Nutrition: Electrolytes

Sodium

Sodium is essential for the proper functioning of the human body. Sodium plays important roles in the body…

Maintaining cellular homeostasis
Maintaining extracellular fluid volume
Regulating blood pressure
Controlling overall electrolyte balance

An individual's general sodium serum levels should fall between 135 to 145 mmol/L. Hyponatremia occurs when an individual's sodium levels fall below 135 mmol/L and is a condition whereby the balance of water is in excess of the balance of salt in the body. The result of hyponatremia may be symptoms such as headaches, confusion, nausea, delirium, muscle cramps, seizure, coma, and/or death. Hypernatremia occurs when an individual’s sodium levels rise above 145 mmol/L and is a condition whereby the balance of water is in deficit of the balance of salt in the body. The result of hypernatremia may be symptoms such as severe thirst, rapid breathing, sleeping difficulty, restlessness, muscle twitching, seizures, coma, and/or death.

General recommendations for sodium consumption is less than 2,300mg per day. There are a number of simple ways that an individual may be able to decrease the sodium levels, such as eating more vegetables, avoiding highly processed foods, finding ‘low sodium’ or ‘no added salt’ substitutes and replacing salt with low sodium seasoning. On the other hand, if an individual has low sodium levels, they may want to gradually add more salt to their diet.

Potassium

Potassium is an important electrolyte in the human body, and it is important for this to be balanced with sodium. Potassium is essential for a number of intracellular interactions such as membrane potential and electrical excitation of both nerve and muscle cells.

Generally, an individual’s potassium serum levels should be between 3.6 to 5.5 mmol/L. If an individual has less than 3.6 mmol/L, they may have hypokalaemia which can cause weakness, fatigue, muscle twitching, renal failure, malnutrition, and cardiac disease. If an individual has more than 5.5 mmol/L, they may have hyperkalaemia which can cause muscle cramps, muscle weakness, rhabdomyolysis, kidney problems, arrhythmias, or paralysis.

The recommended consumption of potassium is approximately 4,700 mg/day of potassium. It is therefore more common for someone to be deficient rather than in excess. In order to provide the body with sufficient potassium it may be beneficial to eat the following potassium rich foods: 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.

Calcium

Calcium is important for the functioning of the body:

Fortification of bones
Contraction of muscles
Transmission of nerve signals
Stimulating of blood clotting
Release of hormones

An individual's calcium serum levels should be between 8.8 to 10.7 mg/dl. Hypocalcaemia occurs when an individual has less than 8.8 mg/dl. This can present as asymptomatic or life threatening. The common causes of low calcium are poor nutrition, vitamin D deficiency, autoimmune disease, or pregnancy. Hypercalcemia occurs when an individual has more than 10.7 mg/dl. Hypercalcemia can have symptoms of gastrointestinal disorders, bone abnormalities, kidney stones, fatigue, constipation, and depression.

The average individual requires around 1,000 mg of calcium per day.

In order to increase calcium levels, an individual should increase their 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 as kale and okra, drinks such orange juice or soy drinks with added calcium, sardines, and bread made with fortified flour. In order to reduce calcium levels, an individual should drink more water and avoid Calcium-rich foods.

Magnesium

Magnesium is important for the functioning of metabolism, muscle contraction and relaxation, glucose regulations, bone development, and neurological functioning. Recommendations for the average individual is to consume approximately 25 grams of magnesium each day. Resulting in magnesium serum levels to fall between 1.46 to 2.68 mg/dl.

An individual with magnesium levels in deficit of 1.46 mg/dl, may have hypomagnesemia, which can have symptoms of mild tremors, generalised weakness, cardiac ischemia, and/or kidney problems. Prolonged magnesium deficiencies can lead to hypertension, cardiovascular disease, type 2 diabetes, osteoporosis, and migraines. The main causes of magnesium deficiency include alcohol use disorder, gastrointestinal losses, loss of kidney function, or laxative abuse. An individual with magnesium levels in excess of 2.68 mg/dl, may have hypermagnesemia, which can have symptoms of nausea, vomiting, abnormally low blood pressure, and/or neurological impairment. The main causes of excess magnesium are kidney disease, malnourishment, alcoholism, and the overuse of antacids.

Despite most individuals consuming sufficient magnesium in a normal healthy diet, it may still be advised to increase magnesium intake through food or supplements. There are many 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 fibre. Magnesium supplementation may also have benefits and select studies have shown that magnesium citrate, lactate, and chloride forms absorbed more completely with more bioavailability than magnesium oxide and magnesium sulphate.

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.

An individual's phosphorus serum levels should fall between 3.4mg/dl and 4.5mg/dl.

Phosphorus levels that fall below 3.4mg/dl may result in hypophosphatemia which can cause loss of appetite, anaemia, muscle weakness, coordination problems, bone pain, abnormal bones, and overall higher risk of infection. Prolonged deficiency can also lead to osteopenia, osteoporosis, and rickets. 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.

Phosphorus levels that rise above 4.5mg/dl may result in hyperphosphatemia, which is associated with chronic kidney disease and cardiovascular disease. The main cause for excessive phosphorus is kidney failure, however, the use of phosphorus containing laxatives and vitamin D intoxication may also contribute to a surplus in phosphate.

Most individuals should have adequate phosphorus levels from consuming a normal healthy diet. It is recommended for an adult to consume at least 1000 mg/day of dietary phosphate. If someone has low levels of phosphorus, they can increase absorption by consuming more vitamin D, since it helps absorption of both phosphorus and calcium. Most phosphorus rich foods include yoghurt, milk, salmon, and cheese. Animal sources tend to have a higher absorption rate than that from plant sources. However, vegan friendly options include lentils, cashews, potatoes, brown rice, and peas. If someone has high levels of phosphorus this may be indicative of high consumption of excessively processed foods. Phosphate additives can contribute up to 1,000mg of total daily phosphorus intakes. To decrease phosphate intake, an individual should avoid highly processed foods with phosphate additives as well as preserved meats such as ham, salami, smoked turkey, or deli chicken breast.

Summary

Overall, electrolytes are essential for basic life functioning, such as maintaining electrical neutrality in cells, generating, and conducting action potentials in the nerves and muscles. Electrolytes can have an imbalance, leading to either high or low levels. High or low levels of electrolytes disrupt normal bodily functions and can lead to even life-threatening complications.