Electrolytes are minerals dissolved in water or other bodily fluids that carry an electric charge (1). They include sodium, potassium, calcium, magnesium, chloride, and phosphate. Electrolytes are essential for the basic cellular functioning of the human body (2).
Sodium
Sodium is essential for the proper functioning of the human body by maintaining cellular homeostasis, maintaining extracellular fluid volume, regulating blood pressure, and controlling overall electrolyte balance. Your sodium serum levels should be between 135 to 145 mmol/L. If you have less than 135 mmol/L, you may have hyponatremia (too much water and not enough salt) which can manifest with symptoms such as headaches, confusion, nausea, delirium, muscle cramps, seizure, coma, and/or death (3). If you have more than 145 mmol/L, you may have hypernatremia (too much salt and not enough water) which can present with symptoms of severe thirst, rapid breathing, sleeping difficulty, restlessness, muscle twitching, seizures, coma, and/or death (4).
The FDA recommends less than 2,300mg of sodium per day. If you want to lower your sodium levels, eat more vegetables, avoid highly processed foods, look for “low sodium” or “no salt added” labels, and replace salt with no sodium seasoning like Mrs. Dash (5). If you want to raise your sodium levels, gradually add more salt to your diet. Different salt types have slightly different sodium contents. A quarter teaspoon of kosher salt has 480 mg, pink himalayan salt has 575mg, coarse sea salt has 580 mg, and table salt has 590 mg of sodium (6). However, the scientific literature suggests that these differences are not significant (7)(8).
Potassium
Potassium is important for multiple intracellular interactions, such as membrane potential and electrical excitation of both nerve and muscle cells (9). Your potassium serum levels should be between 3.6 to 5.5 mmol/L. If you have less than 3.6 mmol/L, you may have hypokalemia which can cause weakness, fatigue, muscle twitching, renal failure, malnutrition, and cardiac disease (10). If you have more than 5.5 mmol/L, you may have hyperkalemia which can cause muscle cramps, muscle weakness, rhabdomyolysis, kidney problems, arrhythmias, or paralysis (11).
Since the average adult should be consuming approximately 4,700 mg/day of potassium, it is much more common to be deficient than in excess. Try to eat the following potassium rich foods to increase your levels: dried fruits, seaweed, nuts, molasses, avocados, lima beans, spinach, potatoes, tomatoes, broccoli, beets, carrots, squash, kiwis, mangos, oranges, bananas, and cantaloupe as well as red meat (9)(11).
Calcium
Calcium is vital for fortifying bones, contracting muscles, transmitting nerve signals, blood clotting, and releasing hormones (9). Your calcium serum levels should be between 8.8 to 10.7 mg/dl. If you have less than 8.8 mg/dl, you may have hypocalcemia which can present as asymptomatic or life threatening (12). The common causes of low calcium are poor nutrition, vitamin D deficiency, autoimmune disease, or pregnancy. If you have more than 10.7 mg/dl, you may have hypercalcemia which can have symptoms of gastrointestinal disorders, bone abnormalities, kidney stones, fatigue, constipation, and depression (13).
The average adult needs around 1,000 mg of calcium per day. If you want to increase your calcium levels, you should also increase your vitamin D levels, because the absorption of calcium in the intestine is controlled by the hormonally active form of vitamin D3. Calcium rich foods include dairy products such as milk and cheese, green leafy vegetables such kale and okra, drinks such orange juice or soy drinks with added calcium, sardines, and bread made with fortified flour (14). To lower calcium, you should drink more water and avoid Calcium-rich antacid tablets (15).
Magnesium
Magnesium is involved with metabolism, muscle contraction and relaxation, glucose regulations, bone development, and neurological functioning (9). An adult human body should have approximately 25 grams of magnesium. Your magnesium serum levels should be between 1.46 to 2.68 mg/dl.
If you have less than 1.46 mg/dl, you may have hypomagnesemia, which can have symptoms of mild tremors, generalized weakness, cardiac ischemia, and/or kidney problems (16). Prolonged magnesium deficiencies can lead to hypertension, cardiovascular disease, type 2 diabetes, osteoporosis, and migraines (17). Main causes can include alcohol use disorder, gastrointestinal losses, loss of kidney function, or laxative abuse. If you have more than 2.68 mg/dl, you may have hypermagnesemia, which can have symptoms of nausea, vomiting, abnormally low blood pressure, and/or neurological impairment (13). Individuals who are at risk include those with kidney disease, malnourishment, alcoholism, and the overuse of antacids.
While most people get enough magnesium in a normal healthy diet, you may still want to increase your magnesium intake through food or supplements (17). Here are some magnesium rich foods: green leafy vegetables such as spinach, legumes such as peanuts or edamame, nuts such as almond or cashews, seeds such as pumpkin or chia, baked potato, and many other foods with high dietary fiber. As for supplements, select studies have shown that magnesium citrate, lactate, and chloride forms absorbed more completely with more bioavailability than magnesium oxide and magnesium sulfate (18).
Chloride
Chloride is the most abundant negatively charged ion outside of the cell. The kidneys regulate serum chloride levels (19). Chloride regulates cell volume, smooth muscle cell contraction, synaptic transmission, pH balance, and muscle activity and immunity. Chloride is not usually measured because there are no appropriate biomarkers of chloride status, plus there is very little evidence on the relationship between chloride intake and health outcomes. Also most individuals consume their salt as sodium chloride (NACL) as their main electrolyte (20), so adequate chloride intake will mirror sodium intake.
Phosphorus
Phosphorus is a positively charged ion found outside of the cell with 85% stored in bones and teeth while 15% is used in soft tissue. Phosphate is regulated by the kidneys and has a crucial role in metabolic pathways, replicating DNA and RNA, and is the energy source for adenosine triphosphate (ATP) pathways (19)(21).
Your phosphorus serum levels should be between 3..4 to 4.5 mg/dl. If you have less than 3.4 mg/dl, you may have hypophosphatemia which can cause loss of appetite, anemia, muscle weakness, coordination problems, bone pain, abnormal bones, and overall higher risk of infection (22). Prolonged deficiency can also lead to osteopenia, osteoporosis, and rickets (22). At risk populations include those with alcoholism, diabetic ketoacidosis, or sepsis. The main cause for phosphate deficiency is poor diet, intestinal malabsorption, or the extensive use of antacids (23).
If you have more than 4.5 mg/dl, you may have hyperphosphatemia, which is associated with chronic kidney disease and cardiovascular disease (24). The most common cause is kidney failure, but the use of phosphorus containing laxatives and vitamin D intoxication may also contribute to a surplus in phosphate (24).
Most individuals should have adequate phosphorus levels while eating a normal healthy diet. An adult should consume at least 1000 mg/day of dietary phosphate (24). However if your levels are low, you can increase your phosphorus absorption by getting more vitamin D, since it helps absorption of both phosphorus and calcium. Most phosphorus rich foods include yogurt, milk, salmon, and cheese. Animal sources tend to have a higher absorption rate than that from plant sources (25). However, vegan friendly options include lentils, cashews, potatoes, brown rice, and peas (23). If you would like to supplement, you should take phosphate salts such as dipotassium phosphate or disodium phosphate which have bioavailability of approximately 70% (26).
On the flip side, you may actually want to reduce your phosphate levels, especially if you are eating highly processed foods. In Westernized countries, there has been a dramatic increase in the use of Phosphate additives in order to preserve moisture, enhance color, and stabilize shelf life (27). Phosphate additives can contribute up to 1,000 mg of total daily phosphorus intakes (23). To decrease your phosphate intake, you should avoid highly processed foods with phosphate additives as well as preserved meats such as ham, salami, smoked turkey, or deli chicken breast (23).
Just keep your levels stable through a rich diet and supplementation, and watch your athelticism blossom.
Works Cited
- https://pubmed.ncbi.nlm.nih.gov/7965369/
- https://www.ncbi.nlm.nih.gov/books/NBK541123/
- https://www.ncbi.nlm.nih.gov/books/NBK470386/
- https://www.ncbi.nlm.nih.gov/books/NBK441960/
- https://www.heart.org/en/healthy-living/healthy-eating/eat-smart/sodium/how-to-reduce-sodium
- https://www.mcgill.ca/oss/article/health-nutrition-you-asked/table-salt-kosher-salt-sea-salt-himalayan-salt-which-one-should-i-buy#:~:text=A%20quarter%20teaspoon%20of%20table,the%20different%20salts%20is%20irrelevant.
- https://www.heart.org/en/healthy-living/healthy-eating/eat-smart/sodium/sea-salt-vs-table-salt
- https://pubmed.ncbi.nlm.nih.gov/33086585/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3648706/
- https://www.ncbi.nlm.nih.gov/books/NBK482465/
- https://www.ncbi.nlm.nih.gov/books/NBK470284/
- https://www.ncbi.nlm.nih.gov/books/NBK430912/
- https://www.ncbi.nlm.nih.gov/books/NBK430714/
- https://www.nhs.uk/conditions/vitamins-and-minerals/calcium/
- https://my.clevelandclinic.org/health/diseases/14597-hypercalcemia
- https://www.ncbi.nlm.nih.gov/books/NBK500003/
- https://ods.od.nih.gov/factsheets/Magnesium-HealthProfessional/
- https://pubmed.ncbi.nlm.nih.gov/11550076/
- https://www.ncbi.nlm.nih.gov/books/NBK541123/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7009052/
- https://www.ncbi.nlm.nih.gov/books/NBK493172/
- https://ods.od.nih.gov/factsheets/Phosphorus-Consumer/
- https://ods.od.nih.gov/factsheets/Phosphorus-HealthProfessional/
- https://www.ncbi.nlm.nih.gov/books/NBK551586/
- https://pubmed.ncbi.nlm.nih.gov/24425729/
- https://pubmed.ncbi.nlm.nih.gov/24854273/
- https://pubmed.ncbi.nlm.nih.gov/23402914/
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