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Overview of Fluid and Electrolyte Physiology (Fluid Compartment)Electrolyte balance and muscle function -
Water is the foundation of all life. The percent of body water changes with development, because the proportions of muscle, fat, bone, and other tissues change from infancy to adulthood. Of all the nutrients, water is the most critical, as its absence proves lethal within a few days.
Maintaining the right level of water in your body is crucial to survival, as either too little or too much will result in less-than-optimal functioning.
Several minerals are key to regulating water balance in different compartments of the body; the most important of these are sodium, potassium, and chloride. In the human body, water is distributed into two compartments: inside cells, called intracellular fluid ICF , and outside cells, called extracellular fluid ECF.
Extracellular fluid includes both the fluid component of the blood called plasma and the interstitial fluid IF that surrounds all cells not in the blood Figure 8.
Figure 8. Fluid compartments in the human body. The intracellular fluid ICF is the fluid within cells.
The extracellular fluid ECF includes both the blood plasma and the interstitial fluid IF between the cells. Although water makes up the largest percentage of body volume, it is not actually pure water, but rather a mixture of dissolved substances solutes that are critical to life.
These solutes include electrolytes, substances that dissociate into charged ions when dissolved in water. Together, these electrolytes are involved in many body functions, including water balance, acid-base balance, and assisting in the transmission of electrical impulses along cell membranes in nerves and muscles.
One of the essential homeostatic functions of the body is to maintain fluid and electrolyte balance within cells and their surrounding environment. Cell membranes are selectively permeable : Water can move freely through the cell membrane, while other substances, such as electrolytes, require special transport proteins, channels, and often energy.
The movement of water between the intracellular and extracellular fluid happens by osmosis , which is simply the movement of water through a selectively permeable membrane from an area where solutes are less concentrated to an area where solutes are more concentrated Figure 8.
To maintain water and electrolyte balance, cells control the movement of electrolytes across their membranes, and water follows the electrolytes by osmosis.
The health of the cell depends on proper fluid and electrolyte balance. For example, consider a person exercising strenuously, losing water and electrolytes in the form of sweat, and drinking excessive amounts of water.
The excess water dilutes the sodium in the blood, leading to hyponatremia , or low blood sodium concentrations. Sodium levels within the cells are now more concentrated, leading water to enter the cells by osmosis. As a result, the cells swell with water and can burst if the imbalance is severe and prolonged.
In contrast, the opposite situation can occur in a person exercising strenuously for a long duration with inadequate fluid intake. This can lead to dehydration and hypernatremia , or elevated blood sodium levels.
The high concentration of sodium in the extracellular fluid causes water to leave cells by osmosis, making them shrink Figure 8.
When a person becomes dehydrated, and solutes like sodium become too concentrated in the blood, the thirst response is triggered. Sensory receptors in the thirst center in the hypothalamus monitor the concentration of solutes of the blood.
If blood solutes like sodium increase above ideal levels, the hypothalamus transmits signals that result in a conscious awareness of thirst.
The hypothalamus also communicates to the kidneys to decrease water output through the urine. This pump transports sodium out of cells while moving potassium into cells. When a nerve cell is stimulated e.
Similar to how a current moves along a wire, a sodium current moves along a nerve cell. Stimulating a muscle contraction also involves the movement of sodium ions. For a muscle to contract, a nerve impulse travels to a muscle.
The movement of the sodium current in the nerve signals the muscle cell membrane to open and sodium rushes in, creating another current that travels along the muscle and eventually leading to muscle contraction. In both nerve and muscle cells, the sodium that went in during a stimulus now has to be moved out by the sodium-potassium pump in order for the nerve and muscle cell to be stimulated again.
Although sodium often gets villianized because of its link to hypertension, it is an essential nutrient that is vital for survival. As previously discussed, it is not only important for fluid balance, but also nerve impulse transmission and muscle contraction.
Sodium can be found naturally in a variety of whole foods, but most sodium in the typical American diet comes from processed and prepared foods. Manufacturers add salt to foods to improve texture and flavor, and also to act as a preservative.
Most Americans exceed the adequate intake recommendation of mg per day, averaging 3, mg per day. Food category sources of sodium in the U. population, ages 2 years and older.
Deficiencies of sodium are extremely rare since sodium is so prevalent in the American diet. It is too much sodium that is the main concern. High dietary intake of sodium is one risk factor for hypertension , or high blood pressure. In many people with hypertension, cutting salt intake can help reduce their blood pressure.
So are about a quarter of people with normal blood pressure, although they may develop high blood pressure later, since salt sensitivity increases with age and weight gain. African Americans, women, and overweight individuals are more salt-sensitive than others.
The Dietary Approaches to Stop Hypertension DASH is an eating pattern that has been tested in randomized controlled trials and shown to reduce blood pressure and LDL cholesterol levels, resulting in decreased cardiovascular disease risk. It is low in saturated fats and rich in potassium, calcium, and magnesium, as well as dietary fiber and protein.
It also is lower in sodium than the typical American diet, and includes menus with two levels of sodium, 2, and 1, mg per day. Potassium is present in all body tissues and is the most abundant positively charged electrolyte in the intracellular fluid. As discussed previously, it is required for proper fluid balance, nerve transmission, and muscle contraction.
Potassium is found in a wide variety of fresh plant and animal foods. Fresh fruits and vegetables are excellent sources of potassium, as well as dairy products e.
Dietary sources of potassium. Your brain sends electrical signals through your nerve cells to communicate with the cells throughout your body. When this happens, it sets off a chain reaction, moving more sodium ions and the change in charge along the length of the nerve cell axon.
The electrolyte calcium is needed for muscle contraction 7. It allows muscle fibers to slide together and move over each other as the muscle shortens and contracts. Magnesium is also required in this process so that the muscle fibers can slide outward and muscles can relax after contraction.
Water must be kept in the right amounts both inside and outside each cell in your body 8. Osmosis is a process where water moves through the wall of a cell membrane from a dilute solution more water and fewer electrolytes toward a more concentrated solution less water and more electrolytes.
This prevents cells from bursting from being too full or shriveling up due to dehydration 9. To stay healthy, your body needs to regulate its internal pH pH is a measure of how acidic or alkaline a solution is. For example, your blood is regulated to stay at a pH of around 7. Having the right balance of electrolytes is fundamental to maintaining your blood pH level Electrolytes are essential for keeping your nervous system and muscles functioning.
In some circumstances, electrolyte levels in your blood can become too high or low, causing an imbalance 11 , 12 , Disturbances in electrolytes can have a harmful effect on your health and can even be fatal in rare cases Electrolyte imbalances often occur due to dehydration caused by excess heat, vomiting or diarrhea.
Some illnesses, including kidney disease, eating disorders and injuries like severe burns, can cause electrolyte imbalances as well 16 , 17 , 18 , However, more severe imbalances can cause symptoms like 20 , 21 :.
If you suspect you have an electrolyte imbalance, be sure to discuss your symptoms with your doctor. Electrolyte imbalances most commonly occur when people are severely dehydrated due to vomiting, diarrhea or excessive sweating.
Severe imbalances can interfere with the way your body functions. As a result, long periods of exercise or activity, particularly in the heat, can cause significant electrolyte loss.
But the actual amount of electrolytes lost through sweat can vary from person to person 23 , In the US, the maximum recommended intake for sodium is 2, mg per day — which is equivalent to 6 grams or 1 teaspoon of table salt However, certain populations, such as endurance athletes who are exercising for more than two hours or those who exercise in extreme heat, may want to consider drinking electrolyte-enriched sports drinks to replace their losses For everyone else, getting the normal amount of sodium from foods and drinking water to remain hydrated is enough.
You lose water and electrolytes, particularly sodium, when you sweat. However, the sodium consumed through your diet is normally enough to cover any losses. The main food sources of electrolytes are fruits and vegetables.
However, in the Western diet, a common source of sodium and chloride is table salt. Below are some foods that provide electrolytes 28 , 29 , 30 :.
Some people drink electrolyte water or supplement with electrolytes like sodium and calcium to ensure they get enough. But in some circumstances, such as during bouts of vomiting and diarrhea where electrolyte losses are excessive, supplementing with a rehydration solution that contains electrolytes could be useful Always read the instructions on over-the-counter replacement solutions.
Also note that unless you have low levels of electrolytes due to excessive losses, then supplementing can cause abnormal levels and possibly illness If you eat a balanced diet that contains good sources of electrolytes, supplementing is usually unnecessary.
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