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Potassium is a mineral that is needed to help the heart, kidneys, and other organs function. Hypokalemia is lower than normal levels of potassium in your blood.

All cells within the body need potassium. It works to regulate water and mineral balance throughout the body. Low levels can cause muscle and nerve problems throughout the body. It can also cause an irregular heart rate.

Potassium enters the body through food and digestion. It passes out of the blood through the kidneys. Hypokalemia occurs when there is not enough potassium being absorbed into the body, too much potassium is removed by the kidneys, or potassium moves from the blood into the cells.

Risk Factors
Factors that may increase with potassium excretion through the kidneys include:

  • Certain medications such as diuretics or beta-2-adrenergic agonists such as albuterol
  • Kidney disease or failure—too much potassium excreted
  • Significant elevation of glucose from poorly controlled diabetes
Factors that may shift potassium into cells:

  • Treatment of elevated glucose and ketoacidosis from poorly controlled diabetes
  • Rapid refeeding after starvation
  • Delirium tremens from severe alcohol withdrawal
Excess loss of potassium from diarrhea

Kidney Damage

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Factors that may decrease your intake or absorption of potassium include:

  • Poor diet
  • Eating disorders
  • Excess alcohol intake
  • Vomiting or diarrhea
Early hypokalemia may not have any symptoms. When symptoms do occur, they may include:

  • Fatigue
  • Muscle weakness
  • Constipation
  • Difficulty breathing
  • Tingling or numbness
  • Irregular heartbeat
  • Fainting
You will be asked about your symptoms and medical history. A physical exam will be done.

Potassium levels in your body fluids will be tested with:

  • Blood tests
  • Urine tests
An EKG may be done to see if the potassium is affecting your heart.

The main goal of treatment is to increase the level of potassium in your body. Talk with your doctor about the best treatment plan for you. Options include:

IV fluids may be given. You may also be given the following to raise the amount of potassium in your blood if it is very low:

  • Potassium
  • Magnesium—if it is also low
Your current medications may be changed if they are the cause of your hypokalemia.

Any underlying condition will be treated.

Dietary Changes
You may be advised to increase the amount of potassium in your diet. You may be referred to a dietitian to help you balance the potassium in your diet.

To help reduce your chance of getting hypokalemia, take these steps:

  • Eat a diet that contains enough potassium.
  • Manage conditions such as diabetes.

American Association of Clinical Endocrinologists

Family Doctor—American Academy of Family Physicians

The Canadian Society of Endocrinology and Metabolism

Hypokalemia. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated November 15, 2013. Accessed February 17, 2015.

Hypokalaemia. Patient UK website. Available at: http://www.patient.co.uk/doctor/hypokalaemia. Updated December 4, 2013. Accessed February 17, 2015.

Hypokalemia. NORD website. Available at: https://www.rarediseases.org/rare-disease-information/rare-diseases/byID/748/viewFullReport. Updated February 2, 2008. Accessed February 17, 2015.

Last Reviewed February 2015

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