Hypokalemia- The Potassium Deficiency Syndrome

Hypokalemia refers to the condition in which the concentration of potassium (K+) in the blood is low. This means that a person who is suffering from potassium deficiency is known to suffer from hypokalemia. Potassium is a type of mineral called an electrolyte. Electrolytes are minerals that maintain your body’s ionic balance. They’re essential for normal nerve, brain, and muscle function.

Other electrolytes include sodium, calcium, and magnesium. Electrolytes carry an electric charge and control the electrical activity of your body, including the heart. They also affect your hydration and muscle function.

Potassium is critical to your body’s functions, and without it, you can have serious health problems. Your body needs potassium to break down and use carbohydrates and proteins. It’s also used to help build muscles.

Low potassium is called hypokalemia. Potassium affects the function of all your muscles, most importantly your heart muscles. That means low potassium can lead to heart arrhythmia or attack, especially in those who already have heart problems.

The normal potassium level is 3.5-5.0 mmol/L (millimoles per litre) Low potassium is defined as a potassium level below 3.5 mmol/L.

What Creates Hypokalemia?

Some chronic conditions can cause low potassium levels. So can vomiting and diarrhoea, along with long-term kidney disease, alcoholism, and eating disorders like bulimia, which involve forced vomiting and excessive use of laxatives.

Because of this, over-the-counter fluids recommended for people with vomiting and diarrhoea usually contain potassium, as do many sports drinks, which are also sometimes suggested to help with those symptoms.

Symptoms of Potassium Deficiency

1Muscle Weakness, Spasms, Cramps and Tetany

In order for muscle cells to contract, a marked difference in intracellular and extracellular potassium concentrations must exist. As potassium levels drop, this concentration difference decreases and the muscles are unable to function normally. This causes generalized fatigue and a variety of muscular symptoms including weakness, spasms, twitching and cramps. In cases of extreme hypokalemia, the muscles can go into a sustained involuntary state of contraction called tetany.

2Paralysis due to potassium deficiency

Extreme potassium deficiency can cause the muscles to go completely limp, a condition called flaccid paralysis. Importantly, the muscles involved in breathing can be affected by this condition, known as hypokalemic paralysis. Breathing can be slow and shallow, or may stop completely.

3Muscle Stiffness, Aching and Tenderness

Severe potassium deficiency not only impairs the function of muscle cells, it also damages them, causing their contents to leak out — a condition called rhabdomyolysis. Symptoms include profound weakness and muscle stiffness, aching and tenderness.

4Abdominal Bloating, Pain and Cramping

The involuntary muscles of the stomach and intestines can also malfunction when the potassium level is too low. Symptoms include abdominal bloating, pain and cramping and constipation. In the extreme, the intestinal activity may virtually stop, a condition called paralytic ileus.

5Heart Palpitations

The rhythmic, coordinated contractions of the heart are controlled by electrical impulses, which are ferried across the heart muscle by a specialized conduction system. Potassium deficiency can disrupt this conduction system, causing heart rhythm abnormalities. The most common symptom is heart palpitations — an awareness of missed beats, extra beats, or a feeling that the heart is pounding too fast or too hard. These rhythm abnormalities can be life-threatening, and cardiac arrest may occur.

6Dizziness and Fainting

Potassium deficiency can cause the kidneys to lose their ability to concentrate urine. As a result, excessive amounts of water are lost from the body and the blood pressure drops. This can cause symptoms of dizziness or fainting, especially when getting up to a standing position.

7Frequent Urination and Extreme Thirst

As noted, potassium deficiency can cause an excessive loss of water through the kidneys. Frequent urination and extreme thirst are common symptoms when hypokalemia has been present for some time.

8Numbness and Tingling

Low potassium causes the nerves to fire abnormally, which may cause numbness, tingling or a burning sensation, especially in the hands and feet.

Low potassium diagnosis

Sometimes the cause of low potassium is not clear. To diagnose the potassium deficiency, the doctor may perform certain tests to rule out other conditions such as renal tubular acidosis, Cushing’s syndrome, and hypocalcaemia.

Blood tests check potassium level, kidney function, glucose, magnesium, calcium and phosphorous if an electrolyte imbalance is suspected. Because low potassium is known to affect heart rhythms (arrhythmias), a doctor may recommend a digoxin level if you are taking a digitalis medicine.

ECG or a heart tracing is done to detect electrical changes in the heart and certain types of irregular heart rhythms that may be caused by low potassium.

Eat the right food to avoid Hypokalemia

There is a majority of food sources from where we can derive potassium in an everyday balanced diet. Here is a list of few sources of food which are rich in potassium.

Fruits:

potassium deficiency - fruitsBananas contain a healthy dose of potassium, and some say bananas can help you avoid muscle cramps. Up your banana intake with a banana-walnut smoothie or some delicious paleo-friendly banana bread. Oranges are another good source, as are mangoes, kiwis, apricots, dates, and avocado.

Vegetables:

potassium deficiency - vegetablesVegetables that are high in beta-carotene also tend to contain a lot of potassium, like carrots, sweet potatoes, and red peppers. You can find a perfect recipe for sweet potato and red pepper soup online.

Fish:

potassium deficiency - fishThe sea is another great source of potassium. Sardines contain plenty of it, with 365 mg per can. Salmon is also a great source of potassium; one fillet contains about 1.94 grams.

Meat:

potassium deficiency - meatGrilled steak can be a healthy part of getting enough potassium, especially when combined with tomatoes, leafy greens, and peanuts.

Potassium is essential for good health, and it’s pretty easy to get enough of it with a healthy diet. Sudden onset of low potassium symptoms should concern you, especially if you are on certain diuretics or have lost fluids through vomiting or diarrhoea. If you experience ongoing symptoms of low potassium, see your doctor for a blood test and treatment recommendations. 

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