Pretty sure I have Hypokalemia due to aggressive b12 supplementation

[lownskater52]

Hey everybody,

I just wrote a post about my weird CBC blood test results ( healthunlocked.com/pasoc/po.... ) and I've done some more research and am realizing that I've given myself hypokalemia due to aggressive b12 supplementation. The research says that for people with severe macrocytic anemia, a sudden spike in b12 can cause a massive draw down in available potassium. Apparently I've gone too far with my supplementation (read post references above for my blood test values).

So it's been 2 weeks since I was diagnosed with b12 deficiency and have been aggresively supplementing b12 daily. Every day I have take 1000 mcg oral b12 (alternating: sublingual and pill. Methyl, cyano, and methyl/adeno) while also having ten (10) 1000 mcg b12 injections in 14 days. While some symptoms have gotten shockingly better (positive weight gain, lower body stability/strength and walking), I've had weird symptoms of twitching, cramps, extreme constipation/bloating, shortness of breath, anxiety off and on with tonight being pretty extreme.

After doing some research, these are clear signs of hypokalemia. How severe, I dont know but I am worried. I'm still walking fine (no paralysis). I'm not vomiting or nauseous. But the twitching/cramping is pronounced. I'm vegan and eat mainly high water content fruits (watermelon, papaya, kiwi, berries, tomatoes etc) and salad daily so I have a high potassium diet already. Apparently not high enough though. I just ran out and got four 250 ml bottles of raw coconut water and sipped on them until I finished them. Not too much improvement as of now. After 14 days of extreme b12 supplementation, I'm going to consider myself loaded and takena break from the supps for a week and see how I do. I'm going to try to get my potassium levels up. Just not sure if I should go to a critical care office to get the potassium issue resolved with an IV or something.

[JanD236]

I’d say that you can’t really guess whether your potassium levels are right or not. If you feel ill then let yourself be the best judge of whether or not to go to your critical care office. A blood test will show if you need intervention or not.

[lownskater52]

At the doctors now getting a CMP done. Should have the results here shortly. Will update.

[lownskater52]

Wow. Really glad I went to get check as it cleared up a lot of information about my past tests and my current issue with potassium.

So the big picture is that my previous CBC test yesterday was probably invalid or in error and that I am indeed losing a good amount of potassium as I aggresively supplement b12.

I went to the doctor this morning and he took another CBC and a BMP (Basic Metabolic Panel). This was to check my anemia and check to see if I was dehydrated. What he showed me (yes, I got a copy of the results) was pretty shocking. First, the CBC results.

Today's Blood Test (5/16)

WBC - 3.6. 4.5 - 11 Normal (Same as yesterday, its fine)

RBC - 4.28. 4.5 - 5.9 N (dramatically higher than yesterday, good)

HGB - 13.9. 13.5 - 17.5 N (dramatically higher than yesterday, good)

HCT - 42.3. 37 - 53 N (huge jump from yesterday, good)

MCV - 98.9. 80 - 100 N (dramatically higher than yesterday, BAD)

MCH - 32.5. 26 - 34 N (dramatically lower than yesterday, good)

MCHC - 32.9. 32 - 36 N (dramatically lower than yesterday good)

So these are the type of results I was expecting to see. With these values I'm not even technically anemic according to the doctor. After I took the first blood test, I immediately went and took 1000 mcg of cyanocobalamin orally as a tablet which I dont think could boost the numbers this much in such a short amount of time. I think the testing machine yesterday was just not working properly. This puts my mind at ease. For comparison, I'll out my starting values compared to my current values from today.

WBC - April 3.1 vs May 3.6. Good

RBC - April 3.93 vs May 4.28 Good

HGB - April 12.7 vs May 13.9 Good

HCT - April 36.2 vs May 42.3 Good

MCV - April 92.1 vs May 98.9 Bad

MCH - April 32.3 vs May 32.5 Neutral

MCHC - April 35.1 vs May 32.9 Neutral/Good

And secondly, the potassium/electrolytes. I'm comparing my potassium and sodium prior to supplementation vs today.

Potassium - April 4.3 vs May 3.8. (3.6 - 5.1 N)

Sodium - April 139 vs May 143 (128 - 145 N)

As you can see, while I'm not technically out of range, my number for potassium has fallen significantly and my sodium level has risen noticeably. And these number were after a night where I drank four 250ml servings of coconut water (very high potassium) and had a breakfast of 10 oranges (very high potassium). I just feel more comfortable and healthy with potassium at the top of the range. I bet last night I was very deficient with numbers below the lower range. I'm going to continue drinking coconut water and eating fruit. I'm taking 3 days off from all b12 supps to see how I feel with a shot on Sunday.

So those are the details. Encouraging CBC numbers and electrolyte numbers to be cautious with. What do you guys think? I might make this it's own individual post as old posts dont get views compared to new.

[tnkarthik28]

Gentlemen, sorry to interrupt. What is hypokalaemic n how do we diagnose? Do we have to just check the pottasium levels? I have PA/atrophic gastrities n taking frequent B12 injections. While reading this post, have this doubt. Sorry for my poor knowledge on these subjects.