To Your Health

Hypokalemia and regulating potassium levels

Q. I have hypokalemia and find it difficult to keep my potassium level stable. I have tried various magnesium combinations without success. Would magnesium potassium taurate be better than magnesium taurate alone?

A. Hypokalemia is a serious and potentially fatal condition in which blood levels of potassium drop below normal. The term "hypokalemia" describes the condition, low blood potassium, without revealing why the condition exists (the prefix "hypo" means low, "kal" refers to kalium or potassium – in Latin – and the end portion "emia" means "in the blood"). Hypokalemia can result from a variety of medical conditions, and the most important step in treating severe hypokalemia is removing the cause.

While the most obvious cause of hypokalemia might be a low-potassium diet, the most common cause is the use of diuretics. Diuretics are medicines that increase the excretion of water and salts in the urine, often used to treat high blood pressure. If you are taking a prescription diuretic, your physician can probably change your prescription to a potassium-sparing diuretic.

Excessive sweating in atheletes, eating disorders, exceedingly high caffeine intake, or the ketoacidosis associated with type 1 diabetes can all result in excessive loss of potassium. Cushing's syndrome or tumors on the adrenal glands, both of which lead to abnormally high levels of the hormone aldosterone, will increase urinary loss of potassium. Each of these conditions require a different remedy.

Although less of a problem for adults (except for bulemics and those who abuse laxatives) hypokalemia related to vomiting and diarrhea is responsible for about 2.5 million infant deaths each year. Nearly all of these deaths occur in the poorer parts of the world, mainly in Asia and Africa, but it is also a leading cause of infant death in the United States. The potassium loss that accompanies vomiting is only partly due to loss of potassium in the vomit. Vomiting also causes loss of stomach acid, and this changes the pH of the blood. An increased blood pH makes the kidneys excrete excessive amounts of potassium.

Although the potassium level is most commonly measured in blood serum, potassium resides mostly inside body cells, and less than 1% of the body's potassium is in the serum. However, because small changes in the serum potassium level can have profound effects on the function of the heart and nerves, serum level is important and hormones from the kidneys tightly control serum-potassium level.

Taurine is needed to keep both potassium and magnesium inside the cells, where they belong. Hypokalemia can sometimes be related to an underlying magnesium deficiency, and a supplement that combines magnesium and taurine makes sense.

Potassium pills are limited to an amount under 100 milligrams, a very small amount compared to the 2000-2500 milligrams per day ordinarily provided in a typical American diet. Before adding a potassium supplement, either as potassium alone or in combination with magnesium and taurine, be sure that you actually need more potassium and are not in a situation of simply needing better control over the potassium already present in your body. A "red-cell potassium" test to indicate your body stores of potassium combined with a serum potassium test to reflect your body's control over potassium should give you and your physician the needed information.

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