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NorthernHeart
NorthernHeart, Board Certified MD
Category: Medical
Satisfied Customers: 99
Experience:  Internal Medicine, Gen Cardiology, Nuclear Card, Echocard
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How often should I have my potassium levels checked. For the

Customer Question

How often should I have my potassium levels checked. For the last month I have had low potassium from 2.9-3.5. Currently 3.2 . I am on Klor Con 20 once a day and drinking pedialyte. This started when I went on a GERD diet and was having stomach symptoms which have mainly resolved. The reason is unknown as my kidney function is fine but there is a new theory that something pituatary or adrenal may be occuring. I am wondering how often this should be checked, as I am worry about it everyday. I have hashimotos, no meds, TSH currently 4.00 and small mitral valve prolapse.
Submitted: 4 years ago.
Category: Medical
Expert:  NorthernHeart replied 4 years ago.
Potassium levels are very labile in the body and can change readily from day to day. That said, if you have demonstrated a range of 2.9-3.5 over the past month, you're starting to build a somewhat safe pattern and can start to decrease the frequency of blood draws. Once a week for a few more weeks would probably be plenty to say you can start backing off and go to every 3-4 weeks. Note, you may get different opinions on frequency of blood draws, as there isn't a lot of data. You're getting into more the art of medicine with your question. Important times to check would be when you have medicine changes, so you can monitor their effects.

With your potassium level being that low, only taking Klor Con 20mEq once daily is a small dose. Are there plans to have you start taking more?

For the potential cause, you mentioned you're not on any medicines, so a common cause of taking diuretics can be ruled out. Are you taking any supplements or over-the-counter natural remedies that may include a diuretic or laxatives?

Have you had your urine potassium level checked? This will help immensely to determine the cause of the low potassium. Do you eat licorice frequently, as this can cause low potassium as well? Once the urine potassium level is checked, you can then be evaluated for hyperaldosteronism, especially if your urine potassium level is high. Also ensure you have your magnesium level checked in your blood, as a low magnesium level will contribute to low potassium levels.

You mentioned GERD. There are severe forms stomach acid secretion which may present as GERD, but are more problematic and need to be evaluated by gastroenterology. If your urine potassium level is low/normal and your "reflux" symptoms persist/worsen, you may need to be seen by a gastroenterologist to evaluate your reflux.

Good luck and feel free to write again if you have more questions.
NorthernHeart and 4 other Medical Specialists are ready to help you
Customer: replied 4 years ago.

 

Thank you for very much. No, I am not on laxative, diuretics or anything else. Also, I do have an appt with a GI physician. I'll mention the checking of the urine potassium and the serum magnesium. I don't eat licorice. Thank you so much for you answer, I appreciate it very much :)

 

 

Sue

Customer: replied 4 years ago.

 

Oh and no there doesn't seem to be plans for the increase in Klor con and that is part of my concern with how often the levels should be done to monitor and increase if needed or decrease.

Customer: replied 4 years ago.

 

And no, I have not had my urine potassium level check but will request that too :) Thank you for all your advice.

Expert:  NorthernHeart replied 4 years ago.
Glad to hear you're seeing a gastroenterologist. I would pursue the urine potassium level and serum magnesium evaluation, as they are cheap, relatively painless tests that can provide significant information as to the etiology of your symptoms. Good luck and let me know if you have other questions.
Customer: replied 4 years ago.
Yes, thank you :)
Expert:  NorthernHeart replied 4 years ago.
The system requires I have the last word, otherwise prevents me from answering other's questions. Sorry to put in an empty post.
Customer: replied 4 years ago.

 

Dr. Northernheart,

 

Magnesium 2.2, urine output Sodium 103, Potassium 127 and Chloride 137. Aldasterone pending. I am wondering if I should stll be drinking a liter a day of Pedialyte?

 

 

Sue

Expert:  NorthernHeart replied 4 years ago.
Your potassium loss in your urine is inappropriately high in the setting of low serum potassium levels. This suggests a gastrointestinal loss is not the cause, so argues against it being due to your stomach (e.g. gastritis) and/or diarrhea.

Given you're not on diuretics and have a normal magnesium level, this rules out a couple causes of low potassium levels. Other, uncommon issues could be due to being on antibiotics (e.g. penicillin).

Your aldosterone level will be an important next step. If the serum aldosterone level is normal, your next step should be to meet with a kidney doctor, as there can be primary problems associated with the kidneys that cause potassium loss.

Good luck and thanks for the update!
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Customer: replied 4 years ago.

 

Ok Aldasterone should be back Saturday. We'll see :) Thank you. I may update again. I have a nephrology appt I made, in case I needed it. Takes 4 weeks to get into a specialist here since there are not many. Thanks again.

 

 

Sue

Expert:  NorthernHeart replied 4 years ago.
Glad to hear you have an appt with the nephrologist. Sounds like you're doing everything you need to, so I hope it goes well.

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