Electrolyte imbalances

The human body consists largely of water, which contains so-called electrolytes. Electrolytes are ions that are essential for the acid-base balance and the creation of membrane potentials. These membrane potentials ensure the transmission of stimuli in the nervous system and control our muscle activity, both of the skeletal muscles and the heart muscle. The most important representatives are sodium, potassium, chloride, calcium, magnesium, phosphate and hydrogen carbonate ions.

Electrolyte imbalances can therefore be life-threatening if they are not corrected early on. Fortunately, this can usually be done easily by adding mineral water and foods like table salt, whole grains, and milk.


Electrolyte disturbances usually arise when the body's water balance is out of balance. There is either an excess of water (overhydration) or a lack of water (dehydration). Depending on the ratio of water to electrolytes being lost or excess, both situations can result in both an electrolyte deficiency and an electrolyte excess. The causes for this can be varied.

They find out, How to recognize the lack of fluids in dehydration.

Sweating as the cause

Exercise, a sauna session or simply a hot summer day lead to sweating and thus inevitably to an electrolyte disorder. Sweating is called hypertonic dehydration. This means that both water and electrolytes are withdrawn from the body, but significantly more water is lost in proportion. The remaining electrolytes in the blood are thereby less diluted and consequently rise. So there is initially an excess of electrolytes. In the longer term, however, the water is absorbed more strongly and this results in an electrolyte deficiency.

To prevent such an electrolyte imbalance, it is important to drink enough. Mineral or tap water are completely sufficient as a source of electrolytes, as they contain the required ions in dissolved form and these can be absorbed by the body so quickly.

The so-called “isotonic” drinks are offered especially for athletes. These contain a similar concentration of electrolytes as those in the blood, which is why the body can absorb them particularly well. However, these beverages often contain flavor enhancers and sugar to balance out the salty taste of the electrolytes. Alternatively, you can mix an apple spritzer with juice and water in a ratio of 3: 1.

Drug-induced electrolyte disorders

Taking certain medications can also cause electrolyte imbalances. Above all, dehydrating / diuretic drugs (diuretics) and laxatives should be mentioned. Regular blood tests are essential for long-term use.
Antibiotics can have a similar effect.
The drugs mentioned should therefore by no means be dosed independently, but always in consultation with the attending physician.

Gastrointestinal disorders

Electrolytes from liquid and solid food are absorbed (resorbed) by the body in the intestine. If there are problems in the gastrointestinal tract, this also affects the electrolyte balance. Possible causes can be:

  • Improper parenteral nutrition (via the blood vessel system)
  • Malnutrition (e.g. due to chronic absorption disorders, eating disorders or chronic alcohol abuse)
  • diarrhea
  • Vomit

Kidney or adrenal disorders

The kidney is the most important organ in the regulation of the fluid and electrolyte balance. But the adrenal gland also produces hormones that have a major impact on it.

Chronic kidney disease leads to a reduced function of the filter system as well as decreased or abolished hormone production in the kidney.Signs of such a disease are decreased urine production, swelling of the hands, face and legs, shortness of breath, difficulty sleeping, loss of appetite, nausea / vomiting, high blood pressure, and coldness and tiredness.

A disease of the adrenal cortex that causes problems in this regard is Addison's disease. This is an autoimmune disease that destroys tissues in the adrenal cortex. In addition to sex hormones, cortisol or aldosterone are no longer formed.
This deficiency manifests itself symptomatically in the form of low blood pressure (hypotension), "hunger for salt", a feeling of weakness, nausea and vomiting as well as weight loss. Another hormone called ACTH, on the other hand, is increased in a counter-regulating manner. When it splits, a product is increasingly created that causes hyperpigmentation of the skin. So Addison patients look like they're back from vacation even though they're actually seriously ill.

Other causes of electrolyte imbalances

Other causes of a disturbance of the electrolyte balance are:

  • Infections (in combination with fever)
  • An uncontrolled diabetes mellitus
  • Bleeding and massive tissue damage such as extensive burns, extensive trauma (injuries), rhabdomyolysis (destruction of muscle tissue) or hemolysis (destruction of blood cells)
  • Drinking sea water
  • Drinking distilled water
  • excessive drinking of isotonic beverages

These symptoms indicate an electrolyte imbalance

Electrolyte imbalances affect the entire body. The muscles as well as the vegetative, cardiovascular and nervous systems are particularly affected. Typical symptoms are:

  • Lethargy, confusion, behavior change, headache, loss of consciousness
  • Nausea, constipation, intestinal obstruction
  • High blood pressure, irregular heartbeat
  • Chest pain, cramps, muscle weakness, paralysis

Read about the consequences of different electrolyte disorders in detail:

  • Hypernatremia
  • Hyperkalemia
  • Hypokalemia

How does the doctor make a diagnosis?

The symptoms just mentioned can be an indication of an electrolyte disorder. The doctor will ask you about your medical history. However, not all symptoms always occur in parallel and many of them, such as nausea, are relatively unspecific and can have many causes.
The examination of the blood is therefore important and groundbreaking for the diagnosis. The electrolyte concentrations are determined in the laboratory using a serum sample.
Next, it is now important to find out the cause of the electrolyte disorder, as long as this was not possible through the anamnesis. More specific tests may follow.

Electrolyte disturbance therapy

First and foremost, there is a balancing of the electrolytes. In the event of a deficiency, these must be substituted orally or intravenously.
The therapy depends on the severity of the electrolyte disturbance and the general condition of the patient. A “healthy” patient who suffers from an electrolyte deficiency due to frequent exercise, for example, can easily compensate for this with water, fruit or even food supplements. On the other hand, a patient who suffers from kidney disease or takes medication should never use these dietary supplements independently and without consulting a doctor. It could worsen or even trigger an electrolyte disorder.
In the next step, treatment of the cause follows. No general procedure can be described here, as this varies greatly depending on the clinical picture.

Duration / forecast

Compensating for the electrolyte disturbance is usually a fairly quick process, as the ions can be absorbed directly in dissolved form.
Of course, it also depends on the severity of the deficiency and the underlying cause. For example, it is more difficult to treat chronic kidney disease than a gastrointestinal infection. In the former case, a permanent solution to the electrolyte disorder must be found, which in the end often results in dialysis. In the case of a simple gastrointestinal infection, on the other hand, oral intake at home is often sufficient or, in the case of more severe courses, infusions at the doctor's.
A tip at this point is the tried and tested “home remedy” cola and pretzel sticks. The latter supply the body with sodium and chloride in the form of salt. The cola should only be taken in small amounts, as sodium can only be absorbed in the intestine in combination with sugar.