Hypokalemia (Low Potassium) – Causes, Symptoms and Treatment

Hypokalemia

Potassium is one of the body’s vital electrolytes. Potassium is needed for cells, tissues, organs, and even the nerves and muscles to function. Without potassium, most of our body organs will eventually give up and stop working.

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Potassium has a vital role to play even in the heart and its related muscles (cardiac muscle). Potassium also helps in regulating your blood pressure.

The average levels of potassium in the blood are 3.6-5.2millimoles per liter (mmol/l). It is, therefore, imperative for the body to maintain balance even in its electrolyte concentration.

Hence if there is anything wrong with the delicate balance of the electrolytes in the body, especially potassium, it can pose a huge problem.

Your body regulates your potassium levels through the kidneys. It does this by allowing excess potassium to be excreted out of the body via urine and sweat.

When potassium is severely reduced, it results in a condition known as hypokalemia. Other names doctors call hypokalemia are hypokalemic syndrome, low potassium syndrome, or hypopotassemia syndrome.

All these names refer to the reduced rates of potassium in the body.

Causes

The kidney is responsible for the regulation of the potassium levels in the body. It does this by regulating the body’s sweat and urine output as well as its concentration.

When the potassium levels in the body are low, it is mostly an indication of an underlying disease condition.

This means most times; hypokalemia is often a symptom of another disease. However, there are other causes of hypokalemia too.

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These causes include;

  • Bartter syndrome: This syndrome is a rare genetic mutation disorder that is often causing disturbances in the kidney and, as such, causes salt and electrolyte (including potassium) imbalance, invariably causing hypokalemia.
  • Gintel Syndrome: Gintel syndrome is a rare syndrome that causes imbalances in the ion concentrations of the body. Once the potassium level drops below average, it can result in hypokalemia.
  • Liddle Syndrome: This is a rare kidney disorder that causes interruptions in the electrolyte imbalance as well as increased blood pressure and hypokalemia.
  • Cushing Syndrome: Cushing syndrome is one rare genetic syndrome that occurs as a result of too much exposure to cortisol. Once this happens, there will a decrease in potassium levels, causing hypokalemia.
  • Eating of substances such as bentonite, otherwise known as clay or glycyrrhizin, which is mostly present in tobacco and natural licorice, can cause a reduction in the potassium levels of the body.
  • There are some diuretics that are known as potassium wasting diuretics. These diuretics cause the depletion of potassium. Some examples of these kinds of diuretics include thiazides, osmotic diuretics, as well as loops.
  • The use of laxatives for a long time will cause the depletion of your electrolytes as well as essential ions such as potassium.
  • High doses of penicillin can cause hypokalemia.
  • Diabetic ketoacidosis.
  • Dilution caused as a result of IV fluid administration.
  • The deficiency of magnesium can lead to reduced production of potassium.
  • When there is a problem with the adrenal glands, it can affect the regulation of potassium.
  • Malnutrition: Inadequate intake of potassium or the lack of the intestines to absorb the potassium, as well as reduced magnesium levels can cause hypokalemia.
  • Hyperthyroidism
  • Delerium Tremens
  • A surge of catecholamine which is usually seen in the case of a heart attack
  • Renal tubular acidosis type I or II
  • Barium Poisoning
  • Familial hypokalemia
  • Some drugs used for the treatment of COPD and asthma, such as insulin and beta II agonist, can cause hypokalemia
  • The excessive intake of alcohol
  • Folic Acid deficiency

Research has shown that women often tend to develop hypokalemia much more than men, and this is because of certain factors that cause an increase in the need for potassium.

Factors such as menstruation, pregnancy, and so on can cause an increased demand for potassium.

Symptoms

Hypokalemia can either be mild or severe. Mild hypokalemia generally doesn’t have symptoms. Most people who have mild hypokalemia never even know they have it.

However, when the condition becomes critical, the patient will experience the following symptoms:

  • Severe weakness and body fatigue
  • Constipation and sometimes bloating
  • Severe muscle cramps
  • Intense heart palpitations
  • Loss of appetite
  • Vomiting
  • Nausea

Generally, according to doctors at the Mayo Clinic, potassium levels that are below 3.6 is considered to be mild hypokalemia; however, anything below 2.5 mmol/l is considered to be critically low and life-threatening.

Those who are in a critical state will experience symptoms such as:

  • Muscle paralysis
  • Respiratory failure as a result of the weakening of the lungs
  • Breakdown and eventual atrophy of muscle tissue.
  • Inability to control bowel movement due to ileus(also known as lazy bowels)

When these symptoms are not treated, the patient will experience abnormal heart rhythms.

Risk factors

There are some factors that put one at risk of developing hypokalemia, and they include:

1. The use of drugs

If you continuously take diuretic drugs that have been known to cause hypokalemia, then you are consciously increasing your chances of developing hypokalemia.

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2. Prolonged illness

Having a disease that continually makes you vomit or have severe diarrhea will increase your chances of having electrolyte imbalances and, as such, developing hypokalemia.

3. The presence of an underlying disease

Having any of the syndromes that were written above can lead to having hypokalemia as it is part of the Symptoms of the disease.

4. People who already have an existing heart condition

People who have any heart problems are at a higher risk of developing hypokalemia. It is essential that their potassium level should be around 4mmol/l.

This is because, even when they have a mild reduction in their potassium levels, it can lead to an abnormal heartbeat.

Hence if you previously have heart problems such as congestive heart failure, a history or family history of heart attack, as well as cardiac arrhythmias, there is a tendency that you will develop hypokalemia quickly.

Diagnosis

Most times, diagnosis is usually made through blood and urine tests. These tests are mostly done to check for the mineral, and potassium levels are normal.

Since heart abnormalities and hypokalemia are closely linked, your doctor will most likely ask you to go for an ECG test in order to your heartbeat as well as any sound that can sound suspicious.

Treatment

Once your doctor has confirmed that you have hypokalemia, he will immediately require that you should be hospitalized. Once in the hospital, the doctor will take the following approaches to tackle the situation:

1. Remove the initial causes

Your doctor will first identify the initial cause of the reduction. This is because hypokalemia is usually a symptom of other diseases. Once the initial cause has been identified, then the next step will be to treat the underlying cause.

2. Restoration of the potassium levels

Once the underlying cause has been treated, you will be given potassium supplements to take, as this will help you boost your potassium levels. However, these supplements should be taken gradually and according to prescription.

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The prescription your doctor will give you will help you to restore your potassium levels gradually. Trying to increase your potassium level all at once can cause unwanted side effects such as abnormal heart rhythm.

However, in cases where the patient has extremely low levels of potassium, the patient might be prescribed an IV drip filled with potassium, as this will help control the uptake of potassium.

3. Monitor the levels of potassium

While in the hospital, a nurse or doctor will be assigned to monitor your potassium levels regularly. This is done to ensure that there is no reversal such that you have an elevated level of potassium, leading to hyperkalemia.

Hyperkalemia, too, can cause several issues. For more information on this, you can refer to an article on hyperkalemia.

Deborah Akinola
Wirter, poet and public speaker