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We are always told to take water with us when we go hiking or to drink water when we participate in sports. The reason is to avoid dehydration. Dehydration leads to loss of electrolytes which can be fatal. Why is that?
Electrolytes areminerals that carry a positive or negative electrical charge when dissolved in water. In the body, they perform many important functions. Potassium is one such mineral. The other essential macro minerals include calcium, chloride, magnesium, phosphorus, and sodium.
When the potassium levels in the blood are too low, a condition called hypokalemia is the result.
Electrolytes power the body's essential processes – they literally keep the body moving. They help nerve, heart, and muscle cells to maintain a positive or negative charge and to carry electrical impulses (nerve impulses and muscle contractions) across themselves and to other cells.
So, they help muscles to contract, including heart muscles, which need a balance of minerals to maintain a steady rhythm.
Electrolytes also regulate the movement of water in and out of cells, helping tissues stay hydrated and blood pressure to stay constant.
Potassium is an essential mineral that performs many functions in the body. One of its functions is to conduct electricity throughout the body to keep the heart beating regularly and the muscles working properly. The level of potassium in the body is regulated by the kidneys.
Too much potassium in the blood is called hyperkalemia. The medical term for low potassium levels is hypokalemia.
The electricity that potassium conducts in the body isused to maintain fluid balance, send nerve signals, and regulate muscle contraction.
The body is about 60% water, divided into intracellular fluid (ICF) inside cells and extracellular fluid (ECF) outside cells. Potassium, the main electrolyte in the ICF, controls water inside cells. Meanwhile, sodium is the main ECF electrolyte, regulates water outside cells.
There must always be a balance of electrolytes inside and outside body cells. If imbalanced, water with fewer electrolytes moves to restore equilibrium, which may cause cells to shrink or swell as water moves in or out.
That's why it's vital to stay hydrated and ingest the right electrolytes, including potassium to maintain optimal fluid balance.
The nervous system acts as a communication network between your brain and body, sending messages through nerve impulses. Potassium, a positively charged electrolyte, plays a key role in this process. It carries a small electrical charge thatactivates various cell and nerve functions.
Its electrical charge helps activate essential cell and nerve functions, such as muscle contractions, heartbeat, and reflexes.
Nerve impulses are generated bythe movement of sodium ions into cells and potassium moving out of cells. This movement of ions changes the voltage of the cell, which sparks a nerve impulse. You need adequate potassium levels to generate a nerve impulse.
Potassium is vital in maintaining a healthy heart rhythm by regulating the electrical signals that control your heartbeat. The heart beats through electrical impulses generated and conducted by specialized cardiac cells.
Potassium, along with other electrolytes like sodium and calcium, helps create and manage these impulses by moving in and out of heart cells.
Both low and high blood potassium levels can affect nerve impulses by changing the voltage of nerve cells.
People with high blood pressure are always warned about sodium (salt) intake. Sodium and potassium levels and their interactions are closely linked toblood pressure regulation. High sodium causes the body to retain water, increasing blood volume and raising blood pressure.
Potassium counteracts this effect by helping the kidneys excrete excess sodium through urine, which reduces blood pressure. The more potassium-rich food you eat, the more sodium you lose through urine, the lower your blood pressure.
It is not possible to state that someone has a potassium deficiency by simply looking at them. Low potassium levels must be confirmed by blood tests. Nonetheless, mild hypokalemia can show up inobservable symptoms like fatigue, muscle weakness, cramping, and constipation.
Heart palpitations or irregular heartbeat
Severe muscle weakness, leading to paralysis
Muscle twitches or cramps
Numbness or tingling
Lightheadedness
Low blood pressure
Difficulty breathing (in severe cases)
Excessive urination
Excessive thirst
Manyfactors can lead to low blood potassium levels, such as:
Excessive sweating especially from strenuous exercise.
Eating disorders such as anorexia nervosa, or bulimia
Frequent vomiting, diarrhea or laxative use as in bulimia nervosa.
Alcohol use disorder (alcoholism).
Use of diuretics (water pills) which increases urination and potassium loss in the urine.
Certain medications including insulin, some antibiotics and corticosteroids.
Adrenal disorders, such as primary aldosteronism and Cushing’s syndrome.
Chronic kidney disease.
Low magnesium levels (hypomagnesemia).
Rare genetic kidney disorders, such as Bartter’s syndrome and Gitelman syndrome, which cause electrolyte imbalances.
Rare conditions, like Liddle syndrome which is associated with increased blood pressure.
Low potassium is seldom caused by a poor diet. Potassium is in many foods and is readily absorbed by the body. A severe potassium deficiency can lead to various health problems, including high blood pressure, kidney stones, and low calcium levels in the bones.
Those at risk of developing low potassium levels include individuals who:
Experience excessive sweating, such as athletes or those walking long distances in heat
Experience chronic vomiting or diarrhea
Overuse laxatives or enemas
Take certain medicines, such as diuretics
Have chronic kidney disease
Have certain endocrine (hormone) or metabolic problems
Have low magnesium levels
Lack potassium in their diet (very rare)
Low potassium levels are not something you can treat by yourself with supplements or over-the-counter medication as you’d need a physician to monitor you.
For mild to moderate cases, doctors prescribe oral supplements. If you are taking other medications your doctor may have to adjust those. If the condition is the result of diarrhea, vomiting, or eating disorders, your doctor may decide to treat those conditions.
You may be wondering if hypokalemia cannot simply be treated with a potassium-rich diet.
Hypokalemia is oftenassociated with other electrolyte imbalances such as hypomagnesemia and hypocalcemia which can exacerbate hypokalemia symptoms and lead to more complications. Severe hypokalemia may require simultaneous oral and IV supplementation. Experts warn that potassium correction must be done cautiously, as fast infusion may cause a heart attack.
Many foods contain potassium, including fruits, vegetables, legumes, lean meat, fish, and dairy. Here is a list of foods that are high in potassium:
Bananas
Spinach
Beet greens
Sweet potatoes
Tomatoes
Avocados
Watermelon
Legumes (chickpeas, lentils, black beans)
Potatoes
Citrus fruits (oranges, grapefruit)
Dried fruit (apricots, prunes)
No, high fiber has the opposite effect. Fiber has been shown toincrease potassium excretion in stool, although the exact mechanisms remain unclear. Some dietary fibers are viscous and form gels in the digestive tract, which can trap nutrients like potassium and reduce their absorption.
Studies show that healthy individuals who consume a high-fiber diet excrete more potassium due to increased stool volume. So, eating food high in fiber increases stool volume, increasing the amount of potassium that's excreted.
Following a diet rich in potassium does not solve the issue. Doctors usually focus ontreating the underlying issue that is causing the low potassium levels. The treatment may include supplements.
If you are taking medication that can cause low potassium, you will need to stop taking them or take a reduced dosage.
In cases of severe hypokalemia, a doctor may recommend intravenous potassium. However, as mentioned earlier, administering potassium must be done with caution to avoid too much potassium in the blood, which is also dangerous.
Too much potassium (hyperkalemia) can also cause irregular heartbeat and heart attack.
Potassium is a vital macro mineral that performs many crucial functions in the body. If your blood potassium levels are low (hypokalemia), it can lead to muscle cramps and weakness, fatigue, and constipation.
However, the most troubling adverse result of very low potassium levels is abnormal heart rhythms, which can result in cardiac arrest.
If you suspect your potassium levels are low or take medicines that could affect your potassium levels consult your doctor. Your doctor may order a serum potassium test or an electrolyte panel to confirm the amount of potassium in your blood.