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Dr. Abby
Dr. Abby, US Board Certified MD
Category: Medical
Satisfied Customers: 10330
Experience:  Family Physician practicing medicine for over 10 years, United States
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My blood test shows high potassium readings. What causes

Resolved Question:

My blood test shows high potassium readings. What causes this? What can I do to lower it?
Submitted: 7 years ago.
Category: Medical
Expert:  Dr. Abby replied 7 years ago.
Do you take any other medications?
What was your potassium level?
Was it a one time elevated reading or has it been more than once?

Dr Abby
Customer: replied 7 years ago.

Dear Dr. Abby, 3 Physicians are already aware of this situation since the elevated potassium levels were generated by 3 blood tests in an attempt to get them within parameters for a cataract operation due this Monday. The anesthetist is loathe to do her job. The upper end of normal is 5.6 and I've read 5.9 all 3 times. My family doctor knows me for 15 years or so and has told the ophthalmologist to go ahead with the procedure. She told me yesterday that she will convince the anesthetist before Monday. I take metoprolol, thyroid, finasteride, nizeral, topiramate, tylenol #4, I get IGG infusions every 4 weeks for hypogammaglobulinemia. I also have celiac disease and scrupulously avoid gluten. I am in a hiatus for a statin drug. I stopped zocor when I suspected it was causing my diarrhea and low abdominal pains (at my doctors advice). This was about a month ago. Sorry, for all this, but you asked.

Expert:  Dr. Abby replied 7 years ago.
Thank you for the information, it is all important when trying to figure out why this is going on.

Is your kidney function normal? Sodium normal?
Customer: replied 7 years ago.

Dear Dr. Abby,

My family doctor has made an appointment for me with a kidney specialist, who I see in two weeks or so, but there have always been kind of cryptic elevated numbers on my tests that have been ignored, it seems to me. And I think they're kidney numbers that have always been somewhat out of whack! I'm sorry I don't have them memorized, 'creatinine' is one that is always a bit high, and something like 'cfr' is also high. One depends on one's physician for these things and sometimes takes things for granted.

They were never terribly far out of range, so I figured they weren't so bad.

Expert:  Dr. Abby replied 7 years ago.
Thank you for the information,

As we get older, our creatinine and GFR does tend to worsen a bit.
Kidney function would have to be pretty bad for the potassium to be high. I suspect that is not what is going on with you.

A potassium of 5.9 can be due to many things and as you are likely discovering, it is hard to figure out at times.
NSAIDS can cause high potassium...if you have been off of the naproxen for a while with persistent high potassium though, this is unlikely to be the cause.
There have also been a few reported cases of high potassium with Topamax. However, this is uncommon.

One common cause of high potassium is the blood draw itself. If the red blood cells break apart during the trauma of a blood draw or during storage of the blood, there is a false elevation of potassium on the reading. However, a repeat draw usually will be normal if this is the cause.

Hormonal problems (low aldosterone levels) can cause high potassium. Typically, we will see disturbances in sodium levels as well.

For you, what you need to do is avoid potassium supplements or high potassium foods (orange juice, bananas). The treatment for high potassium is to determine the underlying cause.
Prescription medications can be given if necessary (diuretics, insulin, etc).
You are not at a dangerous potassium level but it does need to be monitored.

Your doctor is doing the right thing by referring you to a kidney specialist. They are the ones who will be able to figure out why this is happening.

Feel free to ask any follow up questions you may have,

Dr Abby

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Customer: replied 7 years ago.
Dear Dr. Abby, I'm impressed with your analysis. I just stopped taking Aleve so it's too soon to say if there'll be help there. I checked my old lab tests and my potassium was within range last Feb. 2, 2010 with a reading of 4.9, so , all this is quite new. I do get daily migraines and take codeine#4 just to be able to eat. I only typically take one a day. Doctors know of this. Could this have anything to do with the potassium?
Expert:  Dr. Abby replied 7 years ago.
No, I do not think it is the Tylenol #4.
Tylenol #4 is not an NSAID, so it does not have the same side effect as aleve.

The body and its electrolyte balance is very complicated.
The nephrologist hopefully will be able to discern what the underlying cause is.

Dr Abby

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