What Are Electrolytes?

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What Are Electrolytes?

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An electrolyte is " any compound that, in solution or in molten form, conducts

electricity and is decomposed (electrolyzed) by it. It is an ionizable substance

in solution " (Medilexicon's medical dictionary). An electrolyte is any substance

that contains free ions that behaves as an electrically conductive medium

(conducts electricity). All higher forms of life cannot exist without

electrolytes, and that includes humans.

In our bodies, electrolytes include sodium (Na+), potassium (K+), calcium

(Ca2+), bicarbonate (HCO3-, magnesium (Mg2+), chloride (C1-), hydrogen phosphate

(HPO42-), and hydrogen carbonate (HCO3-). Electrolytes regulate our nerve and

muscle function, our body's hydration, blood pH, blood pressure, the rebuilding

of damaged tissue. Various mechanisms exist in our body that keep the

concentrations of different electrolytes under strict control.

Our muscles and neurons are thought of as electric tissues of the body. They are

activated by electrolyte activity between extracellular fluid or interstitial

fluid, and intracellular fluid (fluid inside and outside or between cells).

A muscle contraction needs calcium (Ca2+), sodium (Na+) and potassium (K+) to be

present. If levels of vital electrolytes are wrong, the muscles either become

too weak, or their contractions are too severe. Our heart, muscle and nerve

cells use electrolytes to maintain voltages across their cell membranes to carry

electrical impulses across themselves and to other cells.

The level of an electrolyte in the blood can become too high or too low. Body

electrolyte levels tend to change when water levels in the body change - when

our level of hydration is altered.

Electrolyte levels are kept constant by our kidneys and various hormones - even

when our bodies trigger changes. When we exercise we sweat and lose

electrolytes, mainly sodium and potassium. To maintain electrolyte

concentrations of our body fluids constant these electrolytes must be replaced.

Fresh fruits and vegetables are good sources of sodium and potassium and replace

lost electrolytes. Excess electrolyte levels in our blood are filtered out by

our kidney.

If our consumption of necessary electrolytes is wrong there can be health

consequences. The most common imbalances are hypernatremia and hyponatremia -

too much or too little sodium, and hyper kalemia and hypokalemia, or excessive

and insufficient levels of potassium. Doctors refer to a low electrolyte level

with the prefix hypo- and to a high level with the prefix hyper-.

Elderly people and electrolyte levels

As older people are more susceptible to dehydration and overhydration, they are

also more prone to abnormal electrolyte levels. This is because our kidneys do

not work so well when we become elderly. Some elderly people who have mobility

problems and do not have daily access to some help may have fluctuating levels

of food and fluid intake - these two factors can have an impact on their levels

of electrolytes.

What are the symptoms of electrolyte imbalance?

An electrolyte imbalance can lead to several symptoms. The symptoms will depend

on which electrolyte is out of balance, and whether that level is too high or

low. An altered level of magnesium, sodium, potassium, or calcium may produce

one or more of the following symptoms:

Weakness

Twitching

Seizures

Numbness

Nervous system disorders

Muscle spasm

Fatigue, lethargy

Irregular heartbeat

Convulsions

Confusion

Bone disorders

Blood pressure changes

High blood calcium is a common problem among cancer patients

Hypercalcemia is a common disorder among cancer patients, especially those with

breast cancer, lung cancer and multiple myeloma. It often results from the

destruction of bone due to bone metastases. Signs and symptoms may include:

Frequent urination

Irregular heart beat

Lethargy, fatigue

Moodiness and irritability

Nausea

Stomach pain

Vomiting

Extreme muscle weakness

Being extremely thirsty

Dry mouth or throat

Total loss of appetite

Coma

Confusion

Constipation

As these symptoms may also be the result of the cancer itself or cancer

treatment, it is sometimes difficult for hypercalcemia to be identified straight

away.

What cause electrolyte imbalances?

Kidney disease

Vomiting for prolonged periods

Severe dehydration

Heatwaves - A report found that the number of cases of electrolyte imbalances

increases significantly during heatwaves.

Acid/base (pH) imbalance (acid and alkaline balance in the body is

disproportionate)

Congestive heart failure

Cancer treatment

Some drugs, such as diuretics or ACE inhibitors. A study revealed that 20% of

patients taking diuretics commonly prescribed for high blood pressure or heart

conditions end up with reduced sodium and potassium levels

Bulimia (eating and purging meals, it is an eating disorder)

Severe and persistent vomiting and nausea during pregnancy.

Many sports drinks contain extra potassium and sodium to help restore lost

electrolytes which are lost through sports or intense physical exertion. Experts

say it is not ideal to consume just large quantities of water after we exercise

heavily because our existing electrolyte levels may drop too quickly. The

Academy of Orthopaedic Surgeons (UK) has some tips on preventing cramps.

When children suffer from vomiting and/or diarrhea they will need to replenish

their electrolytes. There are drinks in pharmacies targeted specifically for

such children. A study found that Pedialyte and Gatorade equally effective in

alleviating effects of viral gastroenteritis in children. Another study

published in the May issue of Archives of Disease in Childhood advises that

children with acute vomiting and diarrhea should not use 'flat' carbonated

beverages as an alternative for oral rehydration solution. An interesting

article by s Hopkins Medicine states that any childhood athletic activity

that lasts less than 60 minutes doesn't require electrolytes, so you can safely

skip electrolyte-enriched sports drinks.

What are high- low- calcium, potassium and sodium levels?

Low sodium levels (hyponatremia) - Hyponatremia may result from not eating

enough foods with sodium, too much sweating and urinating, or being

overhydrated. When large amounts of fluids, which do not contain sodium, are

given intravenously the patient may develop hyponatremia. Diuretics make the

kidneys get rid of excess sodium and water faster - sometimes the excretion of

sodium is faster than the excretion of water. When sodium levels are low our

bodies can produce too much of an antidiuretic hormone which tells our kidneys

to retain water - this commonly happens in patients who have pneumonia, stroke,

and those taking certain medications, such as anticonvulsants and some SSRI

antidepressants.

Patients with diabetes, heart failure, liver failure and kidney disorders can

also suffer from low sodium levels. People suffering from hyponatremia may

experience, confusion, headache, irritability, loss of appetite, muscle

weakness, nausea, vomiting, fatigue, decreased consciousness, and even

hallucinations and coma. A study explains that athletes who drink excessive

amounts of fluids during prolonged exercise-particularly novice marathon

runners-can develop dangerously low sodium levels

High sodium levels (hypernatremia) - This is usually caused by water loss

(dehydration) or the use of diuretics. Diuretics can cause both hyponatremia and

hypernatremia. The first symptom of hypernatremia is thirst. Typically, patients

with hypernatremia feel weak and sluggish. When levels are too high people can

suffer from confusion, paralysis, seizures and coma. The best treatment is to

increase water intake - sometimes this is done intravenously.

Low potassium levels (hypokalemia) - This is often caused by using diuretics.

Diuretics tend to make the kidneys excrete more potassium and water in urine.

Diarrhea and vomiting can also cause hypokalemia. If potassium levels drop

slightly no symptoms are usually experienced. Prolonged slightly low potassium

levels usually results in lower insulin production, resulting in an increase in

blood sugar levels. If levels drop too low the patient will suffer from fatigue,

confusion, muscle weakness and cramps. If levels get too low the person can

become paralyzed, and have arrhythmias (unusual heart rhythms). Patients with

heart failure who take digoxin and have moderately low potassium levels tend to

develop abnormal heart rhythms. An interesting article looks at the benefits of

diuretics for heart failure patients, while others wonder whether the change in

electrolyte levels might not outweigh the benefits.

Low potassium is treated with potassium supplements by mouth - this can be

either in tablet or liquid forms. Patients can also raise their potassium levels

by changing their diet. Hypokalemia caused by diuretics can sometimes be

resolved by switching to a potassium-sparing diuretic. This interesting article

explores why cystic fibrosis patients may be prone to low potassium levels.

High potassium levels (hyperkalemia) - This is much more serious than

hypokalemia. Hyperkalemia is usually caused by either kidney failure or some

medications that lower the amount of potassium excreted by the kidneys, such as

the diuretic spironolactone, and angiotensin-converting enzyme (ACE) inhibitors

which are used for hypertension (high blood pressure). Patients taking these

medications combined with potassium supplements or food high in potassium tend

to have rapidly increasing potassium levels because their kidneys cannot get rid

of it fast enough. They should stop taking the potassium supplements and change

their diets. In some cases drugs that speed up the excretion of potassium are

needed. Those with abnormal heart rhythms may be given calcium intravenously.

Heart drugs can cause dangerous build up of potassium.

Low calcium levels (hypocalcemia) - This can happen as a result of a sudden

widespread blood infection, as well as infection in other tissues. If the body

produces less parathyroid hormone the calcium levels can also drop - this may be

the result after the removal of the parathyroid glands during neck surgery.

People with vitamin D deficiency are more prone to hypocalcemia. The main

reasons for low vitamin D are not enough exposure to sunlight and diet. Other

reasons for vitamin D deficiency may include anticonvulsant medications, such as

phenytoin and phenobarbital, or an underactive thyroid gland. People with

hypocalcemia may experience numbness in the hands and/or feet, confusion, and

even seizures. Treatment includes taking oral calcium supplements, and treating

the disorder that caused it.

High calcium levels (hypercalcemia) - This can happen if a bone is broken down

and calcium is released into the bloodstream. When cancer spreads to the bone

there may be calcium release into the bloodstream. In severe cases of Paget's

disease hypercalcemia can become very debilitating. If levels of parathyroid

hormone are too high hypercalcemia is much more likely - this is usually the

result of a tumor in the parathyroid gland. Some cancers may cause parathyroid

hormone levels to rise too much. If thyroid hormone levels are abnormally high

calcium levels can rise excessively.

If calcium levels rise slightly most people do not have any symptoms. If levels

are higher the patient will experience dehydration because the kidneys will

automatically start excreting more water. When levels are very high the patient

will experience nausea, loss of appetite, vomiting and confusion. There is also

a risk of coma and death. Very high levels of calcium need to be treated

immediately.

What is an electrolyte panel (electrolyte test)?

An electrolyte panel is sometimes done as part of a routine physical. It can be

done as it is or as part of a basic metabolic panel or comprehensive metabolic

panel. The test is used to screen for any electrolyte or acid-base imbalance

(the body's balance between acidity and alkalinity) and to check the effect of

treatment on a known imbalance that is affecting the bodily function of an

organ. The electrolyte panel is often used with hospitalized patients or those

who are brought to the emergency room - this is because acid-base and

electrolyte imbalances are frequently part of acute and chronic illnesses.

If a single electrolyte is found to be either too high or too low, the doctor

will keep testing for that imbalance until levels are back to normal. If an

acid-base imbalance is found, blood gas tests may be done. These measure the pH,

oxygen and carbon dioxide levels in an arterial blood sample to determine how

severe the imbalance is and see how the patient responds to treatment.

Electrolytes may also be tested if the patient is prescribed certain drugs,

especially diuretics or ACE inhibitors.