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Definition:

Hypokalemia is a lower-than-normal amount of potassium in the blood. It may result from a number of conditions.



Alternative Names:

Potassium - low; Low blood potassium



Causes, incidence, and risk factors:

Potassium is needed for cells, especially nerve and muscle cells, to function properly. You get potassium through food. The kidneys remove excess potassium in the urine to keep a proper balance of the mineral in the body.

Hypokalemia is a metabolic disorder that occurs when the level of potassium in the blood drops too low.

Possible causes of hypokalemia include:

  • Certain antibiotics (carbenicillin, gentamicin, amphotericin B)
  • Certain drugs, called diuretics, that can cause excess urination
  • Diarrhea (including the use of too many laxatives, which can cause diarrhea)
  • Diseases that affect the kidney's ability to retain potassium (for example, Liddle syndrome, Cushing syndrome , hyperaldosteronism , Bartter syndrome , Fanconi syndrome )
  • Eating disorders (such as bulimia )
  • Eating large amounts of licorice or using products such as herbal teas and chewing tobaccos that contain licorice made with glycyrrhetinic acid (this substance is no longer used in licorice made in the United States)
  • Excessive sweating
  • Excessive vomiting
  • Kidney problems
  • Lack of enough potassium in diet (rarely)


Symptoms:

A small drop in potassium usually doesn't cause symptoms. However, a big drop in the level can be life threatening.

Symptoms of hypokalemia include:

  • Abnormal heart rhythms (dysrhythmias ), especially in people with heart disease
  • Breakdown of muscle fibers (rhabdomyolysis )
  • Constipation
  • Fatigue
  • Muscle weakness or spasms
  • Paralysis (which can include the lungs)


Signs and tests:

Your health care provider will take a sample of your blood to check potassium levels .

Other tests might include:



Treatment:

Mild hypokalemia can be treated by taking potassium supplements by mouth. Persons with more severe cases may need to get potassium through a vein (intravenously).

If you need to use diuretics, your doctor may switch you to a form that keeps potassium in the body (such as triamterene, amiloride, or spironolactone).

One type of hypokalemia that causes paralysis occurs when there is too much thyroid hormone in the blood (thyrotoxic periodic paralysis ). Treatment lowers the thyroid hormone level, and raises the potassium level in the blood.



Support Groups:



Expectations (prognosis):

Taking potassium supplements can usually correct the problem. Without proper treatment, potassium levels in severe cases can drop low enough to cause death.



Complications:

In severe cases, patients can develop paralysis that can be life threatening. Hypokalemia also can lead to dangerous irregular heartbeat. Over time, lack of potassium can lead to kidney damage (hypokalemic nephropathy).



Calling your health care provider:

Call your health care provider if you have been vomiting or have had excessive diarrhea, or if you are taking diuretics and have symptoms of hypokalemia.



Prevention:

Eating a diet rich in potassium can help prevent hypokalemia. Foods high in potassium include:

  • Bananas
  • Bran
  • Brussels sprouts
  • Granola
  • Kiwi
  • Lima beans
  • Milk
  • Oranges
  • Peaches
  • Peanut butter
  • Peas and beans
  • Tomatoes


References:

Schaefer TJ, Wolford RW. Disorders of potassium. Emerg Med Clin North Am. August 2005;23:723-747.

Lafrance JP, Leblanc M. Metabolic, electrolytes, and nutritional concerns in critical illness. Crit Care Clin. April 2005;21:305-327.

Goldman L, Ausiello D. Cecil Textbook of Medicine. 22nd ed. Philadelphia, Pa:Saunders, 2003.

Fukagawa M, Kurokawa K, Papadakis M. Fluid and electrolyte disorders. In Gonzales R, Ziegler R, eds. Current Medical Diagnosis and Treatment 2007. New York, NY:McGraw-Hill, 2006.




Review Date: 9/12/2007
Reviewed By: Robert Hurd, MD, Professor of Endocrinology, Department of Biology, Xavier University, Cincinnati, OH, and physician in the Primary Care Clinic, Cincinnati Veterans Administration Medical Center, Cincinnati, Ohio. Review provided by VeriMed Healthcare Network.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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