High potassium (hyperkalemia) can feel harmless at first — maybe just mild weakness — but it can also disrupt your heart rhythm in minutes. Know the common causes, how doctors spot it, and what actions help lower levels safely.
Potassium is vital for muscles and the heart. Hyperkalemia happens when the body can’t remove extra potassium or you get too much from medicine or diet. Common causes include chronic kidney disease, dehydration, sudden tissue breakdown (like severe injury), and certain drugs — especially potassium-sparing diuretics (spironolactone), ACE inhibitors, ARBs, some antibiotics like trimethoprim, and supplements.
Symptoms are not always obvious. Watch for muscle weakness, numbness or tingling, fatigue, nausea, palpitations, and lightheadedness. If you feel chest pain, faint, or have a very fast/slow or irregular heartbeat, treat it as an emergency — those are signs your heart may be affected.
If a clinician suspects hyperkalemia they’ll order a blood potassium test and often an EKG (electrocardiogram). The EKG helps decide how urgent treatment is — certain changes mean immediate hospital care.
In the ER the typical steps are: stabilize the heart (calcium gluconate), shift potassium into cells (insulin with dextrose, sometimes nebulized salbutamol), and remove potassium from the body (kayexalate, patiromer, or dialysis in severe cases). Your doctor picks the mix based on how high the potassium is and your overall health.
Don’t try emergency moves at home. If you suspect dangerous hyperkalemia — severe weakness, chest pain, fainting, or severe palpitations — call emergency services right away.
If hyperkalemia is mild or chronic, management focuses on treating the cause: adjust or stop meds that raise potassium, manage kidney disease, correct dehydration, and use potassium binders when needed. Regular blood tests and EKGs help track progress.
Small practical tips: keep a current list of your medicines (including supplements), tell any new provider you’ve had high potassium, and avoid starting potassium supplements or salt substitutes that contain potassium without checking first. If you take drugs like spironolactone or an ACE inhibitor, expect routine potassium checks — that’s normal and protective.
Hyperkalemia can be frightening, but most cases are manageable when caught early. If you have chronic kidney problems or take medications that affect potassium, set up a simple follow-up plan with your clinician for lab checks and clear instructions on when to seek urgent care.
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