Hypochloremia

Hypochloremia is a condition in which you have low amounts of chloride in your blood. Another name for chloride is serum chloride anion.

Chloride is a type of electrolyte that’s most common in table salt (sodium chloride). Electrolytes are minerals that have a natural positive or negative charge when you dissolve them in water or other body fluids, such as blood. Healthy kidneys filter out excess chloride and other electrolytes from your blood, which leave your body when you pee.

Chloride helps your body:

• Balance body fluid levels
• Maintain acid and base levels (pH)
• Send nerve signals (impulses)

What are the average chloride ranges?

Healthcare providers measure chloride in millimoles per liter of blood (mmol/L). The typical ranges are:

• Adults: Between 96 and 106 mmol/L
• Children: Between 90 and 110 mmol/L
• Newborn babies: Between 96 and 106 mmol/L
• Premature babies: Between 95 and 110 mmol/L

Healthcare providers diagnose hypochloremia (hi-po-klawr-EE-mee-uh) when chloride levels go below these ranges.

Hypochloremia causes

Conditions that affect how well your kidneys work are some of the more common causes of hypochloremia. These may include an acute kidney injury (AKI) or chronic kidney disease (CKD).

Other conditions that can lower your chloride levels include:

• Congestive heart failure
• Liver disease
• Long-term (chronic) lung diseases, like emphysema
• Long-term respiratory acidosis
• Long-term vomiting or diarrhea
• Metabolic alkalosis
• Sweating a lot
• Syndrome of inappropriate antidiuretic hormone secretion (SIADH)

Certain medications can also lower your chloride levels. These include:

• Bicarbonates (antacids)
• Corticosteroids
• Diuretics
• Laxatives

Can dehydration cause low chloride?

Yes, dehydration can cause low chloride. Dehydration may result from:

• Diarrhea
• Sweating a lot
• Vomiting

Symptoms of hypochloremia

Low chloride levels usually don’t cause any symptoms. But if you have hypochloremia, you may have symptoms of its underlying cause. These symptoms may include:

• Dehydration
• Diarrhea
• Muscle weakness
• Trouble breathing
• Vomiting

Does low chloride mean heart failure?

Having low chloride levels doesn’t mean you have heart failure. But newer research suggests that it may play a larger role in heart failure.

Complications of hypochloremia

Without treatment, hypochloremia may cause:

• Kidney damage
• An irregular heartbeat (arrhythmia)
• Blood pH imbalance

How doctors diagnose hypochloremia

Healthcare providers can diagnose hypochloremia with a chloride blood test, which is part of a routine blood test. You don’t need to stop eating or drinking (fast) before a chloride blood test. But it’s a good idea to let the provider know if you have a fear of needles (trypanophobia). They can help you relax so you feel more comfortable during the test.

Providers sometimes also recommend a urine chloride test. A urine chloride test is a type of pee test (urinalysis) that measures how much chloride is in your pee.

You should get the results of your tests within a few days.

How is hypochloremia treated?

Hypochloremia treatment depends on its cause. Treatment options may include:

• Adjusting your eating patterns to eat more chloride
• Getting intravenous (IV) saline solution
• Stopping, adjusting or finding alternative medications
• Taking chloride supplements
• Working with a kidney specialist (nephrologist) to treat a kidney condition
• Working with a hormone specialist (endocrinologist) to treat SIADH

What should I eat if my chloride is low?

If you have hypochloremia, taking supplements or eating foods rich in chlorides can help raise your chloride levels. But you should first talk to a healthcare provider or dietitian before making any adjustments to your eating patterns. Eating too much salt can be bad for you.

Foods with naturally higher amounts of chloride include:

• Celery
• Lettuce
• Rye
• Tomatoes
• Olives
• Seaweed

Recovery time

The cause of hypochloremia determines your recovery. Depending on its severity, dehydration should resolve within one to three days. But if you have chronic kidney disease or another kidney condition, you may need regular appointments to preserve your kidney function. A healthcare provider will give you a better idea of what to expect in your situation.

When should I see my healthcare provider?

Schedule a visit with a healthcare provider if you have symptoms of a condition that can cause hypochloremia. If a provider diagnoses you with hypochloremia, schedule regular follow-up appointments for blood testing. You may wish to ask the following questions during an appointment:

• What’s causing hypochloremia?
• Are my kidneys OK?
• What treatment do you recommend?
• How often should I get blood tests?
• Should I make any changes to what I’m eating and drinking?
• Should I see a dietitian?
• Should I see a nephrologist?
• Should I see an endocrinologist?

What can I expect if I have hypochloremia?

With proper treatment, the outlook for mild cases of hypochloremia is good.

If a more serious condition causes hypochloremia, you may need to schedule regular appointments to ensure your hypochloremia levels stay in a healthy range.

Can hypochloremia be prevented?

It depends on the underlying cause. But in general, you can help avoid low chloride levels by staying hydrated, including:

• Avoiding alcohol and caffeine, which can cause dehydration
• Drinking the proper amount of water every day
• Taking medications exactly as prescribed by a healthcare provider
• Treating conditions that can cause dehydration, like diarrhea or vomiting

It’s also a good idea to make sure providers have your updated medical history. This is especially important if you have any conditions that may affect your:

• Heart
• Liver
• Kidneys