Most people will not be aware that they have hyperchloremia because the symptoms are almost impossible to identify. Doctors often discover the condition from a chloride blood test, which is part of a routine blood screening to monitor or diagnose electrolyte levels.
A doctor might do these tests if they suspect a person has any of the following:
The doctor will usually do tests for other electrolytes, such as sodium, potassium, and bicarbonate, at the same time.
If a doctor is concerned that a person might have diabetes, they might recommend a urine test as well.
This article explains the chloride blood test and how to interpret the results. High or low levels may have different symptoms and are indicative of a number of different conditions
How to prepare for the test
The test does not require any special preparation. However, always discuss any concerns or questions with a doctor.
A chloride blood test will take less than 10 minutes.
The blood test involves taking a blood sample from a vein, usually in the arm or hand.
The test will take less than 10 minutes and should not cause any harm. Some people might experience slight pain or bruising at the site where the doctor inserts the needle.
Once collected, the blood will go to a lab for analysis. The doctor usually receives the results from the lab within a few days.
What do high or low results mean?
The normal range for chloride is between 98 and 106 milliequivalents per liter (mEq/L).
Chloride levels above the normal range cause a condition known as hyperchloremia. Hyperchloremia happens when the volume of chloride ions rises, which might be due to a number of factors.
Possible causes include:
- Severe dehydration reduces the amount of fluids in the body, which means the levels of electrolytes increase because they cannot dissolve as they usually would.
- Diarrhea and excessive urination causes the body to lose water, which leads to increases in the concentration levels of bicarbonate and chloride
- Metabolic acidosis occurs when the pH of blood is lower than usual, and chloride levels are elevated. This has a serious effect on the body.
- Kidney disease. The kidneys help to balance electrolytes in the body so irregularities might signal a kidney problem.
- Chemotherapy can cause vomiting that may lead to dehydration and hyperchloremia. It can also cause damage to the kidneys, affecting the way they can balance electrolytes in the body.
Newborn babies often have hyperchloremia because their chloride levels rise in the week after birth. However, this is nothing to worry about, as the levels rise naturally and do not indicate a health problem.
Hyperchloremia is common in critically ill people.
Low levels of chloride cause a condition known as hypochloremia. Hypochloremia happens when the volume of chloride ions decreases.
Possible causes include:
- Low salt intake in the diet – table salt, or sodium chloride, is a primary source of dietary salt.
- Metabolic alkalosis, when the pH of blood is higher than usual.
- Certain medications, such as diuretics and laxatives, as these may reduce the amount of fluid in the body.
- Addison's Disease, which is when the adrenal glands that sit on top of the kidneys do not make enough of the hormones needed to maintain a healthy electrolyte balance. When this happens, chloride levels can fall.
Hydration can be a treatment for hyperchloremia.
Treatments vary according to the type of electrolyte balance a person has.
Most people can manage hyperchloremia with some lifestyle changes. For example, if dehydration is causing the hyperchloremia, treatment will likely include hydration, which may involve drinking lots of water every day.
People should eat a healthful, balanced diet and avoid caffeine and alcohol as they are diuretics.
However, anyone who experiences any symptoms that might suggest kidney problems should see a doctor as soon as possible.
If someone develops hypochloremia due to a medication they are taking, the doctor may adjust the dosage or prescribe a different drug. If hypochloremia is mild and due to diet irregularities, the doctor may recommend that the person increases their salt intake.
Outlook and takeaway
The amount of fluid a person consumes through drinking or loses through excessive sweating, diarrhea, or vomiting can affect chloride levels. Maintaining proper hydration may make chloride levels more stable.
Results of the chloride blood test that are not in the normal range are not usually a cause for concern. However, they can signify an underlying condition that might require treatment.
Always discuss test results with a doctor. If the chloride levels fall outside of the normal range, the doctor will recommend the most appropriate treatment.