Hypokalemia: Symptoms, Causes, Risk Factors, Diagnosis, Treatment, Prognosis and Prevention

It is when the potassium levels in the blood are too low.

Potassium is an important electrolyte for the function of nerve and muscle cells , especially for the muscle cells of the heart.

Your kidneys control your body’s potassium levels, allowing excess potassium to leave the body through urine or sweat.

Hypokalemia is also called:

  • Hypokalemic syndrome.
  • Low potassium syndrome.
  • Hypokalemia syndrome.

Mild hypokalemia does not cause symptoms. In some cases, low potassium levels can lead to arrhythmias or abnormal heart rhythms, as well as severe muscle weakness.

But these symptoms usually reverse after treatment. Learn what it means to have hypokalemia and how to treat this condition.

What are the symptoms of hypokalemia?

Mild hypokalemia usually shows no signs or symptoms. In fact, symptoms usually don’t appear until your potassium levels are extremely low. A normal potassium level is 3.6-5.2 millimoles per liter (mmol / L).

Being aware of the symptoms of hypokalemia can help. Call your doctor if you have these symptoms:

  • Soft spot.
  • Fatigue.
  • Constipation .
  • Muscle cramps.
  • Palpitations

Levels below 3.6 are considered low, and any level below 2.5 mmol / L is deadly low. At these levels, there may be signs and symptoms of:

  • Paralysis.
  • Respiratory insufficiency.
  • Breakdown of muscle tissue.
  • Loose intestine.

In more severe cases, abnormal rhythms can occur. This is more common in people who take digitalis medications ( digoxin ) or who have irregular heart rhythm conditions, such as:

  • Fibrillation, atrial or ventricular.
  • Tachycardia (heartbeat too fast).
  • Bradycardia (heartbeat too slow).
  • Premature heartbeat
  • Other symptoms include loss of appetite, nausea, and vomiting.


You can lose too much potassium through urine, sweat, or bowel movements. Inadequate potassium intake and low magnesium levels can lead to hypokalemia.

Most of the time, hypokalemia is a symptom or side effect of other conditions and medications. These include:

  • Bartter syndrome, a rare genetic kidney disorder that causes salt and potassium imbalance .
  • Gitelman syndrome, a rare genetic kidney disorder that causes an ion imbalance in the body.
  • Liddle syndrome, a rare disorder that causes an increase in blood pressure and hypokalemia.
  • Cushing’s syndrome , a rare condition due to prolonged exposure to cortisol.
  • Eating substances such as bentonite (clay) or glycyrrhizin, potassium-wasting diuretics, such as thiazides, loop, and osmotic diuretics.
  • Long-term use of laxatives.
  • High doses of penicillin.
  • Diabetic cetoacidosis.
  • Dilution due to administration of IV fluids.
  • Magnesium deficiency
  • Adrenal gland problems.
  • Malnutrition.
  • Bad absorption.
  • Hyperthyroidism .
  • Renal tubular acidosis types I and 2.
  • Catecholamine surge, as with a heart attack.
  • Medicines such as insulin and beta 2 agonists used for COPD and asthma.
  • Barium poisoning.
  • Familial hypokalemia.

 What are the risk factors for hypokalemia?

Your risks for hypokalemia may increase if you:

  • Taking medications, especially diuretics known to cause potassium loss.
  • You have a long-term illness that causes vomiting or diarrhea.
  • You have a medical condition like the ones mentioned above.

People with heart disease are also at increased risk for complications. Even mild hypokalemia can cause abnormal heart rhythms.

It is important to maintain a potassium level of around 4 mmol / L if you have a medical condition such as congestive heart failure, arrhythmias, or a history of heart attacks.

How is it diagnosed?

Your doctor will usually find out if you are at risk or have hypokalemia during routine blood and urine tests. These tests check the levels of minerals and vitamins in the blood, including potassium levels.

Your doctor will also order an ECG test to monitor your heartbeat, as hypokalemia and heart abnormalities are often related.

 How is hypokalemia treated?

Someone who has hypokalemia and shows symptoms will need hospitalization. They will also require heart monitoring to make sure the heart rhythm is normal.

Treating low potassium levels in the hospital requires a multi-step approach:

  1. Eliminate causes:  After identifying the underlying cause, your doctor will prescribe the appropriate treatment. For example, your doctor may prescribe medicine to reduce diarrhea or vomiting or change your medicine.
  2. Restore potassium levels: You can take potassium supplements to restore low potassium levels. But fixing potassium levels too quickly can cause unwanted side effects like abnormal heart rhythms. In cases of dangerously low potassium levels, you may need an IV drip for controlled potassium intake.
  3. Monitor Levels During Hospital Stay – At the hospital, a doctor or nurse will check your levels to make sure potassium levels don’t reverse and cause hyperkalemia. High potassium levels can also cause serious complications.

After you leave the hospital, your doctor may recommend a diet rich in potassium. If you need to take potassium supplements, take them with plenty of fluids and with or after your meals.

You may also need to take magnesium supplements, as magnesium loss can occur with potassium loss .

What is the prognosis?

Hypokalemia is treatable, treatment usually involves treating the underlying condition. Most people learn to control their potassium levels through diet or supplements.

Make an appointment with your doctor if you have symptoms of hypokalemia. Early diagnosis and treatment can help prevent the condition from developing into paralysis, respiratory failure, or heart complications.

How is hypokalemia prevented?

About 20 percent of people in hospitals will experience hypokalemia, while only 1 percent of adults who are not in the hospital have hypokalemia. You will usually be monitored by a doctor or nurse during your stay to prevent hypokalemia.

Seek medical attention if you have vomiting or diarrhea for more than 24-48 hours. Preventing prolonged bouts of illness and fluid loss is important to avoid hypokalemia.

Potassium rich diet

Eating a diet rich in potassium can help prevent and treat low potassium in the blood. Discuss your diet with your doctor. You will want to avoid taking too much potassium, especially if you are taking potassium supplements. Good sources of potassium include:

  • Avocados
  • Bananas
  • Figs
  • Kiwi.
  • Oranges
  • Spinach.
  • Tomatoes.
  • Milk.
  • Peas and beans.
  • Peanut butter.

While a low potassium diet is rarely the cause of hypokalemia, potassium is important for healthy body functions. Unless your doctor tells you otherwise, eating a diet rich in foods that contain potassium is a healthy option.