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Potassium deficiency causes and therapy
contents
definition
Symptomatology of potassium deficiency
causes
diagnosis
treatment
definition
Basically, a distinction is made between intracellular and extracellular potassium concentrations in the organism. In the normal state, the intracellular concentration is approximately 150 millimoles per liter (mmol / l), the extracellular concentration is around four millimoles per liter. Potassium deficiency is defined in the medical community as insufficient potassium concentration in the blood serum, ie the extracellular area. The technical term is hypokalaemia. This is achieved when the concentration falls below a value of 3.5 millimoles per liter.
Symptomatology of potassium deficiency
Too low a potassium concentration in the organism can trigger a variety of ailments, according to the processes in which potassium is involved. At first, those affected usually experience a general exhaustion and listlessness, which is also associated with the fact that potassium has a decisive influence on the nerve and muscle activity. A pronounced lack of potassium can for the same reason lead to paralysis (paresis) of the muscles. These usually manifest in the limbs, but sometimes also affect other muscles. The impairments of nerve activity by the potassium deficiency also lead to a weakening or sometimes even to a lack of reflexes.
Listlessness can be a consequence of potassium deficiency. (Credit: B.Stolze] In the digestive tract, potassium deficiency is also often noticeable. A typical consequence is constipation, which in turn causes further symptoms such as stomach pressure, feelings of fullness, bloated abdomen and pain during bowel movements. Severe potassium deficiency can, in the worst case, cause a so-called paralytic ileus. This form of intestinal obstruction is due to paralysis of the muscles needed to transport the intestinal contents. It is a potentially life-threatening event in which sufferers, among other things, experience massive abdominal pain and bloated abdomen.
Particularly critical are the effects of potassium deficiency on cardiac function, not only because nerve and muscle activity is generally restricted, but also because potassium has a significant effect on the so-called repolarization of ventricular tissue after an action potential. In potassium deficiency, this repolarization can therefore no longer be appropriate and worst case, the ventricle remains in systole or those affected, a cardiac arrest occurs. Cardiac arrhythmias or heart stuttering, atrial fibrillation and ventricular fibrillation are also possible consequences of the potassium deficiency. In patients with a pacemaker, potassium deficiency also causes heart problems, as the potassium concentration has a significant impact on the voltage-controlled implants. If the potassium concentration is too low, the action potential of the pacemaker increases, causing tachycardia, but usually does not cause such serious problems as potassium deficiency in a healthy heart.
In general, potassium is said to have a hypotensive effect, and pronounced potassium deficiency is considered to be a possible cause of blood pressure derailment or a risk factor for high blood pressure. However, not only the potassium concentration but above all their interaction with the sodium concentration in the organism is crucial for the regulation of the blood pressure.
In addition, there is a close correlation between the potassium concentration and the acid-base balance. Potassium deficiency is therefore considered as a possible cause of acidity of the body, which in turn is associated in particular in naturopathy with a variety of other ailments.
causes
In most cases, potassium deficiency is caused by inadequate uptake of the mineral through the diet and increased excretion of potassium in the course of excessive fluid loss. According to the recommendations of the German Nutrition Society, adults should ingest 2,000 milligrams of potassium daily through their diet, and 1,000 to 9,000 milligrams are recommended for children and adolescents, depending on their age. Since the body excretes a relatively large amount of potassium with urine, inadequate intake of potassium can quickly lead to a deficiency situation in the organism. If there is an increase in fluid loss due to diarrhea or vomiting, for example, the deficiency will be correspondingly faster and may also occur if the recommended daily allowance is adhered to, since significantly more potassium is excreted than is normally the case. This applies in a similar way to (high-performance) athletes who lose a great deal of fluid when sweating and thereby massively excrete potassium. Certain diuretics (diuretic drugs) and laxatives also result in an increased potassium excretion, which can lead to a significant potassium deficiency with prolonged ingestion. Barium poisoning is also a possible cause of potassium deficiency.
Furthermore, the so-called Conn syndrome and the Gitelman syndrome are known as diseases that are associated with a significant potassium deficiency. Conn syndrome - also known as primary hyperaldosteronism - is attributed to excessive secretion 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 may be accompanied by symptoms such as headaches, nosebleeds, tinnitus, visual disturbances or even tightness of 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, which lead to excessive secretion of the steroid hormone aldosterone. The cause of Conn's secondary syndrome may be liver cirrhosis, for example.
Also in the Gitelman syndrome sufferers show a pronounced hypokalaemia, the cause of which, however, could not be completely clarified so far. In addition, the extremely rare hereditary disease may lead to symptoms such as muscle cramps or even paralysis and massive discomfort in the digestive tract already in childhood. The sufferers also suffer from the lack of potassium in a pronounced magnesium deficiency, which in turn can cause more discomfort.
As a possible cause of potassium deficiency is also the regular consumption of larger amounts of cola. Caffeine, glucose and fructose are increasingly used to eliminate potassium and potassium levels are rapidly disappearing with daily intake of more than two liters of cola, according to a 2009 study by Greek scientists at the University of Ioannina. Consumption was reduced, the potassium concentration in the organism of the subjects, however, usually returned to normal quickly, the researchers report.
diagnosis
To determine the potassium deficiency serves a comprehensive blood test. If there is a suspicion of Conn syndrome, the concentration of the steroid hormone aldosterone can also be determined. If this increases, the kidneys are often examined by means of imaging techniques such as computed tomography or magnetic resonance imaging in order to detect possible diseases of the organ. Also measurements of blood pressure may be appropriate as part of the diagnosis.
treatment
A detected potassium deficiency is initially usually treated with an increased potassium intake through the diet. Potassium is considered to be food with a potassium content of 0.2 to one gram per 100 grams. These include various edible mushrooms, potatoes, tomatoes, spinach, beans or even fruits such as apricots, bananas and dates. However, it should be noted that potassium-rich foods have a diuretic effect and are therefore not suitable for patients with impaired kidney function who regularly need to dialysis. If it is not possible to balance the potassium concentration by switching diet, potassium supplements can be used for potassium substitution.
If massive cardiac symptoms are observed due to the potassium deficiency, intensive care inpatient treatment is recommended, in which injections or infusions of potassium aspartate, potassium chloride or potassium malate should result in a slow approximation of the potassium level in the blood serum. The rapid administration of high-dose preparations is counterproductive, since a sudden increase in potassium concentration in turn can lead to significant health problems or even cardiac arrest.
Conn's syndrome is medically treated with drugs designed to reduce the release of the steroid hormone aldosterone. If an adrenal adenoma triggers the increased hormone secretion, usually an operative removal of the affected adrenal gland takes place. With the genetic variants, however, those affected only have the option of drug therapy. You must take permanent medications to regulate the aldosterone secretion and, if necessary, additional antihypertensive drugs.
