What Is Chloride?

Chloride is an essential electrolyte. Electrolytes are minerals that are found in your blood.

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These electrolytes help with:

• Muscle function
• Nerve function
• Keeping the pH of your blood in the normal range
• Maintain your balance of fluids‌

You get most of your chloride in the form of sodium chloride, or salt, in the food you eat.

Compared to the other electrolytes, there have been few research studies on chloride abnormalities. Critical care units often see abnormalities in electrolytes and pH levels, so research on chlorides has been carried out in that setting. A study found that among people in intensive care units, about 6.7% - 37% had low chloride levels.

In people who are critically ill, abnormal chloride levels are linked to more serious stages of illnesses. But the exact reason is unknown.

Causes of Hypochloremia

Because you get chloride from salt, it’s rare to be nutritionally deficient in chloride. In healthy people, chloride is usually absorbed in your gut. Then it’s transported in your blood and distributed to your tissues.

Your kidneys maintain your body’s total chloride levels. Problems with your kidneys can result in an abnormal chloride level in your body.

Hypochloremia can be caused by:

• Diarrhea 
• Vomiting 
• Excessive sweating
• Kidney problems
• Chronic respiratory acidosis, which is when your body can’t remove all the carbon dioxide it produces
• Syndrome of inappropriate antidiuretic hormone excretion (SIADH), when your body makes too much antidiuretic hormones. These hormones help manage the amount of water in your body. 
• Metabolic alkalosis, which is when your body’s pH level becomes too alkaline
• Use of certain medications like corticosteroids, diuretics, laxatives, and bicarbonates

Cancer treatment. Chemotherapy is often used to treat cancer. But chemotherapy drugs may cause an electrolyte imbalance in your body. Some side effects of chemotherapy may not show up until months or years after treatment. One of these is kidney problems, which can cause hypochloremia.

Diagnosis of Hypochloremia

Your doctor may order a chloride blood test as part of an electrolyte panel. An electrolyte panel is a blood test that measures chloride, bicarbonate, potassium, and sodium. Usually, chloride levels aren’t tested individually. 

You don’t need to fast for an electrolyte panel. A healthcare professional will take a blood sample and send it to a lab for testing. 

Sometimes your doctor may also order a urine chloride test. Urine also contains chloride. 

Regular Chloride Ranges

Your blood chloride value is a measurement of the concentration of chloride. That is, the amount of chloride in milliequivalents per liter. So hypochloremia means that your concentration of blood chloride is below the normal range.

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If you have high levels of chloride in your blood, that’s known as hyperchloremia.

If you’re healthy, your blood chloride levels don’t change much during the day. But after you eat, there might be a slight drop in chloride levels because of the gastric juice produced.‌

Treatment of Hypochloremia

Treatment of your hypochloremia depends on the underlying conditions that have caused it. Your doctor will work with you to treat your condition. When correcting your chloride levels, your doctor will base it on your health conditions.‌

You may be given an intravenous (IV) saline solution to restore your electrolyte levels.

If your electrolyte imbalance is mild, your doctor may advise you to eat foods rich in chloride or take a supplement. But check with your doctor before you take any supplements. 

All unprocessed foods have chloride at low levels. Unprocessed meat and fish may have up to 4 milligrams of chloride per gram. Vegetables and fruits generally have less than 1 milligram of chloride per gram. You can add chloride to food in the form of sodium chloride (table salt).‌

But be careful of eating too much salt. It can lead to many health issues such as:

• Kidney disease
• Stroke
• High blood pressure
• Heart failure
• Stomach cancer
• Osteoporosis

Experts recommend the following amount of chloride:

• Adults and children aged 11 to 17 years: 3.1 grams a day
• Children aged 7 to 10 years: 2.6 grams a day
• Children aged 4 to 6 years: 2 grams a day
• Children aged 1 to 3 years: 1.7 grams a day 

Hypochloremia (Low Chloride)

What Is Hypochloremia?

Hypochloremia is an electrolyte imbalance and is indicated by a low level of chloride in the blood. The normal adult value for chloride is 97-107 mEq/L.

Chloride in your blood 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 the acid and base balance in the body.

Causes of Hypochloremia:

• Loss of body fluids from prolonged vomiting, diarrhea, sweating or high fevers.
• Drugs such as: bicarbonate, corticosteroids, diuretics, and laxatives.

Symptoms of Hypochloremia:

• Many people do not notice any symptoms, unless they are experiencing very high or very low levels of chloride in their blood.
• Dehydration, fluid loss, or high levels of blood sodium may be noted.
• You may be experiencing other forms of fluid loss, such as diarrhea, or vomiting.

Things You Can Do For Hypochloremia:

• Make sure you tell your doctor, as well as all healthcare providers, about any other medications you are taking (including over-the-counter, vitamins, or herbal remedies). Do not take aspirin or products containing aspirin unless your healthcare provider permits this.
• Remind your doctor or healthcare provider if you have a history of diabetes, liver, kidney, or heart disease. 
• Keep yourself well hydrated. Drink two to three quarts of fluid every 24 hours, unless you are instructed otherwise.
• Avoid caffeine and alcohol, as these can cause you to have electrolyte disturbances.

Drugs That May Be Prescribed by Your Doctor:

• As with most types of electrolyte imbalance, the treatment of low blood chloride levels is based on correcting the cause. If there is a dysfunction of your endocrine or hormone system, you may be referred to an endocrinologist for treatment. If there are problems with your kidneys, you may need to see a nephrologist.
• If your low blood chloride levels are due to medications or treatments, these may be altered or removed, if possible.

When to Contact Your Doctor or Health Care Provider:

• Nausea that interferes with your ability to eat, and is unrelieved by prescribed medication.
• Vomiting (vomiting more than 4-5 times in a 24 hour period).
• Diarrhea (4-6 episodes in a 24-hour period), unrelieved with taking anti-diarrhea medication and diet modification.
• Severe constipation, unrelieved by laxatives, lasting 2 to 3 days.
• Muscle twitching, irritability, increased urination, poor appetite that does not improve.
• If you notice excessive sleepiness, confusion.

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Note: We strongly encourage you to talk with your health care professional about your specific medical condition and treatments. The information contained in this website is meant to be helpful and educational, but is not a substitute for medical advice.

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