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Nurse Milli, RN
Nurse Milli, RN, Nurse (RN)
Category: Health
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Experience:  20 years experience in many areas of Nursing. Both Hospital and Private Practice experience.
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RA - 130

Customer Question

3 weeks ago I had a seeming episode of heat exhaustion and showed low potassium, low sodium, and mild Anemia on blood work. Only a basic panel was checked though. These symptoms stabilized after about a week of taking electrolyte replacement drinks and calcium and magnesium supplements. The magnesium did not cause any diarrhea.

This past week I have had about 8 episodes of watery diarrhea (possibly from food poisoning) and have been since experiencing severe episodes of dehydration, to the point where I appear very pale, cold, and have collapsed unconscious. I have painful muscle cramps and muscle twitching all over. I have had to keep replacing electrolytes and drinking water or these dehydration episodes continue to worsen until I can't stand upright without passing out unconscious. The diarrhea seems to have stopped as last 2 days movements were no longer liquid.

Other symptoms seem to depend on severity of dehydration - extreme weakness, dizziness, fluctuations between low and high blood pressure, alternate between weak and slow pulse (<50) and weak but fast pulse, shortness of breath, nausea, excessive thirst and urination, chest tightness, cold/pale skin and collapsed veins when most dehydrated.

Initially my doctor thought I had depleted electrolytes from the heat exhaustion and electrolyte replacement seemed to do the trick then. However after the more recent diarrhea these dehydration episodes have become severe unless I am frequently replacing fluids and taking potassium, sodium, magnesium, and calcium.

The magnesium has seemed to have had dramatic effect many times when taken with potassium, but is has not lasted more than a few hours unless I continue taking small amounts. In the past in varying combinations I have shown low blood calcium, low blood magnesium, low blood potassium, and low blood sodium. I have been told before by a few doctors that low potassium and low calcium will not correct if there is deficient magnesium. I have long shown deficiency symptoms of all three of these minerals.

I am praying that supplementation will turn this around again as it has many times before, but if it does not I do not know what else to do.

What do you think is going on?
What do you recommend for treatment?

How serious might this be, and if it were to worsen at what point should I seek emergency care?
Submitted: 1 year ago.
Category: Health
Expert:  Dr. Chip replied 1 year ago.
Up until all this began, no health problems and I assume you had had previous standart blood work that was all normal?
Customer: replied 1 year ago.

I have many recent health problems that I had seemed to be recovering from until the heat exhaustion and diarrhea. I had life threatening GI bleeding 9 months ago and severe Anemia. I have had the same issues with electrolytes, mineral deficiency symptoms, and dehydration while I was recovering from the Anemia, just not as severe. I never had watery diarrhea during that recovery time though which has seemed to have made this problem far worse suddenly.


 


I have had many abnormal test results but there are too many to mention. In relation to electrolytes, recent low sodium, low potassium, and mild Anemia, and a few other abnormalities. Magnesium was not checked but I have shown low before, have long shown deficiency symptoms, and always respond strongly to supplementation with calcium and magnesium. In the past year I have had low potassium, magnesium, and calcium several times, including while in the hospital. I was prescribed multivitamin, magnesium and calcium when discharged from the hospital for the GI bleeding.


 


As I said, many times in the past oral replacement of electrolytes and calcium and magnesium supplementation have shown strong improvement with the present symptoms. However this time the severe diarrhea seems to have suddenly made these electrolyte problems far worse.


 


I am concerned if supplementation is not enough what am I supposed to do. The dehydration symptoms get severe to the point of blacking out unconscious if I am not frequently replacing electrolytes, water, and taking calcium/magnesium. The heart rhythm symptoms always seem to be the warning signs, heart beat becomes slower and weaker (pulse as low as 45), it becomes harder to breathe, urination increases, and it just gets worse from there.


 


Please re-read my first post before you answer because there are so many factors involved here.

Customer: replied 1 year ago.

The muscle cramps and spasms have also been especially bad since the diarrhea. I have many muscles randomly twitching and spasming. I have also lost 8 pounds in the week since the diarrhea started without trying to lose weight.

Expert:  Dr. Chip replied 1 year ago.
OK--have you had your thyroid and parathyroid functions checked as well as cortisol levels? I assume your kidney function is fine?
Customer: replied 1 year ago.

Kidneys have looked good. Have not checked parathyroid or cortisol recently. Did have cortisol checked 2 years ago and was in normal range.


 


My doctor has ordered vitamin D checked soon since I have all the symptoms of calcium deficiency and am lactose intolerant. Calcium has also had a very strong effect improving these electrolyte symptoms but only when taken with substantial magnesium.

Expert:  Dr. Chip replied 1 year ago.
And your thyroid? What is your calcium level?
Customer: replied 1 year ago.

Thyroid has been in normal range usually, slightly high a few times in the past. Calcium has been below normal range in the past when I was in the hospital, don't remember the value. I have all the symptoms regardless, have many risk factors for increased calcium losses and/or reduced absorption, and respond strongly to supplements.

Expert:  Dr. Chip replied 1 year ago.
OK--has all this been evaluated by an endocrinologist?
Customer: replied 1 year ago.

No.

Expert:  Dr. Chip replied 1 year ago.
OK--can you give me exact numbers for your electroytes?
Customer: replied 1 year ago.

Recent was 132 for sodium, 3.4 for potassium. However this was taken when I was feeling much more stable. When I was less stable in the hospital they were lower. I don't remember calcium and magnesium off hand but they have been low on more than one occasion.

Expert:  Dr. Chip replied 1 year ago.
OK--and has your recent diarrhea been evaluated with a stool culture?
Customer: replied 1 year ago.

It was checked for blood by my Dr. and he said it was negative. I don't know what test he did.

Customer: replied 1 year ago.

Actually the stool was checked after the heat exhaustion only because it was very dark. He said a test for blood was negative. It seems it was dark from the higher dose of iron I was taking. Now my dose does not turn it dark.


 


No stool analysis had been done on the diarrhea. I was much too unstable to even see a doctor at the time.

Expert:  Dr. Chip replied 1 year ago.
And you've actually passed out from what you think is either dehydration or electrolyte problems?
Customer: replied 1 year ago.

 


 


Yes I have passed out when the dehydration/urination is excessive. I weigh quite a bit less when that happens and appear very pale, cold and with collapsed veins. When I am able to rehydrate, within about an hour my color returns, veins fill out, and I feel warm again, blood pressure and pulse go back to near normal.


 


 


It does seem lately that drinking juice for the potassium actually aggravates the excessive urination. Could this be from rapid increases in glucose concentration because of the dehydration, similar to what occurs with dehydrated diabetics that causes excessive urination?


 


I am not diabetic but I am prone to wide glucose fluctuations. In the past I have seen it over 200 and as low as the 30's several times. Usually it is between 60-110 though and never above 100 fasting.


 


 


 


 


 


I do think I am starting to see a pattern emerging. The symptoms do seem to always get worse when I am taking higher amounts of sodium but without increase in water. When I eat higher sodium foods my heart starts beating slower (<60, sometimes <50) and weaker, my blood pressure increases, I feel weaker, more short of breath and dizzy. I also feel worsened muscle cramps, sore muscles/neck/back, muscle spasms and twitching. I also have nausea, reduced appetite, and have continued losing weight unintentionally.


 


 


 


 


 


Could a lot of these symptoms, and especially this unusual reaction to sodium, be due to potassium deficiency?


 


Potassium is the only thing I have not been getting large amounts of because most of the foods high in potassium are too high in sugar or carbohydrates which seem to worsen the urination. I had also been on a low carbohydrate, high protein, high sodium diet during the 2 months prior to when these symptoms began.


 


 


 


 


The potassium I gave above was from 4 weeks ago and the symptoms are much worse now than at that time. It had been below 3 when I was in the hospital, and was given potassium, so I am certainly am prone to hypokalemia.


 


 


 


 


 


 

Expert:  Camille-Mod replied 1 year ago.

Hi,

My name is XXXXX XXXXX I’m the moderator for this topic. I am sorry, but It seems that the professional has left this conversation. This happens occasionally, and it's usually because the professional thinks that someone else might be a better match for your question. But don’t worry….. If you are still waiting for an answer, I will try to find a new professional to assist you! Please keep in mind that sometimes finding the right professional can take a little longer than expected. All of our Professionals come on at varying times, so sometimes it’s a bit difficult to predict. Either way....If you would prefer not to wait, please feel free to let me know, and I will cancel this question for you. Thank you.

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Just cancel it.

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