Potassium Excess in Blood

Hyperkalemia is an excess of serum potassium. Most potassium in the body (98%) is found within cells; only a small amount usually circulates in the bloodstream. The balance of potassium between the cells and the blood is critical to the body. It affects the way the cell membranes work and governs the action of the heart and the pathways between the brain and the muscles. If you have excess potassium in the blood it is usually excreted by the kidneys. However the levels can get too high if your kidneys aren't working right which is the most common cause of hyperkalemia. Another cause is damaged cells' releasing potassium into the bloodstream faster than even normal kidneys can clear it. Medications or diet may also affect the amount of potassium in the blood. Hyperkalemia is a serious condition that must be treated promptly.

Signs and Symptoms

• Fatigue
• Weakness
• Tingling numbness or other unusual sensations
• Paralysis
• Palpitations
• Difficulty breathing

What Causes It?

Hyperkalemia has many causes including the following.

• Kidney problems
• Too much acid in the blood as sometimes seen in diabetes
• Diet high in potassium (bananas oranges tomatoes high protein diets salt substitutes potassium supplements)
• Trauma especially crush injuries or burns
• Addison's disease
• Certain medications

What to Expect at Your Provider's Office

You may not be feeling any effects of your hyperkalemia; your health care provider may discover it during a routine blood test or electrocardiogram. Hyperkalemia can cause life-threatening effects without warning. If you experience the symptoms of hyperkalemia you should call 911 or get to an emergency room. You should expect to be admitted to the hospital for further tests and so that your condition can be stabilized. You will be given medications to take care of the immediate problem but more tests may need to be done to determine the underlying cause. If the medications are not successful in lowering the potassium level in your blood dialysis may be recommended.

Treatment Options

Treatment Plan

The goal of treatment is to stabilize the heart and kidneys. Various drugs help to do this by moving potassium from the bloodstream back into the cells or by encouraging the excretion of excess potassium. Once you are stable your provider will determine the root cause of your elevated potassium and treat it. You may have dialysis if all other treatment fails.

Drug Therapies

Prescription

• Insulin—moves potassium from the bloodstream back into cells; various side effects
• Sodium bicarbonate—moves potassium from the bloodstream back into cells; various side effects
• Beta agonists—move potassium from the bloodstream back into cells; various side effects
• Diuretics—cause potassium excretion from kidneys; various side effects
• Binding resins—promote potassium/sodium exchange in gastrointestinal system; various side effects

Over the Counter

N/A

Complementary and Alternative Therapies

Alternative therapies can provide concurrent support and in treatment of the underlying cause once your condition has been stabilized.

Nutrition

• Avoid alcohol caffeine refined foods sugar and saturated fats (meat proteins and dairy products). Eliminate high-potassium foods.
• Drink more water; dehydration can make hyperkalemia worse.
• Eat small amounts of protein and more vegetable proteins and fish than chicken and red meats.
• Small frequent meals can help prevent hypoglycemia.
• Magnesium (200 mg two to three times per day) helps regulate potassium levels.

Herbs

Herbs may be used as dried extracts (capsules powders teas) glycerites (glycerine extracts) or tinctures (alcohol extracts). Teas should be made with 1 tsp. herb per cup of hot water. Steep covered 5 to 10 minutes for leaf or flowers and 10 to 20 minutes for roots.

Of primary concern is the effect of hyperkalemia on the heart.

• Hawthorn (Crataegus oxyacantha) increases cardiac output without increasing cardiac load. It dilates blood vessels helps stabilize cardiac arrhythmias and also supports liver function. Compromised liver function and poor fat digestion can make hyperkalemia worse. Drink 3 to 4 cups of tea per day.
• Lily of the valley (Convalleria majalis) increases cardiac output and has a regulating effect on heart rhythm. It is a diuretic that relieves swelling and has a neutral to slightly lowering effect on sodium and potassium. This herb has toxic side effects and should not be used without supervision from your health care provider.

Homeopathy

Homeopathy may be useful as a supportive therapy.

Physical Medicine

Contrast hydrotherapy. Alternating hot and cold applications brings nutrients to the site and eases inflammation. Use the applications over the kidneys. Alternate three minutes hot with one minute cold. Repeat three times. This is one set. Do two to three sets per day.

Acupuncture

Acupuncture may be helpful in supporting normal kidney function.

Massage

Swedish massage may help to stimulate the kidneys.

Following Up

Your health care provider will probably ask to see you two or three days after you are discharged from the hospital to repeat the potassium tests and electrocardiogram and check your kidney function. He or she will review all the medications you are taking and perhaps advise a change.

Special Considerations

If you are on regular dialysis make sure you keep strictly to your schedule to avoid hyperkalemia and other serious problems.

Supporting Research

Blumenthal M ed. The Complete German Commission E Monographs. Boston Mass: Integrative Medicine Communications; 1998:162.

Lee HS Yu YC Kim ST Kim KS. Effects of moxibustion on blood pressure and renal function in spontaneously hypertensive rats. Am J Chin Med. 1997;25: 21–26.

Wheeless CR. Management of Hyperkalemia. Wheeless' Textbook of Orthopaedics. 1996. Accessed at http://wheeless.belgianorthoweb.be/oo3/24.htm on 2/17/99.

Zwanger M. Hyperkalemia. Emergency Medicine Online Text. 1998. Accessed at http://www.emedicine.com/emerg/topic261.htm on 2/13/99.

Copyright © 2000 Integrative Medicine Communications

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