Hypokalemia – Symptoms, Causes, Treatment


What is Hypokalemia ?

Hypokalemia is a condition wherein the body has lower than normal amounts of potassium.

There are several tiny chemicals in the body that are vital for cellular function. These chemicals are called electrolytes and potassium is one such electrolyte. A major part of potassium in the body is available in the cells, while only two percent is present in the serum. The maintenance and regulation of electric potential within the cells is one of primary functions of potassium. The serum constantly bathes the cells and hence even small changes in the levels of serum potassium can affect the function of the body. The cells in the nerves and muscles are the ones with high electrical impulses. Therefore, such cells are most affected by drop is serum potassium levels.

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The normal blood levels of potassium range from 3.6 to 5.2 millimoles per liter (mmol/L). Serum potassium levels that are lower than 2.5 mmol/L require emergency medical procedures as they can prove to be fatal.

The normal daily dietary intake of potassium is around 270 to 390 mg/dl, and the same amount should be eliminated by the kidneys each day. In case, there is larger amounts of potassium removal, then it can result in hypokalemia.

Some of the sources of potassium in our diet are listed below:

  • Juices of fruits such as prune, orange, grapefruit and apricot
  • Fresh vegetables such as mushrooms, greens, peas, tomatoes and beets
  • Fresh fruits such as cantaloupe, strawberries, oranges, bananas, kiwi, apricots and avocados
  • Meats such as fish, beef and turkey

Symptoms of hypokalemia

The functions of neuromuscular cells such as the discharge of energy or depolarization and the regeneration of energy or repolarization is affected by the levels of potassium. Low levels of potassium prevent the ability of the cells in the nerves and the muscles to recharge or fire up again on a continual basis. This can lead to the following symptoms of hypokalemia:

  • Muscle aches
  • Weakness of the muscles
  • Muscle cramping
  • The heart is also made of muscles and individuals affected by hypokalemia may show abnormal readings in an ECG or an EKG.
  • The patients may also perceive irregular heartbeats or palpitations as well as disturbances in the cardiac rhythms or arrhythmias, which can be life-threatening.

Hypokalemia causes

Poor dietary intake is not one of the common causes of hypokalemia.

Hypokalemia or low levels of potassium are generally caused due to excessive loss of potassium either through the kidneys or through the gastrointestinal tract or through both.

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Loss of potassium through the kidneys may occur due to the following reasons:

  • Increased levels of corticosteroid that result from either Cushing’s syndrome or from the intake of steroid medications
  • Renal tubular acidosis
  • Consumption of diuretic medications such as furosemide or hydrochlorothiazide
  • Low levels of magnesium in the body
  • Increased levels of aldosterone. It is a hormone and its levels can rise due to adrenal tumors or renal artery stenosis

Intestinal loss of potassium may occur due to the following causes:

  • The use of laxatives
  • Vomiting
  • Considerable amounts of potassium loss can also occur in individuals who have undergone bowel surgery and have has an ileotomy formed.
  • Bouts of diarrhea
  • Patients affect by villous adenoma which is a kind of colon polyp can also result in the colon leaking potassium.

Individuals may also lose potassium as a possible side effect of some medications such as:

  • Amphotericin B
  • Aminoglycosides such as tobramycin or gentamicin
  • Prednisone

Treatment for hypokalemia

  • Blood potassium levels that are above 3.0 mEq/liter are of no great concern and are not life threatening. Such cases can be treated by oral replacement of potassium or through oral drugs.
  • Blood potassium levels that are lower than 3.0 mEq/liter may be replaced by intravenous methods. However, all treatments for hypokalemia are treated on a individual basis and depend on a number of factors such as the situation of the ailment, the relevant diagnosis and the ability of the person to ingest medications and fluids through the mouth.
  • Many types of illnesses such as diarrhea, vomiting and gastroenteritis are self-limiting and do not pose any grave dangers. In such cases, the body is able to self-regulate and restore the original levels of potassium on its own.
  • Severe cases of hypokalemia, wherein the loss of potassium is continuous and ongoing may require immediate medical intervention to supplement and replace the potassium.
  • Patients who consume diuretic drugs are bound to lose potassium from their body. Such individuals may require to additionally intake potassium medications. Alternatively, they may change their diet to include more items that contain potassium such as bananas, orange juice, green vegetables, fish, etc. It is important to note that in such cases, there has to be regular monitoring of the kidney functions to prevent any excessive increase in the potassium levels in the body.
  • It is essential to remember that intravenous injection of potassium must be given very slowly else it can result in heart problems.
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