Electrolytes

What Are Electrolytes?

They are minerals in our body fluids that carry an electric charge. They are vital for numerous physiological functions, including:

• Maintaining fluid balance
• Supporting cardiac rhythm and cell function
• Regulating heart, nerve and muscle function
• Balancing pH (acid-base balance)

Key Electrolytes:

• Sodium – Controls fluid balance, blood pressure, nerve and muscle function
• Potassium – Crucial for heart and muscle function
• Chloride – Maintains fluid and pH balance
• Calcium – Needed for bone health, muscle contraction and nerve signalling
• Magnesium – Supports muscle/nerve function and enzyme activity
• Bicarbonate – Helps maintain acid-base balance

Common Problems:

• Hyponatremia (Low Sodium) – Confusion, reduced response, drowsiness and falls
• Hypokalaemia (Low Potassium) – Weakness, constipation and palpitation
• Dehydration with Electrolyte Imbalance – Low BP, dizziness and fatigue

Importance of Electrolytes in the Elderly: Why Elders Are More Vulnerable?

• Reduced Thirst Sensation in Elderly – They may not feel thirsty even when
• Chronic Illnesses – Diabetes, kidney disease and heart disease may affect electrolyte balance
• Medications – Diuretics, laxatives and ACE inhibitors make them prone to dehydration and loss of electrolytes.
• Poor Intake – Appetite changes or swallowing difficulties reduce fluid and salt intake

Importance in Summer:

• During summer, excessive sweating leads to loss of water, sodium, potassium and chloride, causing fatigue, cramps and even serious complications.
• High temperatures increase the risk of dehydration.
• Outdoor activities, infections, and poor intake worsen fluid loss

Importance in Infections:

• Fever, diarrhoea and vomiting (as in dengue, typhoid or gastroenteritis) cause rapid fluid and electrolyte loss

Effects of Electrolyte Imbalance:

• Muscle cramps, fatigue and palpitations
• In severe cases, heat exhaustion or heat stroke

Preventive Steps:

• Encourage regular fluid intake even if not thirsty
• Use ORS, coconut water and buttermilk for electrolyte replenishment
• Avoid excess tea/coffee/alcohol, which increases water loss

When to Evaluate Electrolytes?

Clinical Situations:

• Elderly with sudden confusion, weakness or falls
• Anyone with prolonged fever, vomiting or diarrhoea
• Patients on diuretics and ACE inhibitors, or with kidney disease
• Heat exhaustion/heat stroke symptoms
• Unexplained fatigue, muscle cramps or palpitations

Tests to Order:

• Renal Function Tests – Urea, creatinine
• Serum Electrolytes – Sodium, potassium, chloride and bicarbonate
• Serum calcium and magnesium if indicated

Treatment:

• Mild Cases – Oral rehydration with WHO-recommended ORS
• Moderate to Severe Cases – IV Fluids with electrolytes based on electrolyte values as needed

To Summarize:

• Stay hydrated, not just with water, but with electrolyte-containing fluids like coconut water, buttermilk, salted lemon water, ORS and rice gruel with salt.
• Elderly people should be monitored more closely in summer.
• Recognize danger signs early – confusion, dizziness, cramps, dry tongue and reduced urination.
• Seek medical help if symptoms persist or worsen.
• Follow your doctor’s advice if you have fluid restriction or salt restriction, especially in kidney and heart disease.

Dr. Urmila R, MBBS., DNB (Internal Medicine).,
Associate Consultant- Internal Medicine
Kauvery Hospital, Chennai