• Diuretic ("water pill") medicines can lower sodium through increased urine loss. [1]
• Diarrhea, vomiting and laxative overuse are listed among causes of low potassium. [3]
• Some medicines, including diuretics and proton pump inhibitors, are listed among causes of low magnesium. [2]
• High potassium can reflect kidney disease, and certain medicines and supplements may raise potassium levels. [6]

What people may notice

Symptoms overlap between electrolytes and with many other conditions, so they cannot say which electrolyte is involved. Examples the sources list:

For potassium, a small drop often causes no symptoms or mild ones. [3] Cramps, weakness and tiredness appear in several rows above, so they cannot point to one electrolyte, and they have many other causes.

How it is checked

A blood test called an electrolyte panel can check the levels of the main electrolytes. [5] A basic metabolic panel, also called an electrolyte panel or chem 7, is a common version. [8] Sodium, potassium, chloride and calcium appear in it. [9] Lab ranges differ slightly, and an out-of-range result does not always mean a condition that needs treatment. [10] MedlinePlus gives 136 to 144 mEq/L as a typical sodium range and 3.5 to 5.1 mEq/L for potassium, noting that ranges vary by laboratory. [1][3] Medicines, age, sex and other conditions can change sodium results. [10]

Treatment is clinician-led

Treatment depends on which electrolytes are out of balance, whether there is too little or too much, and what is causing it. [5] In minor cases a diet change may be enough; in others replacement by mouth or IV is used, and too much of an electrolyte may need medicines, fluids or, in severe cases, dialysis. [5] The cause of low blood sodium must be diagnosed and treated. [1] Do not self-treat a suspected imbalance with powders, salt tablets or potassium or magnesium supplements; MedlinePlus says not to take salt tablets for dehydration because they can cause serious complications. [4]

Where to go next

• Illness with vomiting or diarrhea: Oral rehydration solutions.
• Low sodium specifically: Hyponatremia.
• Kidney disease: Minerals and kidney disease.