Dr.Benjamin Wedro, MD, FACEP, FAAEM practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Potassium affects the way neuromuscular cells discharge energy (depolarize)
and then regenerate (repolarize) that energy to be able to fire again. When
potassium levels are low, the cells cannot repolarize and are unable to fire
repeatedly, as is needed for the function of muscles and nerves. It is
understandable then that the effects of low potassium include:
muscle weakness,
muscle aches, and
muscle cramps.
Since the heart is also a muscle, there can be some changes in the
electrocardiogram (EKG or ECG) that are associated with hypokalemia. Palpitations (irregular
heartbeats) may be experienced by the patient. In severe cases, hypokalemia can
lead to dangerous disturbances in heart rhythm (arrhythmias).
What is is potassium?
Small chemicals in the body known as electrolytes are crucial for cells
to function. Potassium is one of the main electrolytes, and is concentrated
within the cells of the body. Only 2% of the body's total potassium is available
in the serum (the fluid part of the bloodstream that is not red or white blood
cells or platelets). Small changes in the serum levels of potassium can affect body
function. One of the important functions of potassium is maintenance of the cell
electrical potential. The serum bathes the cells, and if the serum potassium
level falls, cells with high electrical activity (for example, muscles and nerves) are
particularly affected.
Normal potassium levels measured in the serum range from
3.5 to 5.0 mEq/liter. Normal daily intake of potassium is 70-100 mEq (270 to 390
mg/dl), and requires the kidneys to remove that same amount each day. If more is
removed, the body's total potassium store will be decreased, and the result is hypokalemia (hypo=low + kal=potassium +emia= in the blood) occurs.
Potassium enters the body through dietary intake. Examples of potassium rich
foods include:
Hypokalemia is not commonly caused by poor dietary intake.
Excessive loss is the most common reason that potassium levels are low. Loss
of potassium may occur from both the gastrointestinal (GI) tract and from the
kidney.
Potassium loss from the intestines may be caused by:
Muscle cramps are involuntarily and forcibly contracted muscles that do not relax. Extremely common, any muscles that have voluntary control, including some organs, are subject to cramp. Since there is such variety in the types of muscle cramps that can occur, many causes and preventative medications are known. Stretching is the most common way to stop or prevent most muscle cramps.
Diarrhea is a change is the frequency and looseness of bowel movements. Cramping, abdominal pain, and the sensation of rectal urgency are all symptoms of diarrhea. Absorbents and anti-motility medications are used to treat diarrhea.
Dehydration is the excessive loss of body water. There are a number of causes of dehydration including heat exposure, prolonged vigorous exercise, and some diseases of the gastrointestinal tract. The best way to treat dehydration is to prevent it from occurring.
Gastroenteritis (viral gastroenteritis, stomach flu) is an infection caused by a variety of viruses that results in vomiting and/or diarrhea. Even though it is often called the "stomach flu," it is not caused by the influenza viruses. Viruses that can cause gastroenteritis (stomach flu) include: rotaviruses, adenoviruses, caliciviruses, astroviruses, Norwalk virus, and a group of Noroviruses. Gastroenteritis is not caused by bacteria. The main symptoms of gastroenteritis include vomiting and watery diarrhea, however, headache, fever, and abdominal cramps (stomach ache) may also be present.
Palpitations are unpleasant sensations of irregular and/or forceful beating of the heart. Palpitations can be relieved in many patients by stress reduction, stopping cigarettes, and reduction of caffeine and alcohol.
Nausea is an uneasiness of the stomach that often precedes vomiting. Nausea and vomiting are not diseases, but they are symptoms of many conditions. The causes of vomiting differ according to age, and treatment depends upon the cause of nausea and vomiting.
Hyperkalemia is an abnormally high level of potassium in the blood. Symptoms of hyperkalemia include nausea, fatigue, tingling sensations, or muscle weakness. Hyperkalemia may also cause no symptoms. Slow heartbeat and weak pulse are more serious symptoms. Causes of hyperkalemia include kidney dysfunction, medications, adrenal gland diseases, and potassium shifts. Treatment of hyperkalemia is dependant upon the cause.
Premature ventricular contractions (PVCs) are premature heartbeats originating from the ventricles of the heart. PVCs are premature because they occur before the regular heartbeat. There are many causes of premature ventricular contractions to include: heart attack, high blood pressure, congestive heart failure, mitral valve prolapse, hypokalemia, hypoxia, medications, excess caffeine, drug abuse, and myocarditis.
Myofascial pain syndrome is muscle pain in the body's soft tissues due to injury or strain. Symptoms include muscle pain with tender points and fatigue. Treatment usually involves physical therapy, massage therapy, or trigger point injection.
Heart rhythm disorders vary from minor palpitations, premature atrial contractions (PACs), premature ventricular contractions (PVCs), sinus tachycardia, and sinus brachycardia, to abnormal heart rhythms such as tachycardia, ventricular fibrillation, ventricular flutter, atrial fibrillation, atrial flutter, paroxysmal supraventricular tachycardia (PSVT), Wolf-White-Parkinson syndrome, brachycardia, or heart blocks. Treatment is dependant upon the type of heart rhythm disorder.
Chemically, electrolytes are substances that become ions in solution and acquire the capacity to conduct electricity. Electrolytes are present in the human body, and the balance of the electrolytes in our bodies is essential for normal function of our cells and our organs.
Common electrolytes that are measured by doctors with blood testing include
sodium, potassium, chloride, and bicarbonate. The functions and normal range
values for these electrolytes are described below.
Sodium
Sodium is the major positive ion (cation) in fluid
outside of cells. The chemical notation for sodium is Na+. When combined with
chloride, the resulting substance is table salt. Excess sodium (such as that
obtained from dietary sources) is excreted in the urine. Sodium regulates the total amount
of water in the body and the transmission of sodium into and out of individual
cells also plays a role in critical body funct...