Potassium Deficiency: Causes and Therapy

Loss of drive can be a result of the potassium deficiency. (Image: Uwe / fotolia.com)

Potassium is one of the vital minerals that the body must regularly supply in sufficient quantities. Potassium takes on decisive functions in the organism in regulating cell growth, blood pressure, neuromuscular activities, the so-called membrane potential and many other processes. In the worst case, a potassium deficiency can lead to fatal impairments of the heart function.

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definition

A basic distinction is made between intracellular and extracellular potassium concentrations in the organism. In the normal state, the intracellular concentration is around 150 millimoles per liter (mmol / l), the extracellular concentration is around four millimoles per liter. In the medical community, potassium deficiency is defined as insufficient potassium concentration in the blood serum, i.e. the extracellular area. The technical term is hypokalemia. This is achieved when the concentration falls below a value of 3.5 millimoles per liter.

Loss of drive can be a result of the potassium deficiency. (Image: Uwe / fotolia.com)

Symptoms of potassium deficiency

Too low a potassium concentration in the organism can trigger a variety of complaints, depending on the processes in which potassium is involved. At first, those affected usually experience general exhaustion and listlessness, which is also associated with the fact that potassium has a decisive influence on nerve and muscle activity. For the same reason, a pronounced potassium deficiency can lead to symptoms of paralysis of the muscles. These usually manifest in the limbs, but sometimes affect other muscles as well. The impairment of nerve activity due to the potassium deficiency also leads to a weakening or sometimes even a lack of reflexes.

A potassium deficiency is also often noticeable in the digestive tract. A typical consequence is constipation, which in turn brings with it further complaints such as stomach pressure, feelings of fullness, bloating and pain when defecating. In the worst case, a pronounced potassium deficiency can cause a so-called paralytic ileus. This form of intestinal obstruction is due to paralysis of the muscles, which are required for the transport of the intestinal contents. It is a potentially life-threatening event that plagues those affected with massive abdominal pain and a bloated stomach, among other things.

The effects of potassium deficiency on heart function are particularly critical, not only because nerve and muscle activity is generally restricted, but also because potassium has a decisive effect on the so-called repolarization of the ventricular tissue according to an action potential. In the event of a potassium deficiency, this repolarization can no longer take place appropriately and, in the worst case, the ventricle remains in systole or the affected person experiences cardiac arrest. Cardiac arrhythmias or cardiac stumbling, atrial fibrillation and ventricular fibrillation are also possible consequences of the potassium deficiency. In patients with a pacemaker, potassium deficiency also leads to heart problems, as the potassium concentration has a decisive influence on the voltage-controlled implants. If the potassium concentration is too low, the action potential of the pacemaker increases, which leads to rapid heartbeat (tachycardia), but usually does not cause problems as serious as potassium deficiency in a healthy heart.

In general, potassium is thought to have an antihypertensive effect and a pronounced potassium deficiency is a possible cause of blood pressure derailments or a risk factor for high blood pressure. However, it is not only the potassium concentration but above all its interaction with the sodium concentration in the organism that is decisive for the regulation of blood pressure.

There is also a close connection between the potassium concentration and the acid-base balance. Potassium deficiency is therefore a possible cause of overacidification of the body, which in turn is associated with a variety of other complaints, especially in naturopathy.

causes

Most of the time, potassium deficiency is caused by insufficient intake of the mineral in food, while at the same time increased excretion of potassium in the course of excessive fluid loss. According to the recommendations of the German Nutrition Society, adults should take in 4,000 milligrams of potassium daily through their food, for children and adolescents, 1,100 to 4,000 milligrams are recommended, depending on their age. Since the body excretes a relatively large amount of potassium with the urine, too little potassium intake can quickly lead to a deficiency in the organism.

In the case of increased fluid loss, for example due to diarrhea or vomiting, the deficiency sets in correspondingly faster and can occur even if the recommended daily dose is adhered to, as significantly more potassium is excreted than normal. This also applies in a similar way to (competitive) athletes who lose a lot of fluid when sweating and excrete massive amounts of potassium in this way. Certain diuretics (water tablets) and laxatives also result in increased potassium excretion, which can lead to a significant potassium deficiency if taken for a long time. Barium poisoning should also be mentioned as a possible cause of the undersupply.

Furthermore, the so-called Conn syndrome and Gitelman syndrome are known as diseases that are associated with a significant potassium deficiency. Conn's syndrome - also known as primary aldosteronism - is due to an excessive release of the steroid hormone aldosterone, which in turn results in increased potassium excretion and increased sodium absorption. Among other things, this leads to a significant increase in blood pressure, which can be accompanied by complaints such as headaches, nosebleeds, ringing in the ears, visual disturbances or a tightness in the chest and other complaints.

In the worst case, the disease leads to a so-called hypertensive crisis, which must be treated as a medical emergency. The causes of the so-called primary Conn syndrome are diseases of the adrenal cortex (usually an adenoma or ulcer) and genetic predispositions that lead to an excessive release of the steroid hormone aldosterone. Secondary Conn syndrome can be triggered by cirrhosis of the liver, for example.

In Gitelman's syndrome, too, those affected show pronounced hypokalemia, the cause of which, however, has not yet been fully clarified. The extremely rare hereditary disease can also lead to symptoms such as muscle cramps or even paralysis and massive discomfort in the digestive tract in childhood. In addition to the potassium deficiency, those affected also suffer from a pronounced magnesium deficiency, which in turn can cause further complaints.

Another possible cause of the potassium deficiency is the regular consumption of large amounts of cola. The caffeine contained, the glucose and fructose, increased potassium is excreted and potassium deficiency quickly sets in with daily consumption of more than two liters of cola, according to a study by Greek scientists at the University of Ioannina in 2009. As soon as the cola However, when consumption was reduced, the potassium concentration in the subjects' bodies usually returned to normal quickly, the researchers report.

Diagnosis

A comprehensive blood test is used to determine the potassium deficiency. If Conn's syndrome is suspected, the concentration of the steroid hormone aldosterone can also be determined. If this is increased, the kidneys are often examined using imaging methods such as computed tomography or magnetic resonance tomography in order to determine any diseases of the organ. Blood pressure measurements can also be appropriate as part of the diagnosis.

treatment

An established potassium deficiency is usually countered by increasing the intake of potassium through food. Foods with a potassium content of 0.2 to one gram per 100 grams are considered high in potassium, including various edible mushrooms, potatoes, tomatoes, spinach, beans or fruit such as apricots, bananas and dates. However, it should be noted that foods rich in potassium have a diuretic effect and are therefore not suitable for patients with impaired kidney function who regularly have to go on dialysis. If the potassium concentration cannot be balanced by changing the diet, potassium supplements can be used to replace potassium.

If massive heart problems are observed due to the potassium deficiency, intensive medical inpatient treatment is required, in which injections or infusions of potassium aspartate, potassium chloride or potassium malate are intended to achieve a slow adjustment of the potassium level in the blood serum. The fast administration of high-dose preparations is counterproductive here, since a sudden increase in the potassium concentration can lead to serious health problems or even cardiac arrest.

Conn's syndrome is treated with drugs that are supposed to reduce the release of the steroid hormone aldosterone. If an adenoma of the adrenal glands triggers the increased release of hormones, the affected adrenal gland is usually surgically removed. In the case of the genetically determined variants, however, those affected only have the option of drug therapy.You have to take medication to regulate the release of aldosterone and, if necessary, additional antihypertensive medication.

The potassium deficiency in patients with Gitelman syndrome is usually treated by taking potassium supplements, which, however, can only help to alleviate the symptoms. A cure for the hereditary disease is still not possible, so that the patients are usually dependent on appropriate medicines to balance the potassium level for the rest of their lives.

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