I often discuss my frustration about having too much potassium in my body and my daily battle to find low potassium foods. I complain about potassium so much that some of you may have wanted to exit the blog without reading the post when you saw the word potassium!
Well, sorry, but I feel compelled to publish another potassium post. But this time, the post covers not only the perils of too much potassium – it also discusses how a low potassium level can cause equally dire health problems.
Lest you think I am overreacting, let me share with you some information from two sources. An article on the Cleveland Clinic website entitled Heart Failure Diet notes that an excess of potassium is serious and should be treated immediately. The article also states that having too low a level of potassium can be very dangerous. An article entitled Potassium Primer on the U,S. News website says: "Very low potassium can kill you, and very high potassium can kill you, so it's very important to get it right in that balance.” So with two separate articles warning about the hazards of potassium (including death) – do I have your attention regarding the serious consequences that can result from a potassium imbalance in your body?
You should know that the conditions of low and high potassium have medical names because the doctor may refer to these terms on your medical summaries. Low potassium is known as hypokalemia. Too much potassium is known as hyperlalemia.
The Mayo clinic website has an article on low potassium, and it says that potassium: “helps carry electrical signals to cells in your body. It is critical to the proper functioning of nerve and muscles cells, particularly heart muscle cells. * * * Normally, your blood potassium level is 3.6 to 5.2 millimoles per liter (mmol/L). A very low potassium level (less than 2.5 mmol/L) can be life-threatening and requires urgent medical attention.”
I don’t know about you, but again when I see the terms “life-threatening” or "can kill you" in a description of a medical issue, I pay attention. But I am curious as to what is it that makes these potassium imbalances life-threatening. While this question is not directly answered in the article, I think it is indirectly answered by the comment that “Abnormal heart rhythms (arrhythmias) are the most worrisome complication of very low potassium levels, particularly in people with underlying heart disease.” So when potassium goes out of balance, your heart rhythm can apparently go out of balance as well.
So what can upset the balance, other than eating too much or too little of potassium? According to an article on the Cleveland Clinic website entitled “Heart Failure Diet: Potassium”:
In case you have not seen my other blog posts on my long-standing battle with potassium, I live in the world of “on the other hand”. I currently take the diuretic spironolactone (brand name aldactone) which is a potassium sparing diuretic. I also take Entresto, which has an angiotensin receptor blocker built into it. This means that my body retains potassium and so I am in danger of having too high a potassium level in my body.
I love that the US News article I referenced above has the following fact about potassium:
To set the record straight, I wasn’t paying a lot of attention in my high school chemistry class, but I do remember the periodic table and recognized K for potassium. I also recognize na for sodium and mg for magnesium. These are other substances that my blood tests track. This has led me to often joke that I follow the periodic table diet. I suspect that the term kalium is why low and high potassium are referred to in the medical world as hypokalemia and hyperkalemia.
The importance of the potassium balance is emphasized in the following statements from an article on the Cardiosmart website: "A delicate balance of potassium is needed to properly transmit electrical impulses in the heart. A low potassium level can disrupt the normal electrical impulses in the heart and lead to irregular heartbeats (arrhythmias).” And trust me, as easily as my potassium level can lurch out of control because of what I think are relatively modest servings of higher potassium foods, I know for a fact how very delicate, even precarious, this balance can be.
If you fall into either category, you should not turn a blind eye to your potassium consumption especially if you have heart failure. You should consult with your doctor and hopefully a nutritionist as soon as possible to make sure you are following an appropriate diet. While the Cleveland Clinic article says it provides guidance on potassium content, I did not find the guidance helpful because it seemed to be just a list of foods that do have potassium, to include fruits and vegetables. But it did not break down the categories into low, medium and high levela. Even if you have high potassium, well you have to have some fruits and vegetables in your diet, so knowing which ones have the lower potassium level is very important. This is information that a nutritionist and/or your nurses and doctors can help you with.
But the Cleveland Clinic article does provide a tip that I seem to recall hearing from my medical team, but it was seeing it on paper that made it finally sink in. The article says: Potassium may be used in some foods as a preservative or a salt substitute. While I have been told to avoid salt substitutes because they do contain potassium, the part about being used as a preservative was something that I had glossed over. However, I do read labels carefully, and so I look to see how much potassium is in each product and that should factor in where the potassium was used as a preservative. But one thing you should note either if you are trying to increase or decrease potassium. At this point, some product labels do not contain potassium information. As I recall, this information is not required for another year or two.
Potassium issues are found in some heart conditions and kidney conditions, and I am sure in a number of other chronic health conditions. If you have one of these conditions, your doctor will likely be monitoring your blood to make sure that potassium and other elements are in balance. Also, during your annual physical, your doctor should be taking blood tests and examining all of the results to make sure that you don’t have a problem brewing.
I often hear from people with medical conditions that friends will tell them they need to get more of a certain vitamin, herbal supplement, nutrient, etc. But absent the evaluation of blood work and proof that a person has a licensed expertise in an area, I would hold off on taking any substance until you have a chance to consult your doctor. Your doctor can use blood work and other data to determine there is indeed a deficiency that you need to address – and if so, how.
I have included quotes from a number of websites. In my posts I often refer to the Cleveland Clinic, Mayo Clinic and Cardiosmart because I think these organizations deal a lot with heart issues. But I do this only to educate myself so that I can be aware of issues and have more informed discussions with my medical team. I would never diagnose myself or make decisions without consulting my medical team. So this information is given to you for the same purpose – to help you ask questions and get qualified people to help you find solutions.
A friend recently gave me a copy of a chapter of a book called Thinner This Year by Chris Crowley. The book discusses a strategy for losing weight, and is written in consultation with a nutritionist/exercise physiologist. The chapter deals with the effect of electrolytes (e.g. sodium and potassium) on the body’s electrical system. This reminds me that I need to learn more about electrolytes and how I can balance them for the best impact on my heart. Because if there is one thing I’ve learned many times over, it is the concept that balance is the key to making sure that I don’t stress or weaken my already damaged heart.
Melanie discovered that she had heart failure in 2013. Since that time, she has been learning how to live with the condition, and how to achieve balance and personal growth.