Hypokalemia [posted 7/30/98]
Question: What are the symptoms of low potassium?

Answer: Muscle cramps, fatigue, weakness, cardiac irregularities, decreased tendon reflexes, polyuria, polydipsia.

Potassium
Question: what can make your potassium level drop to a level of two? I recently had an asthma attack and was put on solumedrol and my blood sugar rose to 800. I have never had a blood sugar problem in the past nor a potassium problem. I was listed in critical care for 6 days and I am still having side effects from the drugs and muscle weakness and sometimes get disoriented when standing. The muscles in my lower legs are like jelly after standing for a short time and constantly hurt. My scalp burns and I sweat a fine mist at all times. I have a slight numbing sensation in my legs, lips, side of my face and in the back of my hands. Could these symptoms be from the potassium drip, the solumedrol drip, or the theophylline drip? Or are they there because of the state my body was in during the acute asthma attack? My electrolytes were all messed up also. The asthma is now under control, but I still have the other side effects and would appreciate any information you may have. also, does this mean that I could become a diabetic in the future?

Answer: Steroids are known to raise blood glucose in many individuals. This "side effect" is common and doesn't particularly seem to predict later development of diabetes mellitus. Once the glucose is high it forces potassium out of the cells. Then the potassium is excreted by the kidneys. Correction of the glucose drives the potassium into the cells and often produces a low potassium. It is hard to tell if it was caused by treating your high glucose or not from your scenario. The other side effects will go away once your body’s electrolytes are back to normal. Few people are sicker than those with severe electrolyte disturbances. However, it is usually easy to restore quickly.

Potassium
Question: What are the symptoms of diet too high in potassium? In what case would a patient be advised to cut down on dietary potassium?

Answer: Diets high in potassium are usually thought to be beneficial for most medical problems since they are high in vegetable matter. However, patients in stages of renal failure are commonly told to restrict their potassium intake. Occasionally, patients on certain diuretics will be counseled to avoid extra potassium, but this is unusual. Symptoms of a diet high in potassium are none unless the blood potassium level rises. This only happens if the kidneys are functioning improperly.

Low Potassium Levels
Question: What can cause potassium levels to remain low even with supplements?

Answer: Potential causes of hypokalemia(a favorite question of third year medical students). 1. GI disorders(vomiting, diarrhea, villous adenoma). 2.Renal causes(alkalosis,mineralocorticoid excess,diuretics,licorce[English not American],Conn's Syndrome, Secondary aldosteronism, different renal tubular diseases), 3. Other causes(excess insulin, familial periodic paralysis). Basically, if one's potassium is low there is a pathologic cause. GI is the most common or possible diuretic use. If there is no obvious GI loss or diuretics the above causes will need to be looked for.


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