Which electrolyte disturbances are commonly seen in chronic heavy alcohol use?

• A. Hypokalemia, hypomagnesemia, hypophosphatemia, hyponatremia
• B. Hyperkalemia only
• C. Electrolyte disturbances are not associated.
• D. All electrolytes are normal.

Answer: (A)

Chronic heavy alcohol use disrupts electrolyte balance through poor nutrition, GI losses, and altered kidney and fluid regulation, so multiple deficiencies tend to occur together. Potassium often runs low because of inadequate intake plus vomiting or diarrhea and sometimes renal wasting. Magnesium deficiency is especially common in this group due to poor intake and renal losses, and low magnesium can worsen potassium abnormalities. Phosphate drops because of malnutrition and the body’s shifts during stress and refeeding. Sodium can be low as a result of dilutional hyponatremia from high fluid intake (beer potomania) and fluid retention related to liver disease, which impairs free-water clearance.

So the typical pattern is low potassium, low magnesium, low phosphate, and low sodium, reflecting the overall nutritional and fluid-management challenges seen with chronic heavy alcohol use.