Potassium levels

[pet-lamb]

I'm being advertised by another site that my potassium levels are dangerously high I'm also being told to eat a high potassium diet .this is confusing me. so before I try again with my doctors can someone please check and advise me.

[Foggyme Administrator]

Hi Pet-lamb.

At 5.3mmol/L your potassium level is at (but within) the normal reference range of 3.5 - 5.3mmol/L.

According to the Mayo Clinic, a level of 6.0mmol/L or above requires urgent medical treatment.

Here's what the Mayo Clinic say about potassium levels etc.:

mayoclinic.org/symptoms/hyp...

About potassium and B12 deficiency: if there is no pre-existing medical condition that depletes potassium, additional potassium in the diet is only required in the presence of macrocytic anaemia - usually at the point of diagnosis. This is because the body uses extra potassium in the initial stages of repair to the macrocytic red blood cells, so uses up.potassium quite quickly. And once the initial treatment with B12 injections has commenced, the way the body requires and utilises potassium drops back to 'normal' quite quickly (or whatever normal is for each individual).

So...not everybody automatically requires a high potassium diet.

I've read somewhere (but can't recall where and haven't the time to check) that if macrocytic anaemia is present, potassium levels should be checked 2-3 days following the commencement of B12 injections. Though never heard of any GP's that actually do this.

Some with absorption problems have a 'low-normal' potassium range and these people may want to ensure that sufficient potassium is taken via diet (it's quite easy to calculate the amount of potassium in various food-stuffs, in order get the balance right - lots of charts on the Internet). The daily recommended intake of potassium for adults is 4,700mg daily.

Have to say though, it's a very individual thing - not everybody needs to increase potassium via dietary intake - mine's always been okay 😉😀

Potassium supplements should never be taken unless under the direct supervision of a qualified medical practitioner.

So...you potassium level is at the high end of the reference range, but not in the danger zone.

It's also possible to get a false high if the blood sample is spoilt or if you were dehydrated at the time the blood was taken.

A number of medical conditions (i.e. kidney disease, Addison,s, diabetes etc.) - can also cause non-diet related high potassium levels, so worth thinking if any of that applies to you.

Suggest you eat a 'normal' diet and forgo attempts at high potassium intake.

Also, I see this blood test was taken 31 January, so suggest you discuss these results with your GP (might be worth also asking to have your potassium levels re-checked - if only for your own peace of mind (though your GP may very well say they're normal, so no necessity)).

👍

[pet-lamb in reply to Foggyme]

Thank you foggyme I wasn't dehydrated and don't have the other problems. I spoke to my doctor last week about all my test results but got nowhere .but you have put my mind at rest about the potassium .

So it should be safe to self inject b12 (doctors refused to even allow me to have 1 b12 injection at the surgery) I explained everything on the PA post if you can access it.

[Foggyme Administrator in reply to pet-lamb]

Hi Pet-lamb. Just had a quick look through your previous posts and just a couple of things spring to mind...

Note that you have Hashimoto’s (an autoimmune condition)...

a) is this properly controlled with medication? Many cross-over symptoms betweeen that and those of B12 deficiency. Are all,your thyroid levels (TSH, FT3, FT4 at optimal levels - best post on thyroid forum for more advice about that)

b) those with Hashimoto's often have problems with B12 deficiency - the two often go hand-in-hand (so much so, the advice is to test those with PA for Hashi's).

c) autoimmune conditions tend to travel in clusters - once you have one, it's possible (but not certain) that others will occur. Has your GP tested you for Pernicious Anaemia, another autoimmune condition (you'd need anti-Intrinsic Factor Antibodies tested). Though not a definitive test - half of people with PA test negative for IF antibodies.

d) has your GP done full screen for antibodies (you have one autoimmune condition so should be screened to rule,out potential for others...in light of ongoing symptoms, GP should be looking for answers (especially if they're convinced that B12 deficiency is not the problem.

Raised lymphocytes...

a) can be caused by dehydration, stress, smoking, infection (or recent recovery from)...

b) at 4.6 your level is only slightly raised and all other elements of the full blood count are normal (if something significant was going on, it would show in these elements too)

c) Your CRP (one of the markers of inflammation) not raised - so no indication of active acute or chronic inflammation

d) possibility that raised antibodies from the Hashimoto’s - if under-treated - is causing a small rise in lymphocytes

e) B12 deficiency can cause decrease in lymphocytes - but not always the case

From what you've said in your previous posts, it does sound as if you may have an absorption problem and it's disappointing (to say the least) that your GP is not (at the very least) trying to get to the bottom of your health issues. (Have they checked for the causes clivealive outlines in one of his earlier replies to you?). And then considered other possibilities for,your symptoms...

Are you able to see another GP...or perhaps change GP's...

About the B12 deficiency...lower limit seems to be set very low (even accounting for local statistical average and machine calibrations). BSCH guidelines suggest therapeutic trial of injections for those with a level under 200ng/L, who have symptoms of deficiency (but you know that 😉).

About B12 injections: blood tests on 31 Jan show that you do not have macrocytosis (large red blood cells) so lowering of potassium following start of B12 injections is unlikely to be an issue - especially as your levels are not currently dragging along the bottom.

About safety of first injection - advice to have this under medical supervision is because in rare cases, anaphylactic shock can occur. Symptoms are swelling in lips, face, tongue, throat, difficulty in breathing etc. If this occurs it needs to be treated immediately, as a medical emergency (injection of adrenaline). So...best to be very close to a location where this can be obtained...and have someone with you, who can help you, if needed (just to be one the safe side).

Just be aware that one of the problems with turning to self-injection is that it will then be very difficult to get an accurate diagnosis once B12 injection have started, and also ongoing blood tests /treatment / specialist referrals, if required.

There's also the possibility that other underlying causes for your symptoms may remain undiagnosed and untreated.

And I say this knowing how difficult it is when GP's do not provide appropriate care, testing and treatment, when needed.

Some have had luck with writing a 'B12 treatment appeal' to their GP's and including guidelines and evidence about treatment etc. Might be worth considering...if you decide to do this, I can post in some links to guidelines / evidence that will help.

Or as I said, consider changing your GP...though there's no guarantee that a new GP, would be any better...just the hope that it may be so.

Also note that you've joined the PAS - worth ringing the helpline to ask Martyn Hooper if he can advocate on your behalf.

Good luck with whatever you decide to do.

👍

[pet-lamb in reply to Foggyme]

Thank you foggyme

I'm reluctant to change doctors practice as from what I've heard there's not much between them around here and I'm worried the new one might try to stop my thyroid medication I had to fight hard to get any and I feel that at the moment I have no fight left in me .latest Tsh is 0.39mlU/L [0.3-4.5]

Thyroid picture (including satisfactory thyroxine replacement)

My current doctors (there's lots in the practice) haven't done the checks you mentioned and only do my Tsh once a year now. They refuse to do any other thyroid tests now and as a result I don't know if my other thyroid levels are optional or not . I have a goiter and nodules discovered last year may June? I had a scan then but no other treatment or checks since.

I've never been tested for any other autoimmune diseases that I know of ,except for celiac as I complained of stomach problems and my dad always had these problems my sister and her son and grandson are all confirmed celiac. I tested negative in bloods and the tube down. But the consultant advised me to eat gluten free and I have ever since.

B12 I've decided to wait the 3 months the doctor wanted me to wait to see if the levels drop again. (She only offered this after I implied the doctor at the surgery weren't taking me seriously) But if the GP won't help then I think it's time to write to them. And I am prepared to self inject if I have too . I would take every precaution .I'd take my husband with me to the hospital and park close enough for him to be able to run in for help if needed or it might be better to inject in the hospital toilet (that sounds bad) but I'd be on site at a&e if I need help.

For now I think I should just take the supplements advised by the vitamin D UK site protocols for low and deficient vitamin D and the other things recommend to take at the same time magnesium and k2 and something for low folate . (Unless it would be better to wait until after the next blood test to see if the vitamin d and folate also continue to drop) what do you think .

[Foggyme Administrator in reply to pet-lamb]

Pet-lamb...about the thyroid testing, goitre and nodules...best ask a out that on the thyroid UK forum...they're extremely,knowledgable about these things and can give much better advice than I can 😉.

About supplements - it would be better to wait until after your GP has completed your blood tests - supplementing prior to tests will potentially alter your levels (skew the results) and your GP will then be further convinced that you don't have a problem.

Certainly, don't take any folate until your B12issues have been addressed - supplementing with folate can a) obscure haematological signs of B12 deficiency and allow the deficiency to progress untreated and b) in rare cases cause neurolgical damage (when B12 deficiency is also present).

When both folate and B12 are deficient, B12 injection should be given 24 hours prior to commencing folic acid supplements (again, to prevent rare neurolgical complication/damage).

Sorry, can't remember (and don't have time to check right now) but if you have neurolgical symptoms, I'd suggest writing to your GP (B12 treatment appeal) now rather than waiting for three months. Neurological symptoms of B12 deficiency need immediate treatment to a) prevent potentially irreversible neurolgical damage and b) give the best change of optimal recovery.

Writing to GP and including evidence often gets a better result that just discussing and asking for treatment since the letter and evidence forms a part of you medical record so a) they have to read the evidence: b) the good ones learn and revise their opinions and c) once your request is on record - accountability (theirs) is foregrounded.

If you do write a letter, good idea to ask them to put their response in writing if they further refuse treatment - and ask them to include evidence to support that decision (all are supposed to engage in evidence based practise). They won't be able to provide evidence to support a 'not-treat' decision, because there isn't any 😉.

Good luck with whatever you decide to do.

[deniseinmilden in reply to Foggyme]

Brilliant reply - thank you!

[Foggyme Administrator in reply to deniseinmilden]

😉😀

[Laura333]

Hi, my husband has high potassium, yours is on the high side of normal. His has been up to 6.5, which is way above yours, and he went into hospital to be treated with an insulin infusion.

But as long as he keeps it below 6.0 they dont seem to worry.

Who was it that told you to eat a high potasssium diet? That could be making it high in your bloods. Things like potato, cabbage, beans , peas, even strawberries are all high on potassium. Look it up online and watch your diet, that should bring it down.

[pet-lamb in reply to Laura333]

Thanks laura333 I joined another vitamin D Site it turned out to be from American .the lady seems very knowledgeable but I'm wondering if she could see my levels (photo) properly or just made a mistake. I could see that my reference range was high but hadn't been highlighted by the labs. So I wasn't unduly worried .she on the other hand insisted I was in life threatening danger and confused me further with her insistence I eat a high potassium diet. luckily I trust health unblocked so double checked

[Laura333]

I think a lot of the American blood tests have different ways and numerical levels of measuring, and the two ( ours and theirs) don't match.

Fail to see how a high potassium diet would do anything other than put it up further.

I'd just cut down on the potassium rich foods, or on the way they are prepared.

Potatoes are high, but if boiled are ok, same with a lot of foods, it's the way they are prepared, pre soaking leeches a lot of it out.

On the other hand you do need some potassium, also sodium, so you don't want to cut it out too much.

[pet-lamb]

Thanks Laura333 I think the problem might be that I eat a lot of bananas maybe 1 medium most days.

[Laura333 in reply to pet-lamb]

Yes bananas are really high in potassium, I’d leave them alone for a while and see if your levels come down. Funnily enough my husband had a lot of bananas as snacks also.

[pet-lamb]

Yes thanks laura333 that's what I plan to do it's just that I love bananas. ahh well had the last of those for a little while and I have a list of other potassium rich foods but I don't eat them very often .

[Plucky1976]

Your potassium will fluctuate constantly depending on quite a few things. I did have a low potassium level that I found by chance and so when I started b12 injections I found it would drop after a few loading doses. I was never big on bananas and orange juice but now I find if I just have 2 bananas a day along with a couple of glasses of orange juice a day I have no issues. If your kidneys work properly you will excrete what you don't need.

[pet-lamb in reply to Plucky1976]

I wee a lot it's a standing joke all my sister's are the same yet I'm not diabetic but frequently have a dry mouth dispite copious amounts of fluids

[Plucky1976]

Yes and I find there are days when I'm especially anxious that I do the same but those are the days I realize I need to up the potassium as going frequently is a symptom of low potasium.

[pet-lamb]

But mines at the top

[Plucky1976]

It does fluctuate a lot throughout the day. I was at 4.1 after having some lab work done in the morning and after having my b12 injection that day dropped to 3.0 by 9 pm that same day. It was during my loading doses but it was usually then that my frequency would increase and it would be on the lower side. The very beginning of this b12 journey it was in the 2's. Just have it checked frequently for a while.

[pet-lamb]

Thanks plucky11966 I didn't know it fluctuated mine was done about 10am fasting from about 8pm the night before