If you ever feel lightheaded and fatigued during physical activity, you may chalk it up to dehydration. And you're not far off — these can be signs your electrolyte balance is off. But what is an electrolyte imbalance, exactly, and how do you fix it?
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An electrolyte imbalance can occur if your body contains too much or too little water, according to the U.S. National Library of Medicine (NLM).
Electrolytes are minerals located throughout your body — including sodium, potassium, calcium and magnesium — that balance your fluid levels and support full-body functioning. According to the NLM, electrolytes also help:
- Move nutrients to your cells
- Remove waste products
- Support nerve function and facilitate nerve signals
- Maintain brain and heart function
- Promote effective muscle relaxation and contraction
You get electrolytes from food and drinks, which is why eating enough and staying hydrated should ensure your electrolyte balance stays in check, per the NLM.
According to the National Academy of Sports Medicine, some common sources of electrolytes include:
- Sports drinks
- Electrolyte solutions
- Coconut or coconut water
- Fruits like bananas and watermelon
- Vegetables like spinach and potatoes
But if your electrolytes are out of whack, you may experience some unpleasant symptoms.
Here, Irvin Sulapas, MD, a primary care sports medicine physician and assistant professor of family and community medicine at Baylor College of Medicine in Houston, outlines those symptoms and how to correct an electrolyte imbalance.
If you regularly experience electrolyte imbalances (even mild ones), Dr. Sulapas recommends visiting a sports medicine doctor to rule out underlying conditions like a metabolic issue or chronic electrolyte imbalance. They can help you determine the best electrolyte imbalance treatment for your needs.
1. You're Lightheaded
Feeling dizzy or lightheaded is a common symptom of an electrolyte imbalance, Dr. Sulapas says. You may also feel confused.
In particular, this symptom can be indicative of low sodium intake (a condition called hyponatremia), according to January 2019 research in the Journal of Clinical Hypertension.
2. You Have a Headache
On a similar note, your head can start to hurt if you don't have enough sodium in your system, according to the Mayo Clinic.
This may be the case if you're dehydrated and have lost sodium through sweat, vomiting or diarrhea.
3. You're Tired
Fatigue is another common sign your electrolytes are out of whack, Dr. Sulapas says.
This may be the case if you're experiencing hyponatremia, according to the Mayo Clinic, along with related issues like drowsiness or loss of energy.
You may also feel fatigued as the result of a magnesium deficiency, per the Cleveland Clinic.
How Much Magnesium Should You Get?
Per the 2020-2025 Dietary Guidelines for Americans, adults should aim to eat the following amount of magnesium every day:
- People assigned female at birth: 310 to 320 mg
- People assigned male at birth: 400 to 420 mg
4. You're Short of Breath
If you're constantly feeling like you can't get enough air when you breathe, Dr. Sulapas says it could be tied to an electrolyte imbalance.
Here's why: When you're low on electrolytes, your body has trouble circulating the oxygen your cells need to function, as electrolytes help balance your blood volume and conduct the electrical impulses that keep your heart beating normally.
5. Your Heart Is Racing
Similarly, an electrolyte imbalance can lead to an irregular or fast heartbeat. A magnesium deficiency can cause this issue, according to the Cleveland Clinic.
On the flip side, this symptom can also occur if your body contains too much of certain electrolytes, like potassium (a condition called hyperkalemia), per the Cleveland Clinic.
Underlying health issues like kidney disease, diabetes and congestive heart failure can put you at higher risk for developing hyperkalemia, which is why it's important to watch the amount of potassium you eat if you have any of these conditions, per the Cleveland Clinic.
6. You're Nauseous
Dr. Sulapas says an upset stomach is another sign of an electrolyte imbalance. It can be a sign of both high and low potassium levels, per the Mayo Clinic. It can also indicate that your sodium or magnesium levels aren't right.
Stomach issues may also contribute to an electrolyte imbalance in the first place. That's because dehydration is a common cause of electrolyte loss, according to the NLM, and can occur as the result of vomiting or diarrhea, both of which are often accompanied by nausea.
7. Your Muscles Hurt
Electrolytes play an important role in muscle function: They help your muscles contract and relax, per the NLM. So if you don't have an adequate balance of electrolytes, Dr. Sulapas says your muscles may feel it.
According to the Mayo Clinic and Cleveland Clinic, muscle discomfort — including fatigue, weakness, cramping, spasming, numbness or tingling — can all be signs you have too many or too few electrolytes like potassium, calcium, magnesium and sodium.
8. Your Bones Hurt
Your muscles aren't the only part of your body that can feel an electrolyte imbalance. You may also experience bone pain, typically in the case of excessive calcium levels, per the Mayo Clinic.
That's because high calcium levels in your blood (a condition called hypercalcemia) may occur if the electrolyte leaches out of your bones, which can cause skeletal weakness and discomfort.
Hypercalcemia can lead to complications like kidney stones, kidney failure, abnormal heart rhythm and osteoporosis, so visit your doctor if you experience bone pain and other symptoms like excessive thirst, heart palpitations and lethargy, per the Mayo Clinic.
How to Treat (or Prevent) an Electrolyte Imbalance
Dr. Sulapas says the best way to prevent an electrolyte imbalance is to stay well-hydrated before, during and after exercise.
He also recommends being mindful of your sweat status. For instance, if you tend to sweat a lot or more than others or if you're a "salty sweater" (this may be the case if you notice white lines on your clothes or skin when you exercise), you likely need more electrolyte replenishment than others.
If this sounds like you, Dr. Sulapas recommends having a water bottle, sports drink or electrolyte solution on hand whenever you exercise in hot environments.
"Water should be fine for short durations of exercise (like 30 minutes or less), but for longer bouts of exercise, I recommend replenishing some electrolytes with a sports drink or switching between a sports drink and water," he says. "For endurance athletes, sometimes it's easier to consume gel packets or electrolyte chews to replenish on long runs or races."
But if you're already experiencing mild symptoms of electrolyte loss, here's how to restore your electrolyte balance: Dr. Sulapas recommends taking a break from any activity and instead focusing on rehydrating.
"If you are thirsty, then you are already behind on your hydration," he says.
How Much Water Should You Drink?
Use this equation to determine how much water you should drink every day to stay hydrated and avoid an electrolyte imbalance:
Body weight (in pounds) ÷ 2 = minimum ounces of water you should drink per day.
When to See a Doctor
Many electrolyte imbalance cases are mild enough that you can correct them yourself by rehydrating. But in the case of a severe imbalance, you may need to seek medical attention.
Dr. Sulapas says the warning signs of a dangerous electrolyte imbalance include:
- Feeling like you're about to faint or pass out
- Irregular heartbeat
- Muscle cramping
Experiencing these symptoms indicates you need medical attention, and if you experience confusion or seizures, get emergency care immediately.
- Journal of Clinical Hypertension: "Effects of sodium intake on postural lightheadedness: Results from the DASH-sodium trial"
- U.S. National Library of Medicine: "Fluid and Electrolyte Balance"
- National Academy of Sports Medicine: "25+ FOODS TO REPLENISH ELECTROLYTES: NATURAL SOURCES FOR HYDRATION"
- Mayo Clinic: "Hyponatremia"
- Cleveland Clinic: "Feeling Fatigued? Could It Be Magnesium Deficiency? (And If So, What to Do About It!)"
- Cleveland Clinic: "Hyperkalemia (High Potassium)"
- Mayo Clinic: "High potassium (hyperkalemia)"
- Mayo Clinic: "Hypercalcemia"
- U.S. Department of Agriculture and U.S. Department of Health and Human Services: "2020-2025 Dietary Guidelines for Americans"