Electrolytes Imbalance

Written by Ben Bunting: BA, PGCert. (Sport & Exercise Nutrition) // British Army Physical Training Instructor // S&C Coach.


Electrolytes such as sodium, potassium and calcium can become depleted from sweat during exercise, so replenishing them to achieve peak performance.

Consume fluids two hours before and 100-200ml fluid every 20 minutes during physical activity, as well as sports drinks containing an array of electrolytes for optimal hydration.

What Are Electrolytes?

Electrolytes may be familiar due to sports drinks' promises of replenishing electrolytes lost through sweat. But electrolytes play much larger roles.

They regulate nerve and muscle function, balance blood acidity/pressure levels and even manage heart rhythm - essential elements that enable life itself! 

Electrolytes are mineral substances with either a positive or negative electrical charge when dissolved in water, such as salt (sodium), potassium, calcium, magnesium chloride and bicarbonate.

Your kidneys regulate this balance throughout your bloodstream as it circulates throughout your body; electrolytes also can be found in stomach juices, poo, urine and body fluids containing fluid from within cells.

Electrical Charges

Electrolytes, such as sodium and chloride salts, contain chemical elements with natural electrical charges ranging from positive to negative for chlorine in their formative state.

When these charges appear on atoms they can move freely through liquids and conduct electricity easily - this allows your body to create electricity to make muscles contract or conduct other vital chemical reactions. 

What Causes an Electrolyte Imbalance?

Electrolytes are minerals with an electric charge dissolved into bodily fluids like blood and sweat.

Electrolytes regulate muscle impulses, balance body fluids, transmit nerve signals and are essential for optimal cell health and vitality.

Dehydration is one of the primary sources of electrolyte imbalance, leading to symptoms ranging from mild to serious.

Therefore, regular water consumption during exercise should help replenish electrolytes; replenishment via sports drinks or enhanced waters is often recommended to combat imbalances during and after training sessions in order to ensure maximum performance and safety.

Electrolyte imbalance can also result from poor diet choices, excessive sweating, frequent urination and illness - such as diarrhea.

Any injury or illness which irritates the digestive tract could also contribute to fluid loss and electrolyte depletion.

High blood pressure or diabetes can also contribute to an electrolyte imbalance by altering how your kidneys regulate water and mineral levels in your body.

Electrolyte imbalance can occur when kidney function deteriorates. This may occur as a result of diabetes, kidney disease or another serious illness such as pneumonia.

Electrolyte imbalances affect many individuals; infants, older adults and those living with chronic health conditions are especially susceptible to dehydration or electrolyte imbalances.

Chemotherapy treatments, fevers and certain cancer therapies may irritate digestive systems resulting in excessive fluid loss causing electrolyte imbalances and dehydration.

Left untreated, an electrolyte imbalance may result in severe symptoms like seizures or even life-threatening coma, potentially posing serious risks to health.

What Are the Symptoms of an Electrolyte Imbalance?

 Electrolyte imbalance symptoms vary depending on its severity and source, with sweating and vomiting both potentially leading to fluid loss which in turn causes confusion and dizziness.

Further symptoms may include fatigue, weakness, confusion, irritability and muscle spasms according to the National Library of Medicine (NLM). Severe electrolyte imbalances have even been known to lead to coma or even death in some instances.

Other possible indicators could include high sodium (hypernatremia), or lower magnesium or potassium (hypomagnesemia) levels.

If your body fails to produce enough bicarbonate (known as acidosis) it can lead to confusion, breathing problems and nausea; on the other hand, too much bicarbonate production (known as alkalosis) may result in nausea, confusion and heart arrhythmias. 

What Are the Signs of an Electrolyte Imbalance?

Electrolytes can be obtained through diet and lost through sweat, urine and dehydration.

Excessive intake of processed foods containing sodium while lacking essential vitamins or prolonged sweating due to exercise can wreak havoc with our delicate balance of electrolytes.

Other health conditions, including chronic vomiting or diarrhea, kidney or heart disease as well as certain medications can also disrupt this equilibrium.

Signs of electrolyte imbalance include confusion, headaches and lethargy; severe imbalances can lead to coma or cardiac arrest.

If you suspect an electrolyte imbalance, your doctor may conduct a physical examination and order additional tests to assess it.

These may include hydration tests, EKG/ECG (electrocardiogram), BUN (blood urea nitrogen) and creatinine tests to monitor kidney function - additional tests depend on which mineral caused it.

To avoid electrolyte imbalance, drinking plenty of water while limiting foods high in salt like processed snacks as well as sports drinks with electrolytes can be effective ways of staying hydrated during hot weather and intense exercise, as well as drinking sports drinks containing electrolytes for sustained periods.

What Happens When Your Body is High in Electrolytes?

The body cannot regulate an imbalance in electrolytes when it is too high. This can be due to your kidneys or hormones.

If you have too much of an electrolyte in your body, it can cause symptoms such as:

  • Confusion and irritation.
  • Arrhythmia is characterized by an irregular heartbeat.
  • Breathing difficulties.
  • Fatigue.
  • Headaches.
  • Muscle cramps and weakness.
  • Diarrhea and constipation
  • Nausea and vomiting.

Having lots of sports drinks are not the same thing as drinking water to hydrate. Electrolyte-enhanced beverages are a speciality product that should only be consumed when needed to replenish the body's resources.

You may want to reach for electrolyte drinks in the following situations:

  • After an exercise or physical activity.
  • When you have been sweating heavily on a very hot day.
  • When you are suffering from a dehydrating illness. 

How Do You Feel If Your Electrolytes Are Low?

Your muscles may be cramping or spasming if your electrolyte level is low which can be painful and prevent you from exercising properly.

If you experience muscle cramps regularly, it's time to replenish your electrolytes.

Low electrolytes, such as sodium and potassium, can affect your body's fluid balance and cause headaches. Before taking painkillers, consider boosting your electrolyte level to relieve your headache.

A lack of electrolytes could cause mental fog and fatigue. According to an article in the Handbook of Clinical Neurology published in 2017, electrolyte balances can negatively affect brain function, since they regulate the nerves and muscles in your body, including your brain.

According to MedlinePlus, an online resource of the National Library of Medicine, hyponatremia (low levels of sodium) can cause fatigue, confusion, and difficulty concentrating.

According to a 2021 study published in Frontiers in Pharmacology, digestive issues such as constipation or diarrhea could be another sign that electrolyte balance is present.

Electrolytes such as sodium and magnesium help to regulate fluids within your digestive system. This helps keep things moving smoothly. A lack of electrolytes can cause constipation and loose stools.

Electrolyte imbalances can cause an irregular or rapid heartbeat. The electrolytes potassium, sodium, calcium, and magnesium are essential for heart health because they regulate electrical impulses.

Palpitations, irregular heartbeats or other serious cardiac problems can be caused by being out of balance.

My Experience

Having run a few marathons, two of which were during warmer weather spells than I was used to, I have experienced the signs and symptoms and how it feels to be dehydrated and low on electrolytes. 

Here is what I have experienced:

  • Agitation/frustration
  • Inability to clearly calculate times and distance on my sports watch
  • A feeling of inefficiency when running
  • Severe cramps in my calves
  • Slight confusion

Electrolytes and Performance

Physical activity plays an integral part in optimizing performance and health; whether that be soccer or hitting the gym.

But peak athletic performance doesn't depend solely on fitness level or training regimen; how your body reacts to exercise depends on multiple factors - one being electrolytes.

Electrolytes are essential minerals that play an essential role in maintaining fluid balance, nerve function and muscle contraction, among many other processes.

Human bodies are great at maintaining electrolyte balance; however, sweat loss during exercise can throw it off-balance and impair performance. Athletes should consume a well-balanced diet along with electrolyte tablets or sports drinks to support optimal performance and recovery.

Sweat contains more than just water; it contains an array of essential minerals such as sodium (Na+), chloride (Cl-), and potassium (K+). Drinking plenty of water during exercise is crucial to staying hydrated

However, too much or too little water can dilute electrolytes and throw off your body's balance of hydration; insufficient hydration could even lead to dehydration, increasing fatigue perceptions, exertion levels, and slowing performance.

Can Exercise Cause Electrolyte Imbalance?

Exercising for a long time leads to progressive electrolyte and water loss in the body, as sweat is produced to promote heat loss.

The rate at which you sweat depends on a number of factors, including the temperature and humidity in the environment and your work rate. 

Can Lack of Fluids Impair Athletic Performance?

Body water accounts for 70% of its mass, so when exercising, your body loses fluid through sweat.

If this fluid loss is not replenished during workout sessions, performance may suffer significantly and dehydration symptoms such as nausea, diarrhoea and fatigue may surface; also impairing concentration - something any athlete must maintain to reach peak performance levels.

Two percent body mass loss (1.4 kg for someone weighing 70kg) is enough to slash endurance performance by more than half and lead to heat exhaustion, which can be life threatening.

Dehydration leads to decreased blood volume, reduced skin blood flow and sweat rate, elevated core temperature and an increase in reliance on carbohydrates as fuel sources.

It is vital that athletes understand the importance of staying hydrated, with coaches monitoring hydration intake to make sure athletes drink enough fluids.

Studies conducted among collegiate freshmen football players demonstrated that most CTFTs were knowledgeable of hydration practices and recognized that dehydration can hinder athletic performance.

Yet there were discrepancies between attitudes and behaviors: most participants believed consuming 503-591ml of fluid prior to competition was important practice but only 78.5% actually consumed such amounts before competition began.

Athletes must start training sessions hydrated by drinking plenty of water; however, sports drinks may also help them maintain an ideal balance of nutrients for maximum performance.

When sweat is produced in large amounts, electrolytes (such as sodium) can be lost with it and this has been proven to diminish performance.

To avoid hyponatremia affecting performance it is therefore crucial that athletes consume solutions containing both electrolytes and water together in order to keep hydration levels at their optimum. 

Muscle Contractions

As athletes exercise, their bodies lose electrolytes through sweat. If these losses are not replenished with electrolyte-rich foods and beverages prior to, during, and after workouts to maintain proper balance in their bodies; this will ensure muscles stay strong while the brain functions optimally.

Sodium is an essential mineral, crucial in maintaining fluid balance, regulating blood pH levels, and stimulating muscle contractions and nerve impulses.

Unfortunately, during vigorous exercise sodium can be lost through sweating. Without its replacement it could lead to dehydration, muscle cramps, confusion, diarrhoea and vomiting - plus other electrolytes lost due to sweating such as potassium, calcium and magnesium that our bodies depend on for proper function.

All skeletal muscles must be activated to contract and shorten, yet the actual mechanical response comes from specific electrical signals coming from within our brains that travel down motor neurons that innervate each muscle fiber.

This process, known as excitation-contraction coupling, is fundamental in studying muscle biology.



As we sweat during exercise, our bodies lose electrolytes through sweat that must be replenished through fluid consumption to avoid dehydration and muscle cramping.

Therefore, athletes should make sure to consume fluids with electrolytes prior to beginning training as well as during and after each workout session.

Dehydration can have a dramatic impact on athletic performance. Athletes experiencing dehydration will experience a drop in their heart rate, blood pressure, VO2 max and muscle power as well as an increase in perceived exertion levels.

When electrolyte imbalance occurs in their bodies, an athlete will become tired more easily and experience difficulty focusing and concentrating.

To avoid dehydration and electrolyte imbalance, athletes should aim to consume an equal or slightly greater volume of water than they lose through sweat, as this will prevent essential minerals such as sodium, potassium, calcium, and magnesium from being lost through perspiration.

Neurological Functions

The brain and spinal cord comprise the central nervous system, which transfers information and messages between the brain and rest of body through neurons - nerve cells capable of transmitting fast signals quickly - like computers.

While your brain provides software decision making power for decision making purposes, nerves provide hardware or wiring infrastructure for communicating them throughout your body.

Cerebral function can be broken down into two hemispheres; with one side controlling movements on either side of the body.

Each hemisphere also handles higher functions like cognition, memory and emotions.

Furthermore, deep within the brain lies a structure called the thalamus which relays sensory and motor input from body parts back to cerebral cortex, and an amygdala which sits within temporal lobe of brain is associated with processing emotion and memory processing.

Cerebrospinal fluid surrounds both the brain and spinal cord to protect them from damage, with nerves running from each neuron to connect brain with legs/arms.

This system can be divided into two groups, somatic nervous system and autonomic nervous system.

The somatic nervous system, responsible for muscles and senses, is under conscious mind control, while autonomic nervous systems regulate glands and organs without needing input from conscious mind.

Consume electrolytes according to your physician's advice to avoid taking in too much water and diluting your blood to an unhealthy state, leading to Exercise-associated hyponatraemia (EHN).

EHN symptoms typically appear hours later after excessive fluid consumption; lightheadedness, nausea and puffy hands or feet as well as decreased heart rate, blood pressure drops, confusion and vomiting may ensue; additionally there may be weight loss as a result of EHN.

Electrolyte Imbalance Treatment

Electrolyte imbalances can affect anyone, particularly older adults. This may be caused by loss of kidney function with age or medications like diuretics that alter electrolyte levels.

Certain cancer treatments can also result in hypercalcemia (an elevated calcium concentration), leading to electrolyte disruptions.

Immediately seek medical advice if you suspect an electrolyte imbalance. A blood test will help your doctor assess which electrolytes are out of balance, before treating any underlying health conditions that have contributed to it.

Treatment options could include fluid replacement therapy with intravenous fluids that contain salt and sugar for helping the body restore itself back into a healthier state; medications like magnesium sulfate or calcium gluconate could be prescribed to replace depleted electrolytes such as these.

Unfortunately, drinking just water alone won't do the trick in terms of maintaining the electrolyte balance particularly for athletes exercising or competing over long periods in hot temperature.

Therefore the American College of Sports Medicine advises them to consume an appropriate combination of fluids and electrolyte drinks to compensate for fluid volume losses, prevent cramping and maintain an appropriate osmolality within their bodies.

Conclusion - The Importance of Electrolytes For Athletes

Hydration and electrolyte replenishment are crucial elements of peak athletic performance for athletes.

Electrolytes like sodium, potassium, magnesium and calcium help regulate fluid balance as well as assist muscle contractions and nerve signaling throughout the body.

While essential minerals for everyone, electrolytes become especially essential in athletes as they sweat heavily when exercising; when their electrolyte levels deplete further, symptoms like cramping, weakness, tingling and confusion may develop.

Athletes must consume electrolyte-enriched beverages prior, during, and post exercise in order to keep up their mineral levels and avoid dehydration during training sessions.

Runners and cyclists who sweat profusely should choose sports drinks rich in sodium and potassium as these minerals replenish quickly during physical exertion.

Ultimately, however, how much electrolyte one needs depends on an individual's sweat rate, salt concentration levels, environmental conditions and individual preference - too much electrolyte may cause stomach upset; experiment to find what works for them personally.

An athlete should aim to replace 50 to 80% of the electrolytes lost through sweat during their workouts, as a general guideline.

But it is essential to listen to your body and adjust as necessary - too little replacement could cause fatigue and muscle function loss while too much might cause your body to absorb too many calories and cause bloating.

For optimal health and performance, athletes are advised to choose water-rich beverages low in sugar while adding exact doses of electrolyte tablets or powders for maximum health and performance.

Maintaining adequate body water levels is vital to many bodily processes, including maintaining fluid balance, avoiding cramping and making sure nerves, muscles and blood can function smoothly.


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