How to Prevent Electrolyte Imbalance

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The list of nutrients your body needs to run – vitamins, minerals, proteins, fats and all the rest – includes one more item that most people either forget or know little about: electrolytes.

The National Library of Medicine explains that electrolytes include certain minerals in your blood, urine, tissues and other body fluids that carry a positive or negative electrical charge. Electrolytes are important because they help:

  • Balance the amount of water in your body.
  • Balance your body’s acid-base level, measured on a pH scale.
  • Move nutrients into your cells.
  • Move wastes out of your cells.
  • Make sure that your nerves, muscles, heart and brain work the way they should.

The most important electrolytes, which you get in the foods and beverages you eat and drink, include:

  • Sodium.
  • Calcium.
  • Potassium.
  • Chloride.
  • Phosphate.
  • Magnesium.

“Electrolytes establish an electrical gradient across cell membrane to allow fluid and waste exchange,” says Isabel Maples, a registered dietitian nutritionist in the District of Columbia and a national spokesperson for the Academy of Nutrition and Dietetics. They transmit nerve impulses, stimulate muscles to relax and contract and allow glands to function properly, she says, and they maintain plasma membrane permeability. “Electrolytes also keep the heart beating on a regular rhythm. They can play a role in preventing the muscle cramps that a runner or a construction worker might get,” Maples adds.

Electrolyte Imbalance

Sometimes electrolyte levels in your body can become too low or too high. This is most often caused when the amount of water in your body changes: Either there is too much (overhydration) or too little (dehydration). Water imbalance can come from a variety of causes:

  • Persistent vomiting, diarrhea, sweating or fever.
  • Not drinking or eating enough.
  • Drinking too much water.
  • Chronic respiratory problems, such as emphysema.
  • Liver or kidney disease.
  • Medications such as steroids, diuretics and laxatives.

The typical signs and symptoms of electrolyte imbalance include:

  • Muscle cramps.
  • Nausea.
  • Dizziness.
  • Confusion.
  • Weakness.
  • Loss of appetite.
  • Fatigue.

Many athletes and outdoor workers know to stay hydrated, and dehydration is a common cause of electrolyte imbalance. But overhydrating is also a concern. “If we drink a lot of water, that can throw off sodium,” says Libby Mills, a licensed dietitian nutritionist in Philadelphia and culinary nutritionist for Villanova University’s MacDonald Center for Obesity Prevention and Education. “Overdiluting electrolytes can lead to some pretty serious damage. You can also experience confusion, seizures and you could actually die if electrolytes drop too low,” says Mills, who also teaches nutrition at Neumann University and is a national spokesperson for the Academy of Nutrition and Dietetics. “On the flip side, too much can lead to some of the same symptoms. You want to be in the ‘sweet’ range.”

Preventing Electrolyte Imbalance

For most people, electrolytes are replaced with a normal diet. “Most people actually consume too much sodium and chloride (salt), so replacing those electrolytes is usually not hard,” Maples says. “Food can easily supply way more sodium than one finds in a sports drink, for example. A large glass of orange juice would replace the potassium lost in a marathon. A small bag of pretzels would easily replace the sodium/chloride.”

When you work or exercise hard and sweat a lot, you lose fluids and electrolytes like potassium and sodium. Again, most of these can be replaced with normal diet. “With the idea that the harder you work out, the hungrier you’ll be, there’s no need for potassium supplements or salt tablets,” Maples says. In fact, she notes that potassium supplements can affect heart rhythm and make the heart stop beating and can be dangerous to use unless under a doctor’s care. A doctor might prescribe a potassium supplement for people on certain types of diuretics, for example.

“Eating whole foods is the overall umbrella to stay in that happy range,” Mills agrees. “Drinking fluids, eating watery foods like melons, berries, salads, things that are naturally juicy.”

Normal water consumption of eight glasses a day also keeps you in that happy range. For long bouts of hard work or exercise, Mills recommends following a hydration protocol: Stay properly hydrated before the event, and afterward hydrate slowly and steadily. “It’s not time to chug a gallon of water,” she says, because that could cause overhydration. Maples suggests drinking two to three cups of fluid for each pound lost during the workout. “Two cups of fluid replaces the fluid lost with each pound, but three cups will get you ahead a little – but not too much,” she says.

Are Sports Drinks Necessary?

Consuming electrolyte-enriched beverages and sports drinks serve a purpose, Mills says, “if you are sweating a lot for an extended period of time. In that case, balancing hydration with the inclusion of electrolytes makes sense.” But sports drinks are not needed on a daily basis or for light to moderate workouts, “only if you are sweating excessively for long periods of time,” she says.

If you are dehydrated from excessive diarrhea or vomiting, Maples suggests an oral rehydration solution that contains carbohydrates, fluids and electrolytes. “Sound evidence shows that the electrolytes must be replenished before the body will restore the proper fluid balance,” she says.

A few other notes about electrolytes:

  • A good way to monitor your hydration level is to check your urine color. It should be pale yellow, like lemonade. If it’s dark yellow, like apple juice, that is a sign of dehydration.
  • If you follow a specific diet that excludes certain foods, take care to replace the electrolytes with other sources, especially fruits, vegetables, nuts and some dairy. Foods rich in electrolytes, the National Library of Medicine lists, include spinach, turkey, potatoes, beans, avocados, oranges, soybeans (edamame), strawberries and bananas.

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