Signs and Symptoms of Low Potassium (Hypokalemia) in the Elderly

Signs and Symptoms of Low Potassium (Hypokalemia) in the Elderly

As you age, you are more likely to experience a potassium deficiency, also known as hypokalemia. Research shows that women over 65 years of age are especially vulnerable to low potassium.

Potassium is one of the minerals in your blood that carries an electrical charge. These minerals are called electrolytes. Potassium works together with other electrolytes to help your body to:

  1. Receive nutrients into each cell and rid cells of waste

  2. Balance levels of acids and bases (pH levels)

  3. Conduct electrical impulses for healthy nerve function

  4. Receive and send messages from your brain that make your muscles contract when it’s time to use them.

Potassium even helps to regulate your heartbeat.

Your kidneys control the amount of potassium in your body by eliminating excess potassium through your urine.  Your kidneys maintain the healthy balance between potassium and other electrolytes your body requires to function properly.


What is low potassium (hypokalemia)?

3.6 to 5.2 millimoles per liter (mmol/L) is the healthy range of potassium levels in your blood. If your levels fall below 3.6 mmol/L, you have a potassium deficiency. Potassium levels below 2.5 mmol/L are life-threatening and require immediate medical attention.

In the elderly, decreased body function, loss of appetite, certain diseases, and some medications increase their risk of hypokalemia.


What causes low potassium (hypokalemia)?

Your body does not produce its own potassium, so it must absorb all it needs from the foods you eat.  In spite of this fact, the root cause of most potassium deficiencies is not malnutrition. The vast majority of deficiencies result from the body getting rid of too much potassium. If you develop hypokalemia, your doctor will try to find the reason that your body is eliminating more potassium than it should.

Possible causes of low potassium include:


Excessive urination

Urination is the most common way that your body eliminates excess potassium. Your kidneys control this process. Certain kidney disorders and diseases result in the loss of too much potassium through urination, and in the loss of the kidneys’ ability to regulate potassium levels. Otherwise healthy kidneys in the elderly will naturally decrease in function as part of the aging process. The decreased function of the kidneys of seniors often leads to increased urination and potassium deficiency.


Diuretics or water pills are medications commonly prescribed to seniors for hypertension (high blood pressure) and heart disease. Diuretics cause increased urination that leads to loss of potassium. The use of diuretics is the single most common cause of hypokalemia.


Persistent diarrhea causes potassium to be eliminated before it can be absorbed into the body through the intestines. The excessive use of laxatives or enemas leads to persistent diarrhea and low potassium levels. Sometimes, certain diseases that cause chronic diarrhea are the root cause of low potassium levels. These diseases include Crohn’s disease, celiac disease, ulcerative colitis, and irritable bowel syndrome.


Persistent vomiting leads to malnutrition and decreased potassium intake. Eating disorders like bulimia and anorexia also decrease the amount of potassium the body is absorbing and lead to hypokalemia.

Excessive sweating

Sweating is another way the body eliminates potassium. Excessive sweating in hot weather or during physical activity lowers the body’s potassium levels.

Vitamin or mineral imbalance

An excess of sodium, low magnesium levels, and folate deficiency are all linked to low potassium levels.


In addition to diuretics and laxatives, other medications negatively affect the body’s ability to absorb and use potassium. Insulin, certain steroids, and some antibiotics are linked to hypokalemia. Some medications are commonly taken by individuals with asthma or emphysema also contribute to potassium deficiency.

Alcohol abuse

Excessive alcohol use significantly increases your risk of low potassium levels. Because alcohol enters your bloodstream, it is carried to every organ in your body. Alcohol impairs your organs’ abilities to regulate the balance of water and electrolytes your body needs to function properly.

Some surgeries

Some surgeries decrease the absorption of potassium by your body. Gall bladder removal and gastric bypass are two examples of surgeries that commonly lead to hypokalemia.


What are the warning signs and symptoms of low potassium (hypokalemia)?

The symptoms of low potassium are not always immediately evident. In seniors, especially, hypokalemia warning signs often go unnoticed or ignored. The symptoms to look for include:


Muscle weakness

Your muscles work and contract when they receive messages from your brain to do so. Potassium helps your muscles receive those messages. Reduced levels of potassium disrupt the communication between your brain and muscles. Therefore, a potassium deficiency often produces weak contractions. When potassium levels are extremely low, some of your muscles fail to work at all.

Muscle cramps, aches, and stiffness

The disruption of messages between your brain and muscles will sometimes cause a single muscle or a group of muscles to contract strongly and not release. This long, uncontrolled contraction is called a cramp. If your potassium levels drop too low, you may notice an increase in painful muscle cramps. Potassium also helps control the supply of blood to your muscles. When the flow of blood decreases, your muscles start to break down. Aches and stiffness in your muscles may indicate a potassium deficiency.

Fatigue and mood changes

Potassium affects how your body uses other nutrients. When your body is not able to properly absorb and receive the full benefit from the nutrients you eat, you can experience general fatigue, moodiness, or a sense of “feeling off.”

Constipation and feeling bloated

Digestion requires that the muscles in your esophagus, stomach, and intestines are functioning properly. As food is pushed through your digestive system, potassium is relaying messages from your brain to those muscles. When there is not enough potassium in your body, the muscles don’t work effectively, cramping occurs in your abdomen and the digestion of food slows down.

Heart palpitations

Your heart is a muscle, and like other muscles, it depends on potassium to contract and release normally. When there is a lack of potassium, you may notice heart palpitations. These feel like your heart suddenly starts beating harder, beating more quickly, fluttering or skipping beats. You may notice heart palpitations in your chest, throat, or neck.

Tingling or numbness

The ability of potassium to conduct electrical impulses is critical to healthy nerve function. Without enough potassium in your body, your nerve signals weaken and can cause tingling or numbness in your arms, hands, legs, or feet.

Breathing difficulties

The relationship between potassium and healthy muscle function plays a major role in your ability to breathe normally. Your diaphragm is a muscle that causes your lungs to inflate and deflate. Low potassium can weaken your diaphragm and make breathing difficult. Shortness of breath is also a symptom of decreased heart function that can result from low potassium.

Left untreated, hypokalemia is life-threatening. Extremely low potassium can cause heart failure or stop your breathing. If you have persistent symptoms as described above, see your doctor. With a simple blood test, your doctor can determine whether or not your potassium levels are low. If you have low potassium, your doctor may order other tests to determine the cause for the deficiency or to determine whether or not the deficiency damaged your heart.


How do you treat low potassium (hypokalemia)?

Once diagnosed, hypokalemia is treatable. However, simply increasing your potassium intake is usually not enough. To treat a deficiency, the root cause of your low potassium levels must be found and addressed. Treating the underlying diseases or conditions, modifying behaviors, and changing medications can all be part of your treatment plan. Only after the cause is eliminated can you prevent low potassium from reoccurring.


If your potassium levels are dangerously low, you will probably need to go to the hospital to receive electrolytes through intravenous therapy, also known as an IV. In the hospital, healthcare professionals will watch for signs of serious health complications until your potassium levels return to a normal level.


If your deficiency is moderate, your doctor may prescribe potassium supplements in the form of pills or liquid. Sometimes, potassium supplements can upset your stomach and cause vomiting. If that happens, contact your doctor immediately. Vomiting can cause your potassium levels to fall even lower. You should never start taking potassium supplements without first talking to your doctor. Taking too much can result in high potassium levels which can also have serious health consequences. While you are taking any potassium supplements, your doctor will test your blood levels frequently.


Which foods are high in potassium?

The safest and easiest way to increase the amount of potassium intake is through the foods you eat. Experts recommend that adults, including seniors, should be getting 4,700 milligrams of potassium daily through their diet. Unfortunately, a study conducted from 2003 to 2008 showed that 98% of adults in America are not meeting the minimum recommendation for potassium in their diet. Because of the number of processed foods consumed, most of us in this country are getting too little potassium and too much sodium in the foods we eat. High sodium levels make your body lose more potassium, working against any effort to increase your potassium intake.


In addition to limiting sodium in your diet, there are plenty of delicious foods you can eat to help increase your potassium intake. When the term “high-potassium foods” is mentioned, many people immediately think of bananas. Perhaps surprisingly, although bananas contain some potassium, there are many foods that contain much higher amounts. Some of the best sources of potassium include:

  1. Green vegetables (especially beet greens, cabbage, collard greens, and spinach)

  2. Mushrooms

  3. Summer squash (especially zucchini)

  4. Winter squash

  5. Lentils

  6. Beans (especially white beans, kidney beans, and pinto beans)

  7. Potatoes (including sweet potatoes and yams)

  8. Tomatoes (and low-sodium tomato juice)

  9. Avocados

  10. Apricots (1/2 cup of dried apricots provide 1/3 of the potassium needed each day)

  11. Raisins

  12. Prunes

  13. Oranges

  14. Bananas

  15. Cantaloupe

  16. Peaches

  17. Soy products (like tofu)

  18. Animal products (like beef, pork, poultry, clams, fish, and dairy products)

Sports drinks are often marketed as being good electrolyte replacements. However, they can contain high amounts of sugar and sodium. To increase potassium, orange juice is a much better option than a sports drink.


How Can Centric Healthcare Help?

Medication Therapy Management

When seniors are taking several prescribed medications and supplements, it can become confusing and overwhelming. Centric Healthcare offers Medication Therapy Management (MTM) services that are coordinated with your pharmacist to help optimize the therapeutic outcome of each medication prescribed to you. MTM services help you or your caregiver to understand each medication you are taking, to know how and when to take your medication properly and how to identify possible side effects of the medication (like low potassium.)

Senior Home Care Services

Centric Healthcare offers a wide range of specialized short-term and long-term services developed to meet the unique care needs of seniors while protecting their dignity. We work with you to create a customized care plan for you or your loved one. The care plan can be designed to address nutrition, chronic health conditions, medication administration, and symptoms that are linked to low potassium. Our senior home care providers may also be able to help identify symptoms that seniors might ignore.  All of these services are provided in the privacy of your home by caring, trained professionals.

Medical Nutrition Therapy

A healthy diet is an important part of treating and preventing low potassium. Centric Healthcare offers Medical Nutrition Therapy (MNT) services that can help. A Registered Dietician can help you design a customized nutrition program that is tailor-made for you. When helping you make a plan, we will take into account factors such as your medical history, your current health needs, your dietary restrictions, and many others. Through the MNT services offered by Centric Healthcare, you can make better food choices, eat healthier portions and learn delicious ways to enjoy a healthier lifestyle.

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