Low Potassium Symptoms   * Page by Shelly   Low Potassium hypokalemia Author: Prem C Shukla, MD, Research Director, Assistant Professor, Department of Surgery, Division of Emergency Medicine, University of Texas Southwestern Medical Center Potassium is one of the minerals (also referred to as electrolytes) in the body. Almost 98% of potassium is found inside the cells. Small changes in the potassium that is present outside the cells can have severe effects on the heart, nerves, and muscles. Potassium is important to maintain several bodily functions. Our arms and legs, for example, need potassium for the muscles to move. The heart would not beat without potassium, which is also necessary to regulate blood pressure. The kidney is the main organ that controls the balance of potassium. It removes excess potassium into the urine. When potassium levels are low, you can become weak as cellular processes are impaired. If you have your blood checked, you might compare your readings with normal levels. The normal potassium level is 3.5-5.0 mEq/L (this is a measure used to evaluate the level). Low potassium is defined as a potassium level below 3.5 mEq/L. Almost 1 out of 5 people hospitalized in the United States have a low potassium level. Up to 14% of people otherwise seen in doctors' offices have slightly low potassium levels.                Low potassium can occur for many reasons. Use of water pills (diuretic therapy), diarrhea, and chronic laxative abuse are the most common causes of low potassium in the elderly. Kidney losses Certain kidney disorders such as renal tubular acidosis (see chronic kidney failure and acute kidney failure) Magnesium deficiency Leukemia Loss through stomach and intestines Vomiting Enemas or excessive laxative use Diarrhea After ileostomy operation Effect of medicines Water pills (diuretics) Medicines used for asthma or emphysema (beta-adrenergic agonist type of drugs such as bronchodilators, steroids, or theophylline) Aminoglycosides (a type of antibiotic used for treating certain serious infections) Shift of potassium across cells Use of insulin Certain metabolic states (such as alkalosis) Decreased intake or malnutrition       . Sometimes you may have more than one symptom involving the gastrointestinal (GI) tract, kidneys, muscles, heart, and nerves. Weakness, tiredness, or cramping in arm or leg muscles, sometimes severe enough to cause inability to move arms or legs due to weakness (much like a paralysis) Tingling or numbness Nausea or vomiting Abdominal cramping, bloating Constipation Palpitations (feeling your heart beat irregularly) Passing large amounts of urine or feeling very thirsty most of the time Fainting due to low blood pressure Abnormal psychological behavior (depression, psychosis, delirium), confusion or seeing or hearing things (hallucinations)       If you are monitoring low potassium levels, you may want to avoid long, strenuous physical activities because of sweat loss of potassium. If certain dietary supplements, herbals, diuretics (water pills), or laxatives are causing your symptoms of low potassium, you should avoid taking these products and consult with your doctor        If you are having symptoms of low potassium, call your doctor. Without symptoms, you will not know you have low potassium levels until you have a routine blood test or a heart tracing (ECG). Sometimes the cause of low potassium is not clear. Your doctor may perform certain tests to rule out other conditions such as renal tubular acidosis, Cushing syndrome, and hypocalcemia. Blood tests will check kidney function (BUN and creatinine), glucose, magnesium, calcium, and phosphorous if an electrolyte imbalance is suspected. Because low potassium is known to affect heart rhythms (arrhythmias), your doctor may order a digoxin level if you are taking a digitalis preparation. ECG or a heart tracing is done to detect electrical changes in the heart and certain types of irregular heart rhythms.       Potassium replacement therapy will be directed by the type and severity of your symptoms. Actual treatment will begin after lab tests confirm your diagnosis. People suspected of having severely low potassium need to be placed on a cardiac monitor and should have an IV started. Usually, people who have a mild or moderately low potassium (level of 2.5-3.5 mEq/L), who have no symptoms, or who have only minor complaints only need to be treated with potassium given in pill or liquid form. This is the preferred route because it is easy to give, safe, inexpensive, and is readily absorbed from the GI tract. Some preparations, or too high of a dose, may irritate the stomach and cause vomiting. If cardiac arrhythmias or significant symptoms are present or if the potassium level is less than 2.5 mEq/L, IV potassium should be given. In this situation, admission or observation in the Emergency Department is indicated. Replacing potassium will take more than a few hours. For those who have severely low potassium and have symptoms, both IV potassium and oral medication are necessary. Precautions: When potassium is used with medications such as ACE inhibitors, there is a risk of developing a high level of potassium. Potassium-sparing diuretics and potassium-containing salt substitutes can also result in high potassium levels.        A change in diet may be recommended if you are likely to develop low potassium levels. You may increase intake of bananas, tomatoes, oranges, cantaloupes, and peaches because they are high in potassium. Do not overuse diuretics (water pills) and never use someone else's medicines. If you are on medications, ask your doctor how often you will need to have your electrolytes checked    Usually doctors recommend a certain dosage of potassium and arrange to have a repeat blood level taken 2-3 days later. Your doctor may consider switching to potassium-sparing water pills if you need to continue taking diuretics for another condition Created by Shelly sparrish@piggott.net