Health Encyclopedia

Hypokalemia

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:

Arterial blood gas
BUN and creatinine
Electrocardiogram
Glucose, magnesium, calcium, phosphorous, thyroxine, or aldosterone

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.

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.

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