Potassium Deficiency

Potassium is an important mineral for a multitude of bodily processes. Deficiency in potassium can leave you feeling poorly and even become life threatening. Knowing more about potassium deficiency can truly save your life.

Potassium is a positively charged electrolyte and found almost entirely inside the cells of our body as opposed to floating freely in the blood stream. Potassium is important for muscle function, including the heart, and is kept in balance primarily by the kidneys.

Normal blood potassium levels are between 3.5-5.0 mEq/L (mEq/L stands for milliequivalents per liter of blood). Once the level dips below 3.5 mEq/L you are suffering from low potassium.

Potassium balance is affected by a variety of factors such as fluid balance, blood glucose levels and insulin use, medication use and diseases.

Potassium Deficiency Symptoms

Low potassium generally causes a sense of weakness and malaise.

People complain of tiredness, muscle cramps and overall whole body weakness. Muscle cramps can be mild and progress to a severe degree.

Neurologic symptoms such as tingling, numbness and passing out can occur. Gastrointestinal symptoms such as nausea, vomiting, cramping and bloating are possible. Some others may experience constipation. Palpitations and an irregular heartbeat can occur, but extremely low levels of potassium can result in more serious electrical conduction problems in the heart. Psychiatric symptoms are also known to occur and include depression, delirium, confusion and hallucinations.

Causes of Potassium Deficiency

Medication Side Effects

Certain medications affect the potassium levels and can result in rapid loss of potassium from the body.

Examples include fluid medications such as diuretics that are used to treat high blood pressure, heart failure or leg swelling Aminoglycoside antibiotics, asthma and COPD medications such as albuterol, steroids and theophylline can also cause low potassium. Insulin administration causes temporary low potassium by shifting even more of the potassium inside of cells.

Potassium Loss

Depletion of potassium can occur through several mechanisms. Some are more rapid that others and produce more profound symptoms. Vomiting, diarrhea, excess laxative use, enemas and excess sweating can all result in low potassium. Surgical procedures that alter the length of the colon can also result in significant potassium loss.

Kidney Problems

The kidneys are finely tuned to balance electrolyte concentrations and certain conditions or disease states alter this ability. Acute or chronic renal failure, acidosis in the renal tubules and hormone excess (aldosterone) contribute to low potassium. Magnesium levels are closely tied to potassium and a deficiency of magnesium can result in markedly low potassium. This also makes replacement more difficult.

Diabetic Ketoacidosis

Poorly controlled diabetes triggers a cascade of events that disrupts normal physiology and results in several dangerous problems. The elevated blood glucose cannot be reabsorbed by kidneys and accumulates in the urine. This draws more water into the urine resulting in potassium loss and dehydration. The body's pH becomes acidic as additional ketones are produced. This acidic environment further draws potassium out of the cells and further loss in the urine occurs. The body depleted of potassium as a consequence. Diabetic ketoacidosis also causes abdominal pain and vomiting that leads to additional potassium loss.

Primary Aldosteronism

Primary aldosteronism is part of a complex cascade of hormones that help regulate blood pressure and fluid balance in the body. The adrenal glands sit on top of the kidneys and aldosterone is produced there. Elevated aldosterone causes high blood pressure and also results in excess potassium loss. In essence, the kidney exchange potassium for sodium and potassium is lost into the urine. The end result is weakness, muscle cramps, excessive thirst and heart rhythm abnormalities due to the low potassium.

Other Causes

People with bulimia, anorexia, and alcoholics have a higher likelihood of developing low potassium. Nutritional intake is the primary way we get our required amounts of potassium. Bulimics and anorexic persons both suffer from electrolyte and nutritional deficiencies resulting in low potassium. Alcoholics tend to eat poorly and suffer from low potassium along with lower levels of magnesium and folic acid.

Treatments for Potassium Deficiency

1. Eat Potassium-rich Foods

Your diet is the primary way to obtain adequate amounts of potassium. Certain foods such as squash, sweet potato, yogurt, broccoli, halibut, banana, salmon, pistachios and tuna provide a good supply of potassium. Vitamins also can provide additional sources of potassium, other vitamins and nutrients, but expert recommend whole foods as the best option for ensuring optimum potassium intake.

2. Common Drugs Recommended

Potassium vitamin supplements are the most commonly prescribed medications to treat low potassium. Potassium replacement by mouth is very effective and more safely administered than intravenous (IV) replacement of potassium. Potassium given by IV has to be administered slowly and in much smaller amounts that oral potassium tablets and requires continuous cardiac monitoring during infusion.

3. Medical Treatment

Treatment is geared towards the following goals: stopping potassium loss, replenishing potassium stores, evaluating for toxicity and preventing further episodes of low potassium.

Step One. Stop any offending medications such as diuretics. Treat sources of potassium loss such as diarrhea and gain control of blood glucose (diabetic patients).

Step Two. Replace potassium losses through dietary rich foods. Oral potassium replacement with prescription potassium (oral or IV) is a rapid way to correct low potassium levels. Large doses of oral potassium tablets are well tolerated and save. IV potassium can be given along with oral replacement in cases of extremely low potassium. Magnesium levels should be checked and replaced if low to enhance potassium absorption.

Step Three. Monitor for toxicity. Low potassium can cause palpitations and an irregular heart rhythm. An EKG or cardiac monitor is used in the hospital or clinic setting to monitor during IV potassium replacement. Rapid infusion of potassium burns and can be dangerous. High potassium levels are also dangerous and cause life threatening heart arrhythmias as well.

When to See a Doctor

If you are experiencing symptoms that could be due to low potassium, call your doctor or seek medical care. A lab test can measure the exact level, if treatment is necessary or if another cause is responsible for your symptoms. If you are feeling like passing out, having heart palpitations or experiencing severe muscle cramps you need to seek immediate medical care.

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