Hyperkalemia: What You Need To Know About High Potassium

As a long-time hypertensive, I am no stranger to blood tests — but they are usually a boring part of my routine, and not anything to worry about. When I recently went to have my routine blood work done, the outcome was a little more alarming. My physician's assistant contacted me to tell me that my potassium levels were alarmingly high and that I should have another blood test within the fortnight.

Of course, I was a little shocked to hear that my potassium was elevated, especially when the PA told me how important it was to come in again as soon as possible. I knew that high potassium levels could indicate poor kidney function, which runs in my family, so my thoughts immediately wandered to being stuck to a dialysis machine.

What Is Hyperkalemia?

Hyperkalemia is a medical term that means elevated potassium levels. Potassium is without a doubt an essential mineral; it keeps your heart, kidneys and other body systems running well, and not having enough potassium can lead to serious health problems like hypertension, heart disease, infertility, stroke, arthritis, digestive disorders, and even cancer. Unhealthy lifestyle habits like smoking, abusing alcohol and drugs, being excessively physically active and having eating disorders can all lead to a lack of potassium. These health issues are all pretty common. This is why you have probably heard about people taking potassium supplements to bring their levels of the stuff up.

Hyperkalemia, the opposite problem, is much less discussed, but no less dangerous. Normal blood potassium levels are between 3.6 and 5.2 millimoles per liter (mmol/L), and you have too much if you're over that. Having potassium levels of 7.0 mmol/L or higher poses a real risk to your health. As such, it deserves to be taken extremely seriously and requires immediate medical treatment. More about that later.

Hyperkalemia: Causes And Symptoms Of High Potassium Levels

You can usually expect to have high potassium levels diagnosed during routine blood testing for a preexisting condition or because you're taking medications and your doctor wants to monitor the state of your blood, rather that because you have been feeling poorly. If you're in this boat, you may not have symptoms associated with high potassium levels at all, or at least not symptoms you can recognize as being caused by hyperkalemia. Your potassium levels may rise over time, causing gradual symptoms you cannot easily pinpoint as well.

If you do have symptoms linked to your high potassium levels, they're likely to include some of the following:

• Muscle aches
• Fatigue
• Tingling
• Nausea
• A slow heartbeat and a weak pulse

High Potassium: False Readings And Treatment

Warning: Don't Trust Your 'Diagnosis' Before The Second Test

Hyperkalemia can be caused by some truly frightening medical conditions, so it's no wonder that my physician's assistant was so proactive when my readings came back high — though she wouldn't even tell me exactly how high. I was quite annoyed about having to come in for yet another blood test so soon after the first one. This forced me to take time off work. But yes, I did want to know whether I really did have hyperkalemia.

If you are in a similar situation, it is important to be aware that many initial readings of high potassium are in fact false readings. Blood cells can rupture during or shortly after a blood test, triggering them to leak their potassium into the sample your lab will be testing and indeed falsely elevating the results shown. This is such a common problem that physicians widely recognize the need for a repeat blood test for final diagnosis. 

The second time they drew my blood, they did it with a special thin needle with a sort of stopper inside to make the blood come in all at once. They didn't use the elastic band this time either. Now, my potassium was 4.5. That's on the high end of normal, but within the normal range nonetheless. You, too, may find that your second and more careful blood test tells a different story. In short, there's no reason to panic until you have been tested thoroughly.

Treatment For Hyperkalemia

If you do turn out to have hyperkalemia, your treatment plan may involve a wide variety of solutions, including emergency treatment, lifestyle changes, and medication.

IV calcium, glucose and insulin are all emergency treatments. Kidney dialysis may be necessary to filter the potassium from your blood if your kidney function is poor. Don't panic, though, as this is not the first line of treatment and is only used in life-threatening situations. You may be given sodium polystyrene sulfonate and diuretics as well. Soda bicarbonate is a treatment that's viable in certain cases, if elevated potassium levels are caused by acidosis.

In terms of lifestyle changes, you may be told to either reduce or stop your potassium supplements, if you are taking any, and to alter your diet to cut down on foods rich in potassium. I did this just in case, as soon as the first call came through. I'm a bit of a tomato addict. They're a really good source of potassium, so of course I cut them out immediately, along with spinach, egg plant, bananas and avocado. Coffee is also full of potassium. I'm currently trying to cut down, but it's hard. Basically, all my favorite foods have tons of potassium. I said good bye to Himalaya salt, which can also raise potassium levels.

You may also need to switch over to different medications if you're taking any, because certain medications can lead to higher potassium levels. 

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While hyperkalemia definitely needs to be taken seriously because it can cause life-threatening heart rhythm issues, it can generally be managed well. Discuss your concerns and your treatment with your doctor and follow their instructions to the letter, and everything will probably be OK fairly soon.