Understanding Fluid and Electrolyte Balance

Annette McDermott
Reviewed by Terri Forehand RN
Drinking Water

There is a delicate balance between fluids and electrolytes in the body. Maintaining the right balance is critical to keeping your organs functioning properly.

Fluids

Fluids are found throughout the body with 45 to 75 percent of total body weight being made up of water, states Austin Community College in their Associate Degree Nursing Physiology Review. They also state that body fluids come from the beverages you drink and foods you eat as well as "metabolic water produced during dehydration synthesis of anabolism."

Any reduction of fluids in the body can have a negative effect ranging from thirst to serious dehydration and death. Many factors cause fluid loss such as diarrhea or vomiting, sweating (caused by fever or exercise), frequent urination, and certain medications (such as diuretics) or diseases (including cancer, Cushing's disease and hormonal disorders).

Too much fluid in the body can also be detrimental. The Mayo Clinic states that fluid needs vary by individual but that the Institute of Medicine recommends an adequate intake for men of 13 cups per day and nine cups for women.

Electrolytes

According to Medline Plus, "electrolytes are minerals in your body that have an electric charge." All bodily fluids contain electrolytes including urine and blood.

Electrolyte levels change depending on how much water you ingest. Too little water causes dehydration and lower electrolyte levels while too much causes overhydration, high electrolytes and fluid retention. Both can lead to serious health issues ranging from minor muscle cramping to kidney failure or even death.

Medline Plus lists the following electrolytes as common that can be measured in blood tests:

  • Sodium
  • Calcium
  • Chloride
  • Potassium
  • Magnesium
  • Phosphorous

Electrolyte Imbalance

When electrolytes are too high or low, serious health consequences can occur. Each type of electrolyte imbalance causes different symptoms, although some overlap.

Sodium

Found in body fluids outside of cells, sodium is a positive ion critical to maintaining fluids in the body. Mayo indicates that when too much fluid is consumed, hyponatremia - the diluting of sodium in the body - may occur. Depending on how diluted sodium levels become, resulting symptoms range from nausea and vomiting to coma and death.

When too little fluid is consumed or fluids are lost and not replaced, hypernatremia may occur. This means that there is too much sodium in the body. Symptoms may include thirst, confusion, seizures or coma, according to Merk Manuals.

Potassium

Potassium is an electrolyte found in body cells and critical to muscle and nerve function. Loss of body fluids due to gastrointestinal illness, extreme sweating or diuretics may cause low potassium, known as hypokalemia, in the body. Some hypokalemia symptoms are diarrhea, breathing problems, vomiting and heart arrhythmia, according to Progressive Health.

Too much potassium is also a potential issue and may lead to muscle weakness, heart arrhythmia, palpitations, and tingling of the feet and/or hands.

Chloride

Chloride is found outside of cells and in the blood. As with other electrolytes, too much (hyperchloremia) or too little (hypochloremia) chloride can lead to serious illness. MedicineNet states on its website that hyperchloremia may be caused by diarrhea or kidney disease. Hypochloremia is often caused by excessive sweating or vomiting and by adrenal of kidney disease.

Calcium

An elevated calcium level (hypercalcemia) in the blood leads to weakened bones, kidney stones and other kidney problems, brain issues such as confusion, and digestive orders, says Mayo's website. Low blood calcium (hypocalcemia) can be asymptomatic or cause symptoms including but not limited to seizures, dementia, low blood pressure, or congestive heart failure.

Magnesium

According to the University of Maryland Medical Center, magnesium helps move regulate other electrolytes and nutrients in the body. It's rare to have too much magnesium but low magnesium may be caused by medications, gastrointestinal diseases or illness, diabetes, or kidney disease. Low magnesium levels irritability and anxiety, restless leg syndrome, heart arrhythmias, sleep problems or seizure.

Phosphorous

MedLine Plus' website states that phosphorous is in every body cell and plays a part in how the body processes fats and carbohydrates. They indicate that both low and high phosphorous is rare but high phosphorous levels can occur in people with severe kidney disease or people who have trouble regulating blood calcium.

Striking a Balance

Balancing electrolytes is critical to good health. Ingesting adequate fluids play a key role in preserving that balance. All electrolytes can become imbalanced, but sodium, potassium and calcium are the most common.

Causes of electrolyte imbalance vary depending on your circumstance and health but are often due to dehydration caused by inadequate water intake, poor diet or illness. In order to help prevent a dehydration electrolyte ambulance, follow these tips from WebMD:

  • Drink plenty of water before, during (every 15 to 20 minutes) and after exercise, especially on hot days. If exercising longer than one hour, drink a sports drink instead.
  • Avoid or reduce your intake of beverages containing caffeine such as coffee, tea or colas. Caffeine is a diuretic and may increase the risk of dehydration.
  • Avoid or limit your intake of beer, wine or alcohol as they can lead to dehydration.
  • Unless instructed by a doctor, do not take salt tablets.
  • Stop exercise or activity at the first sign of dizziness, lightheadedness or muscle cramping.
  • Wear lightweight clothing when exercising or working outdoors.
  • Treat diarrhea or vomiting immediately to prevent dehydration.

Preventing Low Levels

You can help prevent low electrolyte levels by staying hydrated and regularly eating foods high in electrolytes such as leafy greens, beans, nuts and seeds and most fruits and vegetables (especially citrus fruits and bananas).

If you need to replenish electrolytes quickly, you can drink a sports drink. However, if you want to avoid sugar, the Global Healing Center recommends adding a pinch of salt and a teaspoon of apple cider vinegar to a glass of water. Salty foods and foods high in potassium such as tomato juice or soup, potatoes, pickles, and nut butters are also good options.

Remember, a severe electrolyte imbalance can be an emergency. If you are symptomatic, it's best to consult your doctor for guidance.

Recognize the Signs

Early signs of dehydration or fluid imbalance can be vague so it's important to recognize the signs. Doing so may help prevent a more serious problem from developing. The Mayo Clinic lists the following dehydration symptoms on its website:

Mild to Moderate Dehydration

  • Dry, sticky mouth
  • Sleepiness
  • Decreased urine
  • Thirst
  • No wet diapers for three hours in infants
  • Few or no tears
  • Dizziness or lightheadedness
  • Dry skin
  • Headache
  • Constipation

Severe Dehydration

  • Extreme thirst
  • Extreme irritability in infants or children
  • Very dry mouth, skin and mucous membranes
  • Sunken eyes and no tears
  • Dark urine and decreased output
  • Low blood pressure
  • Fast heartbeat
  • Rapid breathing
  • Fever
  • Unconsciousness

Call your doctor if you suspect you or a family member is dehydrated. Severe dehydration is a medical emergency.

Listen to Your Body

You should be able to support a healthy balance between electrolytes and fluids by staying hydrated and eating a balanced diet daily. In addition, drink plenty of fluids and pay attention to your body's signals while exercising, working or spending time outside in hot weather, or if you come down with a stomach bug or fever.

Don't ignore dehydration symptoms or symptoms of an electrolyte imbalance. Talk to your doctor about whether or not any medications you take or a health condition you have may impact your fluid and/or electrolyte levels.

Understanding Fluid and Electrolyte Balance