6 signs of electrolyte imbalance, from weight gain and headaches to nausea and confusion, according to an exercise scientist
Gabby Landsverk
- Electrolytes like sodium are key for a healthy body and brain, and too little of them can be risky.
- A lack of electrolytes can cause a range of health issues from mild headache to life-threatening brain damage.
Staying hydrated is crucial during exercise to boost performance and reduce fatigue, but it's possible to drink too much water and throw off your body's delicate balance, with major side effects, according to an exercise scientist.
Known as hyponatremia, a lack of electrolytes is rare but can have serious and sometimes life-threatening consequences, said Sean Langan, an associate research director at the University of Connecticut's Korey Stringer Institute
"Hyponatremia is a fancy term for low sodium. It's relatively rare, but it can lead to sudden death in athletes," he told Insider.
The most common scenario for electrolyte issues in otherwise healthy people is when athletes are exercising for a long period of time at a low intensity and drinking plenty of water, but not sweating it out fast enough, Langan said.
When that happens, the body can end up holding on to too much fluid, diluting the levels of the electrolytes sodium, potassium, and chloride.
Normally, your kidneys help get rid of excess water by making you have to pee. But during exercise, blood flow is diverted from the kidneys to the muscles, and too much water can become an issue, according to Langan.
"The idea is that you're drinking fluids with no salt and drinking them faster than you can pee or sweat them out. You dilute your blood," he said.
Runners tackling a marathon or other endurance event for the first time can be particularly susceptible because their pace will be slow, and they'll likely take advantage of water breaks along the way, according to Langan.
To help prevent electrolyte imbalances, athletes can add a sports drink or similar supplement to their hydration during or after training, he said.
"For the regular person, it's really not something you need to be too concerned about. You should consume them but beyond what you're getting in your diet, there's no need to consume anything extra beyond a sports drink or pinch of salt in your water," Langan said.
Electrolytes are important even if you aren't exercising, too. Other potential causes of hyponatremia include excessive alcohol use, certain medications like diuretics, underlying illnesses, or persistent vomiting or diarrhea, which can make it hard to replenish the body's supply of sodium, according to the Mayo Clinic.
You may want to add more salt and other electrolytes to your water if you notice the following symptoms:
Headaches can be a symptom of mild sodium deficiency.
One problem with treating electrolyte imbalance is that symptoms may not appear early on at all. When they do, symptoms can be very similar to other exercise-related ailments, including heat stroke and exhaustion, according to Langan.
"It's important to be able to distinguish the two so you can properly treat them," he said.
For example, headaches are a common symptom that can easily be attributed to other conditions. They can also range in severity, so figuring out whether electrolyte imbalance is to blame may involve looking for other symptoms occurring at the same time.
Nausea is another common but vague symptom to look out for.
Nausea, feeling sick, and vomiting can also indicate an electrolyte imbalance, as well as other exercise-related ailments, Langan said.
It can be potentially more serious because vomiting and nausea can make it harder to keep down food or drinks that could resupply the body with electrolytes, potentially exacerbating the problem.
In emergency cases, IV electrolytes can be used to help patients recover more quickly, according to the Mayo Clinic.
Dizziness and confusion after a workout are warning signs.
Combined with nausea or headache, feeling dizzy, confused, or foggy after a workout are red flags, Langan said.
Similarly, sudden and unexplained changes to mood or mental health suggest something is seriously wrong, and may indicate that the brain is being affected, according to the Cleveland Clinic.
A person with hyponatremia may feel tired, lethargic, disoriented, or irritable, which could escalate to more serious symptoms and lasting damage to the brain and other organs.
Swelling is a tell-tale sign of lack of sodium as fluid builds up in the body.
One of the clearest ways to distinguish electrolyte deficiency from other possible ailments is to look for swelling during exercise, according to Langan.
Unexplained puffiness to the skin or body can indicate a buildup of fluid — athletes often notice this when their fitness tracker or watch start to feel and look tighter, he said.
Weight gain after exercise is unusual, and a red flag.
To verify whether swelling indicates water retention, you can step on a scale to see if you've added any water weight.
During a long training session, athletes will typically weigh less than when they started due to sweat. For balanced hydration, athletes may do a "sweat test" to weigh in before or after, and try to drink enough to compensate for the fluids lost to sweat during training.
In the case of hyponatremia, the opposite can occur, and athletes may ending up weighing more than when they started, according to Langan.
If so, there's a good chance the athlete is taking in more water than they can use or excrete, causing a buildup and potentially disrupting the proper electrolyte imbalance.
"You still need to hydrate because it improves performance. It's a hard thing to balance," Langan said.
Seizures, weakness, cramps, and coma can be serious side effects.
In severe cases, hyponatremia can lead to hospitalization and is potentially life-threatening, with side effects like seizures, muscle cramps, spasms, or weakness, and even loss of consciousness and coma.
Symptoms can be more dangerous when they occur quickly, in a period of hours, rather than the course of a day or two, according to the Mayo Clinic.
Serious electrolyte issues can be a risk to all the organs but especially the brain, potentially causing permanent brain damage — and trying to treat severe cases too quickly can also be risky, according to research.
Potential risk factors like long exercise, underlying health conditions, and certain medications can also influence your risk of hyponatremia.
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