What is high potassium (hyperkalemia)?
Everyone needs potassium to survive. Potassium is a mineral and an electrolyte. Potassium helps your muscles work, including the muscles that control your heartbeat and breathing. Potassium comes from the food you eat.
Your body uses a certain amount of potassium it needs. The extra potassium that your body does not need is removed from your blood by your kidneys. When you have kidney disease, your kidneys cannot remove extra potassium in the right way, and too much potassium can stay in your blood.
When you have too much potassium in your blood, it is called high potassium, or hyperkalemia. Having too much potassium in your blood can be dangerous. High potassium can even cause a heart attack or death! Unfortunately, many people do not feel symptoms of high potassium until it’s too late and their heart health worsens.
What causes hyperkalemia?
The most common cause of high potassium is kidney disease.
Other causes of high potassium in blood include:
- Some medicines
- Uncontrolled diabetes
- Injuries that cause severe bleeding
- Some rare diseases
If you have kidney disease, you are at risk for high potassium because your kidneys cannot remove the extra potassium in your blood. Instead of leaving your body through your urine, the extra potassium in your blood travels through your kidneys and back into your bloodstream. Over time, more and more potassium can build up in your blood.
What are the symptoms of high potassium in blood?
Many people do not feel symptoms of high potassium. Having too much potassium in your blood can be dangerous. This problem can even cause a heart attack.
If you feel symptoms, some of the most common symptoms are:
- Feeling tired or weak
- Feeling sick to the stomach (nausea)
- Muscle pains or cramps
- Trouble breathing, unusual heartbeat, chest pains
If you have trouble breathing or think there could be a problem with your heart, you must call an emergency phone number.
What are the complications of hyperkalemia?
Having too much potassium in your blood can be dangerous. Potassium affects the way your heart’s muscles work. When you have too much potassium, your heart may beat irregularly, which in the worst cases, can cause heart attack.
If you think you are having a heart attack, you must call an emergency phone number.
Some of the most common signs of heart attack are:
- Feelings of pressure, pain, or squeezing in your chest or arms
- Stomach pain or nausea
- Shortness of breath
- Breaking into a cold sweat
- Sudden feelings of dizziness
What are the tests for high potassium?
The only way to know for sure whether your potassium level in blood is healthy or not is to have a blood test. The test measures how much potassium is in your blood.
This blood test is like many other blood tests that you may be familiar with. A small needle is inserted into a vein on your arm and your blood is drawn out into a tube. The blood is sent to lab to be tested.
Potassium may be called by another name in your test results. If you do not see “potassium”, look for either:
- Serum potassium
A potassium level of higher than 5.2 millimoles per liter (mmol/L) is usually considered high, but your doctor or lab might use slightly different numbers. Talk to your doctor about what your test results mean.
Because very high potassium amount (higher than 6.0 mmol/L) can be dangerous, your doctor or nurse may contact you first if your results are unusually high. In this case, they may ask you to go to an emergency room or hospital.
What are the treatments for high potassium?
There are two ways to treat high potassium: through diet and/or through medicine.
Medicines for treating high potassium are called potassium binders. A potassium binder works by sticking to the potassium in your body and preventing some of it from being taken into your bloodstream. This process helps to keep potassium from building up in your blood. This medicine is a powder, which you can take by mixing it with water and drinking. Talk to your doctor about whether a potassium binder could be an option for you or not.
Eating guide for people with hyperkalemia
If you learn that you have high potassium in blood, your doctor might suggest that you change your diet to take in less potassium.
Ask your doctor or a dietitian about how much potassium you should have and how you can control the amount of potassium you eat. Your dietitian can recommend foods that are low in potassium that you can eat instead of foods that are high in potassium.
Follow these tips to keep your potassium amount at the right level:
- Avoid salt substitutes because they are usually high in potassium.
- Do not forget about drinks. Many fruit juices, like orange and tomato, have high potassium. Potassium can also be found in other drinks including coconut water.
- Pay attention to quantity of food. Use measuring cups and measuring spoons to make sure you know the quantity you are eating or drinking. Remember that if you eat two portions of a food with potassium, you are eating twice as much potassium!
To manage your potassium intake, you need to know how much potassium is in your food and drinks.
- Packaged foods must have nutrition labels, but potassium is not always listed on the label. If you do not see potassium listed on the nutrition label, check the list of ingredients on the package. If the word potassium or an abbreviation for potassium (K, KCl or K+) is listed, there is potassium in the food.
- Starting in July 2020, potassium values will be listed on food nutrition labels.
- Fresh fruits, vegetables, meats, and some dairy products do not have nutrition labels. Ask your dietitian for a list of high-potassium foods and lower potassium options.
Plan ahead if you know you will be eating a meal that is high in potassium. For example, if you are going out for dinner and you know your meal will be higher in potassium, or you know that it will be hard to measure how much potassium is in your meal, plan to eat meals that are low in potassium for breakfast and lunch.
When eating out, you should choose a restaurant that will make changes or substitutions in their dishes. Bring a list of low potassium foods with you to the restaurant.
Foods which are high in potassium include: banana, potato, bean, fish, cheese, poultry, nuts.
Foods which are low in potassium include: some fruits, some vegetables, bread, rice, pasta.