What Are the Early Signs of Hypokalemia?

Temporary low potassium levels in the body may usually not present with obvious symptoms. Long term low levels of potassium can produce the following signs and symptoms:

• Weakness
• Fatigue
• Muscle cramps
• Constipation (due to non-functioning of electrolytes)
• Tingling in the fingertips and toe tips
• Numbness over the body
• Breathing difficulties because of paralysis of muscles of respiration
• Mood changes like irritability or drowsiness.
• Constant thirst and the urge to go to the bathroom.
• Cardiac arrhythmia (irregular heart rhythm).
  • This may be felt as unconsciousness, feeling giddy, or chest pain. This requires immediate medical attention.
• Severe cases can cause muscle paralysis.
  • This may be a temporary condition reversible for replacing the lost potassium.

Some common causes of hypokalemia include:

1. Excessive vomiting
2. Excessive diarrhea 
3. Eating disorders (Anorexia nervosa) where the person eats less to lose weight and this results in severe starvation and dehydration. 
4. Chronic kidney disease-causing increased loss of potassium in the urine
5. Certain medications like diuretics (they decrease fluid level in the body and increase urination) used for blood pressure control, antibiotics, and chronic use of laxatives
6. Poor nutrition is seen in extreme starvation
7. Alcoholism 
8. Diabetic ketoacidosis (high levels of acids called ketones in the blood in uncontrolled diabetes)

Certain diseases can be associated with low potassium, such as:

1. Cushing’s syndrome
2. Gitelman syndrome
3. Liddle syndrome
4. Bartter syndrome
5. Fanconi syndrome
6. Seizures, sensorineural deafness, ataxia, mental retardation, and electrolyte imbalance (SeSAME syndrome)

The doctor will obtain a detailed history and perform a clinical assessment. Blood and urine analysis indicate the level of potassium in the body and can confirm the diagnosis of hypokalemia. An electrocardiogram may be done to rule out heart complications.

The treatment options include:

1. Treating the underlying cause. E.g. Dehydration, underlying any kidney condition, hormonal imbalance.
2. Mild dehydration can be corrected by increasing the fluid intake and 
3. Intravenous solution like ringer lactate may be required in case of required in the case of cardiac arrhythmias.
4. Stopping medication that may be causing hypokalaemia with the doctor’s advice.
5. Psychological support to manage alcoholism and eating disorders.
6. Always talk to your doctor before starting any supplement. Accumulation of potassium in the body may be dangerous to health.