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Do you have an electrolyte imbalance? Check the signs

Read to know why electrolyte imbalance shouldn't be taken lightly.

Written by Sandhya Raghavan |Updated : October 6, 2017 7:36 PM IST

Did you ever wonder why dehydration made you look swollen and bloated? It's your body trying to retain all its water when it senses a shortage of fluids. In other words, it is homeostasis or the process through which your body ensures that your internal environment is maintained, despite the changes in your external environment. When you are dehydrated, your body sends vasopressin, the antidiuretic hormone to tell your kidneys to retain all the water which would have otherwise been lost due to urination. That way, you won't drop dead due to the loss of water.

Homeostasis is a term derived from the Greek roots 'homeo' and 'statis' meaning 'similar to' and 'standing still' respectively and as you can see, it is important for your survival. But for homeostasis to work, it is important that your body has a good electrolyte balance. Minerals like calcium, potassium, magnesium, phosphate and sodium are called electrolytes. These minerals have an electric charge which helps in transmitting electrical impulses necessary for physical movements, thinking, seeing etc.

What causes electrolyte imbalances?

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Causes for electrolyte imbalance can range from diarrhoea to malignancy. Apart from these two, some common causes are dehydration, over exercising, vitamin D deficiency, drug habits, laxative abuse, surgery, cirrhosis or congestive heart failure. Idiopathic causes could also cause an inexplicable loss of electrolytes from the system. The problem is also quite common during pregnancy.

What are the symptoms?

If this delicate balance is disturbed, the body goes haywire and starts exhibiting some serious health symptoms. Commonest ones include muscle spasms, abdominal problems, anxiety, blood pressure changes, heart palpitations and dizziness.

Sodium imbalance:

Hypernatremia or hyponatremia are conditions where there is an excess of a deficiency of sodium in the body. Too much sodium can cause depression, irritability, neurological problems, muscle spasms, nausea, vomiting, laboured breath, intense thirst and fever.1 Less sodium can cause nausea, vomiting, loss of appetite and neurological abnormalities. In the elderly, it can cause frequent falls and impaired walking abilities. Acute hyponatremia can also cause neurological problems caused by water retention in the brain.2

Potassium imbalance:

When the amount of potassium in the blood goes awry, the person could face life-threatening conditions like cardiac rhythm disturbances, neuromuscular dysfunctions and kidney failure. It could also make the heart muscles stop contracting, causing sudden death of the individual.3

Calcium imbalance:

Decreased calcium reserves in the body can be caused by low vitamin D intake. It can exhibit as muscle weakness, cramps, irritability, seizures, impaired mental abilities, fatigue, anxiety, poor memory, disorientation, reduced concentration and psychosis.4 It can also show up as dry skin, coarse hair, alopecia, eczema, psoriasis, dermatitis, delayed tooth eruption and brittle nails. Too much calcium can cause, kidney stones, bone pain, abdominal issues, dehydration and psychiatric problems like anxiety, cognitive dysfunction and insomnia.5

Magnesium imbalance:

When there is an electrolyte imbalance caused by excessive magnesium in the blood, symptoms include weakness, confusion, laboured breathing, low blood pressure, dizziness, sleepiness, low blood calcium, abnormal heart rhythms and cardiac arrest.6 Low levels of magnesium can cause tremors, fatigue, muscle cramps, abnormal heart beats, neural problems, palpitations, irregular eye movements, hallucinations, depression, hypertension and fast heart rate.7

Phosphate imbalance:

Phosphate plays a big role in our biological processes. When there are less reserves of the mineral in the body, it could cause muscle dysfunction, weakness and low cardiac output. Prolonged deficiency of the electrolyte phosphate can cause serious symptoms such as breakdown of the skeletal muscles, brain dysfunction, platelet dysfunction, liver dysfunction, tubular defects of the kidney and metabolic acidosis.9 Elevated levels of phosphate can cause deposits of calcium in tissues or bone growth in soft tissues, excessive levels of parathyroid hormone in the blood and bones diseases like renal osteodystrophy.10

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1. Kim, S. W. (2006). Hypernatemia : Successful Treatment. Electrolytes & Blood Pressure : E & BP, 4(2), 66 71.

2. Sahay, M., & Sahay, R. (2014). Hyponatremia: A practical approach. Indian Journal of Endocrinology and Metabolism, 18(6), 760 771.

3. Viera, A. J., & Wouk, N. (2015). Potassium Disorders: Hypokalemia and Hyperkalemia. American family physician, 92(6).

4. Lehnhardt, A., & Kemper, M. J. (2011). Pathogenesis, diagnosis and management of hyperkalemia. Pediatric Nephrology (Berlin, Germany), 26(3), 377 384.

5. Schafer, A. L., & Shoback, D. M. (2016). Hypocalcemia: Diagnosis and treatment.

6. Goltzman, D. (2016). Approach to hypercalcemia.

7. Soar, J., Perkins, G. D., Abbas, G., Alfonzo, A., Barelli, A., Bierens, J. J., ... & Handley, A. J. (2010). European Resuscitation Council Guidelines for Resuscitation 2010 Section 8. Cardiac arrest in special circumstances: electrolyte abnormalities, poisoning, drowning, accidental hypothermia, hyperthermia, asthma, anaphylaxis, cardiac surgery, trauma, pregnancy, electrocution. Resuscitation, 81(10), 1400-1433.

8. Upala, S., Jaruvongvanich, V., Wijarnpreecha, K., & Sanguankeo, A. (2016). Hypomagnesemia and mortality in patients admitted to intensive care unit: a systematic review and meta-analysis. QJM: An International Journal of Medicine, 109(7), 453-459.

9. Knochel JP. Hypophosphatemia. West J Med. 1981 Jan;134(1):15-26. Review.

PubMed PMID: 7010790; PubMed Central PMCID: PMC1272444.

10. Knochel, J. P. (1977). The pathophysiology and clinical characteristics of severe hypophosphatemia. Archives of Internal Medicine, 137(2), 203-220.

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