A 20-year-old woman was admitted to a Mumbai hospital in an emergency as she complained of not being able to stand up straight and walk properly due to weakness in both her legs. She had no other symptoms. Her blood sugar and thyroid functions were fine, say doctors. The weakness in her legs was sudden and with no previous episodes.
Dr Nikhil Kulkarni, consultant, internal medicine, SL Raheja hospital, Mahim, Mumbai who treated her tells Happiest Health that when doctors carried out an ECG, the results appeared worrisome.
“We then checked her potassium levels with a blood test. A potassium level that falls below 3.5 mmol/L (millimoles per litre) is a deficiency. Her potassium levels were staggeringly low, 1.4 mmol/L,” says Dr Kulkarni.
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After carrying out potassium correction therapy with intravenous administration and bringing the woman’s potassium levels up to 4.2 mmol/L, she recovered fully and started walking again, says Dr Kulkarni.
“A potassium deficiency can affect the connection between the body’s nerves and muscles – the neuromuscular junction. This causes paralysis,” explains Dr Subrata Das, internal medicine specialist, Sakra Hospital, Bengaluru.
Why do we need potassium?
Dr Rajesh Ukkala, general physician, Medicover Hospitals, Hyderabad says that the body requires potassium for proper muscle, nerve and heart functioning. Extreme potassium levels, both high and low levels can be harmful, he says. “It also helps in digestion, maintaining the normal rhythm of the heart and regulating acid balance in the body,” he explains.
According to Dr Das, potassium helps in the proper functioning of the heart. “When there is a potassium deficiency, the electrical conducting system of the heart slows down,” he says.
Dr Ukkala adds that when one has severely low potassium levels in the body (lower than 3.5 mmol/L), they suffer from a condition known as hypokalemia. “This can be a severe, crippling and life-threatening disease,” he says.
Common symptoms of a potassium deficiency
Dr Kulkarni says that some of the common symptoms of a potassium deficiency affect different types of muscles.
Effect on skeletal muscles
- Weakness of skeletal muscles
- Muscle cramps or twitching
- Flaccid paralysis, a neurological condition with rapid onset of paralysis and muscle weakness
- Muscle breakdown or rhabdomyolysis
Effect on smooth muscles
- Constipation
- Urine retention
Effect on cardiac muscles
- ECG changes
- Arrythmia- Irregular heartbeats
- Cardiac arrest
Potassium deficiency can also cause excessive sweating, diarrhea and vomiting, say doctors.
Dr Kulkarni says that the primary organ in the body that controls potassium metabolism are the kidneys. Hence, a deficiency in potassium can affect the functioning of one’s kidneys.
“Low potassium causes extreme thirst and the urge to urinate more frequently. A person may also become incapable of performing normal day-to-day activities with severe muscle weakness which can sometimes result in paralysis and respiratory failure,” adds Dr Ukkala.
Dr Kulkarni says that when one experiences muscle cramps, constipation, palpitations or missed heart beats, they must immediately consult a doctor. “Conditions like dehydration, vomiting, loose motion and sweating should also not be ignored. People with diabetes, heart disease, high BP and kidney diseases should immediately consult a doctor if hypokalemia is suspected,” he adds.
A potassium deficiency can be diagnosed through a blood test or an ECG, says Dr Kulkarni.
What causes hypokalemia or potassium deficiency?
Potassium is present abundantly in our food and a deficiency arises very rarely, says Dr Kulkarni.
Dr Das says that drug-induced potassium deficiency is more common.
“Drug-induced cases, mostly involving diuretics (pills to rid of sodium and water from the body) and a type of blood pressure (BP) medication which lowers the body’s potassium levels, are common. Renal tubular acidosis or RTA — a condition involving the kidneys in which the body is unable to retain potassium — can also lead to a potassium deficiency. We also see many cases of familial hypokalemia, where one has a genetic predisposition to low potassium levels,” he says.
Dr Kulkarni says that in the case of the 20-year-old woman who was paralyzed, hormonal causes led to the potassium deficiency.
“We realised she was suffering from a condition known as Conn’s Syndrome. It is a rare disorder in which aldosterone, the hormone responsible for sodium and potassium metabolism in the body, is produced in excess,” says Dr Kulkarni.
Dr Kulkarni says that the metabolism of potassium and sodium is closely linked and they are inversely proportional. “Potassium levels go high, the sodium levels drop and vice versa. Certain BP medications can lower the levels of both sodium and potassium,” he adds.
Hypokalemia: Tackle with potassium-rich food
The best way to prevent potassium deficiency is by adding potassium-rich foods to your diet as it is available in a lot of fruits and vegetables, say doctors.
Daily potassium requirement of the body is anywhere between 2,500 to 3,500 mg. It may be slightly higher in specially adapted diets for hypertension like DASH diets, for instance, in which the potassium intake can go up to 5000 mg/day, he adds.
If a person has severely low levels of potassium and has been diagnosed with hypokalemia, the diarrhea and vomiting should be treated along with fluid replacement therapy where an IV fluid rich in potassium is administered.
Oral potassium salts are unpalatable and may be administered along with an ORS solution, say doctors.
Takeaways
- A severe deficiency of potassium can lead to a condition known as hypokalemia, which causes muscle weakness and paralysis.
- The best way to prevent potassium deficiency is by naturally boosting the body’s potassium levels by adding potassium-rich foods to the diet.
