Disorders of Potassium Balance

Hyperkalemia

Hyperkalemia is too much potassium in the blood. This most often occurs in people who take certain medicines or people with kidney disease.

This condition often has no symptoms until levels of potassium become high. If symptoms do occur, they include muscle weakness and changes in the heartbeat. A blood test is done to diagnose the problem. An ECG (electrocardiogram) may also be done to test the heartbeat.

If hyperkalemia is caused by a medicine, the healthcare provider may lower the dose or switch to a different medicine. A low-potassium diet may also be prescribed. 

Home care

  • Be sure your healthcare provider knows about all of the medicines you take. Follow your healthcare provider's advice about making changes to your medicines.
  • If a low-potassium diet has been prescribed, follow this closely. If you need help, ask to be referred to a dietitian for advice on how to follow this diet.

Follow-up care

Follow up with your healthcare provider. You may need a repeat blood test within the next 7 days. Schedule this as advised.

When to seek medical advice

Call your healthcare provider right away if any of the following occur:

  • Weakness, dizziness, or lightheadedness
  • Nausea, vomiting, or diarrhea
  • Urinating only in small amounts or not urinating
  • Symptoms don't go away or get worse

Call 911 if any of the following occur:

  • Fast or irregular heartbeat
  • Fainting
  • Severe shortness of breath
  • Chest, arm, shoulder, neck or upper back pain
  • Trouble controlling your muscles

Instructions for Hyperkalemia

You have been diagnosed with hyperkalemia. This means you have a high level of potassium in your blood. Potassium is important to the function of the nerve and muscle cells, including the cells of the heart. But a high level of potassium in the blood cause serious problems such as abnormal heart rhythms and even heart attack.

Diet changes

Eat less of these potassium-rich foods:

  • Bananas (do not eat bananas)
  • Apricots, fresh or dried
  • Oranges and orange juice
  • Grapefruit juice
  • Tomatoes, tomato sauce, and tomato juice
  • Spinach
  • Green, leafy vegetables, including salad greens, kale, broccoli, chard, and collards
  • Melons of all kinds
  • Peas
  • Beans
  • Potatoes
  • Sweet potatoes
  • Avocados and guacamole
  • Vegetable juice (homemade or store-bought) and vegetable juice cocktail
  • Fruit juices
  • Nuts, including pistachios, almonds, peanuts, hazelnuts, Brazil, cashew, mixed
  • "Lite" or reduced sodium salt

Other home care

  • Tell your healthcare provider about all prescription and over-the-counter medicines you are taking. Certain medicines can increase potassium levels.
  • Take all medicines exactly as directed.
  • Have your potassium levels checked regularly.
  • Keep all follow-up appointments. Your healthcare provider needs to monitor your condition closely.
  • Learn to take your own pulse. If your pulse is less than 60 beats per minute or irregular, call your provider.

Follow-up

Follow up with your healthcare provider, or as advised.

When to call your healthcare provider

Call your healthcare provider right away if you have any of the following:

  • Chest pain (call 911)
  • Fainting (call 911)
  • Shortness of breath (call 911 if severe)
  • Slow, irregular heartbeat
  • Fatigue
  • Dizziness
  • Lightheadedmess
  • Confusion
  • Weakness

Hypokalemia

Hypokalemia means a low level of potassium in the blood. This most often occurs in people who take water pills (diuretics). It can also occur because of severe vomiting or diarrhea. You may also have it if you take laxatives for long periods of time. It sometimes happens if you have low magnesium (hypomagnesemia). If you have this, your healthcare provider will treat the low magnesium first.

A mild case of hypokalemia usually causes no symptoms. It is only found with blood testing. More severe potassium loss causes overall weakness, muscle or abdominal cramps, rapid or irregular heartbeats (heart palpitations), low blood pressure, and muscle weakness. 

Home care

  • Take any potassium supplements as prescribed.
  • Eat foods rich in potassium. The highest amount is found in avocado, baked potatoes, spinach, cantaloupe, cod, halibut, salmon, and scallops. White, red, or pinto beans are also very good sources. A modest amount of potassium is found in orange juice, bananas, carrots, and tomato juice.
  • If you take certain types of diuretics, you will also need to take potassium supplements. If you take a diuretic, discuss potassium supplements with your doctor.

Follow-up care

Follow up with your healthcare provider for a repeat blood test within the next week, or as advised by our staff.

When to seek medical advice

Call your healthcare provider right away if any of the following occur:

  • Increased weakness, fatigue, or muscle cramps
  • Dizziness

Call 911 if any of the following occur:

  • Irregular heartbeat, extra beats, or very fast heart rate
  • Loss of consciousness

Instructions for Hypokalemia

You have been diagnosed with hypokalemia. This means you have a low level of potassium in your blood. Potassium helps your nerve and muscle cells work as they should. These cells include the cells in your heart. A low level of potassium in the blood can cause serious problems, such as abnormal heart rhythms and even heart attack.

Diet changes

Eat more potassium-rich foods:

  • Bananas
  • Oranges and orange juice
  • Tomatoes, tomato sauce, and tomato juice
  • Leafy green vegetables, such as spinach, kale, salad greens, collards, and chard
  • Melons (all kinds)
  • Pomegranates
  • Peas
  • Beans
  • Potatoes
  • Sweet potatoes
  • Avocados, including guacamole
  • Vegetable juices, such as V8
  • Fruit juices
  • All nuts and seeds
  • Fish, including tuna, halibut, salmon, cod, snapper, haddock, swordfish, and perch
  • Milk, including fat-free, low-fat, whole, chocolate, and buttermilk
  • Soy milk

Other home care

  • Take a potassium supplement as directed by your healthcare provider.
  • After strenuous exercise or any activity that causes you to sweat a lot, grab a beverage high in potassium. This includes chocolate milk, coconut water, orange juice, or low-sodium vegetable juices.
  • Be sure to eat foods or drink fluids that contain potassium if you are having diarrhea or vomiting.
  • Have your potassium levels checked regularly.
  • Take all medicines exactly as directed.
  • Tell your healthcare provider about all prescription and over-the-counter medicines you are taking. This includes herbal products.
  • Avoid foods that are high in salt. Avoid canned and prepared foods that are high in salt.

Follow-up

  • Make a follow-up appointment as directed by our staff.
  • Keep all follow-up appointments. Your healthcare provider needs to monitor your condition closely.

When to call your healthcare provider

Call your provider right away or go to the emergency room if you have any of the following:

  • Vomiting
  • Fatigue
  • Diarrhea
  • Rapid, irregular heartbeat
  • Shortness of breath
  • Chest pain
  • Muscle cramps, spasms, or twitching
  • Weakness
  • Paralysis

 Disclaimer: The UCLA Health System cannot guarantee the accuracy of such information. The information is provided without warranty or guarantee of any kind. Please speak to your Physician before making any changes.