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What Is Serum Chloride?

By Todd Helfman

Chloride is one of the four main electrolytes found in the serum, or bloodstream. Serum electrolytes, such as sodium, potassium, bicarbonate, and chloride, are important for maintaining the human body's delicate fluid and metabolic acid-base balance. Alterations in the level of any individual main electrolyte greatly effects the homeostatic environment, causing a variety of deleterious effects on the body.


Serum chloride is a negative ion, or molecule, found in the bloodstream; it is paired with sodium, a positive ion, also found in the blood. Paired with sodium, the movement of chloride throughout the body facilitates the movement of sodium, thus allowing fluid accumulations to be controlled. Excess fluid follows the sodium, resulting in homeostasis, or balance. Chloride can be measured with a simple blood test providing a range of serum levels that should be maintained. Effected by a variety of conditions, serum chloride is maintained at levels between 96 and 106 milliequivelants per liter (mEq/L).

Low Chloride

Low chloride, or hypochloremia, is most often the result of inadequate intake of chloride or its loss from the body. Too much fluid can also dilute the serum and cause lower levels of measured serum chloride. A variety of conditions can contribute to hypochloremia, including overhydration, adrenal gland disorders such as Addison's disease, vomiting and diarrhea in addition to congestive heart failure. A number of medications can also contribute to lower serum chloride, in particular certain diuretics, or medications that cause you to loose fluid. They do so so by eliminating chloride from the body to help regulate the sodium and eliminating excess fluid.

High Chloride

High chloride, or hyperchloremia, is exclusively seen in conditions that cause a lowering of the pH level, or acidotic state, in the blood. These conditions include severe dehydration, excessively elevated blood sugars, or diabetic ketoacidosis, aspirin overdoses, certain kidney diseases such as renal tubular acidosis and a number of medications.

Chloride Management

The management of serum chloride disorders is dependent on the underlying pathology causing the abnormality. Medication-induced chloride abnormalities can be corrected by your physician adjusting or changing medications. Controlling chloride losses through vomiting and diarrhea can be controlled with antiemetics and antidiarrheals. Elevated levels of chloride are also managed by correcting the underlying cause, such as regulating excessive blood sugars with insulin and intravenous fluids to correct certain kidney disorders and dehydration.


If you are concerned that you have symptoms possibly consistent with serum chloride level abnormalities, contact your health care provider for evaluation. Do not begin or discontinue any therapy without first discussing the possibilities with your physician.

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