Micro Nutrient Disease: Hypokalemia

Hypokalemia is a fatal disease caused by the deficiency of macronutrient Potassium. Know the symptoms, causes, treatment and diet plan for Hypokalemia. Read more on Desklib.

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Micro Nutrient Disease: Hypokalemia
Part 1
In human body, nutrients play a major role in the functioning of the tissues and organs.
Both macro and micronutrients are important for effective functioning. However, deficiency of
macronutrients leads to fatal diseases osteoporosis, rheumatoid arthritis, insomnia, muscular
weakness, poor memory and many more. One of the fatal diseases caused by the deficiency of
macronutrient is Hypokalemia. This disease is caused by the reduced levels of Potassium in the
blood stream. The term hypokalemia is derived from hypo meaning “under”, kalium meaning
“potassium” and emia meaning “blood condition” (Daly and Farrington, 2013). It is the one of
the familiar water electrolyte imbalances. In human body, cells compose almost 98% of the
body’s potassium and the remaining are found in the extracellular fluid, blood. Because of the
polar nature of potassium, it generates a concentration gradient, governed by sodium-potassium
pump (Na+/K+).
Nerve functions are governed by the electrochemical gradient of the potassium, which
occurs in between extracellular and intracellular region of the body. The main function of
potassium is to repolarize the cell membrane to the state of resting after an event of active
potential. The resting membrane gets hyperpolarized due to the reduced levels of potassium, this
incident is often termed as Goldman equation because the hyperpolarization is caused by the
alterations of potassium gradient. In order to depolarize higher than normal stimulus is required
to activate the action potential. The reduced levels of potassium cause delay in ventricular
repolarization and the activity of IKr potassium is inhibited. These delayed repolarization results
in reentrant arrhythmias.

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Hypokalemia can be caused by various disorders and medications like dialysis,
hypomagnesemia, vomiting, steroids, hyoeraldosteronism, insipidus, genetic kidney disorder,
increased blood pressure, chewing tobacco, excessive perspiration, high dosage of penicillin,
diabetes, obesity, hyperthyroidism, heart attack, skin loss, diarrhea, and inability to consume
food. The symptoms of this disease can be severe because the symptoms like tiredness,
weakness, cramps and constipation can slow down the rhythm of heartbeat and heart attack. In a
healthy individual, the levels of potassium are 3.5 – 5.0 mmol/L and the level of potassium
suffering from hypokalemia is less than 3.5mmol/L. these potassium levels are governed with the
help of electrocardiogram. The reports of electrocardiogram are represented by the T waves
heights. U wave curve imposed on T wave occurs due to prolonged reploarization ventricular
Purkinje fibres. The graph produces prolonged QT intervals due to the low level (3mEq/L) of
potassium in blood serum. There is a formula to calculate potassium deficiency, which is
Kdeficit (in mmol) = (Knormal lower limit − Kmeasured) × body weight (kg) × 0.4
The treatment of hypokalemia involves the improvement of potassium level by diet or
treating disorders like diarrhea and by prescribing appropriate medications based on the
requirements of the patient. Mild hypokalemia can be treated by consuming potassium rich foods
orally or by taking potassium rich supplements. Foods like lima beans, leafy green vegetables,
coconut water, bananas, red meats, citrus foods, potatoes, broccoli, avocadoes, kiwis, tomatoes,
nuts, mangoes, bran cereals and many more are rich in potassium and are safe to consume in
order to increase the potassium levels. Intravenous supplementation is required to treat severe
hypokalemia (Veltri and Mason, 2015). Intravenous supplementation are generally given through
central line to avoid heating sensation at the infusion site, sometimes it might cause damage to
vein because of highly concentrated potassium. In the situation when the patient is resistant to

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the treatment of hypokalemia, the concomitant hypomagnesemia is used for potassium
replacement as magnesium is a cofactor of potassium. Excess intake of potassium will result in
causing Hyperkalemia, where the levels of potassium are increased.
Part 2
The body experience some changes, when the body’s potassium levels are reduced, these
changes are known as hypokalemia also known as low potassium syndrome (Theisen-Toupal,
2014). In human body, macro nutrients play an important role to keep the functioning of the
organs. Deficiency of macronutrients leads to fatal diseases osteoporosis, rheumatoid arthritis,
insomnia, muscular weakness, poor memory and many more (Viera and Wouk, 2015). In case of
hypokalemia, the body’s potassium levels become too low, due to excess potassium discharge
through sweat, bowel movements or urine. The term hypokalemia is derived from hypo meaning
“under”, kalium meaning “potassium” and emia meaning “blood condition”. It is the one of the
familiar water electrolyte imbalances. In human body, cells compose almost 98% of the body’s
potassium and the remaining are found in the extracellular fluid, blood. Potassium is important
for the functioning of nerves and muscle cells. As potassium is a charged particle, their polarity
performs a significant role in Na+/K+ pump. The main function of the pump is to deliver
potassium into the cells and at the same time draws sodium out of the cells, which creates an
electrochemical gradient. Therefore, low levels of potassium results in causing disturbance in the
functioning of Na+/K+ pump, as more sodium is drawn out of the cells.
The cause of hypokalemia can be a genetic kidney disorder, increased blood pressure,
chewing tobacco, excessive perspiration, high dosage of penicillin, diabetes, obesity,
hyperthyroidism, heart attack, skin loss, diarrhea, family history of hypokalemia and many more.
With the help of urine tests and blood tests, hypokalemia can be diagnosed. Hypokalemia is

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highly linked with the heart disorders, for this reason an electrocardiogram test is also prescribed
by the Doctors to analyze the heartbeat. In a healthy individual, the normal potassium levels are
3.5-5 mmol/L. Levels of potassium below 3mmol/L triggers symptoms of hypokalemia. The
main symptoms experienced by a hypokalemic patient are tiredness, constipation, muscle
weakness, cramps, ileus, difficulty in respiration, numbness, abnormal heartbeats, muscle
stiffness, mood changes, increased bowel movements, tetany, polyuria (excessive urination),
reduced appetite, vomiting, polydipsia (excessive thirst) and inability to perform mental
activities. The patients suffering from hypokalemia are provided assistance to recover the
reduced levels of potassium.
The treatment of hypokalemia involves the improvement of potassium level by diet or
treating disorders like diarrhea and by prescribing appropriate medications based on the
requirements of the patient. Mild hypokalemia can be treated by improving diet and potassium
chloride medications. Potassium rich foods like broccoli, tomatoes, potatoes, cauliflower, pecans,
cheese, leafy green vegetables, lima beans, citrus fruits, mangoes, dried fruits, eggs, asparagus,
bran cereals, red meats, nuts, avocadoes, beets, coconut water, winter squash, cantaloupe, carrots
and bananas, are given to the potassium to boost the potassium levels. However, increased intake
of potassium rich foods might result in excessive weight gain and increase in expenses. The
potassium chloride supplements contain efficient amount of potassium, but the only drawback is
the side effects, which includes nausea and vomiting due to unpleasant taste. In the case of
severe hypokalemia, where the levels of potassium are reduced to 2 mmol/L, intravenous
medications are required.
Nevertheless, there are some side effects of intravenous supplementation like, highly
concentrated potassium when infused to the vein through central venous catheter, it might cause

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vein damage and the sensation of burning at the infusion site. Patients resistant to the
hypokalemic treatment are compliant to diuretics spared by potassium (Blanchard et al., 2015).
Potassium’s cofactor magnesium is also provided in replacement of potassium uptake. Potassium
rich diets helps in preventing loss of potassium. Excess intake of potassium will result in causing
Hyperkalemia, where the levels of potassium are increased.
Part 3
Infants or toddlers suffering from low levels of potassium are recommended specific diet
plan, which involves potassium rich foods (Kanbay et al., 2013). Intake of excess salt and
carbohydrates are not recommended. Potassium rich foods like broccoli, tomatoes, potatoes,
cauliflower, pecans, cheese, leafy green vegetables, lima beans, citrus fruits, mangoes, dried
fruits, eggs, asparagus, bran cereals, nuts, avocadoes, beets, coconut water, winter squash,
cantaloupe, carrots and bananas, are given to the potassium to boost the potassium levels. For
children aged between 0-3 years the doctors suggest certain diet menus. Inclusion of potassium
rich vegetables like, pumpkin, brussel sprouts, sweet potato, spinach, chard, parsnips, cooked
mushrooms, beet greens and leafy vegetables, potassium rich fruits like papaya, melon, mango,
apricot, kiwi, nectarine, figs, prunes, dates, honeydew, pear, orange, banana and fresh fruit
juices, is highly recommended.
Intake of Potassium rich grain products like, ginger bread, porridge, whole grains, bran
flakes cereals, bran cereals and granola cereals helps in increasing the potassium levels in blood
serum. Certain meats and alternatives like, navy beans, kidney beans, tofu, pork, beef, blacked
beans, peanut butter, fish, lentils, squash seed kernels, almonds, lamb, poultry, pecans, walnuts
and eggs have beneficial effects in the levels of potassium. Fats and oils are avoided, as they are
not the source of potassium. Certain sweets like honey candies, gelatin, sugar and corn syrups are

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provided in moderate amounts. Dairy products like custard, yoghurt (sweetened), ice cream and
milk are advised. Adequate amount of water intake is important for maintaining the potassium
and salt balance. A sample menu for 0-3 year old children is given below:
Breakfast (8:00 A.M.) -
Milk (1/2 glass)
Bran cereals or oatmeal (1/2 cup)
Fruits (1/2 cup)
Snack (11 A.M.) –
Fruit juice (1/2 glass)
Wafers (2)
Lunch (1 P.M.) –
Milk (1/2 glass)
Fruit (1/2 cup)
Cooked Vegetables (1/2 cup)
Meat (100gm)
Whole grain Bread (1 piece)
Snack (4 P.M.) -
Oatmeal cookie (1)

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Fruit Yoghurt (1/2 cup)
Wafer
Dinner (7 P.M.) –
Milk (1/2 glass)
Cooked Green vegetables (1/2 cup)
Mashed potatoes (2 tbsp.)
Chicken (1 ½ oz.)
Snack (10 P.M.) –
Milk (1/2 glass)

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References
Blanchard, A., Vargas-Poussou, R., Vallet, M., Caumont-Prim, A., Allard, J., Desport, E., ... &
Essig, M. (2015). Indomethacin, amiloride, or eplerenone for treating hypokalemia in
Gitelman syndrome. Journal of the American Society of Nephrology, 26(2), 468-475.
Daly, K., & Farrington, E. (2013). Hypokalemia and hyperkalemia in infants and children:
pathophysiology and treatment. Journal of Pediatric Health Care, 27(6), 486-496.
Kanbay, M., Bayram, Y., Solak, Y., & Sanders, P. W. (2013). Dietary potassium: a key mediator
of the cardiovascular response to dietary sodium chloride. Journal of the American
Society of Hypertension, 7(5), 395-400.
Theisen-Toupal, J. (2014). Hypokalemia and hyperkalemia. Volume 4, Issue 1, An Issue of
Hospital Medicine Clinics, 4(1), 34.
Veltri, K. T., & Mason, C. (2015). Medication-induced hypokalemia. Pharmacy and
Therapeutics, 40(3), 185.
Viera, A. J., & Wouk, N. (2015). Potassium Disorders: Hypokalemia and Hyperkalemia.
American family physician, 92(6).