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1. What Is Hyperchloremia?
Hyperchloremia is an electrolyte imbalance and is indicated by a high level of chloride in the blood. The
normal adult value for chloride is 97-107 mEq/L.
Chloride is an important electrolyte and works to ensure that your body's metabolism is working correctly.
Your kidneys control the levels of chloride in your blood. Therefore, when there is a disturbance in your
blood chloride levels, it is often related to your kidneys. Chloride helps keep the acid and base balance in
the body.
What Are Some Causes Of Hyperchloremia?
Causes of hyperchloremia may include:
 Loss of body fluids from prolonged vomiting, diarrhea, sweating or high fever (dehydration).
 High levels of blood sodium.
 Kidney failure, or kidney disorders
 Diabetes insipidus or diabetic coma
 Drugs such as: androgens, corticosteroids, estrogens, and certain diuretics.
Usage
1. The electrolytes are distributed throughout all body fluids including theblood, lymph, and the
fluid inside and outside cells.2 The negative charge of chloride balances against the positive
charges of sodium and potassium ions in order to maintain serum osmolarity.
What Is Hypomagnesemia?
Hypomagnesemia is an electrolyte imbalance and is indicated by a low level of magnesium in the blood.
The normal adult value for magnesium is 1.5-2.5 mEq/L.
Magnesium is one of many electrolytes in your body and normal levels of magnesium are important for the
maintenance of heart and nervous system function.
What Causes Hypomagnesemia?
Your body regulates magnesium levels by shifting magnesium into and out of cells. A shift of potassium
into the cells causes hypomagnesemia.
Magnesium can be excreted by your kidneys. Any damage to your kidneys, when they are not working
properly, may cause a decrease in magnesium levels.

2. There are other causes of hypomagnesemia. These include:
 You may be taking in too little magnesium in your diet.
 If you have stomach or bowel problems, you may not be able to absorb the magnesium you take in.
 Magnesium may not be absorbed properly due to alcohol use, diarrhea, or laxative use.
 Increased excretion of magnesium from your body
 Renal (kidney) damage - Losses of magnesium from the kidneys are a common cause of magnesium
deficit.
 Certain drugs, including Cisplatin, Amphotericin B, or certain antibiotics may affect your kidneys.
 Endocrine disorders - such as Aldosteronism, or dysfunction with the thyroid and parathyroid glands
or diabetes.
 Pregnancy
What Are Some Symptoms of Hypomagnesemia To Look For?
You may not have any symptoms, unless your blood test results show that your magnesium levels are
significantly decreased.
Muscle weakness, confusion, and decreased reflexes with severely low blood magnesium levels. You may
also notice "jerky" movements, high blood pressure, and irregular heart rhythms with severely low blood
magnesium levels.
What Is Hypermagnesemia?
Hypermagnesemia is an electrolyte imbalance and is indicated by a high level of magnesium in the blood.
The normal adult value for magnesium is 1.5-2.5 mEq/L.
Magnesium is one of many electrolytes in your body. Normal levels of magnesium are important for the
maintenance of heart, and nervous system function.
What Causes Hypermagnesemia?
Your body regulates magnesium levels by shifting magnesium into and out of cells. When there is a
breakdown or destruction of cells, the electrolyte magnesium moves from inside the cell, to outside of the
cell wall. This shift of magnesium outside of the cells causes hypermagnesemia.
Magnesium is excreted by your kidneys. Any damage to your kidneys, when they are not working properly,
may cause an increase in magnesium levels.
Other causes of hypermagnesemia include:

3.  Increased destruction or shift of potassium from within the cells. As seen with Tumor Lysis Syndrome,
when you receive chemotherapy, the drugs will act by breaking down the tumor cells. When there is a
rapid amount of cellular destruction, the components of the cells (including magnesium and potassium),
will move outside of the cell and into the blood stream. People who receive chemotherapy for Leukemia,
Lymphoma, or multiple Myeloma, may be at risk for Tumor Lysis Syndrome, if there is a large amount of
disease present.
 Decreased excretion of potassium from your body.
 Renal (kidney) failure is the most common cause of magnesium excess. Your kidneys are not able to
process and excrete magnesium and other electrolytes.
 You may be taking in too much magnesium in your diet, usually in the form of laxatives (such as milk of
magnesia), or antacids.
What Are Some Symptoms of HypermagnesemiaTo Look For?
You may not have any symptoms, unless your blood magnesium levels are significantly elevated. You may
have muscle weakness, confusion, and decreased reflexes if your blood test results show severely low
blood magnesium levels.
Usage
Magnesium is a cofactor in more than 300 enzyme systems that regulate diverse biochemical
reactions in the body, including protein synthesis, muscle and nerve function, blood glucose control,
and blood pressure regulation [1-3]. Magnesium is required for energy production, oxidative
phosphorylation, and glycolysis.
What is hyperphosphatemia?
Hyperphosphatemia may be described as high levels of inorganic phosphate in the blood.
The normal range for phosphorous is 2.5-4.5 mg/dL. Normal values may vary from laboratory to
laboratory.
Phosphate, or phosphorous, is similar to calcium, as it is found in your teeth and bones. Like calcium, you
need vitamin D in order to absorb phosphate properly.
The kidneys excrete phosphate. Therefore, the most common cause of increased phosphate levels (or
hyperphosphatemia) is the kidney's inability to get rid of phosphate. Hyperphosphatemia is also seen in
people who have:
 Excessive dietary intake of phosphate (also from laxatives or enemas)
 Your body may have a deficiency in calcium or magnesium, or it may have too much Vitamin D, resulting in
hyperphosphatemia.
 Severe infections can cause increased phosphate levels, resulting in hyperphosphatemia.

4.  Cell destruction - from chemotherapy, when the tumor cells die at a fast rate. This can cause tumor lysis
syndrome.
 Problems with your breathing (respiratory acidosis)
 You may have high phosphate levels from prolonged exercise, which causes muscle damage. Certain
athletes and distance runners may get this, called rhabdomyolysis.
 You may have problems with your thyroid, parathyroid gland, or other hormones, causing increased levels
of phosphate in your bloodand resulting in hyperphosphatemia
 Kidney failure can cause hyperphosphatemia
What are some symptoms of hyperphosphatemia to look for?
 Signs of hyperphosphatemia include an elevated blood phosphate level. Other electrolyte values are likely
to be affected, depending on your disease.
 There are no symptoms of hyperphosphatemia. You may not know that your blood phosphate levels are
elevated. The symptoms that you have are due to the underlying disease.
What is hypophosphatemia?
Hypophosphatemia may be described as low levels of inorganic phosphate in the blood.
Phosphate, or phosphorous, is similar to calcium, and is found in your teeth and bones. You need vitamin
D in order to absorb phosphate. The kidneys excrete (get rid of) phosphate from our bodies.
The normal range for phosphorous is 2.5-4.5 mg/dL. Normal values may vary from laboratory to
laboratory.
Hypophosphatemia is also seen in people who have:
 Poor absorption of phosphate - your body is not absorbing the phosphate
 If you had stomach surgery
 If you are lacking in Vitamin-D (which is needed to absorb phosphate)
 The absorption of phosphate is being blocked by aluminum hydroxide found in laxatives such as Maalox or
Amphogel.
 Certain medications prevent phosphate from being absorbed.
 Problems with your blood electrolyte levels, such as low blood magnesium (needed to absorb
phosphorous), or high blood calcium (which binds to the phosphorous, making it lower than normal).
 Certain breathing problems can lead to hypophosphatemia
 Low blood phosphate levels may also be the result of an increased loss of bicarbonate from your urine.
This may be a result of:
 Kidney dysfunction or damage- This form of damage to the kidneys does not cause failure (when your
phosphate levels will be higher than normal), but it causes you to excrete or get rid of too much
phosphorous through the kidney

5.  Water pills or diuretics
 Endocrine problems - such as a hyper parathyroid or thyroid gland, poorly controlled diabetes
 Alcoholism - drinking too much alcohol on a regular basis
 Rickets
 If you are being treated for severe, uncontrolled diabetes (or elevated blood glucose)- phosphate likes to
follow or accompany glucose into the cells, so you may have severely low blood phosphorous levels
following this treatment
What are some symptoms to look for?
 Signs of hypophosphatemia include a lower than normal blood phosphate level. Other electrolyte values
are likely to be affected, depending on your disease. There are no symptoms of hypophosphatemia, unless
the values are critically low. Then you may notice trouble breathing or respiratory problems, confusion,
irritability, or coma. These all may occur with phosphorous levels of 0.1-0.2 mg/ dL.
 You may not know that your blood phosphate levels are lower than normal, if they are not life-threateningly
low. If your phosphorous levels are below 1.0 mg/dL, your tissues may have more trouble connecting
hemoglobin with oxygen - which is critical for breathing. You may become mild to moderately short of
breath.
 The symptoms that you notice, with lowered phosphate levels, are due to the disease that is causing this
abnormality. If the disease itself is corrected, and with phosphorous supplementation, your blood
phosphorous levels should return to the normal range and your hypophosphatemia will go away.
What is Hypocalcemia?
Hypocalcemia is an electrolyte imbalance and is indicated by a low level of calcium in the blood. The
normal adult value for calcium is 4.5-5.5 mEq/L.
Calcium is important for healthy bones and teeth, as well as for normal muscle and nerve function. Normal
blood calcium levels are maintained through the actions of parathyroid hormone (PTH), your kidneys and
intestines.
If your blood test results show hypocalcemia, your doctor may check your albumin level as well. If
your albumin is low, your calcium level should be corrected for this. A corrected calcium level will be
higher if the albumin is low.
What Causes Hypocalcemia?
There are many causes of hypocalcemia, these include;
 Vitamin D deficiency
 Chronic renal failure
 Magnesium deficiency

6.  Alcoholism
 Biphosphonate therapy - drugs used to treat high blood calcium levels or pills used to treat osteoporosis.
 Certain types of leukemia or blood disorders
 A complication of chemotherapy, tumor lysis syndrome, occurs when your body breaks down tumor cells
rapidly, after chemotherapy. This may cause hypocalcemia, high blood potassium levels, and other
electrolyte abnormalities. This is very serious, and if your blood test results indicate you suffer from it, your
doctor or health care provider will need to closely monitor you during this time.
 Drugs such as diuretics, estrogens replacement therapy, fluorides, glucose, insulin, excessive laxative use,
and magnesium may also lead to hypocalcemia.
 Certain things in your diet, like caffeine, phosphates (found in soda pop), and certain antibiotics may make
it difficult for you to absorb calcium.
 Vitamin D, however, helps you to absorb calcium in your body.
What Are Some Symptoms of Hypocalcemia To Look For?
 The most common sign of hypocalcemia is what is called "neuromuscular irritability." Your nerves and
muscles, which are directly related to blood calcium levels, may spasm or twitch.
 If your blood test results indicate hypocalcemia, you may notice muscle cramps in your legs or your arms.
 The symptoms of hypocalcemia you experience may relate to how fast or how slowly the fall in blood
calcium levels occur.
 If you have long-standing low blood calcium levels, you may notice no symptoms of hypocalcemia.
 If you have an "acute" or sudden drop in your blood calcium level, you may notice more twitching.
 You may notice, with mildly lowered blood calcium levels, numbness and tingling of your fingers and toes.
 You may notice that you are depressed, or more irritable if you have mildly low hypocalcemia.
 With severely lowered blood calcium levels, you may become confused or disoriented. Your heart muscle
may contract irregularly due to the electrolyte disturbance.
What is Hypercalcemia?
Hypercalcemia is an electrolyte imbalance and is indicated by an excess of calcium in the blood. The
normal adult value for calcium is 4.5-5.5 mEq/L.
There are many reasons for an elevated blood calcium level. Reasons for the hypercalcemia may include:
 Cancer that started in the bone, or cancer that has spread to the bone.
 Some cancers can cause hypercalcemia themselves, without spread to the bone.
 Other conditions such as; overactive parathyroid gland or Paget's disease of the bone.
 Some medications cause hypercalcemia such as: alkaline antacids, diethylstilbesterol (DES), long-term
use of diuretics, estrogens and progesterone.
What Happens In Hypercalcemia?

7. Cancer cells that spread to the bone can secrete substances that can cause cells found in the bone
called osteoclasts to dissolve or "eat away" a portion of the bone. These tumors or lesions weaken the
bone and can lead to complications. Some of the complications resulting from this bone break down are
bone pain, fractures and less commonly, hypercalcemia.
What Are Some Symptoms of Hypercalcemia To Look For?
 Mild hypercalcemia may not produce any symptoms. However, symptoms of nausea, poor appetite,
vomiting and constipation may be present with mild increases in blood calcium levels.
 Moderate high levels of hypercalcemia may produce fatigue or excessive tiredness. Heart rhythm
abnormalities, increased urinary frequency, and kidney stones may also be present.
 With higher levels of hypercalcemia, patients may experience muscle twitching, anxiety, depression,
personality changes and confusion.
 With very high levels of hypercalcemia excessive sleepiness, coma even death may occur.
 The severity of symptoms for hypercalcemia depends not only on how high the calcium level is, but also on
how fast the rise in serum calcium has occurred.
Usage
1. The bones and teeth contain over 99% of the calcium in the humanbody. Calcium is also
found in the blood, muscles, and other tissue.Calcium in the bones can be used as a
reserve that can be released into the body as needed.