Key takeaways:
Chloride is an electrolyte. Along with other electrolytes, like sodium, it reflects your body’s fluid balance. It also gives clues about your blood’s pH (acid-base) balance.
Chloride is usually checked as part of a panel of other electrolyte blood tests. Looking at all the results together will help find the cause of high or low chloride levels.
Different health conditions and medications can affect your blood chloride level. Many of these have to do with your kidneys or your digestive system.
Getting blood test results can be stressful, especially if something is out of the normal range. Chloride is one result that can spark confusion. It’s an electrolyte that can signal whether your body has a healthy balance of fluids and chemicals. But it can be a little confusing to know what it means when your level is high or low.
What is a chloride blood test?
Chloride is an electrolyte found in your blood. The term “electrolyte” is used a lot these days, so it may be hard to know exactly what it means. An electrolyte is simply a particle that has an electrical charge when dissolved in fluid, like blood.
Chloride is one of many electrolytes that circulate in your blood. Other examples include sodium and potassium. Chloride is usually checked as part of a panel of bloodwork called a basic metabolic panel. This panel looks at electrolytes, glucose, and kidney function.
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What does a chloride blood test tell you?
Chloride on its own doesn’t give much specific information. But when combined with other tests on a blood panel, it can give important clues about the balance of fluids and acids in your body. If your chloride level is off, there could be an underlying condition that needs treatment.
Temporary changes in your body, like being dehydrated or drinking a lot of water, can affect chloride in the short term. Other conditions, like kidney disease or lung disease, can affect chloride over the long term.
Chloride blood test results
For most laboratories, a normal chloride test result is between 96 mEq/L and 106 mEq/L (or mmol/L). The lab’s normal reference range will also be listed. In some cases, the way the blood is drawn or processed can affect your result.
What causes low chloride levels?
A low chloride level, called hypochloremia, happens when your result falls below the lab’s normal reference range. Some health conditions that cause this include:
Vomiting or diarrhea
Some medications, like diuretics or laxatives
Addison’s disease, a condition where the adrenal glands don’t make enough of certain hormones
Chronic lung disease, like chronic obstructive pulmonary disease (COPD) or cystic fibrosis
Some forms of kidney disease
Low chloride can also happen after taking too many antacids or drinking large amounts of water. If chloride is very low, other electrolytes will usually be abnormal too. For example, sodium is often low when chloride is low.
What causes high chloride levels?
A high chloride level, or hyperchloremia, is when your blood chloride result falls above the standard range. Some reasons for high chloride include:
Metabolic acidosis, which can happen with health conditions or substances that cause acid to build up in your body
Dehydration
Some forms of diarrhea
High chloride levels often go along with changes in other electrolytes, like sodium. A healthcare professional will look at your chloride in the context of all your lab results. That’ll give clues about the cause.
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Why do you need a chloride blood test?
Chloride is most often checked as part of a routine panel of bloodwork. It’s not usually ordered as a test on its own. Some specific reasons to check electrolytes, including chloride, include:
Tracking side effects of medications, like diuretics, that can affect electrolytes
Following health conditions that affect fluid balance and electrolytes, which is common with conditions like heart failure, kidney disease, or intestinal conditions that affect nutrition and absorption
Making decisions about intravenous (IV) fluids and medications for hospitalized patients
Investigating the cause of certain symptoms such as confusion, weakness, or heart rhythm problems
Chloride levels are also sometimes checked in urine, sweat, or stool samples. These tests are usually done to diagnose or manage particular health conditions.
Chloride blood test preparation
You don’t need to do anything specific to prepare for a chloride blood test. But since chloride is often tested along with other levels, like blood sugar, you may need to follow specific instructions for those tests.
What happens during a chloride blood test?
Chloride blood tests are done through a blood draw. This means a healthcare professional will place a very small needle into one of your veins — usually your arm — to obtain a small test tube of blood.
Are there any risks taking a chloride blood test?
There are no significant risks to a chloride blood test. You may experience a small amount of pain or bruising from the blood draw itself, if at all.
The other “risk” to consider is that an abnormal test result may cause unnecessary concern or anxiety. But know that chloride that’s just outside the normal range is unlikely to mean anything serious. This is especially true if your other tests are normal. In some cases, you’ll repeat a blood test to see if the results are similar.
If you’re feeling sick and have abnormal chloride results, contact a healthcare professional. This is especially true if you:
Have vomiting or diarrhea that won’t stop
Feel dizzy, weak, or confused
Have trouble breathing
Have significant or worsening swelling
Have muscle twitching or tingling sensations
Frequently asked questions
There are no specific foods you need to avoid if your chloride level is high. Because dehydration is a possible cause of a high chloride level, hydrating foods and drinks may help. But the best treatment really depends on the cause of your high chloride level. It’s important to coordinate with your healthcare team before making any drastic changes to your diet on account of your chloride level.
The best way to fix low chloride levels also depends on the cause. For example, if vomiting or diarrhea is causing low chloride, hydration may be all you need. But if heart failure is the cause of your low chloride, you may need to limit fluids. This is why it’s important to talk to a healthcare professional before you try to address low chloride levels on your own.
There are no specific foods you need to avoid if your chloride level is high. Because dehydration is a possible cause of a high chloride level, hydrating foods and drinks may help. But the best treatment really depends on the cause of your high chloride level. It’s important to coordinate with your healthcare team before making any drastic changes to your diet on account of your chloride level.
The best way to fix low chloride levels also depends on the cause. For example, if vomiting or diarrhea is causing low chloride, hydration may be all you need. But if heart failure is the cause of your low chloride, you may need to limit fluids. This is why it’s important to talk to a healthcare professional before you try to address low chloride levels on your own.
The bottom line
Chloride is an electrolyte that reflects your body’s fluid balance. There are temporary and long-term medical conditions that can affect your chloride level. Usually, other lab results, like changes in sodium levels or in your body’s pH, also provide clues about the cause.
A chloride level that’s only a little above or below the normal range isn’t usually a sign of a serious problem, especially if your other results are normal. But it’s important to contact your healthcare team if you’re feeling sick. They can interpret the results with you to find out the cause of your abnormal lab results.
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References
Arora, N. (2023). Serum chloride and heart failure. Kidney Medicine.
Berend, K., et al. (2012). Chloride: The queen of electrolytes? European Journal of Internal Medicine.
Burger, M., et al. (2022). Metabolic acidosis. StatPearls.
Mosca, A. M., et al. (2021). Addison’s disease: A diagnosis easy to overlook. Curēus.
