Chloride

Overview

Chloride is one of the body’s three major electrolytes (the other two being sodium and potassium). They exist as fully dissociated ions and are the main particles responsible for osmotic pressure in body fluids. The osmotic pressure is very rigidly controlled, primarily by regulatory mechanisms that determine the rate of resorption of ions and water through the kidney. These substances are called electrolytes because they carry an electronic charge in their dissociated (ionic) state. This enables them to influence the solubility of proteins and other substances throughout the body. Hormonal control of chloride, sodium and potassium levels is mediated by the adrenal cortex and the anterior pituitary gland.

Dosage Info

Dosage Range

Estimated safe and adequate intake of chloride for adults is from 1.5-5 grams daily.

Most Common Dosage

Chloride is available in high amounts from dietary intake. It is seldom taken as a nutritional supplement.

Dosage Forms

Tablets, granules, powder and depending on the salt, as an injection (Rx only).

Adult RDI

None established

Adult ODA

None established

RDA

Active Forms

Sodium chloride and potassium chloride are the most commonly utilized chloride salts.

Absorption

Chloride ions are readily absorbed through the intestinal tract.

Toxicities & Precautions

General

Excess chloride is efficiently excreted through the kidneys, and therefore chloride toxicity has not been reported.

Functions in the Body

Anion Functioning

Primary anion functioning in the extracellular fluids throughout the body, which includes the blood, lymph and the fluid in the spaces between cells. Approximately 85 percent of the chloride ions reside in extracellular fluids and 15 percent in the intracellular fluids.

Osmotic Equilibrium

Helps to maintain normal osmotic equilibrium by controlling the distribution and balance of water throughout the body.

pH Balance

Helps to maintain the acid/base pH balance throughout the body.

Digestion

As part of gastric hydrochloric acid, chloride is necessary to maintain the normal acidity of the stomach for the processes of digestion.

Red Blood Cells

Participates in the chloride-bicarbonate shift by having the ability to move in and out of red blood cells and blood plasma. This action assists the plasma transport of tissue CO2 as bicarbonate to the lungs for excretion.

Nerve Transmission

The electrolytes, in conjunction with calcium and magnesium, function in the maintenance of nerve transmission and normal muscle activity (contraction and relaxation).

Clinical Applications

Acute Diarrhea

Chloride is one of the components in hypotonic oral rehydration solutions that are used to treat dehydration from acute diarrhea. (1)

Congenital Chloride Diarrhea

This condition causes watery diarrhea with high fecal chloride excretion. The basic defect involves the active Cl-/HCO3- exchange mechanism of the distal ileum and colon. Treatment of these children requires full oral replacement of the fecal losses of Cl-, Na+, K+, and water. (2) , (3)

Dehydration

Chloride, as part of normal saline, is one of the components in solutions that are used to treat patients who are dehydrated. (4) , (5) In some cases, a flavored solution of sodium chloride solution encourages drinking and rehydration. (6)

Strenuous Exercise

During strenuous exercise, ingestion of sodium chloride (as high as 60 mmol/l) may be beneficial with fluid replacement. (7) , (8) Ingestion of sodium chloride increases both glucose and fluid delivery by stimulating their uptake in the small intestine. (9) Sodium chloride supplementation also helps maintain normal extracellular fluid volume and in prolonged exercise, it helps prevent hyponatremia. (10)

Low Plasma Volume

Hypovolemia, or low plasma volume is a type of dehydration condition that sometimes develops in people during initial exposure to high altitudes, such as in mountain climbing. Treatment consists of providing an ionic drinking solution containing sodium, chloride, and citrate ions. (11)

Symptoms and Causes of Deficiency

Chloride deficiency is quite rare due to the widespread availability and use of table salt (sodium chloride). Extensive diarrhea, frequent vomiting, adrenal insufficiency, and long-term use of loop diuretics can cause chloride deficiency. A chloride deficiency creates a condition called metabolic alkalosis, which can cause diarrhea, vomiting and sweating. Other symptoms of chloride deficiency include weakness, poor digestion and loss of appetite, and hair loss. Increased sweating can also cause chloride depletion.

Dietary Sources

The primary dietary source of chloride is table salt (sodium chloride). Chloride also occurs abundantly in vegetables and animal foods.

References

  1. View Abstract: Mahalanabis D, et al. Hypotonic Oral Rehydration Solution in Acute Diarrhoea: A Controlled Clinical Trial. Acta Paediatr. Mar1995;84(3):289-93.
  2. View Abstract: Holmberg C. Congenital Chloride Diarrhoea. Clin Gastroenterol. Jul1986;15(3):583-602.
  3. View Abstract: Hoglund P, et al. Distinct outcomes of chloride diarrhoea in two siblings with identical genetic background of the disease: implications for early diagnosis and treatment. Gut. May2001;48(5):724-7.
  4. View Abstract: Banister A, et al. Treatment of Hypernatraemic Dehydration in Infancy. Arch Dis Child. Mar1975;50(3): 179-86.
  5. View Abstract: Kriemler S, et al. Preventing dehydration in children with cystic fibrosis who exercise in the heat. Med Sci Sports Exerc. Jun1999;31(6):774-9.
  6. View Abstract: Kriemler S, et al. Preventing Dehydration in Children with Cystic Fibrosis who Exercise in the Heat. Med Sci Sports Exerc. Jun1999;31(6):774-79.
  7. View Abstract: Clapp AJ, Bishop PA, et al. Effects of carbohydrate-electrolyte content of beverages on voluntary hydration in a simulated industrial environment. AIHAJ. Sep2000;61(5):692-9.
  8. View Abstract: Shirreffs SM, Maughan RJ. Volume repletion after exercise-induced volume depletion in humans: replacement of water and sodium losses. Am J Physiol. May1998;274(5 Pt 2):F868-75.
  9. View Abstract: Ames RP. The effect of sodium supplementation on glucose tolerance and insulin concentrations in patients with hypertension and diabetes mellitus. Am J Hypertens. Jul2001;14(7 Pt 1):653-9.
  10. Lemon P. Nutritional Factors in Strength and Endurance Training. Medicine and Sport Science. 1992;35:160-73.
  11. View Abstract: Greenleaf JE, et al. Sodium Chloride-citrate Beverages Attenuate Hypovolemia in Men Resting 12 h at 2800 m Altitude. Aviat Space Environ Med. Oct1998;69(10):936-43.