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9 Common Causes of Low Potassium Levels (Hypokalemia)

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Hypokalemia is a condition in which your body has low potassium levels. It is easy to overlook potassium deficiency unless you understand how it develops, what it means for your health, and how it impacts your quality of life.

But what causes low potassium depends on several factors. Hypokalemia can be due to certain disorders, medications or drugs, chronic alcohol abuse, intense physical activity, and nutritional deficiency. Understanding these possible reasons and the signs of low potassium makes it easier for your physician to plan the correct treatment.

Find out more about the causes of low potassium as you read on – and if you suspect hypokalemia, make sure to take the potassium blood test

  1. Digestive Disorders 

Loss of gastrointestinal function leads to hypokalemia and impacts fluid and salt balance, which drops electrolyte levels. This is because common digestive problems impact intestinal absorption of nutrients – and that includes potassium. 

With that, digestive disorders like inflammatory bowel disease (IBD), especially Crohn’s disease and ulcerative colitis, can be reasons for low potassium. These conditions induce prolonged vomiting and severe diarrhea.  

Moreover, eating disorders like bulimia nervosa and anorexia nervosa can also lead to hypokalemia. In fact, it is regarded as the most consequential impact of the said disorders. Severe hypokalemia leads to heart arrhythmias, muscle weakness, and cardiomyopathy that can be fatal.    

  1. Adrenal Gland Disorders

The adrenal glands produce a hormone called aldosterone, which helps regulate the water and salt ratio in the body. Adrenal gland disorders like hyperaldosteronism promote hyperkalemia. This condition promotes excessive production of aldosterone, leading to high blood pressure and low potassium in the blood.  

Hyperaldosteronism can be induced by noncancerous tumors that form in the adrenal glands. Your doctor may suspect the condition if you have sudden hypertension, muscle spasm, numbness, weakness, and so on. 

In addition, hypokalemia can also stem from congenital adrenal hyperplasia (CAH), mainly through the medication necessary to treat the condition. Other similar disorders induce the opposite as they influence the development of hyperkalemia or excessive potassium levels.

Pro Tip: Health issues involving your adrenal glands lead to other complications, not just potassium imbalance, but hypertension, diabetes, and even depression. Check the health of your adrenal glands by assessing their hormone production. Take the aldosterone blood test and cortisol test

  1. Kidney Problems

Although chronic kidney disease will most likely lead to hyperkalemia (excessive potassium in the blood) as potassium builds up in the blood, several medical conditions could have the opposite effect. Health problems involving your kidney functions can cause hypokalemia in the same way that kidney disease can be due to low potassium levels. 

For example, frequent urination caused by an infection can cause too much potassium excretion (kaliuresis). Once left untreated, it could complicate problems in your glomerular filtration, where wastes cannot be filtered out of your system. 

Additionally, when hypokalemia develops, kidney function also gets significantly disrupted. For instance, Bartter Syndrome, a genetic renal tubular disorder, promotes hypokalemia and other electrolyte abnormalities.  

The two-way relationship between kidney problems and potassium makes it imperative to monitor your electrolytes when you’re diagnosed with kidney disease and infections. Likewise, if you have hypokalemia, consider having your kidney functions checked. 

  1. Metabolic Disorders 

While chronic disorders included in the list of low potassium causes have an indirect connection to hypokalemia, some disorders can have a profound impact in terms of severity. 

For example, diabetic ketoacidosis, a severe and even life-threatening complication of diabetes causing your blood to become too acidic, can be tied to hypokalemia. This can link to the condition itself and the treatment involved. 

Additionally, metabolic alkalosis, characterized by increased body pH levels, is often accompanied by low potassium levels. Metabolic alkalosis can be due to extreme sodium absorption, which disrupts potassium levels and leads to hypokalemia.

Pro Tip: Since diabetes can be a gateway to having low potassium in the blood, it’s best to know how to spot diabetes based on the physical changes you can experience and other common symptoms. Take diabetes blood tests for proper diagnosis and immediate treatment. 

  1. Certain Medications 

Drugs classified as diuretics induce the removal of salts like sodium from the body. As a result, it makes you produce more urine, which is why they are also called water pills. But when you urinate frequently, you don’t just lose sodium but potassium and other electrolytes as well. 

Some known diuretics that can lower potassium include furosemide, chlorthalidone, and hydrochlorothiazide. Other drugs have the same side effects on potassium levels, such as glucocorticoids, mannitol, and high-dose penicillin. 

If you’re taking these medications for an extended period, your doctor may recommend electrolyte screening, especially if you exhibit symptoms of medical conditions like hypokalemia. That said, make sure to let your healthcare provider know of any side effects caused by the prescribed drug treatment. 

  1. Too Much Sweating (Hyperhidrosis)

Sweat is an exit way for potassium to leave the body, along with urine. Perspiring at a normal rate will not impact your potassium level and other electrolytes like sodium. But if it happens excessively, you’ll be at risk of developing hypokalemia.

Sweating can result from extremely hot weather or too much physical activity. However, it could also be due to a condition called hyperhidrosis, wherein your sweat glands become overactive due to impaired nerve signal transmission. 

If you experience excessive sweating for no particular reason, whether it’s the temperature, medication, or illness, consult your doctor to understand the cause and extent of your condition. By doing so, you also protect yourself from hypokalemia. 

  1. Heavy Alcohol Drinking 

If you’re a chronic alcohol drinker, you should consider taking an electrolyte panel blood test, as chronic alcoholism leads to critical electrolyte imbalances, including hypokalemia. In fact, severe hypokalemia is observed among patients who frequently do binge alcohol consumption.

In addition, a 2021 case study shows that alcohol abuse leads to high tolerance for low potassium levels, leavinOthery disregard any hypokalemia symptom. This, in turn, can result in thyrotoxic periodic paralysis (TPP), particularly among those with hyperthyroidism and thyrotoxicosis. 

Did You Know? TPP is a severe form of muscle weakness. While uncommon, it can be fatal if not diagnosed early. Hence, aside from a potassium blood test, monitor your thyroid function as well by taking a thyroid panel test to screen for hyperthyroidism and other related conditions.   

  1. Intense Training or Workout

Rigorous exercise can leave your body with low levels of potassium. When the muscle is hard at work, it requires more glucose that even its stored version (glycogen) needs to be metabolized to comply with the increasing demand. In this process, your muscle cells lose potassium along with other electrolytes. As a result, you may experience muscle spasms, fatigue, weakness, muscle cramps, nausea, and even vomiting. 

The more intense your workout is, the more potassium you’ll drop through profuse sweating. This can be made worse if you’re training under scorching hot weather, as you also reduce your water content. 

With all these in mind, you should opt to replenish not just the water you lost but the electrolytes as well. This is why athletes and those who are into grueling sports and activities ensure they keep electrolyte-infused waters with them or other similar beverages. On top of that, it’s best to consistently practice conditioning before exercising.

  1. Low Dietary Potassium

It’s unlikely to develop hypokalemia due to low dietary sources, as potassium can be acquired from many staple foods like potatoes, chicken, beans, bananas, oranges, tomatoes, salmon, etc. However, it’s not completely impossible, especially if you have nutrient malabsorption due to Crohn’s disease, ulcerative colitis, and other IBDs.  

The recommended dietary intake of potassium is 4,700 mg per day. But this could vary depending on the results of your potassium blood test and what your doctor prescribes. 

If you do have hypokalemia due to limited food sources of potassium, make sure to include the following fruits and vegetables in your meals.

  • Spinach
  • White beans 
  • Dried apricots 
  • Swiss chard
  • Oranges
  • Bananas
  • Avocado
  • Yogurt
  • Clams
  • Parsnips
  • Potatoes
  • Tomatoes 

Take an over-the-counter (OTC) oral potassium supplement only if it’s recommended by your physician, which will be most likely if the hypokalemia is a side effect of a certain treatment or a direct consequence of another disorder. 

What Happens if Potassium Is Too Low?

Potassium deficiency causes abnormal heart rhythm, muscle spasms and weakness, paralysis, and even death. These conditions can aggravate other disorders and disrupt essential bodily functions.

Like other nutrients, potassium levels influence your body’s overall wellness. It helps keep fluid and acid-base balanced and blood circulate properly, regulates muscle contractions, aids in the transmission of never signals, and ensures good digestion. 

Get Tested for Hypokalemia 

Finding out if you have hypokalemia requires taking a potassium blood test. Your doctor will most likely request a test if you show signs of low potassium. 

Mild hypokalemia can make you feel tired all the time and have heart palpitations, constipation, muscle spasms, as well as tingling in your extremities. On the other hand, severe low potassium causes muscle weakness, hypotension, heart arrhythmias, excessive thirst, frequent urination, and lightheadedness. 

While these symptoms of low potassium provide good information for the diagnosis, to determine hypokalemia, your doctor will have to compare your blood potassium levels to the healthy range. For adults, potassium levels should fall between 3.5 to 5.2 mmol/L. Below this range confirms hypokalemia.  

Frequently Asked Questions 

What cancers cause low potassium?

Anyone with cancer has a high risk for electrolyte imbalance, which include hypokalemia. Patients with breast, stomach, kidney, pancreatic, thyroid, prostate cancer, and so on can have low potassium as part of the condition’s complications and the side effects of the treatment. 

Since it’s often asymptomatic, electrolyte imbalance can develop unnoticed among those with cancer. Thus, monitoring your fluid and electrolyte levels through the electrolyte panel blood test is important. 

What causes low potassium levels in the elderly?

Low potassium levels among the elderly can be linked to dehydration, nutritional deficiency, and health problems like chronic kidney disease and diabetic ketoacidosis, which likely develops with lifestyle and age. In addition, those taking diuretic medications, beta-agonists, and the like for other diseases are also prone to low potassium.   

According to research, hypokalemia is prevalent among people aged over 65 at a rate of 3.24%. The causes of low potassium levels in the elderly depend on several factors – which should be closely examined to monitor the severity of the imbalance. For one, it could be due to the intake of drugs that promote hypokalemia. Likewise, it could also be part of an electrolyte imbalance linked to certain diseases.  

Pro Tip: Since hypokalemia can be prevalent among people of old age, it’s crucial to undergo proper health screening for conditions that might lead to hypokalemia and other similar imbalances. You can start assessing your risk by taking the initial evaluation blood test for male age and female age management

Can you die from low potassium?

A dramatic decrease in potassium levels increases your risk for heart arrhythmia and can lead to cardiac arrest or heart failure. This makes it possible for you to die of hypokalemia or low potassium, especially if you already have a cardiovascular disease like chronic heart failure. In addition to irregular heartbeat, blood vessels also tend to construct, leading to hypertension. These events contribute heavily to the fatal impact of hypokalemia

The Bottom Line 

The consequences of hypokalemia should not be undermined, especially if you have heart health issues or have been diagnosed with cancer. In addition, if you have a potassium deficiency, it’s also likely that you have other electrolytes slipping off the normal range. By understanding the reasons for low potassium, your doctor may adjust treatment, prescribe supplements, and run additional tests – interventions that will restore your health.

Medically Approved By Dr. Edward Salko, MD

Dr. Edward Salko is the board-certified physician who reviews lab tests provided by PERSONALABS™. He earned his Bachelor of Science in chemistry and pre-med from the University of Florida in Gainesville and his Doctor of Osteopathy Medicine in 1980 from Kansas City University School of Medicine.

Dr. Salko’s career has specialized in family and emergency medicine. His passion is to provide clients with the tools they need in the most convenient way possible to allow them to take charge of their own healthcare. He has held a variety of positions in Kansas, Florida and Washington. Currently, in addition to his duties as Medical Director for Personalabs, he is a practicing emergency physician in Kennewick, Washington.

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