Potassium deficiency, also known as hypokalemia, is the most common electrolyte deficiency syndrome. Occurring in 20% of hospitalized patients and 2-3% of outpatients. Even though hypokalemia is relatively common, it can be hazardous for the person suffering it, causing heart and respiratory alterations that could be deadly. Potassium is an electrolyte necessary for all cellular functions; the human body cannot survive without potassium. It contributes in the exchange of nutrients of every cell, and is key in some physiological processes like muscle contraction and neurological signaling.
Despite the fact that reports show that most Americans do not meet the suggested daily intake (90mmol/day) of potassium, hypokalemia is mostly caused due to medical conditions or as a side effect of medications.
The most common cause of potassium deficiency is the use of diuretics. Diuretics, also known as water pills, stimulate urine production. They are mostly used to treat cardiac and kidney conditions, such as heart failure and chronic kidney disease; the main side effect of diuretics is the loss of potassium through urine. Another pill that can cause potassium deficiency are laxatives and enemas, used to treat constipation. In this scenario, the potassium is lost through the liquid feces that comes with the use of laxatives.
Other causes of hypokalemia are vomiting and diarrhea. In general, any condition that causes liquid loss can produce potassium deficiency. Nutrition can also affect the levels of potassium, but deficiency only occurs in malnourished patients, when the levels of potassium can be incredibly low and constitute one of the causes of death for the severely malnourished people.
Among the medical conditions that can cause potassium deficiency, we have kidney disease, gastrointestinal disorders that cause chronic diarrhea (like Crohn’s disease), hormonal imbalance, anemia, and genetic syndromes.
The severity of the symptoms are determined by the levels of potassium. When the deficit is small, the person will not have any symptoms at all. Symptoms become more dangerous as the levels of potassium drop. Although the clinical manifestations change from patient to patient, here are the most common signs of potassium deficiency:
1. Fatigue
Potassium is essential for the muscle contraction process. Lower levels of potassium will cause weaker contractions causing the person to feel tired and heavy, as if every move is harder to make – this is the earliest sign of potassium deficiency.
2. Muscle Cramps and Spasms
Potassium ions are key in the muscle contraction. Moving inside and outside the muscle cell allowing contractions to take place. When levels of potassium drop, the muscles are not able to contract properly and erratic contractions appear. Cramps and spasms are painful prolonged contractions, and constitute the most common symptom of potassium deficiency.
3. Muscular Paralysis
When the levels of potassium are very low, the muscle contraction cannot occur. Some patients will have sudden flaccid muscular paralysis. This means that the muscles cannot contract causing them to relax for extended periods. Genetic conditions such as hypokalemic periodic paralysis, causes severe weakness or flaccid paralysis of the muscles that can last for hours or days.
4. Constipation
The intestines have a layer of muscle that allow them to contract and mobilize the stool. Just as it happens to other muscles, potassium deficiency causes weaker contractions of the intestine muscles, which leads to constipation.
5. Numbness
Potassium also has a major role in neural transmission. Deficiency of potassium affects the nerves directly, causing weak nerve signals that generate paresthesia; a tingling sensation, and numbness that happens in the hands, arms, legs, and feet.
6. Heart Arrhythmias
The heart is a muscle, and as mentioned before, muscles need potassium to work properly. Depending on how severe the potassium deficiency; alterations on the heart rhythm will appear and they can become progressively more dangerous, depending on the levels of potassium, causing heart arrhythmias. Patients can experience palpitations (sensation of the heart beating faster and harder), but it can be as serious as causing loss of consciousness. You must always consult your doctor if you experience palpitations since this is a symptom present in many serious conditions.
7. Breathing Difficulties
Trouble breathing can be caused by many different conditions, and you should always consult your doctor if you have trouble breathing. During the process of breathing, the lungs contract and expand; at the same time, the diaphragm muscle contracts and relaxes to allow the movement of the lungs. The diaphragm is one of the most important muscles of the body, and if it does not work properly we cannot breathe. Potassium deficit affects breathing by defaulting the contraction of the diaphragm muscle. Also, some studies link potassium deficiency to the lungs itself, affecting the contraction and expansion of them. Additionally, potassium deficiency can cause spasms on the diaphragm muscle that manifest as hiccups.
These common signs of potassium deficiency are not exclusive to this pathology and you should consult your doctor if you experience any of them. Potassium deficiency can be treated. The treatment depends on the levels of potassium; however, in most of the cases the levels of potassium can be restored.
