The most common sign of low electrolytes is muscle cramping, which can be excruciating and debilitating. The best way to keep electrolytes balanced in your body is by paying attention to your thirst. Jones recommends drinking about two cups of fluid two hours before any physical activity.

Then, try to drink 4 to 6 ounces every 15 to 20 minutes during physical activity. Finally, have a drink after you finish exercising. Staying hydrated is key to maintaining a balance of electrolytes. Water is the most natural choice for hydration. It is less expensive and more available than any other drink.

Coconut water is another alternative for replenishing electrolytes. Coconut water is low on the glycemic index, so it won't dramatically affect your blood sugar.

Studies have also shown that it may help reduce blood pressure and cholesterol — a heart-healthy reason to drink it. However, sports drinks are often more appealing. Sports drinks contain electrolytes and carbohydrates, which replenish body energy.

Many sports drinks have sodium chloride or potassium chloride added to them, which are major electrolytes lost when exercising. The added sugar and flavor in these drinks often entice people to drink a larger quantity compared to water.

Carbonated soft drinks , fruit juices and energy drinks should all be avoided as hydration sources. They contain far too much sugar and empty calories. To adjust fluid levels, the body can actively move electrolytes in or out of cells. Thus, having electrolytes in the right concentrations called electrolyte balance is important in maintaining fluid balance among the compartments.

The kidneys help maintain electrolyte concentrations Water and electrolyte balance The kidneys are bean-shaped organs that figure prominently in the urinary tract.

Each is about 4 to 5 inches 12 centimeters long and weighs about one third of a pound grams. One lies read more by filtering electrolytes and water from blood, returning some to the blood, and excreting any excess into the urine.

Thus, the kidneys help maintain a balance between the electrolytes a person takes in every day by consuming food and beverages and the electrolytes and water that pass out of the body in the urine are excreted.

If the balance of electrolytes is disturbed, a person can develop health issues. For example, an electrolyte imbalance can result from the following:. Becoming dehydrated Dehydration Dehydration is a deficiency of water in the body. Vomiting, diarrhea, excessive sweating, burns, kidney failure, and use of diuretics may cause dehydration.

People feel thirsty, and as dehydration read more or overhydrated Overhydration Overhydration is an excess of water in the body. read more. Rapid sodium corrections can have severe consequences like cerebral edema and osmotic demyelination syndrome ODS.

Other factors like chronic alcohol misuse disorder and malnutrition also play a role in the development of ODS. Potassium is mainly an intracellular ion. The sodium-potassium adenosine triphosphatase pump is primarily responsible for regulating the homeostasis between sodium and potassium, which pumps out sodium in exchange for potassium, which moves into the cells.

In the kidneys, the filtration of potassium takes place at the glomerulus. Potassium reabsorption occurs at the proximal convoluted tubule and thick ascending loop of Henle.

Aldosterone increases potassium secretion. Potassium derangements may result in cardiac arrhythmias. Hypokalemia occurs when serum potassium levels are under 3. The features of hypokalemia include weakness, fatigue, and muscle twitching.

Hypokalemic paralysis is generalized body weakness that can be either familial or sporadic. Muscle cramps, muscle weakness, rhabdomyolysis, and myoglobinuria may be presenting signs and symptoms of hyperkalemia.

Calcium has a significant physiological role in the body. It is involved in skeletal mineralization, contraction of muscles, the transmission of nerve impulses, blood clotting, and secretion of hormones. The diet is the predominant source of calcium.

Calcium is a predominately extracellular cation. Calcium absorption in the intestine is primarily controlled by the hormonally active form of vitamin D, which is 1,dihydroxy vitamin D3. Parathyroid hormone also regulates calcium secretion in the distal tubule of the kidneys.

Hypocalcemia diagnosis requires checking the serum albumin level to correct for total calcium. Hypocalcemia is diagnosed when the corrected serum total calcium levels are less than 8.

Checking serum calcium levels is a recommended test in post-thyroidectomy patients. Humoral hypercalcemia presents in malignancy, primarily due to PTHrP secretion. The acid-base status of the blood drives bicarbonate levels.

The kidneys predominantly regulate bicarbonate concentration and maintain the acid-base balance. Kidneys reabsorb the filtered bicarbonate and generate new bicarbonate by net acid excretion, which occurs through the excretion of titrable acid and ammonia.

Diarrhea usually results in bicarbonate loss, causing an imbalance in acid-base regulation. Magnesium is an intracellular cation. Magnesium is mainly involved in adenosine triphosphate ATP metabolism, proper functioning of muscles, neurological functioning, and neurotransmitter release.

When muscles contract, calcium re-uptake by the calcium-activated ATPase of the sarcoplasmic reticulum is brought about by magnesium. Alcohol use disorder, gastrointestinal conditions, and excessive renal loss may result in hypomagnesemia.

It commonly presents with ventricular arrhythmias, which include torsades de pointes. Hypomagnesemia may also result from the use of certain medications, such as omeprazole.

Chloride is an anion found predominantly in the extracellular fluid. The kidneys predominantly regulate serum chloride levels. Most chloride, filtered by the glomerulus, is reabsorbed by both proximal and distal tubules majorly by proximal tubule by both active and passive transport. Hyperchloremia can occur due to gastrointestinal bicarbonate loss.

Hypochloremia presents in gastrointestinal losses like vomiting or excess water gain like congestive heart failure. Phosphorus is an extracellular fluid cation. Phosphate plays a crucial role in metabolic pathways.

It is a component of many metabolic intermediates and, most importantly, of ATP and nucleotides. Vitamin D3, PTH, and calcitonin regulate phosphate simultaneously with calcium.

The kidneys are the primary avenue of phosphorus excretion. Phosphate imbalance is most commonly due to one of three processes: impaired dietary intake, gastrointestinal disorders, and deranged renal excretion. A blood specimen for electrolytes uses lithium heparin tubes, plus the standard phlebotomy equipment and personnel, as with any blood draw.

Blood is collected in lithium heparin tubes and then goes to the laboratory to evaluate serum electrolytes. Measurement of electrolytes will help clinicians in the diagnosis of a medical condition, the effectiveness of treatment, and the potential side effect of medications.

Examples include:. A patient with heart failure receiving diuretics needs a workup for sodium, potassium, bicarbonate, and magnesium, as diuretics can exert adverse effects on electrolyte balance.

A patient that presents with weakness needs a basic electrolyte workup, as an electrolyte imbalance, especially in sodium and potassium levels, can lead to generalized weakness.

A patient with gastroesophageal reflux disease on long-term proton pump inhibitor therapy should be monitored for hypomagnesemia. Factors such as total protein content, hormones, and total body volume status can biochemically influence electrolyte levels.

Hypomagnesemia can lead to hypocalcemia due to its effects on parathyroid hormone activity. Intravenous insulin administration is associated with a spurious decrease in potassium levels as insulin shifts potassium intracellularly.

Therefore, a patient with hypoalbuminemia, as seen in liver cirrhosis or nephrotic syndrome, will demonstrate artificially abnormal serum calcium levels. Hyponatremia, hypernatremia, and hypomagnesemia can lead to neurological consequences such as seizures.

Hypokalemia and hyperkalemia, as well as hypocalcemia, may cause cardiac arrhythmias. Some consequences of potassium, calcium, and magnesium abnormalities are fatigue, lethargy, and muscle weakness. Patients should be counseled to take all medications exactly as prescribed to avoid any potential adverse effect of electrolyte imbalance.

They should also call for immediate medical help if experiencing generalized weakness, muscle aches, or altered mental status. Disclosure: Isha Shrimanker declares no relevant financial relationships with ineligible companies.

Disclosure: Sandeep Bhattarai declares no relevant financial relationships with ineligible companies. This book is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.

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StatPearls [Internet]. Treasure Island FL : StatPearls Publishing; Jan-. Show details Treasure Island FL : StatPearls Publishing ; Jan-. Search term. Electrolytes Isha Shrimanker ; Sandeep Bhattarai.

Author Information and Affiliations Authors Isha Shrimanker 1 ; Sandeep Bhattarai 2. Affiliations 1 UPMC Pinnacle.